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Objectives. To characterize, by means of bibliometric indicators, the scientific publications of the Peruvian Experimental Medicine and Public Health Journal, 2010-2017. Materials and Methods. A bibliometric study in which the publications were retrieved from the data base of Scopus. The bibliometric production indicators were: number of publications per year and type of publication. Brief original and original articles were considered as units of analysis based on number of authors, institutional affiliation, and country of corresponding author, type of research and study design. The impact indicators were: number of citations by publication according to Scopus, metric of impact, such as CiteScore, Scimago Journal & Country Rank (SJR), and SciELO Public Health. Results. A total of 1,045 publications were made by the RPMESP: 40.1% of publications corresponded to original articles and original briefs; 1,837 authors contributed with these publications; 134 institutional affiliations were declared by the corresponding authors; 48,0% were research works on determinants of a health problem; on the other hand, 90.5% corresponded to observational studies. The publications analyzed received 945 citations, of which 78.5% were for publications for the 2010-2013 period. Conclusions. Four of ten publications of the RPMESP correspond to brief original or original articles. According to diverse formulas of calculation, the impact metric of the RPMESP shows an ascending trend; however, their magnitude is lower versus other regional journals. [ABSTRACT FROM AUTHOR]

Objective: To determine the characteristics of the original papers about the plants properties published in Peruvian medical journals. Material and methods. We reviewed the bibliographic databases of SciELO Peru and SISBIB for the period 2004-2008. Results. We found 825 original papers in 14 journals, but only 45 were included to the study. The number of the included original papers by year was 3 (2004), 5 (2005), 9 (2006), 13 (2007) y 15 (2008). The journals that published the highest rate of original papers about plants were journals from medical faculties Rev Med Vallejiana (33%), Horizonte Médico (29%) y An Fac Med (13%). The institutions that developed more studies were Universidad. Nacional Mayor de San Marcos (45,5%), Universidad de San Martín de Porres (22%) y Universidad Nacional de Trujillo (13%). from 226 authors, 11 were the most productive authors with the 22,1% of the total production. from 57 studied plants, the most investigated were Lepidium sp. (maca), Croton palanostigma (sangre de grado), Calophyllum brasiliense (lagarto caspi) and Smallanthus sonchifolius (yacón). The potential uses of the plants more researched were nutritional, antineoplastic, antioxidative, hypoglycemic and arterial hypotensive. There were only six (13,3%) clinical studies and the rest was experimental or biochemical. Conclusions. The published scientific medical production related to the plant properties is scanty but growing, mainly done in the public and private universities with almost null participation of the private enterprise. There is an elite of highly-producing authors. [ABSTRACT FROM AUTHOR]

Objective. To determine the prevalence and incidence of arterial hypertension, as well as the prevalence of previous diagnosis of arterial hypertension (self-reported) among the adult population of Peru. Materials and methods. Systematic review and meta-analysis of epidemiological studies available in LILACS, EMBASE, MEDLINE and Global Health. Studies were included if they followed a random sampling approach in adult population. Screening and assessment of manuscripts was carried out independently by two researchers. A random-effects meta-analysis was conducted to quantify the overall prevalence and incidence of hypertension. The Newcastle-Ottawa scale was used to assess the risk of bias in the manuscripts. Results. A total of 903 papers were screened, and only 15 were included in the estimation of hypertension prevalence, 8 in the assessment of previous hypertension diagnosis, and 4 for incidence estimations. The pooled prevalence of hypertension was 22.0% (95% CI: 20.0% - 25.0%; I2=99.2%). This estimate was lower in national studies [20.0% (95% CI: 17.0% - 22.0%; I2=99.4%] than in sub-national studies [24.0% (95% CI: 17.0% - 30.0%; I2=99.2%]. The pooled prevalence of previous hypertension diagnosis was 51.0% (95% CI: 43.0% - 59.0%; I2=99.9%). The pooled incidence of hypertension was 4.2 (95% CI: 2.0 - 6.4; I2=98.6%) per 100 person-years. The included studies did not present high risk of bias. Conclusions. Our findings show that one in five Peruvians has hypertension, and that four new cases appear per 100 persons per year; in addition, only half of the subjects with hypertension are previously diagnosed. [ABSTRACT FROM AUTHOR]

This paper analyzes the implementation, initial results, and sustainability of innovations in the provision, financing, and management of mental health services in Peru, carried out during 2013-2018. By applying new financing mechanisms and public management strategies, 104 Community Mental Health Centers and eight Protected Homes were implemented, which prove to be more efficient than psychiatric hospitals. The set of 29 centers created between 2015 and 2017 produced in 2018 an equivalent number in consultations (244,000 vs. 246,000) and patients attended (46,000 vs. 48,000) than the set of three psychiatric hospitals, but with 11% of financing and 43% of psychiatrists. The way mental health care is being provided is changing in Peru by involving citizens and communities in ongoing care and creating better conditions for the exercise of mental health rights. Community mental health reform has gained broad support from political, international, and academic sectors, and from the media. We conclude that the reform of community-based mental health services in Peru is viable and sustainable. It is in a position to scale up the entire health sector throughout the country, subject to the commitment of the authorities, the progressive increase in public financing, and national and international collaborative strategies. [ABSTRACT FROM AUTHOR]

Objetives. To identify prevalence and incidence epidemiological studies of type 2 diabetes mellitus in adult subjects of the general population in Peru. Material and methods. Observational studies with a random sample from the general population were evaluated. Diabetes definition must have included at least one bio-marker (e.g., fasting glucose). The search was conducted in LILACS, SciELO, Scopus, Medline, Embase and Global Health without restrictions. Risk of bias was assessed with the Newcastle-Ottawa scale. Results. The search yielded 909 results and one more was added form other sources. After filtering and careful evaluation, 20 papers were selected representing 9 studies (n=16,585). One study was nationally-representative and another one was semi-national (ENINBSC, 2004-05 y PERUDIAB, 2010-12); the former reported a prevalence of 5.1% in people aged ≥35 years, whereas the latter reported 7.0% in subjects aged ≥25 years. Other studies addressed a few cities or selected populations, like the PERU MIGRANT Study (2007-08) which reported the prevalence in people of rural areas (0.8%), rural-to-urban migrants (2.8%) and in urban sites (6.3%). Three studies conducted follow-up rounds; PERUDIAB was one of those, yielding a cumulative incidence of 19.5 new cases per 1000 person-years. All the studies had low risk of bias. Conclusions. Population-based studies suggest that the prevalence of type 2 diabetes has increased, with two new cases per 100 person-years. Scientific evidence is still limited regarding people in the Amazon region and from rural settings. [ABSTRACT FROM AUTHOR]

Objective. To analyze the evolution of published scientific articles on HIV/AIDS in Peru. Methods. A bibliometric analysis of papers on HIV/AIDS published in journals indexed in MEDLINE, SciELO and LILACS until October 2010. We selected research papers fully developed in Peru, and multicenter studies with participating Peruvian sites. Results. We identified 257 publications on HIV/AIDS, showing an increase since 2003. The average publication delay was 2.8±1.8 years. Only 94 (36.6 %) articles were published in Spanish. The most studied areas were epidemiology (36.6 %) and clinical topics (35.8 %). The cross-sectional design was the most frequent (56.8 %) followed by case series. According to the WHO classification, studies to learn more about the disease and risk factors predominated (85.6 %) and according to the intervention areas, 46.7 % focused on diagnosis and treatment. Most studies were conducted in Lima (65.9 %). 48.2 % of studies focused on people living with HIV/AIDS. finally, Revista Peruana de Medicina Experimental y Salud Pública was the journal that published most articles on HIV/AIDS (9.7 %). Conclusions. We found a growth in scientific production on HIV / AIDS in Peru; however, we believe that the research undertaken was not based on an agreed national agenda or national research priorities, which might have limited its dissemination and application. [ABSTRACT FROM AUTHOR]

The global human resources for health (HRH) challenge remains persistent. In 2006, the World Health Report identified 57 crisis countries, and, despite increased attention and investment in strengthening the workforce, those countries are still in crisis. While chronic HRH problems still exist, progress has been made in some countries where innovative programs have been implemented that show promise, or specific initiatives have been scaled up. Yet, these have not been substantive enough to move countries out of the "crisis" category. While many countries have HRH plans, this paper asserts that a major reason countries remain in crisis is the lack of sustained implementation to achieve concrete workforce strengthening results. This is true despite the fact that there have been major investments in a broad range of tools and resources aimed to support implementation of plans and initiatives. Given this picture, the paper states that it is critical for HRH leaders to take action to ensure that already available tools are disseminated, adapted and used to foster effective implementation at the country level. The paper highlights four such tools as examples that can be used to build implementation capacity, and acknowledges more like them. Having highlighted these tools, the paper concludes by offering recommendations as to how to support more results-oriented implementation. These recommendations are organized around three linked components: 1) providing sufficient advocacy to leadership at the national level to mobilize and commit them to implementation action, 2) assembling and managing the requisite assets (including the institutional arrangements, people and money) into a coherent and powerful whole, and 3) using accountability as a foundational tool to assess progress in implementation, track key indicators, celebrate achieving key milestones and identify problems when indicators are not achieved. [ABSTRACT FROM AUTHOR]

This paper will contribute to the scientific development of new approach on the pishtaco in Peru by means of medical anthropological analysis. The model emphasizes presentation and analysis of historical, pharmaceutical, and anthropological evidence supporting use of human tissues with specific medical goals in Peruvian and European regions. We can find the origin of this phenomenon around the sixteen and seventeen centuries in Europe: The pishtaco has no an Andean origin. The methodology and main conclusions of this paper could provide to the scientific community an alternative perspective to the conventional anthropological and ethnological research, as an example of a medical anthropological analysis of the pishtaco character. Professionals involved in intercultural health projects could have a new insight on this issue thanks to these results. They will obtain an adequate historical-cultural context for the interpretation and understanding of people and native communities' beliefs about health, body and medical systems. [ABSTRACT FROM AUTHOR]

Hipolito Unanue is considered as the Founding Father of Peruvian medicine. He was closely related to political affairs and he was one of the most important exponents of science during the late colonial period. However, his contributions in what is now called environmental health have been largely unnoticed. This paper presents an analysis of Dr. Unanue's studies, particularly his papers on weather, air, water, and vectors; so this may support the proposal for considering Dr. Hipolito Unanue as a pioneer for environmental health in Peru. [ABSTRACT FROM AUTHOR]

Triatomines susceptibility levels to pyrethroid insecticides were assessed using the World Health Organization (WHO) technique, employing impregnated paper with a 0,1% concentration of the following active compounds: alphacypermethrin, betacyfluthrin, cyfluthrin, cypermethrin, and deltamethrin. Triatoma infestans and Panstrongylus herreri in nymph V and adult stages were used for the assessments. Mortality rates after 24-hour exposition to insecticide-impregnated paper were determined, and the majority of Triatoma species of the two species was susceptible to the insecticides tested. Only in some cases resistance was found amongst P. herreri nymph V stages from two locations in Jaén province, Cajamarca department, as well as in some T. infestans adult and nymph V stages captured in Vitor valley, Arequipa department. [ABSTRACT FROM AUTHOR]

In 2013, the Joint United Nations Programme on HIV/AIDS (UNAIDS) proposed, in terms of public health, to end the HIV epidemic by 2030 by achieving the so-called 90-90-90 targets by 2020. This goal will only be possible if coverage in the HIV care continuum indicators is increased. With the methodology proposed by PAHO/WHO, this paper estimates the indicators of the continuum of care in Peru for 2014, consisting of diagnostic coverage, antiretroviral treatment (ART), and viral suppression in people living with HIV (PLHIV). Of the 72,000 PLHIV estimated in Peru for 2014, 64% were diagnosed, 56% and 55% were linked and retained in the system, respectively; 46% were receiving ART, and 36% had viral suppression. The main gaps identified were: 19,917 PLHIV did not know their diagnosis, 25,078 had no access to treatment, and 25,633 did not achieve viral suppression at study closing. This is the first estimation exercise of the continuum of care indicators in Peru. These indicators will serve as a baseline for the monitoring progress toward the 90- 90-90 Targets. It is also the starting point for analysis and research on the determinants of each gap and new proposals by authorities and actors involved in the fight against HIV in Peru. [ABSTRACT FROM AUTHOR]

Echinococcosis is a parasitic infection caused by Echinococcus granulosus, which, in its cystic state, forms the socalled hydatid cyst. It presents important morbidity, with possible sequelae related to the location, and high costs due to surgical and prolonged pharmacological treatment. The liver and the lung are the most common anatomical locations, and much rarer are the kidney, spleen, brain, and heart, where the latter represents 0.5 to 2% of total cases. Peru is an endemic country of this anthropozoonosis and mainly records cases in the central highlands (95%). This paper presents the case of a 10-year-old girl, diagnosed with this disease, CE1 ultrasound classification, clinical group 1 (confirmed by pathological anatomy) with specific surgical and pharmacological treatment (albendazole) afterward. The patient recovered satisfactorily from the surgery and was discharged at 16 days, without complications. [ABSTRACT FROM AUTHOR]

This paper discusses the role of socio-cultural factors in strengthening integrated mobile health systems. Emphasis is placed on the importance that any initiative in mobile health should consider the analysis of socio-cultural factors during the process of the development and implementation of programs and research interventions. The socio-cultural and socio-technical approach also consider the human factor and considers the conditions of the environment and the context beyond the technological resources of the mobile health system and the infrastructure that supports it. Methodologies such as observational studies, focus groups, and in-depth interviews should be included ideally in any mobile health study. We also present a case study in the north area of Lima (Peru), adapting the Community-Based Participatory Research platform that is based on a socio-technical approach and evaluates the socio-cultural approach with the objective to optimize the diagnosis process of tuberculosis using mobile health. [ABSTRACT FROM AUTHOR]

The development of person-centered clinical care is inscribed within an international programmatic movement towards a medicine focused on the totality of the person. This movement, with broad historical bases, has been maturing since 2008 through conferences among global health institutions, research projects and academic publications. This paper is aimed at elucidating the conceptual principles of person-centered medicine (PCM) and to delineate strategies for the practical application of such principles in clinical care services. The above objectives have been approached through literature reviews, international consultations, and reflections on the patterns and indications obtained. The principles identified for person-centered medicine are the following: Ethical commitment, holistic framework, cultural awareness and responsiveness, communication and relational focus, individualized clinical care, common ground among clinicians, patient and family for joint diagnostic understanding and shared decision making, person- and community-centered organization of integrated services, and person-centered medical education and research. Additionally, pertinent strategies have been delineated for the implementation of such principles in clinical care. The authors conclude that the presented principles and strategies are consistent with suggestions offered in the literature and may serve as bases for the design of indices and scales. Their continuous refinement is proposed through future international and local studies. to clarify the key concepts of the movement as well as strategies for their practical clinical application. [ABSTRACT FROM AUTHOR]

Knowledge translation (KT) in Public Health involves the use of scientific evidence by decision makers when generating health policies directed to accelerate the benefits resulting from research and innovation in health system and ultimately people's health. In this paper we review the definitions and conceptual frameworks related to systematization of KT processes. The different approaches to KT share the concept that KT is composed by two main elements: a product (information) developed through scientific method with a friendly format for the target public and an action devoted to support or promote a health related practice using the aforementioned product. The understanding and application of KT is a key element for effective use of knowledge in decision making. [ABSTRACT FROM AUTHOR]

The slow scientific development in Latin America in recent decades has delayed the incorporation of laboratory animal experimentation; however, this situation has started to change. Today, extraordinary scientific progress is evident, which has promoted the introduction and increased use of laboratory animals as an important tool for the advancement of biomedical sciences. In the aftermath of this boom, the need to provide the scientific community with training and guidance in all aspects related to animal experimentation has arisen. It is the responsibility of each country to regulate this practice, for both bioethical and legal reasons, to ensure consideration of the animals' rights and welfare. The following manuscript is the result of papers presented at the International Workshop on Laboratory Animal Testing held at the Technical University of Ambato, Ecuador; it contains information regarding the current state of affairs in laboratory animal testing and emphasizes critical aspects such as main species used, ethical and legal principles, and experimental and alternative designs for animal use. These works aim to ensure good practices that should define scientific work. This document will be relevant to both researchers who aim to newly incorporate animal testing into their research and those who seek to update their knowledge. [ABSTRACT FROM AUTHOR]

Diarrhea remains the third leading cause of death in children under ive years, despite recent advances in the management and prevention of this disease. It is caused by multiple pathogens, however, the prevalence of each varies by age group, geographical area and the scenario where cases (community vs hospital) are recorded. The most relevant pathogens in public health are those associated with the highest burden of disease, severity, complications and mortality. In our country, norovirus, Campylobacter and diarrheagenic E. coli are the most prevalent pathogens at the community level in children. In this paper we review the local epidemiology and potential areas of development in ive selected pathogens: rotavirus, norovirus, Shiga toxin-producing E. coli (STEC), Shigella and Salmonella. Of these, rotavirus is the most important in the pediatric population and the main agent responsible for child mortality from diarrhea. The introduction of rotavirus vaccination in Peru will have a signiicant impact on disease burden and mortality from diarrhea. However, surveillance studies are needed to determine the impact of vaccination and changes in the epidemiology of diarrhea in Peru following the introduction of new vaccines, as well as antibiotic resistance surveillance of clinical relevant bacteria. [ABSTRACT FROM AUTHOR]

Anopheles (Nyssorhynchus) darlingi has been reported since 1931 in border areas of the department of Loreto, mainly along the borders with Brazil and Colombia. In 1994, during an outbreak of malaria, An. darlingi was found in neighboring towns to Iquitos. At present, its distribution has expanded considerably in Loreto. This paper reviews literature available for all possible information on the distribution of mosquitoes, particularly anopheline in the Amazon region of the country, with special emphasis on An darlingi. Entomological collections were also conducted in the departments of Madre de Dios and Ucayali in order to know and verify the distribution of An. darlingi. At present, the distribution of the species is confined to localities in southeastern Peru with Bolivia border towns, in a town near the Abujao River in the department of Ucayali, and widely in the northeastern region of the Amazon basin of Loreto in Peru. [ABSTRACT FROM AUTHOR]

The epidemiological picture of sporotrichosis and paracoccidioidomycosis in Peru and Latin America is sporadic, fragmented, and geographically limited, mainly due to lack of mandatory reporting and limited diagnostic coverage. However, research contributions related to understanding the interaction of these fungi, the response of the host and the environment, the use of spatial analysis that relates the distribution of these mycoses, population density and climate, contributes to the design of prevention and control strategies of these mycosis and suggest epidemiological risk maps management, based on the habitat of the fungus. This information will be used by doctors, tourists and people living in rural areas where mycoses are endemic. The aim of the paper is to present a review of the topic through research findings that contribute to the prevention and control of these mycosis. [ABSTRACT FROM AUTHOR]

Objectives. To estimate the prevalence of antibodies against measles, rubella and hepatitis B in children aged between 1 and 4 years in Peru. Materials and methods. A national survey was conducted based on a questionnaire and capillary blood sample taken on filter paper in order to study antibodies against measles, rubella and hepatitis B in children from 1 to 4 years of age. A stratified, multistage, probability sampling design was used to be representative at the national level and at level of seven ambits, including the Metropolitan Lima Area, the rest of the urban coast, the rural coast, the urban highlands, the rural highlands, the urban jungle and the rural jungle. The capillary blood samples were processed according to the standardized protocols for detection of antibodies using the ELISA technique and commercial reagents. Results. The survey showed a national prevalence of antibodies against measles, rubella and hepatitis B of 91.6% (CI 95%: 90.6%; 92.7%), 91.3% (CI 95%: 90.3%; 92.4%) and 95.9% (CI 95%: 95.0%; 96.8%) respectively. There was no evidence of significant differences in the prevalence among the ambits of study or among the socioeconomic strata of the conglomerates for any of the three types of antibodies. Conclusions. In children from 1 to 4 years of age, the national prevalence of antibodies against measles and Rubella was between 90-93%, while the prevalence of antibodies against Hepatitis B (anti-HBsAg) was between 95-97%. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) persists as a major public health problem in our country. The appearance of resistant strains has complicated its control and questioned the appropriateness of the current measures towards prevention and control. An analysis from social determinants related to TB, converge on irregular treatment that generates disease persistence and appearance of resistance to TB drugs. The objective of this paper is to identify the role of the government in the treatment of TB patients, to recognize difficulties of treatment adherence considering that its fulfillment depends on the patient, despite that it has direct consequences on public health, and to discuss TB management alternatives with an approach based on individual and collective human rights. International literature shows limit experiences of individual rights and collective ones, but based on health policies and health legislation. In Peru, a new approach is required to guarantee population health without infringing individual rights [ABSTRACT FROM AUTHOR]

Research about accessibility to medicines through household surveys is very important in order to verify the reality and effectiveness of interventions done to increase the access of the population to the medications. Unfortunately, such studies, on top of being very few, have methodological problems, which mostly result from a lack of uniformity in the operational definitions of access and the differentiation with the dimensions of accessibility. The aim of this paper is to propose setting a difference between both terms. We propose an operational definition of access to medications as the process of verification of the purchase of a drug by a patient, independently from many factors that can affect this process. The term "usability of drugs" is introduced, defining it operationally as aimed at measuring the dimensions of the accessibility to the medications: physical availability, affordability, geographical accessibility, acceptability (or satisfaction). [ABSTRACT FROM AUTHOR]

Budgetary Impact Analysis (BIA) applied to health care can be defined as the estimate of the net financial costs that a given intervention would represent for a health care institution given the case it was covered. Routinely, BIAs are used to decide the inclusion or exclusion of drugs in therapeutic schemes; actually, the increased use of BIAs have raised awareness about the fact that health economic evaluations represent a partial view in the analysis of the consequences of incorporating health technologies. This paper seeks to identify the determinants and components of BIA, and to describe the development of a spreadsheet model that enables us to assess the Budget impact of any health technology and perform estimations with differing degrees of complexity. Its design explicitly adapts to the user skills and gaps in information, thus seeking to promote the development of these tools in the management fields in our countries. [ABSTRACT FROM AUTHOR]

Human resources are the backbone of health sector actions; however, they are not necessarily the area with the greatest attention, therefore, the Ministry of Health of Peru (MINSA) together with regional governments, led the Decentralized and Agreed Sector Plan for the Capacity Development in Health 2010-2014 (PLANSALUD) with the aim of strengthening the capacities of Human Resources for Health (HRH) and contribute to health care efficient development, quality, relevance, equity and multiculturalism, in the context of descentralization, the Universal Health Insurance (AUS) and health policies. To achieve this goal, they have proposed three components (technical assistance, joint training and education - health articulation) that bring together an important set of interventions, which are planned and defined according to the national, regional and local levels, thus contributing to improve the government capacity, capability management and delivery of health services. This paper presents a first approach of PLANSALUD, including aspects related to planning, management, financing, structure and functioning, as well as monitoring and evaluation measures. [ABSTRACT FROM AUTHOR]

Recently, the translational research model (TR) has been established as a key feature in health worldwide. The objectives of this review are: (1) to define the TR and describe its complex nature; (2) to identify the components of the TR; (3) to link the TR to the decision-making process in health policies; (4) to recognize frequent obstacles and challenges of the association between the TR and the decision-making process in health policies. A systematic literature review was conducted in scientific databases and selected grey literature was done including TR and health policy as key words. We found 60 papers. Results show that the concept of TR and its theoretical formulation has evolved over time and has only recently incorporated the complexity that exists in the transference of scientific knowledge to health. International literature shows different applications of the TR in both research and clinical practice. The application of the TR to public health and health policy decision making is relatively new but necessary and could become a priority for health policies in the countries. [ABSTRACT FROM AUTHOR]

Vibrio cholerae and V. parahaemolyticus are the two Vibrio species with a major impact on human health. Diseases caused by both pathogens are acquiring increasing relevance due to their expansion at global scale. In this paper, we resume the ecological aspects associated with the arrival and spreading of infections caused by V. parahaemolyticus and V. cholerae in Peru from a South American perspective. Moreover, we discuss the similarities in the emergence in Peru of cholera cases in 1991 and V. parahaemolyticus infections in 1997. These constituted exceptional experiments to evaluate the relationships between the Vibrio epidemics and changes in the environment. The epidemic radiations of V. cholerae and V. parahaemolyticus constitute to clear examples supporting the oceanic dispersion of pathogenic vibrios and have enabled the identification of El Niño events as a potential mechanism for the spreading of diseases through the ocean. [ABSTRACT FROM AUTHOR]

Neurocysticercosis, the infection of the human central nervous system by the larval stage of the cestode Taenia solium, is an important cause of epilepsy and other neurological manifestations in Peru and most developing countries. Since 1987, the Cysticercosis Working Group in Peru has performed a series of epidemiological studies which led to estimate the impact and to better understand the transmission of Taenia solium. This information was later applied to the design and execution of a control program in Tumbes, in the Northern Coast of Peru. This paper reviews the main epidemiological indings, as well as the conceptual framework of the elimination program and the tools used. Advances in the control of taeniasis/cysticercosis in our country open the road towards its elimination and potential eradication. [ABSTRACT FROM AUTHOR]

In the year 2003, in the faculty of Medicine of the Universidad Nacional Mayor de San Marcos, the Permanent Program of Training for the Integral Attention of the Victims of Violence was created, has been training human resources for the comprehensive health care to victims of violence. In this sense, we was considered necessary to develop a methodology for health professionals, identifying their training needs and the conditions under how they work. It is in this context, that the year 2004, a base line study was delineated in the Microrred de Salud Huaycán, in the east of Lima city; that included diverse stages with a multisectorial approach with the aim to identify the training needs of the health professionals, as well as the evaluation of the logistic and administrative support for the development of training activities to diverse levels. In this paper, the procedures and principal results are exposed, in a succinct way. There was demonstrated that the population of Huaycán were affected by the sequels of the political violence; nevertheless, the health services have severe limited resources to give appropriate health care to victims of violence. The health professionals require an intensive training on this issue. An adequate logistic and administrative conditions allowed to carry out an appropriate training program. We suggest that this methodology will facilitate to construct products and instruments for a suitable and speciic training for the integral health care to the victims of the violence. [ABSTRACT FROM AUTHOR]

Human toxocarosis is an important parasitic zoonosis caused by larval stages of Toxocara species, the roundworms from dogs and cats. Larval migration through different soft tissues in the human generates several clinical entities in the patient, such as visceral larva migrans, ocular toxocarosis, and neurotoxocarosis. Deinitive diagnosis by histopathological methods is very difficult or almost impossible and, nowadays, the diagnosis is usually made by clinical signs/symptoms, epidemiological background of the patient and the use of hematological and immunological tests which finally help to confirm the clinical suspicion of the illness. The purpose of this paper was to update the available knowledge on the use of different tools for both the diagnosis and following up of human toxocarosis. [ABSTRACT FROM AUTHOR]

Southern Cone Sub-Regional Project on Cystic Echinococcosis Control and Surveillance: Argentina, Brasil, Chile and Uruguay, is a joint and collaborative tool with the aim of promoting the implementation or the strengthening of programs for disease control. The paper describes the background, the institutional aspects that regulates the structure and functions, as well as the guidelines deined in the technical and operational project. The article emphasize the achievements through Projects of Technical Cooperation among Countries, and the development of integrated and innovative approaches for prevention and control of the disease and training of human resources of the control programs. Some of the challenges are: to achieve the sustainability of the project, implementation of technical groups for analysis and assessment at request of the countries, improvement of the regional information systems, to continue training human resources of the control programs and to expand and strengthen the technical cooperation among countries [ABSTRACT FROM AUTHOR]

Objective. To revise the available evidence on the cost-effectiveness of antiviral regimens for treatment of chronic hepatitis B. Material and methods. We performed a systematic revision on MEDLINE, LILACS NICE and COCHRANE databases, searching for economic evaluations of antiviral regimens for treatment of chronic hepatitis B. We included original studies, systematic revisions and management guidelines including information on the cost-effectiveness of this treatment. We registered the characteristics and results of the retrieved documents. Results. We obtained 29 original papers, 4 revision articles and 4 management guidelines. Most of these publications have been done in the last 5 years. There was conflict of interest in 73% of original articles, due to authors working for the pharmaceutical industry. 93% of articles that evaluate the cost-effectiveness of giving treatment for chronic hepatitis B against management of its complications find that it is indeed cost-effective to give antiviral treatment. 3/6 studies that evaluate lamivudine against other drugs find it as a dominant strategy, 3/5 find entecavir as the dominant strategy, 1/1 find tenofovir dominant, 1/4 find conventional interferon as dominant and none of them find adefovir or pegylated interferon as dominant strategies. Conclusions. We consider that the available evidence suggests that to give antiviral treatment for chronic hepatitis B is a cost-effective intervention for many health systems, including ours. It has varying indexes of cost-effectiveness according to the evaluated regimens. Ideally, we should perform local economic evaluations in this issue. [ABSTRACT FROM AUTHOR]

The development and adoption of a national drug policy is an essential component of health policy, a critical element for effective implementation of actions that promote population health care improvement. This paper aims to contextualize the National Drug Policy adopted in Brazil, trying to collaborate in future discussions of guidelines for access to medicines. The guidelines that guide this policy are geared towards use of essential drugs, drug regulation, reorganization of pharmaceutical services, promotion of rational drugs use, scientific and technological development, promoting the production of medicines, ensure the safety, efficacy and quality of drugs and development and training of human resources. [ABSTRACT FROM AUTHOR]

This paper is a short review of the discovery of Chagas disease and the current information of the epidemiological and clinical aspects of the disease observed in Peru. With the discovery of Trypanosoma cruzi in the blood of a child in 1909, the isolation of the etiologic agent in experimental animals and the finding of similar parasites in the intestinal content of triatomines, Carlos Chagas determined the parasite's life cycle and, clinical symptoms of this new entity designated as Chagas disease. Eight years after Dr Carlos Chagas discovery (1917), Dr. Edmundo Escomel born in Arequipa, reported the presence of Triatoma infestans in the valleys of Arequipa department and after two years the first human case of Chagas disease from Madre de Dios. In Peru, have been described 19 species of triatomines, and several studies show guinea pig "cuy" as the most important reservoir of the parasite. The endemic areas are present in the south, north and northeast, mainly the Amazonian area. Recently, Tacna has been declared free of vectorial transmission and we hope others parts of the country could receive similar certification. [ABSTRACT FROM AUTHOR]

In this paper we describe the current situation of the epidemic of multidrug-resistant tuberculosis (TB MDR) and extensively-drug resistant tuberculosis (TB XDR) in Peru. We do an analysis of our situation in comparison with the rest of Latin America, and of the temporal spatial distribution of the TB XDR cases in Lima, We also present our reflection about what is happening and we believe it must change, as summarized in giving due weight to a problem that is coming over and we should put before own interests, the interests of humanity, therefore we cannot keep silent, and we must declare TB as a national health emergency. That is an answer, hopefully, still viable for Peru. [ABSTRACT FROM AUTHOR]

We performed a bibliometric study, searching for articles published by authors affiliated Ica, in indexed scientific journals, with the aim to know the biomedical scientific production in this Peruvian province during the decade from 1998 to 2007. We found 37 papers, most research in the public health area, ten of which were published in journals out of circulation. The most common affiliation of the authors is the faculty of Sciences of the universidad Nacional San Luis Gonzaga (46.9%), while the faculties of medicine and nursing are those that occur less frequently (both 2.7%). It should enhance the scientific output of institutions in health sciences in the province of Ica, requiring more training and motivation to become a publishing culture in their students and professionals. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify key indicators related to the health of families in their homes and surroundings, and so, to understand the importance of inform Peruvian people about the Healthy Housing Initiative promoted by Pan American Health Organization. We have focused on health factors related to housing in different regions of Peru, taking into account the local ways of life, prioritizing the analysis on lower-income socio-economic groups within the cities, and considering that healthy housing is an important component within environmental health. The material presented is resultant of interviews with professionals with experience in the health and housing field, as well as comparing bibliographic information and news with our subjective perception of reality, aiming to reach conclusions and recommendations. Given the status of housing conditions in Peru and their impact on the health of the population, it becomes necessary to encourage the formation of a national network that may bring together various public and private institutions that have been working from different approaches in promoting the improvement of housing and environmental conditions in Peru, in order to complement their capabilities and support each other in their activities. Finally, we believe that healthy housing is a right and an obligation for people, in tune with the right for health and life and it is also a shared responsibility between local governments and the population. [ABSTRACT FROM AUTHOR]

Natural disasters affect lives and property, devastating communities for extended periods. This paper shows how some knowledge based on experiences and progress of science biological, psychosocial and behavioural, are still helping us to understand the behaviour of the survivor. The ability to implement guidelines and aid operations, data and practices based on evidence and empirical studies in the field of disaster is an evolutionary process for professionals in this field. [ABSTRACT FROM AUTHOR]

People living with HIV/AIDS (PLWHA) are increasingly using the Internet to find health information. Global literature about education of PLWHA regarding information and communication technologies (ICTs) is scarce. The objective of this paper is to report the evaluation of a workshop offered to PLWHA to evaluate the quality of the health information available on the Internet. A computer-based workshop was offered to 25 PLWHA from different districts of Lima during one day. A Spanish version of the eHEALS scale was used before (pre-test) and after (post-test) the workshop to assess consumer' perceived skills/knowledge at using ICTs for health. 21 PLWHA completed the pre and post-test. At the end of the workshop, most participants (95.2%) agreed or strongly agreed that they were able to evaluate health Web sites on the Internet. A pre and post-test comparison showed significant gains in 6/8-item measure of eHEALS. The one-day workshop could help PLWHA to evaluate the quality of the information available on the Internet, and it might improve their auto-reported knowledge and skills towards the use of ICTs in health. This workshop might serve as a model to other educational programs for PLWHA. [ABSTRACT FROM AUTHOR]

The objective of this review paper is to show a historic overview for the development of population policies in Peru, specially focusing in the role of Peruvian physicians and public health specialists and foreign agencies during the past forty years. The main argument is that these policies have not been sustained -- mainly because of political reasons -- which led national participating institutions to have a weak role, to have poor negotiating capabilities with international donors and to a constant return to topics that may have been solved in the past. Lack of understanding and lack of willing for getting over all inconsistencies within this historical pattern partly explains all the difficulty for maintaining population policies as a priority in the national agenda. This is a historical review based in looking at documents and press articles, as well as performing deep interviews with some actors of population policies in this country. [ABSTRACT FROM AUTHOR]

Objectives: To assess the extent of dengue fever virus infection after the first outbreak that occurred in Casma District, Ancash (February to April 2002). Materials and methods: A seroepidemiological study was performed after the outbreak, 400 blood specimens obtained using a probabilistic, two-staged and conglomerate sampling technique were collected in filter paper, and they were analyzed for this study. A patient was considered as infected if a positive result in the IgM and IgG capture-ELISA for dengue fever was found. Results: Prevalence of dengue fever infection on the basis of this seroepidemiological survey was 14,1% (95% confidence interval [CI]: 9,8-18,4%). Consequently, it is estimated that 3939 cases of dengue fever serotype 1 infection occurred in Casma District during the outbreak from February to May 2002. 60% of all positive cases developed symptoms, the Epidemiological Surveillance system reported only 832 cases of classic dengue fever and no severe cases were found. Conclusions: Seroprevalence in the first dengue fever outbreak in Casma District in April 2002 was 14,1% The epidemiological surveillance system detected 21% of the total estimated number of infected persons (approximately 1:5); and 32,5% of cases that developed symptoms. [ABSTRACT FROM AUTHOR]

In this paper, historical reference is made about legal provisions for recognition of the training and certification of medical specialists in Peru through university programs provided since 1928 and culminating in 1973 with the legal authorization by the relevant state authority to implement the Second Specialization Program in Human Medicine and to grant the Certification of Specialist in the Name of the Nation upon completion of a university residency program and specialized training by the "regular modality", and the recognition by the university with the "non-regular modality". In Peru it has been established to the present that the Professional Certifications of Specialists in Human Medicine "in the Name of the Nation", both in "regular modality" as well as in "non-regular modality", can only be granted by public or private universities authorized for this mission and, besides, no other public or private institution can claim this role that corresponds exclusively for the Peruvian University. [ABSTRACT FROM AUTHOR]

Last August, the IPCC (Intergovernmental Panel on Climate Change) celebrated its 20th anniversary. Since the Second Assessment Report, the IPCC is currently focusing on the potential effects of climate on health. However, the diseases related to climate, beyond the victims of the so-called natural disasters are increasing all over the world. This paper presents a brief overview on the reports and the overall picture of the current situation. [ABSTRACT FROM AUTHOR]

This paper presents three cases of eosinophilic migratory nodular panniculits in Perú. This is a parasitic disease caused by a nematode belonging to the Gnathostoma species. The infection occurs after eating contaminated raw fish or undercooked seafood. Our first patient represents the first documented case of eosinophilic migratory nodular panniculits diagnosed in Peru. He had multiple recurrences. The other two cases developed life threatening condition because of the location of the lesions. [ABSTRACT FROM AUTHOR]