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In 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.

Objective For a cohort of tuberculosis patients in Carabayllo, Peru, we describe the prevalence of medical comorbidities and socio-economic needs, the efforts required by a comprehensive support program (“TB Cero”) to address them, and the success of this program 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 8 (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 76 (60%) were given additional support, most commonly food vouchers and assistance in accessing healthcare. Conclusion Carabayllo tuberculosis patients face many challenges in addition to tuberculosis. A collaborative, comprehensive treatment support program can achieve high rates of linkage to care for these needs This article is protected by copyright. All rights reserved.

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 antecedente de inmunización contra fiebre tifoidea, seleccionado 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 del 84% y una especificidad del 87% para el punto de corte > 1:160 para eldiagnóstico de fiebre tifoidea. Las prevalencias de serología O positiva para los diferentes puntos de corte (> 1:20, > 1:40 y > 1:80), fue significativamente mayor en mujeres (41.6%, 12.4% y 3.9%) que en hombres (41.1%, 9.1% y 1.1%) (p0.05). 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 frecuenteinfección subclínica lo cual perpetúa la endemicidad de esta enfermedad.