A5076901201- Tuberculosis Research and Epidemiology
- COVID-19 and Mental Health
- Pneumocystis jirovecii pneumonia detection and treatment
- COVID-19 Clinical Research Studies
- Child Nutrition and Water Access
- Pneumonia and Respiratory Infections
- Global Maternal and Child Health
- Healthcare Systems and Reforms
- Infectious Diseases and Tuberculosis
- SARS-CoV-2 and COVID-19 Research
- SARS-CoV-2 detection and testing
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Disease Management Strategies
- Digital Mental Health Interventions
- Clinical Reasoning and Diagnostic Skills
- Global Health and Epidemiology
- Parasitic infections in humans and animals
- Lung Cancer Diagnosis and Treatment
- Congenital Anomalies and Fetal Surgery
- Pleural and Pulmonary Diseases
- COVID-19 diagnosis using AI
- Mobile Health and mHealth Applications
- HIV/AIDS Research and Interventions
- Mycobacterium research and diagnosis
- Community Development and Social Impact
Peruvian University of Applied Sciences
2021-2024
EsSALUD
2015-2024
Instituto de Investigación Nutricional
2024
Universidad Peruana Cayetano Heredia
2003-2019
Prisma
2002-2019
Wellcome Trust
2016-2019
Imperial College London
2016-2019
McMaster University
2018
North Manchester General Hospital
2016
Liverpool School of Tropical Medicine
2016
Even when tuberculosis (TB) treatment is free, hidden costs incurred by patients and their households (TB-affected households) may worsen poverty health. Extreme TB-associated have been termed "catastrophic" but are poorly defined. We studied TB-affected households' association with adverse TB outcome to create a clinically relevant definition of catastrophic costs.From 26 October 2002 30 November 2009, (n = 876, 11% multi-drug-resistant [MDR] TB) healthy controls 487) were recruited...
Objective: To characterize the presentation of burns in children and risk factors associated with their occurrence a developing country as basis for future prevention programs. Design: Case-control study. Setting: Burn unit National Institute Child Health (Instituto Nacional de Salud del Niño) Lima, Peru. Methods: A questionnaire was administered to all consenting guardians admitted (cases) general medicine (controls) units during period 14 months. Guardians patients were questioned...
Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru.
Background. Unlike other respiratory infections, tuberculosis diagnoses increase in summer. We performed an ecological analysis of this paradoxical seasonality a Peruvian shantytown over 4 years.
MethodsThe study evaluated the impact of a socioeconomic support intervention -described in Box 1 -in 32 contiguous shanty towns Callao, Peru, northern, coastal extension Objective To evaluate on tuberculosis preventive therapy initiation household contacts patients and treatment success patients.Methods A non-blinded, household-randomized, controlled was performed between February 2014 June 2015 Peru.It included being treated for their contacts.Households were randomly assigned to either...
Contacts of tuberculosis index cases are at increased risk developing tuberculosis. Screening, preventive therapy, and surveillance for underused interventions in contacts, particularly adults. We developed a score to predict adult contacts cases.In 2002-06, we recruited aged 15 years or older with pulmonary who lived desert shanty towns Ventanilla, Peru. followed up until February, 2016. used Cox proportional hazards model identify case, contact, household factors from which derive classify...
The prevalence and characteristics of human taeniasis/cysticercosis porcine cysticercosis were assessed in an endemic area the Peruvian highlands. Individuals from 10 communities had stool examinations (N = 2,951) serologic testing for Taenia solium antibodies 2,583). total population present 703) was also examined by serology. Cysticercosis is hyperendemic this associated with important number seizure cases. Human seroprevalence village ranged 7.1-26.9% (mean, 13.9%). Seroprevalence higher...
The End TB Strategy mandates that no tuberculosis (TB)-affected households face catastrophic costs due to TB. However, evidence is limited evaluate socioeconomic support achieve this change in policy and practice. objective of the present study was investigate economic effects a TB-specific intervention. setting 32 shantytown communities Peru. participants were from consecutive patients throughout treatment administered by national programme. intervention consisted social through household...
Poverty drives tuberculosis (TB) rates but the approach to TB control has been disproportionately biomedical. In 2015, World Health Organization's End Strategy explicitly identified need address social determinants of through socio-economic interventions. However, evidence concerning poverty reduction and cost mitigation strategies is limited. The research described in this article, based on 2016 Royal College Physicians Linacre Lecture, aimed knowledge gap. was divided into two phases:...
BackgroundActive case-finding among contacts of patients with tuberculosis is a global health priority, but the effects active versus passive are poorly characterised. We assessed contribution to detection and compared sex disease characteristics between diagnosed through these strategies.MethodsIn shanty towns in Callao, Peru, we identified index followed up aged 15 years or older for tuberculosis. All were offered free programmatic entailing sputum smear microscopy clinical assessment....
Cash transfers are key interventions in the World Health Organisation’s post-2015 global TB policy. However, evidence guiding TB-specific cash transfer implementation is limited. We designed, implemented and refined a novel socioeconomic intervention that included transfers, which aimed to support prevention cure resource-constrained shantytowns Lima, Peru for: Community Randomized Evaluation of Socioeconomic Intervention Prevent (CRESIPT) project. Newly-diagnosed patients from study-site...
The epidemiological impact and cost-effectiveness of social protection biomedical interventions for tuberculosis-affected households might be improved by risk stratification. We therefore derived externally validated a household-level score to predict tuberculosis among contacts patients with tuberculosis.
During January-September 2024, a national active case-finding program in Peru's prisons screened >38,000 persons for tuberculosis (TB) using chest radiography with automated interpretation and rapid molecular tests. The found high percentages of TB, rifampin-resistant asymptomatic infections, demonstrating the urgent need systematic screening among incarcerated populations.
The effects of HIV co-infection and multi-drug resistant tuberculosis (MDRTB) on prognosis are poorly defined. Therefore, we studied infectiousness mortality 287 patients treated with standard, directly observed, short-course therapy in the Peruvian community. During 6–17 months treatment, 49 (18%) died, whom 48 (98%) had AIDS 28 (57%) MDRTB; 17/31 (55%) MDRTB-patients died within 2 diagnosis, before traditional susceptibility testing would have identified their MDRTB. Most non-MDRTB became...
Tuberculosis (TB) pleural disease is complicated by extensive tissue destruction. Matrix metalloproteinase (MMP)-1 and -9 are implicated in immunopathology of pulmonary central nervous system TB. There few data on MMP activity TB pleurisy. The present study investigated MMP-1, -2 their specific inhibitors (tissue inhibitor (TIMP)-1 -2) tuberculous effusions, correlated these with clinical histopathological features. Clinical data, routine blood tests, fluid/biopsy material were obtained from...
Tissue destruction characterizes infection with Mycobacterium tuberculosis (Mtb). Type I collagen provides the lung's tensile strength, is extremely resistant to degradation, but cleaved by matrix metalloproteinase (MMP)-1. Fibroblasts potentially secrete quantitatively more MMP-1 than other lung cells. We investigated mechanisms regulating Mtb-induced collagenolytic activity in fibroblasts vitro and patients. Lung were stimulated conditioned media from Mtb-infected monocytes (CoMTb). CoMTb...
Chatbots have emerged as a first link to care in recent years. The COVID-19 pandemic, and consequent health system disruptions, expanded their use. Socios En Salud (SES) introduced chatbots Peru, which experienced one of the highest excess COVID mortalities world.SES government identified unmet population needs, could be amenable virtual interventions. were developed screen individuals for these conditions; we describe period deployment, number screenings, people who received...
In most developing countries, 10% of acute neurologic cases are patients with neurocysticercosis (NCC). Determining specific factors associated contracting NCC will facilitate its diagnosis and prevention. We examined multiple socioeconomic, demographic, environmental, medical, behavioral characteristics 946 Peruvian for a correlation NCC, which was diagnosed by the highly sensitive electroimmunotransfer blot (EITB) or immunoblot assay. Eighteen percent (172 932) serum samples 28% (101 362)...
BACKGROUND: These clinical standards aim to provide guidance for diagnosis, treatment, and management of drug-susceptible TB in children adolescents. METHODS: Fifty-two global experts paediatric participated a Delphi consensus process. After eight rounds revisions, 51/52 (98%) participants endorsed the final document. RESULTS: Eight were identified: Standard 1, Age developmental stage are critical considerations assessment TB; 2, Children adolescents with symptoms signs disease should...
Tests for pleural tuberculosis are insensitive and expensive. We compared nonproprietary microscopic-observation drug-susceptibility (MODS) culture with Löwenstein-Jensen evaluation of specimens. MODS was associated greatly increased diagnostic sensitivity shorter time to diagnosis, (sensitivity biopsy specimens, 81% vs.51%; 11 days vs. 24 days; P < .001). The technique is inexpensive, allows testing, a considerably improved method tuberculosis.
Abstract Objectives Mobile phone interventions have been advocated for tuberculosis care, but little is known about access of target populations to mobile phones. We studied among patients with tuberculosis, focusing on vulnerable and who later had adverse treatment outcomes. Methods In a prospective cohort study in Callao, Peru, we recruited interviewed 2584 between 2007 2013 followed them until 2016 outcomes using national registers. Subsequently, further 622 2017. Data were analysed...