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Peru Status Report

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Peru Status Report

  1. INDIGENOUS HEALTHAND ADAPTATION TO CLIMATE CHANGE<br />Peruvian Amazon<br />Status Report<br />By:<br />César Cárcamo<br />IreneHofmeijer<br />Alejandro Llanos<br />Carol Zavaleta<br />
  2. STUDY SITES<br />
  3. Peruvian Amazon<br /><br />
  4. Peruvian Amazon<br />
  5. Ethnic Groups<br />Loreto: <br />Shawi<br />Ucayali: <br />Shipibo-Konibo<br />
  6. Shawi<br />Region: Loreto<br />Province: Alto Amazonas<br />District: Balsapuerto<br />Communities: <br />1. Nuevo Progreso<br />2. Puerto Porvenir<br />
  7. Shipibo-Konibo<br />Region: Ucayali Province: Coronel Portillo Districts: Calleria; Iparia<br />Communities: 1. Panaillo 2. Puerto Consuelo<br />Source: EsderasSilvano<br />Source: Google Maps<br />
  8. Community Characteristics<br />
  10. Project Management<br />Administrative lead: <br />Cayetano Heredia Foundation (CHF)<br />Dr. Alejandro Llanos<br />Dr. Cesar Carcamo<br />Management:<br />Indigenous Health unit (CHF)<br />Dra. Carol Zavaleta<br />Dr. Isaac Alva<br />Connie Fernandez (Biologist)<br />Associates: <br />Global Health Unit (CHF)<br />Dra. Patricia Garcia<br />Faculty of Public Health – Epidemiology department (UPCH)<br />Dra. Magaly Blas<br />Angela Bayer (Sociologist)<br />Tropical Medicine Institute (UPCH)<br />Dr. Eduardo Gotuzzo<br />
  11. Partner Organizations<br />Indigenous Groups: <br />
  12. Partner Organizations<br />Ministries of Health:<br />Loreto<br />DIRESA Loreto<br />Red de Salud Alto Amazonas<br />Connie Fernandez<br />Ucayali<br />DIRESA Ucayali<br />Epidemiology department<br />Dr. Cayo<br />Environmental health unit<br />Ing. Saenz<br />
  13. Partner Organizations<br />Others:<br />Peruvian Amazon Research Institute (IIAP)<br />Virginia Montoya (Anthropologist)<br />Elsa Rengifo (Biologist)<br />Manuel Saudre (Agronomist)<br />Jose Choy (Agronomist)<br />National Meteorology and Hydrology Services (SENAMHI) – Loreto Branch<br />Marco Paredes (Engineer)<br />
  14. Collaborators<br />International Labour Office<br />PRO 169 <br />LiliamLandeo (regional coordinator)<br /> <br />Instituto del Bien Comun<br />Ucayali<br />Carlos Arana (regional coordinator)<br />Mario Osorio (in charge of SICNA)<br /> <br />
  15. Proposed Methodologies<br />
  16. Objectives<br />Primary Objective: <br />Estimate incidence in indigenous communities of: <br />Water / airborne disease:<br />common diarrheal infection; intestinal parasitic diseases; cyclosporidium; leptospirosis<br />respiratory infections ( flu, bronchitis, etc.); neumonia<br />Vector-borne disease: <br />malaria; dengue; leishmaniasis; yellow fever; arbovirus<br />Skin diseases: <br />Scabies; miasis; bacterial and fungal diseases<br />Sexually transmitted infections<br />Food-quality<br />Secondary Objective: <br />Identify individual / behavioural / environmental risk factors associated to problems above. <br />
  17. Cohort Study<br />Implement community based prospective cohort study: <br />Size: 1,000 approx<br />Length: 3 years<br />Frequency: <br />Baseline study start of year 1<br />Additional study end of year1, 2, and 3<br />Every three months for water/airborne diseases<br />Will allow to determine seasonal variations<br />
  18. Methods<br />Standardized questionnaire: <br />Socio-demographic characteristics<br />Health-related knowledge and behaviours<br />Perceived health status<br />Recent Illness<br />Use of health care<br />
  19. Methods<br />Clinical evaluation: <br />Assess nutritional status<br />General health status<br />Including hypertension<br />Skin lesions<br />Traces of leishmaniasis<br />Febriles<br />
  20. Methods<br />Anthropometrics:<br />Height and weight <br />Laboratory tests: <br />Malaria thick smears<br />Leishmaniasis skin test <br />Yellow fever and Dengue IgG,<br />Glucose test<br />Syphilis treponemic test and hematocrit.<br />Ova and parasites stool analysis<br />
  21. Methods<br />Entomological surveillance: <br />To be carried out by MoH at study sites <br />Water quality:<br />With support from MoH<br />Experience and tools to locally test for: <br />Fecal coliforms<br />Turbidity / conductivity<br />pH<br />parasitology<br />Heavy metal testing must be done in Lima<br />
  22. Ethical Considerations<br />Community approval: <br />Already obtained from community leaders<br />Approval must be reconfirmed<br />Could result in modification to methodologies<br />Local indigenous coordinator: <br />To help communicate the process before, during, and after the development of each research protocol<br />
  23. Ethical Considerations<br />Treatments: <br />Provided by MoH national programs: <br />Malaria<br />Leishmaniasis<br />Provided by IHACC:<br />Antibiotics<br />Anemia<br />Parasites<br />Syphilis<br />
  24. Ethical Considerations<br />Team members with experience working with indigenous groups: <br />Dr. Alejandro Llanos<br />Dr. Patty Garcia<br />Dr. César Cárcamo<br />Dr. Isaac Alva<br />Dr. Carol Zavaleta<br />
  25. Results Dissemination<br />Annual coordination meetings with: <br />Community representatives: <br />Chief and project coordinator<br />Indigenous leaders: <br />National, regional, and local indigenous organizations<br />National authorities: <br />Regional government and local municipality<br />Ministry of health representative<br />Other local collaborators<br />
  26. Thank you <br />