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Item type:Publication, Ecosyndemics: The potential synergistic health impacts of highways and dams in the Amazon(Elsevier, 2020-05-15)Ecosyndemics refer to disease interactions that result from environmental changes commonly caused by humans. In this paper, we push scholarship on ecosyndemics into new territory by using the ecosyndemic framework to compare two case studies—the Southern Interoceanic highway in Peru and the Belo Monte hydroelectric dam in Brazil—to assess the likelihood of socio-environmental factors interacting and leading to ill health in a syndemic fashion. Assessing these two case studies using an ecosyndemic perspective, we find that the construction of dams and highways in tropical forests create the conditions for increases in vector-borne illnesses, surges in sex work and sexually-transmitted infections, and increased psychological stress resulting from violence, delinquency, and the erosion of social cohesion. We suggest that these processes could interact synergistically to increase an individual's immune burden and a population's overall morbidity. However, we find differences in the impacts of the Interoceanic highway and the Belo Monte dam on food, water, and cultural systems, and observed that community and corporate-level actions may bolster health in the face of rapid socio-ecological change. Looking at the case studies together, a complex picture of vulnerability and resilience, risk and opportunity, complicates straight-forward predictions of ecosyndemic interactions resulting from these development projects but highlights the role that the ecosyndemic concept can play in informing health impact assessments and future research. We conclude by proposing a conceptual model of the potential interactions between psychological stress, vector-borne illnesses, and sexaully-transmitted infections and suggest that future investigations of synergistic interactions among these factors draw from the biological, social, and ecological sciences. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Antimicrobial resistance in humans, animals, water and household environs in rural Andean Peru: exploring dissemination pathways through the one health lens(MDPI, 2021-05-01)Antimicrobial resistance (AMR) is a global public health threat, especially for low and middle-income countries (LMIC) where the threat has not been fully identified. Our study aims to describe E. coli AMR in rural communities to expand our knowledge on AMR bacterial contamina-tion. Specifically, we aim to identify and describe potential dissemination routes of AMR-carrying bacteria in humans (children’s stools), community water sources (reservoirs and household sources), household environments (yard soil) and domestic animals of subsistence farmers in rural Andean areas. Our cross-sectional study was conducted in rural households in the region of Cajamarca, Peru. A total of 266 samples were collected. Thirty-four point six percent of reservoir water and 45% of household water source samples were positive for thermotolerant coliforms. Of the reservoir water samples, 92.8% were positive for E. coli, and 30.8% displayed resistance to at least one antibiotic, with the highest resistance to tetracycline. E. coli was found in 57.1% of the household water sources, 18.6% of these isolates were multidrug-resistant, and displayed the highest resistance to tetracycline (31.3%). Among samples from the children’s drinking water source, 32.5% were positive for thermotolerant coliforms, and 57.1% of them were E. coli. One third of E. coli isolates were multidrug-resistant and displayed the highest AMR to tetracycline (41.6%) and ampicillin (25%). Thermotolerant coliforms were found in all the soil samples, 43.3% of the isolates were positive for E. coli, 34.3% of the E. coli isolates displayed AMR to at least one antibiotic, and displayed the highest AMR to tetracycline (25.7%). We determined thermotolerant coliforms in 97.5% of the child feces samples; 45.3% of them were E. coli, 15.9% displayed multidrug resistance, and displayed the highest resistance to ampicillin (34.1%). We identified thermotolerant coliforms in 67.5% of the animal feces samples. Of those, 38.7% were E. coli, and 37.7% were resistant to at least one antibiotic. For all the samples, the prevalence of resistance to at least one antibiotic in the E. coli and Klebsiella spp. isolates was almost 43% and the prevalence of MDR in the same isolates was nearly 9%, yet the latter nearly doubled (15.9%) in children’s stools. Our results provide preliminary evidence for critical pathways and the interconnectedness of animal, human and environmental transmission but molecular analysis is needed to track dissemination routes properly. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Antimicrobial resistance in rural settings in Latin America: a scoping review with a one health lens(MDPI, 2021-09-01)Antimicrobial resistance (AMR) in rural Latin America is not fully understood. The transmission pathways are partially known since research predominantly focuses on the urban hospital setting. The contribution to AMR from environmental factors is usually only mentioned in large-scale animal production. To understand the state of the literature on AMR in rural LA, we carried out a scoping review using the One Health (OH) perspective. OH recognises the concomitant contributions and interconnectedness of humans, animal, and the environment, thus, we used the OH perspective to select those articles adopting a holistic view of the problem. We searched original articles in English, Spanish, and Portuguese in four peer-reviewed databases and included 21 publications in the analysis. We charted data on bibliometrics, design, data collection sources, and instruments. We identified the human, animal, and environmental contributions to AMR in rural locations, and information gaps on AMR transmission routes and AMR drivers. Intensive and non-intensive animal production systems and agricultural practices were the most frequently found human contributions to AMR. Poultry, swine, cattle, and fish were the most frequent livestock mentioned as sources of AMR bacteria. Animal carriage and/or transfer of AMR determinants or bacteria was recognised as the primary contribution of livestock to the problem, while water, soil, and farming were predominant environmental contributions. We found that only 1 article out of 21 considered the OH approach as a framework for their sampling scheme, whereas 5 out 21 discussed all the three OH components. There were hardly any descriptions of humans or human waste as reservoirs for AMR in rural locations, and rural health centres or hospitals and wildlife were not represented. No studies identified mining as an anthropogenic activity driving AMR. More OH-oriented studies, with emphasis on molecular approaches—for identification and comparison of AMR genes—are sorely needed to understand better the existence of a network of interconnected transmission routes in rural Latin America and provide efficient strategies to prevent further AMR emergence. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Water insecurity and gender-based violence: Exploring links and steps for prevention. A comparative study of Indonesian and Peruvian women(European Organization for Nuclear Research, 2022-02-10)Gender-based violence (GBV) is one of the most prevalent public health threats in the world today, withas many as one in four women affected. Household water insecurity is the inability to access and benefitfrom affordable, adequate, reliable and safe water for well-being and healthy living. Thus, this researchseeks to explore whether water insecurity is associated with gender-based violence in the home and, if so,under what circumstances in Sumba, Indonesia, and Tambogrande, Peru. For this, a mixed methodology was designed, with qualitative and quantitative instruments. In the case ofPeru, 358 surveys were applied to adult women from two populated centers, Community 1, which has a totalpopulation of 1,771, and Community 2, which has a total population of 941, both located in rural areas.from Tambogrande, Piura. 51 in-depth interviews and 5 participatory workshops were also carried outwith the communities and local public servants. With this, it is sought that the results help to identifypolicies and practices that contribute to the vulnerability or resilience of women. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Whole-genome characterisation of ESBL-producing E. coli isolated from drinking water and dog faeces from rural Andean households in Peru(MDPI, 2022-05-01)E. coli that produce extended-spectrum β-lactamases (ESBLs) are major multidrug-resistant bacteria. In Peru, only a few reports have characterised the whole genome of ESBL enterobacteria. We aimed to confirm the identity and antimicrobial resistance (AMR) profile of two ESBL isolates from dog faeces and drinking water of rural Andean households and determine serotype, phylogroup, sequence type (ST)/clonal complex (CC), pathogenicity, virulence genes, ESBL genes, and their plasmids. To confirm the identity and AMR profiles, we used the VITEK®2 system. Whole-genome sequencing (WGS) and bioinformatics analysis were performed subsequently. Both isolates were identified as E. coli, with serotypes -:H46 and O9:H10, phylogroups E and A, and ST/CC 5259/- and 227/10, respectively. The isolates were ESBL-producing, carbapenem-resistant, and not harbouring carbapenemase-encoding genes. Isolate 1143 ST5259 harboured the astA gene, encoding the EAST1 heat-stable toxin. Both genomes carried ESBL genes (blaEC-15, blaCTX-M-8, and blaCTX-M-55). Nine plasmids were detected, namely IncR, IncFIC(FII), IncI, IncFIB(AP001918), Col(pHAD28), IncFII, IncFII(pHN7A8), IncI1, and IncFIB(AP001918). Finding these potentially pathogenic bacteria is worrisome given their sources and highlights the importance of One-Health research efforts in remote Andean communities. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Water insecurity and gender-based violence: a global review of the evidence(Wiley, 2022-10-03)We reviewed the existing literature documenting the association between water insecurity and gender‐based violence to (1) describe the characteristics and contexts of available studies, and (2) identify and classify documented gender‐based violence across domains of water insecurity (access, affordability, adequacy, reliability, and safety). 18 peer‐reviewed articles mentioned associations between water insecurity and gender‐based violence. All studies were conducted in sub‐Saharan Africa and South Asia and were published in English. The most common manifestation of the relationship between water insecurity and gender‐based violence was an increased risk of sexual and physical violence for women who walked long distances to access water. This was followed by intimate partner violence sparked by the inability to meet domestic obligations due to household water inadequacy. Despite these trends, the domains of water insecurity, and the types of violence experienced by women, were often intertwined. We conclude that there is a dearth of information assessing gender‐based violence and water insecurity, especially in Latin America, North America, and Southeast Asia, and involving locally‐based scholars. We suggest that the spectrum of what is considered “violence” in relation to water insecurity be expanded and that scholars and practitioners adopt the term “gender‐based water violence” to describe water‐related stressors that are so extreme as to threaten human health and well‐being, particularly that of women and girls. Finally, we encourage the development of cross‐culturally validated measures of gender‐based violence, which can be deployed in conjunction with standardized measures of water insecurity, to evaluate interventions that target these linked threats to global health. This article is categorized under: Engineering Water > Water, Health, and Sanitation Human Water > Rights to Water - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Molecular characterization by multilocus sequence typing and diversity analysis of Rickettsia asembonensis in Peru(Mary Ann Liebert Inc., 2022-03-01)Despite several reports worldwide documenting the presence of Rickettsia asembonensis in samples derived from ectoparasites, animals and more recently humans, genomic information of these specimens remains scarce, and when available, is usually limited to small genomic fragments of limited value. We generated complete sequences for two conserved (17-kDa antigen gene and gltA ) and three variable ( sca4 , ompB and ompA ) genes in five R. asembonensis DNA samples detected in cat and dog fleas in Peru. Complete gene sequences were used to conduct multi-locus sequence typing and phylogenetic analyses to assess diversity and infer relationships among strains and other reference sequences. The 17-kDa antigen gene was highly conserved across Rickettsia species. Of the variable genes ompB was the most variable, but this diversity was not captured through phylogenetics alone even when efforts were made to maximize potential diversity in terms of flea species, animal host and location. Through a combination of de novo and reference-based genome assembly we identified a 75 bp insertion in ompA that encodes a 25 aa repetitive motif found in other Rickettsia species, but not present in the original prototype strain from Kenya. R. asembonensis has only recently been shown to be a bona-fide human pathogen. As such, and compounded by a lack of available genomic information, it remains understudied. Our work directly addresses the lack of genomic information available worldwide for the study of these novel Rickettsia species and specifically contributes to our understanding of the diversity and molecular epidemiology of R. asembonensis in Peru. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Water insecurity, self-reported physical health, and objective measures of biological health in the Peruvian Amazon(John Wiley and Sons Inc, 2022-12-01)Objectives: This study examines the associations between water insecurity, self-reported physical health, and objective measures of biological health among 225 Awajún adults (107 women; 118 men) living in the Peruvian Amazon, a “water-abundant” region. Methods: A survey, which included multiple measures of self-reported physical health, and objective measures of biological health such as blood pressure and nutritional and immune biomarkers. Results: Greater water insecurity was associated with multiple measures of self-reported physical health, including higher incidence of reported diarrhea, nausea, back pain, headaches, chest pain, fatigue, dizziness, overall poor perceived health, and “being sick.” These symptoms align with the physical strain associated with water acquisition and with drinking contaminated water. A significant association between higher water insecurity and lower systolic blood pressure emerged, which may be linked to dehydration. None of the other biomarkers, including those for nutrition, infection, and stress were significantly associated with water insecurity scores. Conclusions: These analyses add to the growing body of research examining the associations between water insecurity and health. Biocultural anthropologists are well-positioned to continue probing these connections. Future research will investigate relationships between measures of water insecurity and biomarkers for gastrointestinal infection and inflammation in water-scarce and water-abundant contexts. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Scoping review of cultural responsivity in interventions to prevent gender-based violence in Latin America(SAGE Publishing, 2024-12-24)In this article, we review existing interventions to prevent gender-based violence (GBV) in Latin American contexts to evaluate the extent to which this work incorporates cultural responsivity-meaning whether the interventions consider the unique norms, identities, and attributes of specific cultures. We follow Arksey and O'Malley's steps for conducting systematic scoping reviews. We reviewed articles from 2003 to 2023 across 12 databases. Fifteen peer-reviewed articles met the criteria for inclusion, which included being published in English or Spanish, focused on proposed or implemented interventions to prevent GBV based in Latin America, and published in the last 20 years. The selected studies contained information about separate GBV interventions (proposed or implemented) in 10 different countries in Latin America, in both rural and urban contexts. We categorized five interventions as most culturally responsive, six studies as moderately culturally responsive, and four studies as showing minimal attention to cultural responsivity. We found that culturally responsive interventions tended to involve working closely with men and women in local communities as "peer facilitators" or "community-based researchers." These interventions challenged socio-cultural norms related to gender, family, and parenting, including attention to machismo and other forms of hegemonic masculinity. The present study is the first one to examine cultural responsiveness within GBV interventions in Latin America, and it is relevant for researchers, service providers, and communities in Latin America who are concerned with preventing GBV. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Study protocol: Improving response to malaria in the Amazon through identification of inter-community networks and human mobility in border regions of Ecuador, Peru and Brazil(BMJ Publishing Group, 2024-04-15)Understanding human mobility’s role in malaria transmission is critical to successful control and elimination. However, common approaches to measuring mobility are ill-equipped for remote regions such as the Amazon. This study develops a network survey to quantify the effect of community connectivity and mobility on malaria transmission. Methods We measure community connectivity across the study area using a respondent driven sampling design among key informants who are at least 18 years of age. 45 initial communities will be selected: 10 in Brazil, 10 in Ecuador and 25 in Peru. Participants will be recruited in each initial node and administered a survey to obtain data on each community’s mobility patterns. Survey responses will be ranked and the 2–3 most connected communities will then be selected and surveyed. This process will be repeated for a third round of data collection. Community network matrices will be linked with each country’s malaria surveillance system to test the effects of mobility on disease risk. Ethics and dissemination This study protocol has been approved by the institutional review boards of Duke University (USA), Universidad San Francisco de Quito (Ecuador), Universidad Peruana Cayetano Heredia (Peru) and Universidade Federal Minas Gerais (Brazil). Results will be disseminated in communities by the end of the study.
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