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Copyright of Revista de Investigaciones Veterinarias del Peru is the property of Universidad Nacional Mayor de San Marcos (UNMSM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Currently, in Latin America, including Peru, the treatment of gonorrhea is still empiric and information regarding antimicrobial resistance is scarce in some countries because of the limited resources, which can contribute to the rising rates of reported multidrug-resistant gonococcal strains. In that context, it is mandatory to continuously monitor and report antimicrobial resistance in N. gonorrhoeae to update treatment recommendations.Methods: This descriptive study analyzed genital and anal samples from symptomatic patients who attended 15 sexually transmitted infections health facilities from 8 different regions in Peru during the years 2018 to 2019 within the framework of Sentinel Surveillance. After establishing the presumptive diagnosis, the isolates were sent to the Laboratory of Sexually Transmitted Bacteria of the National Institute of Health of Peru in Lima where the species were confirmed (N = 165) and susceptibility profiles were determined.Results: Among the 165 isolates, 95.2% corresponded to male patients, between 18 and 22 years of age (40.6%), half reported having a sexual partner and being heterosexual. Clinically, 89.7% manifested the presence of urethral exudate. Microbiology showed 95.2% of the isolates resistant to ciprofloxacin and 9.1% non-susceptible to azithromycin. Reduced susceptibility to ceftriaxone and cefixime was observed in 1.2% and 3.6% of the isolates respectively. All strains tested were susceptible to spectinomycin.Conclusions: This study demonstrated that in Peru, fluoroquinolones should not be recommended or used in N. gonorrhoeae infections due to the high percentage of resistant strains. In addition, nationwide access to gonococcal resistance testing, molecular diagnostics and antimicrobial stewardship should be implemented to control the spread of gonococcal antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Background: During the pandemic in Peru, the COVIDA (Collaboration Network of Volunteer Brigade Members for the Investigation, Detection, and Primary Management of Community Cases Affected by COVID-19) project proposed an innovative way to provide telemonitoring and teleorientation to COVID-19 patients, led by health care student volunteers. However, it has not been described how this interaction is perceived from the patient's perspective and which factors increase their engagement with this service., Objective: The aim of this study is to describe the perceptions of patients about COVIDA and identify factors associated with their engagement with this service., Methods: A mixed methods study was conducted to evaluate perceptions of patients that participated in the COVIDA project. This telehealth intervention organized by the National University of San Marcos was implemented in Peru from August to December 2020. The service involved daily phone calls by volunteer students to monitor registered COVID-19 patients until the completion of the 14th day of the illness or if a warning sign was identified. The volunteers also provided teleorientation to address the patients' needs and concerns. Quantitative analysis was performed to describe the characteristics of the patients and to assess the factors related to their engagement with the service, which was defined by the percentage of participants who completed the follow-up according to their individual schedule. Qualitative analysis through semistructured interviews evaluated the patients' perceptions of the service regarding the aspects of communication, interaction, and technology., Results: Of the 770 patients enrolled in COVIDA, 422 (55.7%) were female; the median age was 39 (IQR 28-52) years. During the monitoring, 380 patients (49.4%) developed symptoms, and 471 (61.2%) showed warning signs of COVID-19. The overall median for engagement was 93% (IQR 35.7%-100%). Among those patients who did not develop warning signs, engagement was associated with the presence of symptoms (OR 3.04, 95% CI 2.22-4.17), a positive COVID-19 test at the start of follow-up (OR 1.97, 95% CI 1.48-2.61), and the presence of comorbidities (OR 1.83, 95% CI 1.29-2.59). Patients reported that the volunteers provided clear and valuable information and emotional support. Communication via phone calls took place smoothly and without interruptions., Conclusions: COVIDA represents a well-accepted and well-perceived alternative model for student volunteers to provide telemonitoring, teleorientation, and emotional support to patients with COVID-19 in the context of overwhelmed demand for health care services. The deployment of this kind of intervention should be prioritized among patients with symptoms and comorbidities, as they show more engagement with these services., (©Stefan Escobar-Agreda, Javier Silva-Valencia, Percy Soto-Becerra, C Mahony Reategui-Rivera, Kelly De la Cruz-Torralva, Max Chahuara-Rojas, Bruno Hernandez-Iriarte, Daniel Hector Espinoza-Herrera, Carlos Alberto Delgado, Silvana Matassini, Javier Vargas-Herrera, Leonardo Rojas-Mezarina. Originally published in JMIR Formative Research (https://formative.jmir.org), 13.09.2024.)

Background: During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables., Methods: This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05., Results: Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =-0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74-6.63 and APR = 3.68, 95% CI: 1.31-10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05)., Conclusion: Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time., (© 2024. The Author(s).)

Background: The dentist should have a thorough knowledge of the science, protocols and procedures for dental shade selection in order to mimic dental tissue with restorative materials, respecting the individual needs and attitudes of each patient and providing them with a pleasant and esthetically acceptable appearance. The present study evaluated the knowledge and attitudes of dental interns from two Peruvian universities about dental shade selection and its relationship with sociodemographic factors., Methods: The present cross-sectional and analytical study was carried out on Peruvian dental interns from the Universidad Nacional Federico Villarreal and the Universidad Privada de San Juan Bautista during May to June 2022. Two validated questionnaires on knowledge and attitudes about dental shade selection were used. A Poisson regression model with robust variance using the adjusted prevalence ratio (APR) was used to assess the influence of the variables: age group, sex, place of origin and type of university, considering a significance level of p<0.05., Results: The results showed that 40.8% (95% CI: 34.0% - 47.6%) of the interns presented unfavorable attitudes while 90.1% (95% CI: 86.0% - 94.2%) presented insufficient knowledge. It was also found that dental interns under 29 years of age were 32% less likely to have unfavorable attitudes (APR = 0.68, 95% CI 0.48 - 0.96) and 11% more likely to have insufficient knowledge (APR = 1.11, 95% CI 1.01 - 1.24) about tooth shade selection compared to dental interns aged 29 years and older. Finally, women were 55% more likely to have unfavorable attitudes about tooth shade selection compared to men (APR = 1.55; 95% CI: 1.08 - 2.22)., Conclusion: The majority of dental interns presented insufficient knowledge and less than half had unfavorable attitudes about dental shade selection. In addition, being a student under 29 years of age was a risk factor for presenting insufficient knowledge and at the same time constituted a protective factor for presenting unfavorable attitudes. Likewise, being a female student was a risk factor for presenting unfavorable attitudes about dental shade selection., (© 2023. The Author(s).)

Background: The COVID-19 pandemic has promoted a shortage of filtering facepiece respirators (FFRs) and the emergence of new FFRs brands. We aimed to determine the fit provided by in-use FFRs in Peruvian healthcare workers (HCWs) during the COVID-19 pandemic., Methods: We enrolled 279 HCWs from 37 primary healthcare centers with highest burden of care for TB in Peru, of which 263 were assessed using quantitative fit tests (QNFT). Results were expressed as real-time fit factor (rt-FF) and overall fit factor (overall-FF), which was categorized as ≥100 (optimal result), 50-99, and <50., Results: We identified 3M 1860 FFRs (33.1%), Xiantao Zhong Yi ZYB-11 FFRs (24.6%) and Makrite 9500 FFRs (20.5%), mainly. Eighty-seven FFRs (33.1%) had an optimal overall-FF, 27 (10.3%) between 50-99, and 149 (56.6%) less than 50. Of the 87 FFRs with optimal overall-FF, 73 (83.9%) were 3M 1860 FFRs. Of the 27 FFRs with overall-FF between 50-99, 7 (25.9%) were Makrite 9500, while of the 149 with overall-FF less than 50, 58 (38.9%), and 47 (31.5%) were Xiantao Zhong Yi ZYB-11 and Makrite 9500, respectively., Conclusion: Xiantao Zhong Yi and Makrite FFRs do not adapt adequately to the face of Peruvian HCWs, most having fit factors less than 50.

Bats are important natural reservoir hosts of a diverse range of viruses that can be transmitted to humans and have been suggested to play an important role in the Zika virus (ZIKV) transmission cycle. However, the exact role of these animals as reservoirs for flaviviruses is still controversial. To further expand our understanding of the role of bats in the ZIKV transmission cycle in Latin America, we carried out an experimental infection in wild-caught Artibeus lituratus bats and sampled several free-living neotropical bats across three countries of the region. Experimental ZIKV infection was performed in wild-caught adult bats (4 females and 5 males). The most relevant findings were hemorrhages in the bladder, stomach and patagium. Significant histological findings included inflammatory infiltrate consisting of a predominance of neutrophils and lymphocytes, in addition to degeneration in the reproductive tract of males and females. This suggests that bat reproduction might be at some level affected by ZIKV. Leukopenia was also observed in some inoculated animals. Hemorrhages, genital alterations, and leukopenia are suggested to be caused by ZIKV; however, since these were wild-caught bats, we cannot exclude other agents. Detection of ZIKV by qPCR was observed at low concentrations in only two urine samples in two inoculated animals. All other animals and tissues tested were negative. Finally, no virus-neutralizing antibodies were found in any animal. To determine ZIKV infection in nature, the blood of a total of 2056 bats was sampled for ZIKV detection by qPCR. Most of the sampled individuals belonged to the genus Pteronotus sp. (23%), followed by the species Carollia sp. (17%), Anoura sp. (14%), and Molossus sp. (13.7%). No sample of any tested species was positive for ZIKV by qPCR. These results together suggest that bats are not efficient amplifiers or reservoirs of ZIKV and may not have an important role in ZIKV transmission dynamics., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Aguilar-Setién et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Academic dishonesty is an intentional behavior that transgresses ethics in the teaching-learning process. The present study aimed to evaluate the factors associated with the perception of university professors about academic dishonesty in dental students from two universities in the Peruvian capital., Methods: This cross-sectional, analytical study evaluated 181 professors from two Peruvian universities between March and July 2022. A validated 28-item questionnaire was used to measure the perceived academic dishonesty of their students. A logit model was used to evaluate the influence of the variables gender, marital status, place of origin, academic degree, specialization, academic area, years of teaching experience, scientific publications, ethical training and university of origin, considering a significance level of p < 0.05., Results: According to the median, professors perceived that their students sometimes had attitudes and motivations to commit academic dishonesty. The professors whose origin was the capital city were twice as likely to perceive dishonest attitudes in dental students as those whose origin was a province (OR = 2.04; 95% CI: 1.06-3.93). University professors in pre-clinical courses were 0.37 times less likely to perceive dishonest attitudes than those teaching in the dental clinic (OR = 0.37; CI: 0.15-0.91). University professors in basic science courses and professors in preclinical courses were 0.43 times (OR = 0.43; CI: 0.19-0.96) and 0.39 times (OR = 0.39; CI: 0.15-0.98) less likely to perceive dishonest motivations in their students compared to university professors in the dental clinic. Gender, marital status, academic degree, specialty, years of teaching experience, scientific publications and ethical training were not found to be influential factors (p > 0.05)., Conclusion: Although all university professors surveyed perceived dishonest attitudes and motivations in their students, university professors from the capital city perceived such attitudes more. In addition, being a preclinical university professor was a hindered factor for perceiving such dishonest attitudes and motivations. It is advisable to implement and constantly disseminate regulations that empower academic integrity as well as to manage a system for reporting misconduct and to make students aware of the impact of dishonesty in their professional training., (© 2023. The Author(s).)

Bluetongue virus (BTV) is an arbovirus that is transmitted between domestic and wild ruminants by Culicoides spp. Its worldwide distribution depends on competent vectors and suitable environmental ecosystems that are becoming affected by climate change. Therefore, we evaluated whether climate change would influence the potential distribution and ecological niche of BTV and Culicoides insignis in Peru. Here, we analyzed BTV ( n = 145) and C. insignis ( n = 22) occurrence records under two shared socioeconomic pathway scenarios (SSP126 and SSP585) with five primary general circulation models (GCMs) using the kuenm R package v.1.1.9. Then, we obtained binary presence-absence maps and represented the risk of transmission of BTV and niche overlapping. The niche model approach showed that north and east Peru presented suitability in the current climate scenario and they would have a decreased risk of BTV, whilst its vector would be stable and expand with high agreement for the five GCMs. In addition, its niche overlap showed that the two niches almost overlap at present and would completely overlap with one another in future climate scenarios. These findings might be used to determine the areas of highest priority for entomological and virological investigations and surveillance in order to control and prevent bluetongue infections in Peru.

Background: Telementoring seems to be a promising strategy to deliver training and counselling to physicians in remote areas. In Peru, early graduated physicians must work for the Rural and Urban-Edge Health Service Program where they face important training needs. The aim of this study was to describe the usage of a one-on-one telementoring program for rural physicians and evaluate the aspects related to the perceptions of acceptability and usability., Methods: Mixed methods study on recently graduated physicians who work in rural areas and participate in the telementoring program. The program used a mobile application to connect these young doctors with specialized mentors to answer queries about real-life problems raised by working in a rural area. We summarize administrative data to assess participant characteristics and their participation in the program. Additionally, we conducted in-depth interviews to explore the perceived usability, ease of use, and reason for non-use of the telementoring program., Results: Of 74 physicians (mean age 25, 51.4% women) enrolled, 12 (16.2%) actively used the program and performed a total of 27 queries, which received response in an average time of 5.4 ± 6.3 h. In the interviews, the main reasons for non-use were connectivity issues, feelings of shame, and self-efficacy. For those who used the telementoring program they referred it was easy to use and solve their inquiries timely., Conclusions: The implementation of a telementoring program sought to provide guidance to recently graduated physicians working in rural areas. Low use rates show that administrative and process-related deficiencies in the program implementation need to be improved., (© 2023. The Author(s).)

This study aimed to validate an ODK digital mobile application (ODK-DMA) in contacts exposed to multidrug-resistant tuberculosis (MDR-TB) in Lima, Peru. Using a questionnaire in an application on a mobile device, we registered 129 household contacts of 29 index cases of MDR-TB under treatment in 10 health facilities in South Lima in August 2018. The mean time of registration per contact was found to be 4 minutes. The prevalence of active TB symptoms among MDR-TB contacts was 3.1%. An acceptability questionnaire was completed by 31 respondents; all reported feeling comfortable or very comfortable with recording their data in the ODK-DMA, although 10% expressed concerns about confidentiality. We concluded that the ODK-DMA was a feasible and acceptable tool for registering household contacts exposed to cases with MDR-TB. Future studies should consider the use of mobile platforms for the monitoring of MDR-TB contacts.

Interspecies transmission is an important mechanism of evolution and contributes to rotavirus A (RVA) diversity. In order to evaluate the detection frequency, genetic diversity, epidemiological characteristics and zoonotic potential of RVA strains in faecal specimens from humans and animals cohabiting in the same environment in the department of Cusco, Peru, by molecular analysis, 265 faecal specimens were obtained from alpacas, llamas, sheep and shepherd children, and tested for RVA by RT-PCR. Genotyping was performed by multiplex PCR and sequence analysis. Rotavirus A was detected in 20.3% of alpaca, 47.5% of llama, 100% of sheep and 33.3% of human samples. The most common genetic constellations were G3-P[40]-I8-E3-H6 in alpacas, G1/G3-P[8]-I1-E1-H1 in llamas, G1/G3/G35-P[1]/P[8]-I1-E1-H1 in sheep and G3-P[40]-I1/I8-E3-H1 in humans. The newly described genotypes P[40] and P[50] were identified in all host species, including humans. Genotyping showed that the majority of samples presented coinfection with two or more RVA strains. These data demonstrate the great genetic diversity of RVA in animals and humans in Cusco, Peru. Phylogenetic analysis suggested that the strains represent zoonotic transmission among the species studied. Due to the characteristics of the human and animal populations in this study (cohabitation of different host species in conditions of poor sanitation and hygiene), the occurrence of zoonoses is a real possibility., (© 2019 Blackwell Verlag GmbH.)

Porcine reproductive and respiratory syndrome virus (PRRSV) causes significant economic losses to the swine industry worldwide. While PRRSV has been endemic in North America since 1989, it was not until 1999 that the virus was first described in South America. Notably, recently an increased number of PRRSV outbreaks have been reported in South American countries. However, epidemiological information related to these outbreaks is limited and the genetic characteristics of the PRRSV strains circulating in the region are poorly understood. In this study, we describe the genetic analyses of PRRSV strains associated with severe PRRS outbreaks in Peru. Samples originating from 14 farms located in two Departments in Peru (Lima and Arequipa), were subjected to RT-PCR amplification of the PRRSV ORF5 gene and sequencing followed by restriction fragment length polymorphism (RFLP) analysis. Results demonstrated the circulation of PRRSV-2 in Peru. Notably ORF5 RFLP typing revealed that 15 (75%) of the PRRSV strains detected in this study belong to the RFLP 1-7-4 type. Phylogenetic analysis showed that the Peruvian strains are closely related to the highly virulent PRRSV 1-7-4 strains that emerged in the US in 2013-2014. Results here indicate the presence of highly virulent PRRSV 1-7-4 strains in Peru and provide important information on the geographical distribution of PRRSV, confirming the recent geographical expansion of this important swine pathogen towards South America., (© 2019 Blackwell Verlag GmbH.)

Food security (a pressing issue for all nations) faces a threat due to population growth, land availability for growing crops, a changing climate (leading to increases in both abiotic and biotic stresses), heightened consumer awareness of the risks related to the use of agrichemicals, and also the reliance on depleting fossil fuel reserves for their production. Legislative changes in Europe mean that fewer agrichemicals will be available in the future for the control of crop pests and pathogens. The need for the implementation of a more sustainable agricultural system globally, incorporating an integrated approach to disease management, has never been more urgent. To that end, the Valorizing Andean Microbial Diversity (VALORAM) project (http://valoram.ucc.ie), funded under FP7, examined the role of microbial communities in crop production and protection to improve the sustainability, food security, environmental protection, and productivity for rural Andean farmers. During this work, microbial volatile organic compounds (mVOCs) of 27 rhizobacterial isolates were identified using gas chromatography/mass spectrometry (GC/MS), and their antifungal activity against Rhizoctonia solani was determined in vitro and compared to the activity of a selection of pure volatile compounds. Five of these isolates, Pseudomonas palleroniana R43631, Bacillus sp. R47065, R47131, Paenibacillus sp. B3a R49541, and Bacillus simplex M3-4 R49538 trialled in the field in their respective countries of origin, i.e., Bolivia, Peru, and Ecuador, showed significant increase in the yield of potato. The strategy followed in the VALORAM project may offer a template for the future isolation and determination of putative biocontrol and plant growth-promoting agents, useful as part of a low-input integrated pest management system.

The world's fourth largest food crop, potato, originates in the Andes. Here, the community composition of arbuscular mycorrhizal fungi (AMF) associated with potato in Andean ecosystems is described for the first time. AMF were studied in potato roots and rhizosphere soil at four different altitudes from 2,658 to 4,075 m above mean sea level (mamsl) and in three plant growth stages (emergence, flowering, and senescence). AMF species were distinguished by sequencing an approx. 1,500 bp nuclear rDNA region. Twenty species of AMF were identified, of which 12 came from potato roots and 15 from rhizosphere soil. Seven species were found in both roots and soil. Interestingly, altitude affected species composition with the highest altitude exhibiting the greatest species diversity. The three most common colonizers of potato roots detected were Funneliformis mosseae, an unknown Claroideoglomus sp., and Rhizophagus irregularis. Notably, the potato-associated AMF diversity observed in this Andean region is much higher than that reported for potato in other ecosystems. Potato plants were colonized by diverse species from 8 of the 11 Glomeromycota families. Identification of the AMF species is important for their potential use in sustainable management practices to improve potato production in the Andean region.

Creutzfeldt-Jakob disease (CJD) is a fatal neurological disease caused by pathological isoform of the human prion protein. Clinical features of six cases of the sporadic form of CJD with definitive diagnosis by histopathology, and five cases with probable diagnosis were reported in patients treated at the Peruvian National Institute of Neurological Sciences. The average age of onset in definite cases was 55.8 years and in probable cases was 59.6, mostly males. The average disease duration was 8.8 months. A typical EEG was found in 50% of definite cases and in 80% of probable. The 14-3-3 protein in cerebrospinal fluid was positive in a probable case, and typical MRI findings were observed in two probable cases. All cases studied had a typical clinical course of the disease, and it is considered as the first report of CJD in Peru.

The Central Andean Highlands are the center of origin of the potato plant (Solanum tuberosum). Ages of mutualism between potato plants and soil bacteria in this region support the hypothesis that Andean soils harbor interesting plant growth-promoting (PGP) bacteria. Therefore, the aim of this study was to isolate rhizobacteria from Andean ecosystems, and to identify those with PGP properties. A total of 585 bacterial isolates were obtained from eight potato fields in the Andes and they were screened for suppression of Phytophthora infestans and Rhizoctonia solani. Antagonistic mechanisms were determined and antagonistic isolates were further tested for phosphate solubilization, 1-aminocyclopropane-1-carboxylate (ACC) deaminase activity, and production of NH3- and indole-3-acetic acid (IAA). PGP was studied in healthy and R. solani diseased plantlets under growth room conditions. Performance was compared to the commercial strain B. subtilis FZB24(®) WG. Isolates were dereplicated with matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS), and identified with 16S rRNA gene sequencing and multi locus sequence analysis (MLSA). A total of 10% of the isolates were effective antagonists, of which many were able to solubilize phosphate, and produce IAA, ACC deaminase, NH3 and hydrogen cyanide (HCN). During growth room experiments, 23 antagonistic isolates were associated with plant growth-promotion and/or disease suppression. Ten isolates had a statistically significant impact on test parameters compared to the uninoculated control. Three isolates significantly promoted plant growth in healthy plantlets compared to the commercial strain, and seven isolates outperformed the commercial strain in in vitro R. solani diseased plantlets., (Copyright © 2012 Elsevier GmbH. All rights reserved.)

Selection of the priority tuberculosis (TB) research topics in Peru occurred in three stages: a literature review of TB research findings and information in Peru; proposal of the most important topics by 31 key investigators identified through 233 articles published between 1981 and 2011,16 (48.5%) of the 33 regional coordinators of the National Tuberculosis Prevention and Control Strategy, and influential 16 academics and officials in the area of TB; and a participatory workshop attended by 103 health professionals and officials grouped under 10 thematic discussion groups. Of the 49 research topics identified in the second stage of the process, the 30 most important ones for Peru were selected and prioritized during the workshop. These topics, selected through this inclusive, transparent, and participatory methodology, became the National Tuberculosis Research Agenda in Peru for 2011 - 2014. These results should help to improve TB control strategies in the country and optimize the use of financial and human resources.

Little is known about feces disposal practices, their determinants and feasibility for change, despite their importance in the control of diarrheal diseases. We report here the results of formative research for the development of an intervention to promote sanitary disposal of feces of young children. The study was conducted in a densely populated shanty town area of Lima, where water and sanitation systems are scarce. In-depth interviews were undertaken with mothers, husbands and community leaders. Group discussions were held with mothers in order to validate findings from the interviews, investigate particular topics further and explore reactions to possible intervention strategies. The principal defecation sites for young children were diapers, potties, the ground in or near the home, the hill, latrines and flush toilets. The main determinants found were the age of the child, the effort required by the method, perceptions of dirtiness and the availability of resources. Almost all children under one year of age use diapers but the high resource cost of diaper washing is a strong motivation for mothers to move their children on as early as possible. Potties were considered the most socially acceptable and 'hygienic' defecation method for children between one and three years of age. Nevertheless, defecation directly onto the ground is common at this age. Potty training is deemed to be quite difficult and the long term achievements are determined by the initial training success. In most cases, the training process is authoritative and inconsistent. The use of latrines and flush toilets is not considered appropriate for children until they are three to four years old. Based on these initial findings, a micro-trial was conducted to assess the feasibility and acceptability of promoting greater use of potties and associated practices. The results of the trial were very encouraging and provided valuable information for the design of a community-wide intervention. Our findings help explain why the emphasis given in most sanitation projects, where efforts have been concentrated on the promotion of latrines, has failed to induce their utilization by small children. Sanitation projects should incorporate interventions that will promote hygienic defecation and stool clearance practices for infants and small children.

The intestines of 20 grey Peruvian foxes (Pseudalopex culpaeus) were examined for the presence of Echinococcus granulosus and other intestinal parasites. Echinococcus granulosus was not found in foxes but Taenia hydatigena and T. multiceps were found in 7 and 4 animals respectively. The grey fox may not be a suitable definitive host for E. granulosus. However, it may act as a sylvatic reservoir of T. hydatigena and T. multiceps in the central Peruvian Andes.