Needs, Acceptability, and Value of Humanitarian Medical Assistance in Remote Peruvian Amazon Riverine Communities

Juan F. Sanchez U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Eric S. Halsey U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Angela M. Bayer U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Martin Beltran U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Hugo R. Razuri U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Daniel E. Velasquez U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Vitaliano A. Cama U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Paul C. F. Graf U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Antonio M. Quispe U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Ryan C. Maves U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Joel M. Montgomery U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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John W. Sanders U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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Andres G. Lescano U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California

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DOI:
https://doi.org/10.4269/ajtmh.14-0329
Volume/Issue:
Volume 92: Issue 6
Page(s):
1090–1099
Restricted access
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Much debate exists regarding the need, acceptability, and value of humanitarian medical assistance. We conducted a cross-sectional study on 457 children under 5 years from four remote riverine communities in the Peruvian Amazon and collected anthropometric measures, blood samples (1–4 years), and stool samples. Focus groups and key informant interviews assessed perspectives regarding medical aid delivered by foreigners. The prevalence of stunting, anemia, and intestinal parasites was 20%, 37%, and 62%, respectively. Infection with multiple parasites, usually geohelminths, was detected in 41% of children. The prevalence of intestinal parasites both individual and polyparasitism increased with age. Participants from smaller communities less exposed to foreigners expressed lack of trust and fear of them. However, participants from all communities were positive about foreigners visiting to provide health support. Prevalent health needs such as parasitic infections and anemia may be addressed by short-term medical interventions. There is a perceived openness to and acceptability of medical assistance delivered by foreign personnel.

Author Notes

* Address correspondence to Andres G. Lescano, Head, Department of Parasitology and Director, Public Health Training Program, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Avenida Venezuela Cdra. 36 S/N, Centro Médico Naval, Lima, Callao 02, Peru. E-mails: willy.lescano@med.navy.mil or wlescano@hotmail.com

Financial support: This study was supported by the U.S. Southern Command (SOUTHCOM) under work unit 847705 82000 25GB B0016 and the National Institutes of Health/Fogarty International Center (NIH/FIC) under Training Grant 2D43 TW007393.

Copyright statement: Several authors of this manuscript are military service members or employees of the U.S. Government. This work was prepared as part of their duties. Title 17 U.S.C. § 105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. § 101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.

Authors' addresses: Juan F. Sanchez, Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Callao, Peru, E-mail: juan.f.sanchez@med.navy.mil. Eric S. Halsey, Department of Virology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru, and Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: ycw8@cdc.gov. Angela M. Bayer, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA, and Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru, E-mail: angelabayerx@gmail.com. Martin Beltran, Peruvian Ministry of Health, Alto Amazonas Health Network, Yurimaguas, Peru, E-mail: mjbeltran72@hotmail.es. Hugo R. Razuri and Joel M. Montgomery, Department of Emerging Infections, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru, E-mails: hugorazuri@gmail.com and ztq9@cdc.gov. Daniel E. Velasquez and Vitaliano A. Cama, Centers for Disease Control and Prevention (CDC), Division of Parasitic Diseases and Malaria, Atlanta, GA, E-mails: iqm6@cdc.gov and vec5@cdc.gov. Paul C. F. Graf, Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru, and Naval Medical Center, Division of Infectious Diseases, San Diego, CA, E-mail: paul.graf@med.navy.mil. Antonio M. Quispe, Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru, E-mail: aquispe@jhu.edu. Ryan C. Maves, Department of Bacteriology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru, and Naval Medical Center, San Diego, CA, E-mail: ryan.maves@med.navy.mil. John W. Sanders, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Commanding Officer, Lima, Peru, E-mail: john.w.sanders38.mil@mail.mil. Andres G. Lescano, Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru, and Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru, E-mails: willy.lescano@med.navy.mil or wlescano@hotmail.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2015
Received:
27 May 2014
|
Accepted:
29 Jan 2015
|
Published Online:
03 Jun 2015
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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