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Strengthening Health Research Collaboration in Lima, Peru: IMTAvH's Impact on Tropical Medicine

The Instituto de Medicina Tropical Alexander von Humboldt (IMTAvH) in Lima, Peru, established in 1968, focuses on enhancing institutional collaboration and research in tropical medicine and public health. With partnerships that span multiple topics including Leishmaniasis, Mycobacterioses, and Malnutrition, IMTAvH promotes training and research excellence. The institution is equipped with advanced facilities for clinical research and diagnostics, serving as a reference center for local and regional health issues, especially in response to challenges posed by mass rural immigration and infectious diseases.

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Strengthening Health Research Collaboration in Lima, Peru: IMTAvH's Impact on Tropical Medicine

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  1. DGIS -ITG IMT A. von HUMBOLDT (IMTAvH) Lima, Peru Institutional strengthening & collaboration

  2. Lima & UPCH • Lima, massive rural immigration • in 1970-1980: 2 10 M • Universidad Peruana Cayetano Heredia • National General Hospital (4th line) • Northern Lima, 3 million inhabitants

  3. UNIVERSIDAD PERUANACAYETANO HEREDIAFacultades Facultad de Medicina “Alberto Hurtado” Facultad de Ciencias y Filisofía Facultad de Estomatología Facultad de Veterinaria y Zootecnia Facultad de Educación Facultad de Enfermería Facultad de Salud Pública y Administración “Carlos Vidal Layseca” Facultad de Psicología • Private University, founded 1962 • 8 Facs, 6.500 students • Hospital: 420 beds, training in 28 • medical specialities, 900 students • 3 Research Institutes, • including IMT AvH

  4. IMTAvH (1968) • Clinics for Tropical and Infectious Diseases • 150 consultations /day, 36 beds, • 9 infectiologists, 3 dermatologists • 7 labs • 9 courses, pre- & post-graduate incl. Gorgas Course

  5. IMTAvH- ITG 1987 Spin-off from DGIS/IMTA cooperation with Bolivia  joint research project EC-STD (INCO) Leishmaniases 1988 Collaboration for Mycobacterioses Françoise Portaels / Humberto Guerra 1987 Collaboration for Mycoses Danielle Swinne / Betty Bustamante 1989 Memorandum of Understanding (MoU) 1996 Collaboration in Malnutrition (P. Kolsteren)  joint EC-INCO project Antwerp -Lima - Cochabamba 1996 MoU expanded + Nutrition, Public Health, STD 1998 Framework Programme DGIS-ITG-IMTAvH "International Strenthening & Collaboration"

  6. COLLABORATION • 5 topics 12 partners 4 ITMA departments • Leishmaniases *Jorge Arevalo Parasitology • cut., muco-cut. Alejandro Llanos- • Cuentas, MD • *Jean-Claude Dujardin, • D Sc • Mycobacterioses Humberto Guerra, MD Microbiology • TB, MDR-TB, Buruli Françoise Portaels, D Sc • Mycoses Betty Bustamante, MD Clinical Sciences & Sporotrichosis Danielle Swinne, D Sc Institute of Public Health Brussels • Malnutrition Iris Pecho Public Health Micronutrients, Anna Prada • co-infections Patrick Kolsteren • Clinical Research Eduardo Gotuzzo Clinical Sciences (since 2000) Tine Verdonck • HIV/TB, skin ulcer • * Coordination: 2 local coordinators (JA/Lima, JDC/Antwerp) + 1 promotor (DLR/Antwerp)

  7. SYNERGY BETWEEN TOPICS • Clinical epidemiologyofHIV/TB andskin ulcer • Molecular tools for diagnosis and epidemiology • INSTITUTIONAL STRENGTHENING • Human Resources: tech training, M Sc, PhD • Centralized equipment for cryobanking & molecular biology • Computerized management of reference collections: clinical specimens, pathogens, sera • DistanceLearning: CD- ROM Trop. Med. cfr Erwin Van den Ende

  8. DGIS INPUT, BUDGETARY

  9. BREAKDOWN 2000 BUDGET 12 M 4

  10. QUALITY CONTROL • 2001  Administrative management: 2nd back-up site visit (LS + JVL) •  External evaluation: 1 Lat-Am + 1 EU experts • 2002  New 5-yr Master Plan to be identified by IMTAvH • institutional priorities • QC indicators • sustainability • DGIS PROGRAMME •  Strengthens institutional sustainability •  reference and teaching capacity •  competitivity in research fund raising: EC-INCO, WHO/TDR, NIH…

  11. Major achievements (equipment) • Improvement of basic laboratory facilities • Common facilities for sample storage (-70°C) • Bio-Safety • Common laboratory facilities for molecular biology

  12. Major achievements (training) • Clinical research: 2 MDs • Leishmania: 2 PhD, 4 MSc, 2 MSc • Mycology: 1 MSc • Mycobacteriology: 5 Medical students, 1 MSc • Nutrition: 2 experts, multidisciplinary team • Common activities: management biological samples

  13. Major achievements (science) Clinical research: • TB: many patients with MDR, frequent co-infection PCP-TB • Skin ulcer (differential diagnosis): predictive value of clinical and epidemiological information; mostly due to Leishmania, PCR without biopsy (scrap) • Translation of CD-Rom on Tropical Medicine in spanish (+/- 75% achieved)

  14. Major achievements (science) Leishmania: • PCR identification of Leishmania species directly in biopsies (first in the world): prognosis and epidemiological surveillance • Development of methodologies for analysis of differential gene expression (virulence, drug resistance) • Opening of a research line on the influence of vit A on disease progress

  15. Major achievements (science) Mycobacteriology: • Implementation of phage-based methodology for identification of Mycobact. infection and determination of drug-resistance • Detection of resistance to second line drugs in the general population of TB patients and in patients with MDR-TB (16% kanamycin, 10% ofloxacin) • Detection of autochtonous cases of Buruli ulcer

  16. Major achievements (science) Mycology: • possibility to be regional/national reference centre • initiation of studies on molecular epidemiology of fungi Nutrition: • 71% anemia < 5 years: despite good quality of iron-enriched bread, this is not provided to children; search for alternative strategies. • Effect of nutritional supplements on parasitoses

  17. Output (publications) • Leishmania: 1 PhD thesis, 1 MSc thesis, 3 papers • Mycology: 3 papers • Mycobacteriology: 1 manual, 1 paper, 5 abstracts in proceedings • Nutrition: reports, papers in the pipeline • Clinical research: 1 paper in preparation

  18. Output (projects) • Leishmania: 2 TDR, 1 INCO-Dev (Drug resistance), 1 QOL (epidemiological surveillance) • Mycology: 2 clinical trials • Mycobacteriology: 1 INCO-Dev (concerted action), 1 submission to TDR • Nutrition: 1 INCO-Dev, 1 USAID • Clinical research: 2 submissions to TDR

  19. Ref. Sample collection Role of nutritional status Molecular diagnosis and epidemiology Synergy Clinical research Tropical and Infectious diseases Leishmaniases Mycoses Mycobacterioses HIV/AIDS

  20. Prospects • Clinical trials • Reference centre for molecular diagnosis and epidemiology of pathogens (inter-regional course) • Immunology (starting from HTLV/Strongyloides)? • …(Cysticercose, neuro-)

  21. DGIS Institutional strengthening Stability, continuity, pilot studies for competitivity in research projects (EC-INCO, WHO-TDR, NIH..)

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