Program Director/Principal Investigator (Last, First, Middle): LESCANO, Andres G. The last five years have been a volatile period in South America with the massive emergence of Zika and its congenital syndrome, the Brazil yellow fever outbreak that threatened to exhaust the regional vaccine stockpile, the Venezuelan crisis that led to significant migration and measles outbreaks, and an unprecedented surge in malaria cases that crippled the progress achieved in malaria control. Indeed, Peru was affected by these challenges and suffered its largest dengue outbreak on record with nearly 70,000 cases and 89 deaths after the sudden 2017 Coastal El Nio event. Therefore, to strengthen early detection and effective responses to these epidemic threats, we will provide advanced Master?s and doctoral training opportunities to Ministry of Health personnel. This will create an Epidemiology Master?s program in the Amazon Basin and strengthen our satellite research unit on the northern coast of Peru and secure the long-term sustainability of our new epidemiology doctorate. These strategies will result in better-trained epidemiologists in larger numbers, and present in the critical, high-risk areas where they are needed the most. Our objective will be to consolidate and secure a self-sustainable and cost-effective epidemiology doctorate in Peru by replicating the successful model of our Master?s program and creating a continuous pipeline of emerging diseases epidemiologists to respond to outbreaks and prevention and control efforts. The expected outcomes for the next five years are: 1) 20 PhDs graduates from the Peru program and 12 more under training with a streamlined curricula to improve graduation and research outcomes, 2) 30 graduates from a new, decentralized Epidemiology Master?s program in Iquitos and 90 additional graduates from our Lima Master?s, ~15% conducting research in emerging diseases and ~20% from the public sector, 3) One doctoral and five Master?s graduates of the Peruvian CDC trained jointly with the US CDC, 4) Six highly-selected Peruvian doctorates trained in world-class programs abroad, four reinserted in Peru in productive research careers, 5) A large pipeline of young professionals trained and engaged in emerging diseases research via on-site internships (30) and short courses (150). Experienced research leaders in world-class institutions such as Cayetano, San Marcos, Minas Gerais and Johns Hopkins universities will partner with Peru and US CDC supported by a broad network of 30 local and foreign organizations working in Peru. The partners of this program provide a unique, rich and nurturing research environment with extensive multi-year grant funding from the NIH and other sources that promotes innovation and addresses hypothesis of public health and scientific significance, particularly for arbovirosis, antimicrobial resistance, respiratory infections and zoonotic diseases. Our track record demonstrates proof of concept for the proposed goals after creating an Epidemiology Master?s and Doctorate in Peru, graduating over 200 Master?s students and sponsoring doctoral training for 16 Peruvian scientists at prestigious US and UK universities. Almost 15% of our Master?s students have already moved into PhD training, and our first cohort alone has published >200 papers after graduating, a four-fold increase year compared to prior coursework. More than half of our doctoral trainees abroad have graduated and started productive scientific careers, and overall, they have published an average of 11 manuscripts each. Current and future trainees are likely to be even more productive due to enhanced research opportunities, improved coursework and added mentoring. OMB No. 0925-0001/0002 (Rev. 01/18 Approved Through 03/31/2020) Page Continuation Format Page

Public Health Relevance

LESCANO, Andres G. Emerging infections continue to be primary concerns in Peru, South America and the world. Zika erupted in the Americas after quietly circulating in Brazil for nearly two years with a catastrophic and yet unexplained impact on microcephaly and the overall Zika congenital syndrome. The Peruvian north coast of Peru recently suffered its largest dengue outbreak on record after the 2017 Coastal El Nio event appeared without warning, leading to nearly 70,000 cases and 89 recorded deaths. Antimicrobial resistance continues to advance worldwide despite major efforts to promote the rational use of antibiotics while Chapare arenavirus re-emerged in neighboring Bolivia just a few weeks ago. Early detection and effective response to future outbreaks of emerging diseases will required better-trained epidemiologists, in larger numbers, and present in high-risk areas. OMB No. 0925-0001/0002 (Rev. 01/18 Approved Through 03/31/2020) Page Continuation Format Page

National Institute of Health (NIH)
Fogarty International Center (FIC)
International Research Training Grants (D43)
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Special Emphasis Panel (ZRG1)
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Sina, Barbara J
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Universidad Peruana Cayetano Heredia
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Flores, Elaine C; Fuhr, Daniela C; Bayer, Angela M et al. (2018) Mental health impact of social capital interventions: a systematic review. Soc Psychiatry Psychiatr Epidemiol 53:107-119
Rojas-Jaimes, Jesùs; Frischtak, Helena L; Arenas, Jose et al. (2018) Case Report: Mucosal Leishmaniasis Presenting with Nasal Septum Perforation after Almost Thirty Years. Am J Trop Med Hyg 99:327-330
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Arroyo, Gianfranco; Rodriguez, Silvia; Lescano, Andres G et al. (2018) Antibody Banding Patterns of the Enzyme-Linked Immunoelectrotransfer Blot and Brain Imaging Findings in Patients With Neurocysticercosis. Clin Infect Dis 66:282-288
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Carnero, Andres M; Mayta-Tristan, Percy; Konda, Kelika A et al. (2017) Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru. Sci Eng Ethics 23:1183-1197
Varela-Contreras, Omar A; Valladares-Garrido, Mario J; Toro-Huamanchumo, Carlos J et al. (2017) [Teaching blindly: Need for surveys and evaluations in medical students and physicians from Peru]. Rev Med Chil 145:680-681
Sanchez, Juan F; Carnero, Andres M; Rivera, Esteban et al. (2017) Unstable Malaria Transmission in the Southern Peruvian Amazon and Its Association with Gold Mining, Madre de Dios, 2001-2012. Am J Trop Med Hyg 96:304-311

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