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Universidad Peruana Cayetano Heredia

Lima, Peru


Background: Non-communicable diseases kill people at economically and socially productive ages, and exert their greatest effects in the developing world: 80 percent of chronic disease deaths occur in low- and middle-income countries. In 2000, in the Latin American and Caribbean regions the leading cause of mortality was cardiovascular diseases (CVD), which accounted for 31 percent of all deaths. In Peru, a low- and middle-income country, years of life lost to non-communicable disease is 42 percent, as a proportion of the total years of life lost due to premature mortality in the population.

In 1975, only 27 percent of people in the developing world lived in urban areas. By 2000, the proportion was 40 percent, and projections suggest that by 2030 the developing world will be 56 percent urban. Urbanization – heavily influenced by migration – poses a considerable challenge for public health, especially in developing countries. Understanding the effects of urbanization is one of the grand challenges concerning chronic non-communicable diseases.

Globally, approximately 50 percent of all households and 90 percent of rural households use solid fuels as the main domestic source of energy. Use of biomass fuels is the most important source of indoor air pollution worldwide. Biomass fuel exposure is currently considered to be the most important risk factor for chronic obstructive pulmonary disease (COPD) after cigarette smoking. In Peru, a large majority of rural households continue to use biomass fuels for cooking and home heating. Individuals living in rural villages are particularly vulnerable to exposure to hazardous levels of indoor air pollution from biomass fuel combustion because of inadequate ventilation.

Objectives: The primary objective is to build a long-term sustainable research infrastructure in Peru, with a focus on clinical research in non-communicable chronic cardiovascular and pulmonary diseases.

Research Activities: *Assess the cardiovascular risk factors profile in Lima (very urban) and Tumbes (less urban). Also assess disease progression, from a baseline disease-free status to hypertension and diabetes. *Examine the prevalence of COPD in two Peruvian populations: one that burns solid fuels for energy and one that uses electricity or kerosene. Characterize the longitudinal rate of decline in lung function over a four-year period in a Peruvian population that predominately burns solid fuels for energy.

Training: Young scientists who are focused on the study of chronic cardiovascular and pulmonary diseases will be trained. Training will focus on the entire cycle of research, including study design, grant writing, management of research projects, analysis of data, and manuscript preparation and publication of data. Mentoring, seminars and journal clubs, training in human subject protection, and mentoring by experts in their fields will help young investigators as they become involved with the research activities.

About Centers of Excellence: To help combat chronic diseases in developing countries, the UnitedHealth Chronic Disease Initiative and the NHLBI support a global network of collaborating Centers of Excellence. Each center includes a research institution in a developing country paired with at least one partner academic institution in a developed country. These Centers of Excellence are developing infrastructures for research and training to enhance their capacity to conduct population-based or clinical research to monitor, prevent, or control chronic diseases, with a focus on cardiovascular and pulmonary diseases.

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