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Principal Investigator: Eduardo Gotuzzo
Organization: UNIVERSIDAD PERUANA CAYETANO HEREDIA
Fiscal Year: 2024
Award: $749,874
Funding agency: Center for Global Health
Project Summary/Abstract
Acute febrile illness (AFI) is an important cause of morbidity and productivity loss in Latin America.
Despite efforts for surveillance and advancements in diagnostic capacity, the etiology of AFI is still
unknown in over 50% of cases. Our Project of Febrile Illness Surveillance in the Andean and Amazon
Countries (“PISAAC”) proposes to study AFI etiology and epidemiology, to strengthen the core public
health systems that prevent and mount prompt containing responses in front of outbreaks.
PISAAC, led by Dr. Eduardo Gotuzzo at Universidad Cayetano Heredia, is a multi institutional
initiative developed in close collaboration with key actors and institutions at the Peruvian Ministry of
Health (MoH), including the Peruvian National Health Institute (INS). This initiative will be carried out
in partnership with the National Institute of Health Leopoldo Izquieta Perez (INSPI) and Escuela
Superior Politécnica del Litoral (ESPOL), in Ecuador, aiming to develop a coordinated effort to
establish a systematic surveillance system within the Coastal, Andean and Amazon regions of South
America. Additional key partners include U.S. Naval Medical Research Unit Nº6, and the University of
Texas Medical Branch in Galveston.
Our specific aims are to determine the etiology and epidemiology of acute undifferentiated febrile
illness in strategically selected regions of Peru and Ecuador, improve laboratory capacity for the
diagnosis of illness, produce timely and accurate surveillance data, and develop a workforce that can
continue with these measures. Additionally, we aim to determine the prevalence of antimicrobial
resistance, and the etiology and antimicrobial resistance of acute diarrheal disease.
The study will start in two regions in Peru during the first year. Subsequently, during the second year,
two regions in Ecuador will be added, and 1 to 2 new regions per country will be added per year. The
initial stage is a prospective study of sentinel surveillance that will enroll subjects that present to
healthcare centers of primary and secondary care level with AFIs. Blood and serum samples will be
taken at acute presentation for PCR based tests and serology. Additionally, urine and nasal samples
will be collected and stored along with serum alliquotes in a biorepository for future studies.
Convalescent sera will be collected for paired serology testing in those patients that resulted negative
for initial testing with molecular methods. During the second year, components of antimicrobial
resistance (AMR) surveillance and diarrheal disease surveillance will be implemented, as these two
health problems are considered public health priorities for Peru.
PISAAC is in a unique position to strengthen the national surveillance and emergency response
systems as it builds upon the pre-existing infrastructure and public health delivery platforms, provides
strategic complementary partnerships across lab diagnosis to disease control and addresses the core
technical areas demanded by the Global Health Security Agenda.