I conducted my research as an intern with the U.S. Naval
Medical Research Unit-6, NAMRU-6. My projects are based out of Iquitos, the
largest city in the Peruvian amazon and also the largest city in the world
inaccessible my road.
I have been assigned two malaria projects during my time
here. The first project relates to the treatment of Plasmodium Falciparum, a
species of malaria, with combined artesunate-mefloquine therapy. This project
first requires identifying patients that meet the study criteria. Once
identified, patients are transported to the Hospital Iquitos Apoyo, the
regional hospital, and treated for 3 days with artesunate then discharged home
for an additional 3 day treatment with mefloquine. Subsequently, the patient’s
health and parasetemia levels are followed for 42 days.
My second project is on the distribution of recurrent
Plasmodium vivax in the town of Padrecocha. Malaria vivax is commonly
associated with recurrent infection, which in this case is defined as the presence
of parasites in the blood within 1 year after initial infection without
additional exposure or genetic mutation of the original parasite strain. The
original goal of the project was to conduct spatial-temporal analysis to
compare recurrent and normal vivax cases. Through my literature review, I have
discovered that the P450 gene is responsible for the metabolism of primaquine,
one of the two commonly used drugs to treat vivax. Prior research has shown
that mutations in various alleles of the P450 gene cause medications to be
ineffective. If possible, using the already collected patient blood samples, I
am interested in running assays to determine the type of mutation if any in the
Padrecocha population.
Due to the diversity of projects, I do not have a typical
day. Often I will go into Hospital Iquitos Apoyo to assist my PI or spend my
days in the village of Santo Thomas with one of the phlebotomist collecting
blood samples and conducting patient recruitment for the artesunate trial. In
order to get to Santo Thomas, I first ride
on motor-taxi or rickshaw, then switch to a motorcycle for the 20 minute dirt
road portion of the journey. Similarly, for the Padrecocha project, my day
starts with a 30 minute boat ride and I spend the rest of the day working in
the community and searching for patients.
Spending my summer in Peru working on these research
projects has been such an amazing opportunity. I have learned so much about the
Amazonas region of Peru, gotten a crash course in infectious diseases, but mostly
have grown so much more as an individual. I had the chance to interact daily with
medical students from across the country and see where I could potentially fit
in best myself. The experience confirmed my interest in practicing global
healthcare and that I would enjoy doing so under the command of the U.S.
military. Most importantly, I was able to greatly improve my Spanish and
reminded myself that with a little work and a fair amount of “gracias” and “lo
sientos” you can get anywhere.
