AMS was common and adversely impacted plans of one in five travelers. Acetazolamide was associated with decreased AMS but was prescribed infrequently. Other preventive measures were not associated with a decrease in AMS in this population. Pre-travel preparation was suboptimal.

Latin America is among the highly endemic regions for cystic echinococcosis (CE). In Peru, an estimated 1,139 disability-adjusted life years are lost annually from surgical treatment of CE. This is comparable with the combined total for Argentina, Brazil, Uruguay, and Chile. The prevalence of human infection has been investigated in the central Peruvian Andes, but there are no community-based screening data from other regions of Peru. We carried out a population survey in January 2015 using abdominal ultrasound to estimate the prevalence of abdominal CE in the Canas and Canchis provinces, in the Cusco region of Peru. Among 1,351 subjects screened, 41 (3%) had CE. There was significant variation between communities with similar socioeconomic features in a small geographical area. A history of CE was reported by 4.1% of the screened subjects, among whom 30.3% still had CE on ultrasound. Among patients reporting previous CE treatment, 14.9% had CE in active stages. Limited education, community of residence, and knowing people with CE in the community were associated with CE. These results demonstrate a significant burden of CE in the region and suggest the need for further investigations, control activities, and optimization of clinical management for CE in this area.

Most travelers arriving to Cuzco had received pretravel health information, and the majority obtained it from more than one source. Recommendations addressed for specific health risks, such as altitude sickness prophylaxis, were received by few travelers.

Background Acute mountain sickness (AMS) may occur after rapid ascents to altitudes > 2500 m. Cusco (3350 m) in Peru is a popular destination for altitude inexperienced travelers. This study aimed at evaluating the incidence and risk factors for AMS among a cohort of foreign Spanish language students in Cusco. Methods We performed a cohort study among young healthy foreign Spanish language students arriving to Cusco between 2012 and 2016. Consenting students answered an enrollment questionnaire on demographics, travel history, and intended AMS preventive behavior within 48 hours of arrival. At 4 to 5 days after enrollment participants answered a second questionnaire about actual preventive behavior before symptoms and the development of symptoms compatible with AMS during their first 48 hours in Cusco. We used the 2018 Lake Louis Scoring System (LLSS) for AMS diagnosis. Participants with headache and a score ≥ 3 were considered to have AMS. Results We enrolled 142 language students, the median age was 21 years (IQR 20–25) and 57% were female. Participants decreased physical activity (38%), increased fluid intake (34%), drank coca leaf tea (34%), took acetazolamide (16%), and acclimatized at a lower altitude (6%) to prevent AMS. Thirty nine percent had AMS. In the multivariate analysis, obesity (OR 14.45 [2.33–89.6]) and female sex (OR 4.32 [1.81–10.28]) were associated with increased risk of AMS. Taking acetazolamide (OR 0.13 [0.03–0.56) was associated with decreased AMS risk. Consumption of coca leaf tea was not associated with decreased risk of AMS. Conclusions In our cohort, AMS affected two out of five travelers. Obesity and female sex were associated with increased risk. Drinking coca leaf tea for prevention did not decrease the risk of AMS. Acetazolamide prophylaxis was associated with decreased risk of AMS.