ARPEC Project: A prospective multicentre birth cohort study of iron deficiency anaemia in Peru: Learned lessons from a pandemic

Introduction: Childhood iron deficiency anaemia continues to be a global burden, with potential risk factors ranging from food insecurity, maternal undernutrition, unsafe birth delivery and antibiotic exposure to sanitation and environmental contamination. The interplay of the complexity of diverse risk factors, which go beyond biological and ecological components to structural characteristics, is poorly understood. Understanding the interplay of risk factors becomes relevant in a country like Peru, with high-profile government investments in anaemia reduction over the last 20 years and very few achievements.  

Methodology: ARPEC is a prospective multicentre birth cohort study of anaemia, child growth and development in three Peruvian regions. ARPEC uses an Ecohealth approach, composed of an interdisciplinary team that set out to recruit 300 mothers and their newborns in three Peruvian cities at the beginning of 2020, with one-year follow-up studies, including mixed methods, environmental, biological, nutritional, epidemiological, and socio-political data. The study received bilateral Grant support from the British and Peruvian governments through Newton-Paulet Fund. The study obtained ethical approval and published its research protocol. Data collection will end in December 2022. 

Results: The challenges of conducting research during the pandemic were manifold and increased the difficulties of establishing a research network across three Peruvian public institutions and one UK institution. Challenges included national emergency suspending research activities, scarcity of health supplies, late access to vaccines by research staff, cancellation and postponement of all in-person training, data collection and monitoring and supervision activities, funders' uncertainty for non-cost extensions, and political and institutional circumstances. Focus groups and qualitative or quantitative interviews are conducted virtually through remote meetings wherever possible to decrease the potential risk of COVID-19 infection. When necessary, adequate personal protective equipment, alcohol gel, and antigen test are available. Against all odds, we learned as a team to protect everyone by protecting each other. 

Conclusion: The COVID-19 pandemic impacted Peru disproportionately on conducting research. Environmental studies were particularly hit because of insufficient support and inadequate research culture in the first place. Creating and nurturing a strong research team during the pandemic has been vital to progress and learning how to adapt for future research challenges.