REVISTA PERUANA DE MEDICINA

EXPERIMENTAL Y SALUD PÚBLICA

On behalf of the authors, I request the publication of the article entitled:

In the section:
Original Brief Review Case Editorial
Article Report Report

Letters to Special Public Health

As corresponding author, I declare, on behalf of all the authors, that we are aware of and accept the
publication conditions contained in the “Instructions for the submission of articles to the Revista Peruana de
Medicina Experimental y Salud Pública (RPMESP)”.

The manuscript presented here is original and has not been submitted to another scientific journal, nor has
it been published, in whole or in part, in another scientific journal.

The manuscript does not contain findings derived from falsification or fabrication of data, does not present
plagiarism or authorship problems and will not be submitted to another journal for publication until
receiving the editorial decision of RPMESP.

In case of publication, we maintain our intellectual authorship rights; however, we assign the rights of
publication in printed or electronic format to RPMESP.

We, the authors, understand that we will not receive (or demand) any royalties or compensation of any kind
or nature from the Instituto Nacional de Salud or RPMESP for the publication of the article.

The authors declare that, once the article has been approved, we will not make any changes in the number
or order of authors, and that all authors comply with the authorship criteria established in the instructions
for authors.

In case of any contravention of the above, on behalf of all authors, I exempt the RPMESP and the Instituto
Nacional de Salud from any liability. We, the authors, declare that we are jointly and severally liable for any
consequences arising from such contravention.

If submitting original articles, brief reports or scientific letters, please check as appropriate:

The research involves human subjects 1. The project has been approved by an institutional ethics
committee.

The research is related to tuberculosis or COVID-19 and is registered in the Health Research Projects (PRISA)
platform (only for research conducted in Peru).

1
According to the Technical Document “Ethical Considerations for Health Research with Human Subjects”, approved by Ministerial Resolution
No. 233-2020-MINSA, research with human subjects is any activity in the social, biomedical, behavioral or epidemiological sciences that involves
the systematic collection or analysis of data with the aim of developing or contributing to generalizable knowledge; and where human subjects
(1) are exposed to manipulation, intervention, observation, or other interaction with researchers directly or by altering their environment; or (2)
may be individually identifiable through the collection, preparation, or use by investigators of biological materials or personal, medical, or other
records. Studies involving human subjects include, but are not limited to, epidemiological research, genetic research, social science research,
research on medical records or other personal information, research on stored samples, among others.
 The clinical trial is registered in the Peruvian Clinical Trials Registry (REPEC) platform (for Peruvian articles) or
in one of the primary registries of the World Health Organization Registry Network or registries approved by
the International Committee of Medical Journal Editors (ICMJE)
(http://www.icmje.org/about-icmje/faqs/clinical-trials-registration/) (for international articles).

Author Contribution Statement:

We suggest reviewing the criteria for authorship recognized by the ICMJE, which recognizes as authors those who
meet the following requirements: 1) contributed significantly to the conception or design of the manuscript, or to
the collection, analysis or interpretation of the data; 2) wrote or critically reviewed the content of the manuscript;
3) approved the final version to be published; and 4) assume responsibility for all aspects of the manuscript, to
ensure that issues related to the accuracy or integrity of any of its parts will be adequately addressed and resolved.

Contributions: The corresponding author is responsible for accurately and truthfully describing the authors’
contribution. For this purpose, he/she must use the National Information Standards Organization (NISO) taxonomy
of contributor roles (CRediT), available at https://credit.niso.org/. Likewise, the ICJME criteria for authorship should
be taken into account when describing the authors’ roles.

Describe as follows: PPP and ABC conceptualized, designed the methodology and conducted the research, analyzed
the data, wrote the initial draft, and drafted and revised the final version. PPP obtained the funding and provided
resources for the research. ABC managed the research activities. PPP and ABC assume responsibility for the article.

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Funding Statement:

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Conflict of Interest Statement:

The journal’s statement is based on the conflict of interest (COI) statement recommended by the ICMJE.
(http://www.icmje.org/disclosure-of-interest/)

Do any of the authors have any conflict of interest to disclose? ( ) Yes ( ) No

Yes – Indicate the name of the authors and what conflict of interest they present:
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Preprint statement:

Is the manuscript a preprint? ( ) Yes ( ) No

Yes – Name of the preprint server: __________________________________________________________

Has the research been presented at a scientific event (congress or conference)?:

( ) Yes ( ) No

Yes – Information of the event (name of the event, organization, year): ________________________________
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Is the research part of a thesis?:

( ) Yes ( ) No

Yes – Information of the thesis (name of the thesis, degree or professional title, university, year of publication):
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I sign this document in authorized representation of all authors and I am responsible for the correspondence during
the whole process of revision, editing and eventual publication of the article.

Corresponding author’s signature

Names and surnames of the corresponding author: