ABSTRACT
BACKGROUND: The purpose of this study was to evaluate the knowledge, attitudes, and practices about HIV/AIDS of high school students in Panama City, Panama and the impact of a peer-to-peer intervention project. METHODS: There were 659 participants in two public and two private schools, one of each got the intervention and the other serving as control. A questionnaire was used as a pretest and post-test to measure the effects of the intervention. The intervention consisted of 12 weekly sessions led by professionally trained peers using four different modalities: theater, group dynamics, videos, and discussions. RESULTS: The difference in the knowledge scores of the questionnaire resulted in an improvement in both the private (ES=0.63) and the public (ES=0.52) schools with the intervention. Another important finding was that the idea of abstinence as disease prevention for high school students rose from 7% to 60% (public school) and from 27% to 62% (private school) in response to an open-ended question. CONCLUSIONS: There were other significant positive findings that demonstrate the efficacy of this peer-to-peer model educating high school students about lowering the risks of contracting HIV/AIDS. This model could also be used to prevent or mitigate other risky behaviors.
Subject(s)
Adolescent Behavior/psychology , HIV Infections/prevention & control , Health Education , Sexual Behavior/psychology , Students/psychology , Adolescent , Attitude to Health , Female , Health Education/methods , Health Education/organization & administration , Health Knowledge, Attitudes, Practice , Humans , Male , Panama , Peer Group , Program Evaluation , Risk Factors , Risk-Taking , Surveys and QuestionnairesABSTRACT
BACKGROUND: Rotavirus vaccination was introduced in Panama in March 2006. This study was carried out in order to describe the trends in gastroenteritis-related (GER) hospitalizations and mortality in children <5 years of age during the pre- and post-vaccination periods. METHODS: Data from the Expanded Program on Immunization (Ministry of Health) were used to calculate vaccine coverage. GER mortality and hospitalizations were obtained through database review of the Contraloría General de la República and hospital discharge databases of five sentinel hospitals, for the period 2000-2008. Mean rates of GER mortality and mean numbers of hospitalizations during the baseline pre-vaccination period (2000-2005) were compared to those of 2007 and 2008. RESULTS: National coverage for the second rotavirus vaccine dose increased from 30% in 2006 to 62% in 2007 and 71% in 2008, varying from 62% in the West region to 77% in the Panama region. Overall, at 2-years post-vaccine introduction, the GER mortality rate in Panama had decreased by 50% (95% confidence interval (CI) 46-54). During 2000-2005, the GER mortality rate in children (<1 year) was 73/100 000, decreasing by 45% (95% CI 40-51) in 2008. In children aged 1-4 years, the GER mortality rate was 20.3/100 000 (2000-2005), decreasing by 54% (95% CI 48-60) in 2008. The Panama region registered the highest mortality rate reduction (69%; 95% CI 58-81) for 2008. During 2008, GER hospitalizations among children <5 years of age decreased by 30% (95% CI 21-37) from the mean number of hospitalizations during 2000-2005. CONCLUSIONS: A substantial reduction in GER mortality and hospitalizations was observed following the introduction of rotavirus vaccine in Panama.
Subject(s)
Gastroenteritis/mortality , Gastroenteritis/prevention & control , Rotavirus Infections/mortality , Rotavirus Infections/prevention & control , Rotavirus Vaccines/administration & dosage , Rotavirus/immunology , Child, Preschool , Gastroenteritis/immunology , Gastroenteritis/virology , Hospitalization , Humans , Immunization/methods , Infant , Infant, Newborn , Panama/epidemiology , Rotavirus Infections/immunology , Rotavirus Infections/virology , Rotavirus Vaccines/immunologyABSTRACT
The aim is to review the encephalitis in infants and adolescents as well as its etiology, clinical manifestation, epidemiology, physiopathology, diagnostic methods and treatment, and the neuropsyquiatric signs appearing an influenza epidemy. Encephalitis is an inflammation of the central nervous system (CNS) which involves the brain. The clinical manifestations usually are: headache, fever and confusional stage. It could also be manifested as seizures, personality changes, or psiqyiatric symptoms. The clinical manifestations are related to the virus and the cell type affected in the brain. A meningitis or encephalopathy need to be ruled out. It could be present as an epidemic or isolated form, beeing this the most frequent form. It could be produced by a great variety of infections agents including virus, bacterias, fungal and parasitic. Viral causes are herpesvirus, arbovirus, rabies and enterovirus. Bacterias such as Borrelia burgdorferi, Rickettsia and Mycoplasma neumoniae. Some fungal causes are: Coccidioides immitis and Histoplasma capsulatum. More than 100 agents are related to encephalitis. The diagnosis of encephalitis is a challenge for the clinician and its infectious etiology is clear in only 40 to 70% of all cases. The diagnosis of encephalitis can be established with absolute certainty only by the microscopic examination of brain tissue. Epidemiology is related to age of the patients, geographic area, season, weather or the host immune system. Early intervention can reduce the mortality rate and sequels. We describe four patients with encephalitis and neuropsychiatric symptoms during an influenza epidemic.
Subject(s)
Brain Diseases/virology , Encephalitis, Viral/diagnosis , Influenza, Human/diagnosis , Acute Disease , Adolescent , Brain Diseases/diagnosis , Brain Diseases/therapy , Child , Child, Preschool , Diagnosis, Differential , Encephalitis, Viral/physiopathology , Encephalitis, Viral/therapy , Female , Humans , Influenza, Human/physiopathology , Influenza, Human/therapy , Male , PrognosisABSTRACT
El objetivo fue revisar la encefalitis en niños y adolescentes, su etiología, manifestaciones clínicas, fisiopatología, métodos diagnósticos y tratamiento, enfatizando las manifestaciones neuropsiquiátricas de la encefalitis durante una epidemia de influenza. La encefalitis se considera una inflamación del sistema nervioso central (SNC) que compromete el cerebro. Se manifiesta usualmente por cefaleas, fiebre y trastorno del estado de conciencia. Puede además manifestarse por convulsiones, cambios en la personalidad y manifestaciones obsesivas (síntomas neuropsiquiátricos). Las manifestaciones dependerán del tipo de virus y las células afectadas. La encefalitis puede ser causada por una gran variedad de agentes infecciosos incluyendo virus, bacterias, hongos y parásitos. Causas virales de encefalitis incluyen herpesvirus, arbovirus, rabia y enterovirus. Casos establecidos de bacterias incluyen Borrelia burgdorferi y rickettsia y el Mycoplasma neumoniae, al cual se atribuyen varios casos de encefalitis. Otros agentes como el hongo Coccidioides immitis e Histoplasma capsulatum pueden también generarla. Más de 100 agentes se han asociado a encefalitis. El diagnóstico de encefalitis constituye un reto para el clínico, y su etiología infecciosa usualmente se identifica entre el 40% al 70% de casos. El diagnóstico se hace con absoluta certeza sólo con una biopsia cerebral. La epidemiología depende de ciertos factores como la edad, la localización geográfica, la época del año, las condiciones climáticas y la inmunocompetencia del huésped. El tratamiento temprano puede disminuir el riesgo de muerte y las secuelas. Describimos cuatro pacientes con encefalitis y manifestaciones neuropsiquiátricas durante una epidemia de influenza, con el fin de alertar sobre esta asociación.
The aim is to review the encephalitis in infants and adolescents as well as its etiology, clinical manifestation, epidemiology, physiopathology, diagnostic methods and treatment, and the neuropsyquiatric signs appearing an influenza epidemy. Encephalitis is an inflammation of the central nervous system (CNS) which involves the brain. The clinical manifestations usually are: headache, fever and confusional stage. It could also be manifested as seizures, personality changes, or psiqyiatric symptoms. The clinical manifestations are related to the virus and the cell type affected in the brain. A meningitis or encephalopathy need to be ruled out. It could be present as an epidemic or isolated form, beeing this the most frequent form. It could be produced by a great variety of infections agents including virus, bacterias, fungal and parasitic. Viral causes are herpesvirus, arbovirus, rabies and enterovirus. Bacterias such as Borrelia burgdorferi, Rickettsia and Mycoplasma neumoniae. Some fungal causes are: Coccidioides immitis and Histoplasma capsulatum. More than 100 agents are related to encephalitis. The diagnosis of encephalitis is a challenge for the clinician and its infectious etiology is clear in only 40 to 70% of all cases. The diagnosis of encephalitis can be established with absolute certainty only by the microscopic examination of brain tissue. Epidemiology is related to age of the patients, geographic area, season, weather or the host immune system. Early intervention can reduce the mortality rate and sequels. We describe four patients with encephalitis and neuropsychiatric symptoms during an influenza epidemic.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Brain Diseases/virology , Encephalitis, Viral/diagnosis , Influenza, Human/diagnosis , Acute Disease , Brain Diseases/diagnosis , Brain Diseases/therapy , Diagnosis, Differential , Encephalitis, Viral/physiopathology , Encephalitis, Viral/therapy , Influenza, Human/physiopathology , Influenza, Human/therapy , PrognosisABSTRACT
In 2005, Panama experienced the largest dengue epidemic since 1993. We conducted both a prospective clinical and a national economic study. The full cost analysis measured costs of dengue cases and of dengue control efforts in the entire country. Costs are in 2005 US$. Ambulatory patients were 130 of the 136 participants, with 82% adults (18+) and 62% women. Duration of fever and illness averaged 6.1 (standard deviation [SD], 5.3) and 21.2 (SD 13.5) days, respectively. Loss in quality of life averaged 67% (SD 21) during the worst days of illness. An average ambulatory and hospitalized case cost $332 and $1,065, respectively. Although 5,489 cases were officially reported, the Ministry of Health (MOH) estimated 32,900 actual cases, implying a total cost of $11.8 million. Additionally, estimated government spending on dengue control efforts was $5 million. This dengue epidemic had a major disease impact and an economic cost of $16.9 million ($5.22 per capita).
Subject(s)
Cost of Illness , Dengue/economics , Dengue/epidemiology , Disease Outbreaks/economics , Health Care Costs/statistics & numerical data , Adult , Ambulatory Care/economics , Child , Dengue/mortality , Female , Hospitalization/economics , Humans , Male , Panama/epidemiology , Prospective StudiesABSTRACT
Panama is the first country in the Central American region that has officially discarded chloroquine as a first-line drug to treat Plasmodium falciparum cases. Here we describe the clinical and molecular findings from autochthonous P. falciparum fatal cases, and the epidemiological situation that led to a change in the national antimalarial drug policy. Our results illustrate the potential pathogenicity of the strain of P. falciparum circulating in the country and provide molecular evidence of parasite resistance to chloroquine and antifolate drugs. The public health threats of these findings for the Central American region are discussed.
Subject(s)
Antimalarials/therapeutic use , Chloroquine/therapeutic use , Drug Resistance/genetics , Malaria, Falciparum/drug therapy , Plasmodium falciparum/drug effects , Adult , Animals , Child, Preschool , DNA, Protozoan/analysis , Fatal Outcome , Female , Genotype , Health Policy/legislation & jurisprudence , Humans , Male , Mutation/genetics , Panama , Plasmodium falciparum/genetics , PregnancyABSTRACT
La diarrea infantil continúa siendo un grave problema de salud a nivel mundial principalmente en países en vías de desarrollo como Panamá. Sin embargo, los parásitos y otros agentes asociados a los episodios de diarrea en niños menores de cinco años han sido poco estudiados en nuestro medio. En este sentido se propuso realizar la presente investigación a fin de determinar la frecuencia de la infección con protozoarios enteropatógenos en heces diarreicas de niños menores de cinco años de la provincia de Panamá. La metodología utilizada consistió en análisis microscópico (directo y tinción de kinyoun) y detección de coproantígenos (ELISA). Se encontró que el 37.3% (132/354) de las muestras de diarrea evaluadas presentaron infecciones con protozoarios. El 65.9% (87/132) de las muestras positivas provienen de niños menores de dos años de edad. La infección con Cryptosporidium spp.estuvo frecuentemente asociada (24.6%) a los casos de diarrea infantil provenientes del distrito de la Chorrera. Se estima que el 77.6% de los casos de giardiasis y el 100% de los casos de criptospidiosis no estan siendo identificados en los laboratorios investigados. La baja frecuencia de los casos de Entamoeba sp.(>5%) sugiere una relación de menor importancia para los casos de diarreas estudiados.Por otro lado los resultados obtenidos con una prueba de aglutinación demostraron una frecuencia relativamente baja (13%,46/354) para la infección con rotavirus. Los resultados obtenidos en este estudio deben alertar a los directores y trabajadores de la salud en la provincia de Panamá.
Subject(s)
Diarrhea, Infantile , Eukaryota , PanamaABSTRACT
Substantial data suggest that flavonoid-rich food could help prevent cardiovascular disease and cancer. Cocoa is the richest source of flavonoids, but current processing reduces the content substantially. The Kuna living in the San Blas drink a flavanol-rich cocoa as their main beverage, contributing more than 900 mg/day and thus probably have the most flavonoid-rich diet of any population. We used diagnosis on death certificates to compare cause-specific death rates from year 2000 to 2004 in mainland and the San Blas islands where only Kuna live. Our hypothesis was that if the high flavanoid intake and consequent nitric oxide system activation were important the result would be a reduction in the frequency of ischemic heart disease, stroke, diabetes mellitus, and cancer--all nitric oxide sensitive processes. There were 77,375 deaths in mainland Panama and 558 deaths in the San Blas. In mainland Panama, as anticipated, cardiovascular disease was the leading cause of death (83.4 +/- 0.70 age adjusted deaths/100,000) and cancer was second (68.4 +/- 1.6). In contrast, the rate of CVD and cancer among island-dwelling Kuna was much lower (9.2 +/- 3.1) and (4.4 +/- 4.4) respectively. Similarly deaths due to diabetes mellitus were much more common in the mainland (24.1 +/- 0.74) than in the San Blas (6.6 +/- 1.94). This comparatively lower risk among Kuna in the San Blas from the most common causes of morbidity and mortality in much of the world, possibly reflects a very high flavanol intake and sustained nitric oxide synthesis activation. However, there are many risk factors and an observational study cannot provide definitive evidence.
Subject(s)
Diabetes Mellitus/mortality , Flavonoids/administration & dosage , Myocardial Ischemia/mortality , Neoplasms/mortality , Nitric Oxide/physiology , Stroke/mortality , Adolescent , Adult , Aged , Cause of Death , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle AgedABSTRACT
An entomologic search was carried out to collect intradomicile triatomines in dwellings from rural communities in the western border of the Panama Canal, Panama. Sixty-nine triatomines were collected inside 20 houses of 67 houses investigated. Rhodnius pallescens was the only triatomine species found and included adults of both sexes and nymphs. A significantly high Trypanosoma cruzi (72.7%) and T. rangeli (40%) vector infection rate was detected. Blood meal analysis showed that 68% of R. pallescens had fed on humans. Human serologic analysis and hemoculture performed on inhabitants from triatomine-infested houses showed that 32.1% (18 of 56) of the samples were trypanosome infected. Thirteen samples (23.2%) had antibodies against T. cruzi. Six of these seropositive samples were from children less than 15 years old. Trypanosoma rangeli was isolated in five hemoculture samples, all from children less than 11 years old. The epidemiologic implications of these findings in terms of human infection are discussed.
Subject(s)
Insect Vectors/parasitology , Rhodnius/parasitology , Trypanosomiasis/epidemiology , Trypanosomiasis/transmission , Animals , DNA, Protozoan/analysis , Female , Housing , Humans , Male , Panama Canal Zone/epidemiology , Polymerase Chain Reaction , Rural Health , Trypanosoma/genetics , Trypanosoma/isolation & purification , Trypanosoma cruzi/genetics , Trypanosoma cruzi/isolation & purification , Trypanosomiasis/etiology , Trypanosomiasis/parasitology , Trypanosomiasis/prevention & controlABSTRACT
Estudio de investigación de carácter descriptivo, y de corte transversal, que describe las características de amigabilidad de los servicios de salud que oferta el Programa Nacional de Salud Integral del Adolescente (PNSIA) desarrollado en las instalaciones del Ministerio de Salud y de la Caja de Seguro Social en el país. La evaluación incluyó encuestas pre elaboradas a funcionarios de salud y a adolescentes de 10 a 19 años, usuarios de los servicios en todas las regiones sanitarias del país.Los resultados señalan que las condiciones de eficiencia de los servicios de salud son en su mayoría deficiente para la atención integral del adolescente y las características de amigabilidad de los servicios que oferta el PNSIA del sector público de salud panameño se cumplen parcialmente
Subject(s)
Adolescent , Adolescent , Health Services Accessibility , Public Health , PanamaABSTRACT
Estudio de investigación de carácter descriptivo, y de corte transversal, que describe las características de amigabilidad de los servicios de salud que oferta el Programa Nacional de Salud Integral del Adolescente (PNSIA) desarrollado en las instalaciones del Ministerio de Salud y de la Caja de Seguro Social en el país. La evaluación incluyó encuestas pre elaboradas a funcionarios de salud y a adolescentes de 10 a 19 años, usuarios de los servicios en todas las regiones sanitarias del país. Los resultados señalan que las condiciones de eficiencia de los servicios de salud son en su mayoría deficiente para la atención integral del adolescente y las características de amigabilidad de los servicios que oferta el PNSIA del sector público de salud panameño se cumplen parcialmente
Subject(s)
Adolescent , Health Services Accessibility , Public Health , PanamaABSTRACT
Informa que el VIH/SIDA es un problema de gran magnitud en Panamá que ha sido objeto de diferentes intervenciones, de las cuales se desconoce su impacto y costo efectividad. Como se trata de una infección transmitida sexualmente, las intervenciones orientadas a los cambios de comportamiento sexual en adolescentes se ha propuesto como una medida de prevención que de resultar efectiva cambiaría la evolución de este problema.Se realizó un estudio prospectivo, observacional, analítico para comparar dos modalidades educativas en VIH/SIDA de escuelas de educación media. Se aplicaron encuestas de conocimientos, actitudes y práctica autoadministradas a estudiantes del grupo modelo y del grupo control, al iniciar y finalizar el año escolar. Los costos se obtuvieron mediantes registros de insumos y producción de las actividades que componen las intervenciones educativas en comportamientos para prevenir el VIH/SIDA entre adolescentes de la provincia de Panamá en 2004 y 2005: Sin embargo en ambas escuelas se observó una proporción de prejuicios y conceptos equivocados en relación al infectado por VIH/SIDA y a los riesgos de infección
Subject(s)
Acquired Immunodeficiency Syndrome , HIV , PanamaABSTRACT
A molecular epidemiology study was conducted to determine the distribution of antimalarial drug resistance alleles among field isolates of Plasmodium falciparum. Samples were obtained during an epidemic affecting Kuna Amerindians in Panama. A high prevalence of mutations associated with chloroquine, pyrimethamine, and sulfadoxine was observed. Genotype analysis of msp2 revealed a low genetic diversity of P. falciparum parasites circulating in the studied area. The public health implications of these findings for the Central American region are discussed.
Subject(s)
Antimalarials/pharmacology , Disease Outbreaks , Drug Resistance/genetics , Malaria, Falciparum/epidemiology , Mutation , Plasmodium falciparum/drug effects , Plasmodium falciparum/genetics , Animals , DNA, Protozoan/analysis , Humans , Malaria, Falciparum/parasitology , Molecular Epidemiology , Panama/epidemiology , Prevalence , Protozoan Proteins/geneticsABSTRACT
A total of 206 serum samples from children (3-14 years old) living in the Amador County (La Chorrera District, Province of Panama) were screened by indirect immunofluorescence antibody test (IFAT) for the presence of antibodies against Trypanosoma cruzi. Positive sera were confirmed by recombinant enzyme-linked immunosorbent assay (ELISA) and Western blot analysis. The presence of blood trypanosomes was investigated by hemoculture and subsequently identify by a duplex polymerase chain reaction (PCR) followed by dot blot hybridization. The results indicated a prevalence of 9.7 percent for trypanosome infections, a seroprevalence of 2.9 percent against T. cruzi and a predominance of T. rangeli infection (6.8 percent). The immunological and clinical implications of these findings are discussed.
Subject(s)
Child, Preschool , Child , Adolescent , Animals , Humans , Antibodies, Protozoan/blood , Endemic Diseases , Trypanosoma/classification , Trypanosomiasis/diagnosis , Blotting, Western , Enzyme-Linked Immunosorbent Assay , Fluorescent Antibody Technique, Indirect , Polymerase Chain Reaction , Prevalence , Panama/epidemiology , Sensitivity and Specificity , Seroepidemiologic Studies , Trypanosoma/genetics , Trypanosoma/immunology , Trypanosoma/isolation & purification , Trypanosomiasis/epidemiology , Trypanosomiasis/parasitologyABSTRACT
A total of 206 serum samples from children (3-14 years old) living in the Amador County (La Chorrera District, Province of Panama) were screened by indirect immunofluorescence antibody test (IFAT) for the presence of antibodies against Trypanosoma cruzi. Positive sera were confirmed by recombinant enzyme-linked immunosorbent assay (ELISA) and Western blot analysis. The presence of blood trypanosomes was investigated by hemoculture and subsequently identify by a duplex polymerase chain reaction (PCR) followed by dot blot hybridization. The results indicated a prevalence of 9.7% for trypanosome infections, a seroprevalence of 2.9% against T. cruzi and a predominance of T. rangeli infection (6.8%). The immunological and clinical implications of these findings are discussed.
Subject(s)
Antibodies, Protozoan/blood , Endemic Diseases , Trypanosoma/classification , Trypanosomiasis/diagnosis , Adolescent , Animals , Blotting, Western , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay , Fluorescent Antibody Technique, Indirect , Humans , Panama/epidemiology , Polymerase Chain Reaction , Prevalence , Sensitivity and Specificity , Seroepidemiologic Studies , Trypanosoma/genetics , Trypanosoma/immunology , Trypanosoma/isolation & purification , Trypanosomiasis/epidemiology , Trypanosomiasis/parasitologyABSTRACT
An outbreak of hantavirus pulmonary syndrome occurred in the province of Los Santos, Panama, in late 1999 and early 2000. Eleven cases were identified; 9 were confirmed by serology. Three cases were fatal; however, no confirmed case-patient died. Case-neighborhood serologic surveys resulted in an overall hantavirus antibody prevalence of 13% among household and neighborhood members from the outbreak foci. Epidemiologic investigations did not suggest person-to-person transmission of hantavirus infection. By use of Sin Nombre virus antigen, hantavirus antibodies were detected in Oligoryzomys fulvescens and Zygodontomys brevicauda cherriei. This outbreak resulted in the first documented cases of human hantavirus infections in Central America.
Subject(s)
Hantavirus Pulmonary Syndrome/epidemiology , Adolescent , Adult , Aged , Animals , Antibodies, Viral/blood , Child , Child, Preschool , Disease Outbreaks , Disease Reservoirs , Female , Orthohantavirus/immunology , Hantavirus Pulmonary Syndrome/diagnosis , Health Surveys , Humans , Infant , Male , Middle Aged , Panama/epidemiology , Population Surveillance , Rodentia/virologyABSTRACT
The first outbreak of hantavirus pulmonary syndrome (HPS) in Central America was documented on the Azuero peninsula of Panama in late 1999 and 2000. Reverse transcriptase-polymerase chain reaction evidence implicated only Choclo virus in symptomatic HPS with a mortality rate of 20%, although two rodent-borne hantaviruses (Choclo virus and Calabazo virus) were identified in the peridomestic habitat. Neighborhood serosurveys around case households found seroprevalence rates as high as 30%, the highest in the Americas except for western Paraguay. We report here population-based serosurveys for 1,346 adults and children in four communities, three on the Azuero peninsula and one in adjacent central Panama. Overall seroprevalence ranged from 33.2% in a population engaged in farming and fishing on Isla de Cañas, to 16.3% and 21.2% in two mainland agricultural communities, to 3.1% in central Panama, with a modest male predominance of 1.2:1. Nine percent of children 4-10 years old were seropositive, and seroprevalence increased with age in all communities, with highest levels of 52% in those 41-50 years old cohort on Isla de Cañas. Univariate analysis identified correlations between seroprevalence and multiple agricultural and animal husbandry activities. However, stepwise logistic regression models identified only raising animals (cows, pigs, goats, poultry) and fishing as significant independent variables. Human infection with hantavirus on the Azuero peninsula, either with Choclo virus or combined with Calabazo virus, is frequent but rarely results in hospitalization due to respiratory illnesses resembling HPS.
Subject(s)
Antibodies, Viral/blood , Hantavirus Infections/epidemiology , Orthohantavirus/immunology , Adolescent , Adult , Child , Child, Preschool , Female , Hantavirus Infections/virology , Humans , Male , Middle Aged , Panama/epidemiology , Risk Factors , Seroepidemiologic StudiesABSTRACT
The objective of the present study was to determine the efficacy of prototype diagnostic serological assays for American Cutaneous Leishmaniasis (ACL) in Panama. As such, we prospectively sampled 100 cutaneous leishmaniasis case-patients and tested their sera in two serological assays based upon novel soluble antigen preparations made from propagating the parasites in a protein-free, serum free media. Using serum and a Leishmania mexicana antigen preparation to sensitize plates, the assay correctly identified 89% of the case-patients. While using serum with an antigen preparation from Leishmania braziliensis, the assay correctly identified 71% of the patients. Concerning both test formats, performance was near equal in true positive and presumptive positive subsets demonstrating the improved sensitivity of these assays over reference methods of choice. Since the incidence of leishmaniasis in Panama has increased dramatically in the past 10 years, these assays may be useful in clinical and epidemiological studies and control programs.
Subject(s)
Antigens, Protozoan/blood , Enzyme-Linked Immunosorbent Assay/methods , Leishmania mexicana/growth & development , Leishmaniasis, Cutaneous/diagnosis , Adult , Animals , Antibodies, Protozoan/blood , Humans , Leishmaniasis, Cutaneous/blood , Leishmaniasis, Cutaneous/immunology , Panama , Prospective Studies , Sensitivity and Specificity , Specimen HandlingABSTRACT
Describe el problema del dengue y las investigaciones participativas que se realizan con la población, y los sub-registros de los casos reportados que impiden conocer la magnitud y distribución real de este problema de salud, que tiende a concentrarse en los lugares con mayor densidad de población, principalmente entre los campesinos inmigrantes y los indígenas,lo que limita las oportunidades de desarrollo y bienestar de la población
Subject(s)
Dengue , Family Planning Policy , Family Planning Services , Health PlanningABSTRACT
Muestra la importancia de involucrar a la comunidad en el diseño y aplicación de medidas de prevención y control, presenta el reto de desarrollar mensajes que propicien la adopción permanente de un comportamiento preventivo en la población