RESUMO
Background: The foot transit of migrant peoples originating from the Caribbean, South America, Asia, and Sub-Saharan Africa through the Darién Forest (DF) in Eastern Panamá towards North America has increased in recent years from approximately 30,000 people/year to >133,000 in 2021. In the DF, there is no food/housing provision nor healthcare access. Very little is known of sexual and reproductive health (SRH) among this population. This study used rapid epidemiological methods to describe the SRH situation among migrant peoples in transit through the DF. Methods: This cross-sectional study randomly selected migrant people in transit (men and women) at a Migrant Reception Station in Darién, Panamá, between January 4-11, 2022. Data collection included a self-applied questionnaire (≥18 years); clinical screening (≥12 years); and HCG, treponemal antibodies, and HIV(I/II) lateral-flow tests with blood samples (≥12 years). Descriptive analyses were used to report findings. Results: In all, 69 men and 55 women participated in the self-applied questionnaire, 70 men and 51 women in clinical screening; 78 men and 63 women in HCG, treponemal antibody and HIV testing. Overall, 26.1% (18/69) men and 36.4% (20/55) women reported sexual intercourse within the past month. The last sex partner was casual among 43.0% (21/49) of men and 27.8% (10/36) of women; of those, 42.9% (9/21) of men and 80.0% (8/10) of women reported this sex was condomless. Among women, 20.0% (11/55) tested positive for pregnancy; 5 of these pregnancies were planned. Of those screened, a reproductive tract infection symptom was reported by 5.7% (4/70) of men and 58.8% (30/51) of women. A total of 32.7% (18/55) of men and 18.2% (8/44) of women reported no prior HIV testing. Of 78 men, HIV and treponemal antibodies were found among 1.3% (n = 1) and 2.6% (n = 2), and among 63 women, 3.2% (n = 2) and 3.2% (n = 2), respectively. Conclusions: This rapid epidemiological assessment found high recent sexual activity, low condom use with casual partners, and a need for increased HIV and syphilis testing and treatment. There is a need for increased testing, condom provision, and SRH healthcare access at migrant reception stations that receive migrant peoples in transit through Panamá.
RESUMO
La Atorvastatina es usada en el tratamiento de hiperlipidemias por su acción de inhibición de la 3-Hidroxi-3-Metilglutaril Coenzima A reductasa. Adicionalmente, se ha demostrado que pueden reducir el estrés oxidativo y la susceptibilidad de la LDL-C a la oxidación. Considerando estos efectos pleiotrópicos de la Atorvastatina, se propuso esta investigación con el objetivo de evaluar el posible efecto antioxidante de la Atorvastatina, sobre los niveles séricos de α-Tocoferol y Retinol en individuos hiperlipidémicos. Previo consentimiento informado, a 30 individuos hiperlipidémicos, se les determinó el perfil lipídico, (enzimático-colorimétrico) y vitaminas A y E (HPLC) antes y después de tratamiento por un corto peróodo (7 días) con dosis diferentes de Atorvastatina según criterio médico. El tratamiento con 10 mg disminuyó significativamente los Triglicéridos, el Colesterol Total y LDL-C, (p=0.0308), (p=0.031) y (p=0.0193), con un incremento del 2,26% en las HDL-C. La dósis de 20 mg intensificó significativamente el efecto mencionado para los triglicéridos, Colesterol total y LDL-C (p=0.0211), (p=0.0001) y (p=0.0001) respectivamente. Los valores de Vitaminas A y E presentaron un incremento significativo con la dosis de 20 mg. El tratamiento con Atorvastatina a las dosis de 10 y 20 mg disminuyeron Triglicéridos, el Colesterol Total y LDL-C en una forma dosis-dependiente. Este efecto y el incremento de las vitaminas A y E reflejan no sólo un efecto hipolipidemiante, sino además a un efecto pleiotrópico, en este caso antioxidante
The Atorvastatin is used in the treatment of hyperlipidaemia owing its action of inhibition 3-hydroxy-3-methylglutaryl coenzyme A reductase. Additionally, they have showed to reduce oxidative stress and the susceptibility of LDL-C to oxidation. Considering these pleiotropic effects of Atorvastatin this research was proposed with the objective to evaluate the possible antioxidant effect of the Atorvastatin on the serum levels of ¦Á-Tocopherol and Retinol in hyperlipidemia individuals. Methodology: prior informed consent, 30 individuals with hyperlipidemia, was analyzed for lipid profile (enzymatic-colorimetric) and vitamins A and E (HPLC) before and after short-term treatment (7 days) with different doses of Atorvastatin. Results: Treatment with 10 mg significantly decreased triglycerides, total cholesterol and LDL-C, (p = 0.0308), (p = 0.031) and (p = 0.0193), an increase of 2.26% in HDL-C. The dose of 20 mg intensified significantly the mentioned effect, triglycerides, total cholesterol and LDL-C (p = 0.0211), (p = 0.0001) and (p = 0.0001), respectively. The values of Vitamins A and E showed a significantly increase with dose of 20 mg. Conclusion: Treatment with Atorvastatin at doses of either 10 or 20 mg decreased triglycerides, total cholesterol and LDL-C in a dose-dependent manner. The effect and the increase of Vitamin A and E levels could reflect not only a lipid lowering effect, but also a pleiotrópico, in this case antioxidant effect
