33 research outputs found

    Discovery of Markers of Exposure Specific to Bites of Lutzomyia longipalpis, the Vector of Leishmania infantum chagasi in Latin America

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    Leishmania parasites are transmitted by the bite of an infected vector sand fly that injects salivary molecules into the host skin during feeding. Certain salivary molecules can produce antibodies and can be used as an indicator of exposure to a vector sand fly and potentially the disease it transmits. Here we identified potential markers of specific exposure to the sand fly Lutzomyia longipalpis, the vector of visceral leishmaniasis in Latin America. Initially, we determined which of the salivary proteins produce antibodies in humans, dogs, and foxes from areas endemic for the disease. To identify potential specific markers of vector exposure, we produced nine different recombinant salivary proteins from Lu. longipalpis and tested for their recognition by individuals exposed to another human-biting sand fly, Lu. intermedia, that transmits cutaneous leishmaniasis and commonly occurs in the same endemic areas as Lu. longipalpis. Two of the nine salivary proteins were recognized only by humans exposed to Lu. longipalpis, suggesting they are immunogenic proteins and may be useful in epidemiological studies. The identification of specific salivary proteins as potential markers of exposure to vector sand flies will increase our understanding of vector–human interaction, bring new insights to vector control, and in some instances act as an indicator for risk of acquiring disease

    Social Construction of Cervical Cancer Screening Among Women in Panama City, Panama

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    To learn how to address health issues specific to Hispanic cultures in an effort to address health disparities, learning from cultural aspects that affect health from the countries of origin would be most useful. Community programs built on rigorous and systematic research prove to be more powerful than ad-hoc programs. Qualitative research techniques offer powerful alternatives for public health professionals to develop adequate and directed programs at the community level, especially among underserved communities and those represented by oral/spoken traditions. The study was conducted among 132 working class single and married Mestizo women between the ages of 20-40 living in Panama City, Panama. This group of women has the highest incidence of HPV in Panama so are at the highest risk of cervical cancer. Using social construction as the theoretical framework, this study uses four different qualitative research techniques: free listing, pile sorting, individual semi-structured, and group interviews. Key findings include the importance of religion and family, women’s understandings of the relationship between sexuality and health, influence of media, other women, and husbands help construct screening knowledge among women in the study. Culturally relevant health education interventions and programs delivered in a group format at the community level in a participatory mode would be most effective in reaching women in Panama and other Hispanic populations. Future quantitative studies and influences of social networks are suggested

    Characterization of Non-tuberculous Mycobacteria Isolates in a National Mycobacterial Laboratory in Panama:

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    Background: Nontuberculous mycobacteria (NTM) are becoming more frequently isolated in microbiology laboratories. There is no standardized diagnosis, treatment, and/or monitoring of patients with NTM disease. We described the experience of the Panama National Mycobacterial Laboratory in isolating NTM in patients suspected to have active tuberculosis in Panama. Methods: Data registries of the National TB Program Laboratory of Panama between 2012 and 2015 were reviewed. Demographic information, relevant history, sample source, and isolate identified for each specimen obtained at the time of specimen submission was extracted. Identification of mycobacterial species were made using culture and PCR. Data were exported to an Excel workbook and a descriptive analysis was performed using STATA. Results: A total of 4,545 samples were received during this period. Of these, 288 (6.3%) were not processed. From the remaining 4,257 samples, 705 (16.5%) were negative, 2,783 (65.3%) were positive for M. tuberculosis, and 769 (18%) were confirmed NTM. NTM species identification was achieved in 715 (93%) using PCR. Median age was 55 years (0 – 92); 49.4% were male. The most frequent NTM isolate was M. avium complex in 172 (22.3%) samples, followed by M. fortuitum in 131 (17%). M. chelonae was isolated in 98 (12.7%) samples, M. gordonae in 50 (6.5%), M. scrofulaceum in 20 (2.6%), and M. triviale in 16 (2.0%). NTM isolation steadily rose over the study period with 490 (63.7%) of the samples being from 2015 and 465 (94.5%) of these typified by PCR. Specimens mainly originated from the Panama metropolitan area (88.2%) and were mostly sputum samples (70.8%). Conclusion: Nontuberculous mycobacteria represented an important proportion of isolates among TB suspects in Panama. The implementation of more sensitive diagnostic techniques is increasing the recovery of NTM. Further evaluation of the clinical significance of these finding is required for appropriate guideline implementation

    Characterization of Non-tuberculous Mycobacteria Isolates in a National Mycobacterial Laboratory in Panama:

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    Background: Nontuberculous mycobacteria (NTM) are becoming more frequently isolated in microbiology laboratories. There is no standardized diagnosis, treatment, and/or monitoring of patients with NTM disease. We described the experience of the Panama National Mycobacterial Laboratory in isolating NTM in patients suspected to have active tuberculosis in Panama. Methods: Data registries of the National TB Program Laboratory of Panama between 2012 and 2015 were reviewed. Demographic information, relevant history, sample source, and isolate identified for each specimen obtained at the time of specimen submission was extracted. Identification of mycobacterial species were made using culture and PCR. Data were exported to an Excel workbook and a descriptive analysis was performed using STATA. Results: A total of 4,545 samples were received during this period. Of these, 288 (6.3%) were not processed. From the remaining 4,257 samples, 705 (16.5%) were negative, 2,783 (65.3%) were positive for M. tuberculosis, and 769 (18%) were confirmed NTM. NTM species identification was achieved in 715 (93%) using PCR. Median age was 55 years (0 – 92); 49.4% were male. The most frequent NTM isolate was M. avium complex in 172 (22.3%) samples, followed by M. fortuitum in 131 (17%). M. chelonae was isolated in 98 (12.7%) samples, M. gordonae in 50 (6.5%), M. scrofulaceum in 20 (2.6%), and M. triviale in 16 (2.0%). NTM isolation steadily rose over the study period with 490 (63.7%) of the samples being from 2015 and 465 (94.5%) of these typified by PCR. Specimens mainly originated from the Panama metropolitan area (88.2%) and were mostly sputum samples (70.8%). Conclusion: Nontuberculous mycobacteria represented an important proportion of isolates among TB suspects in Panama. The implementation of more sensitive diagnostic techniques is increasing the recovery of NTM. Further evaluation of the clinical significance of these finding is required for appropriate guideline implementation

    Pertussis vaccine effectiveness following country-wide implementation of a hexavalent acellular pertussis immunization schedule in infants and children in Panama

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    Despite high pediatric vaccination coverage rates (VCRs), pertussis incidence has increased worldwide, including in several countries in Latin America in the last two decades. Given the few vaccine effectiveness (VE) studies in Latin American countries, this retrospective, observational, cohort study estimated the effectiveness of hexavalent acellular (aP) primary and booster vaccination (wP) against pertussis in infants (6.5–18.5 months) and children (18.5–48.5 and 48.5–72.5 months) in Panama. Age-specific incidence rates (IRs) were calculated for the vaccine’s pre-initiation (2001–2013), initiation (2014), and post-initiation (2015–2019) periods. VCRs and trends were determined, and VE was analyzed using a case coverage or screening method to compare proportions of vaccinated cases and vaccinated individuals in the population. Between 2001–2019, 868 confirmed pertussis cases were reported in Panama; 712 (82.0%; 54.8 cases/year) during the pre-initiation period, 19 (2.2%; 19 cases/year) during the initiation period, and 137 (15.8%; 27.4 cases/year) during the post-initiation period. Panama underwent cyclical increases in IRs, which varied between age groups. VCRs increased for primary and booster doses. Between 2015 and 2019, third-dose yearly vaccine coverage increased, on average, 3.3%. Specifically, during the post-initiation period, 109/137 (79.6%) of cases were unvaccinated. Relative VE was estimated at 96.2% [95% CI: 86.5%, 98.9%] with three doses; 100% with 4 and 5 booster doses. Absolute VE was estimated at 99.3% with three doses only. These results show that vaccination played an important role in maintaining a low number of pertussis cases in Panama, affirming the need for sustained investment and commitment to vaccination programs
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