Detection through the use of RT-MqPCR of asymptomatic reservoirs of malaria in samples of patients from the indigenous Comarca of Guna Yala, Panama: Essential method to achieve the elimination of malaria.

BACKGROUND: Plasmodium vivax is the main causative agent of malaria in Panama. However, the prevalence of asymptomatic infections in the different endemic regions remains unknown. Understanding the epidemiological behavior of asymptomatic infections is essential for the elimination of malaria. This study aimed to determine the prevalence of asymptomatic malarial infections in one of the main endemic regions of Panama using multiplex real-time reverse transcription RT-MqPCR. METHODS: A cross-sectional study was conducted in three communities in the Guna Yala Comarca. A total of 551 thick blood smears and their respective samples on filter paper were collected from volunteers of different ages and sexes from June 20 to 25, 2016. Infections by the Plasmodium spp. were diagnosed using microscopy and RT-MqPCR. All statistical analyses were performed using the R software. RESULTS: The average prevalence of asymptomatic infections by P. vivax in the three communities detected by RT-MqPCR was 9.3%, with Ukupa having the highest prevalence (13.4%), followed by Aidirgandi (11.1%) and Irgandi (3.3%). A total of 74 samples were diagnosed as asymptomatic infections using RT-MqPCR. Light microscopy (LM) detected that 17.6% (13/74) of the asymptomatic samples and 82.4% (61/74) were diagnosed as false negatives. A 100% correlation was observed between samples diagnosed using LM and RT-MqPCR. A total of 52.7% (39/74) of the asymptomatic patients were female and 85.1% (63/74) were registered between the ages of 1 and 21 years. Factors associated with asymptomatic infection were community (aOR = 0.38 (95% CI 0.17-0.83), p < 0.001) and age aOR = 0.98 (95% CI 0.97-1.00), p < 0.05); F = 5.38; p < 0.05). CONCLUSIONS: This study provides novel evidence of the considerable prevalence of asymptomatic P. vivax infections in the endemic region of Kuna Yala, representing a new challenge that requires immediate attention from the National Malaria Program. The results of this study provide essential information for the health authorities responsible for developing new policies. Furthermore, it will allow program administrators to reorient and design effective malaria control strategies that consider asymptomatic infections as a fundamental part of malaria control and move towards fulfilling their commitment to eliminate it.

Brote de Zika en Panamá. Caracterización del primer brote epidémico del virus Zika registrado en Panamá

Introducción: La caracterización de los brotes de Zika es de gran importancia para lograr determinar los factores de riesgos individuales y colectivos que participan en su ocurrencia y es la base para el desarrollo de estrategias efectivas para la vigilancia, prevención y control de la transmisión de esta enfermedad. Objetivo: Describir epidemiológicamente las principales características del primer brote epidémico de Zika registrado en Panamá, en la Comarca de Guna Yala. Materiales y métodos: Se diseño y realizó un estudio descriptivo y retrospectivo del primer brote de Zika ocurrido entre el 27 de noviembre de 2015 y el 22 de enero de 2016 en Guna Yala, Panamá. Resultados: Se colectaron un total de 68 muestras de suero de pacientes sospechosos, 38 muestras fueron positivas por PCR para Zika en la Comarca de Guna Yala, Ustupo registró la mayor cantidad de casos (n = 29, 76,3%), el (n = 43; 86%) de los casos fueron menores de 59 años, el (n = 37; 74%) de los casos eran población económicamente activa (14 a 65 años de edad) y el (n = 30; 60%) de los casos fueron de sexo femenino. Conclusión: Este estudio ha permitido mostrar la facilidad con que las enfermedades arbovirales como el Zika puede introducirse, propagarse y llegar a producir un impacto en la salud pública de la población, el sistema de salud y establecerse en las regiones donde ocurren estos eventos sanitarios. Es necesario realizar más estudios, el fortalecimiento de la vigilancia epidemiológica y la consideración de los factores de riesgo para garantizar la sostenibilidad de las intervenciones sanitarias y lograr reducir el impacto social y económico de este arbovirosis. (provisto por Infomedic International)

Introduction: The characterization of Zika outbreaks is of great importance to determine the individual and collective risk factors involved in their occurrence and is the basis for the development of effective strategies for surveillance, prevention and control of Zika transmission. Objective: To describe epidemiologically the main characteristics of the first epidemic outbreak of Zika recorded in Panama, in the Guna Yala region.  Materials and methods: A descriptive and retrospective study of the first Zika outbreak that occurred between 27 November 2015 and 22 January 2016 in Guna Yala, Panama, was designed and conducted.  Results: A total of 68 serum samples were collected from suspected patients, 38 samples were positive by PCR for Zika in the Guna Yala Comarca, Ustupo registered the highest number of cases (n = 29, 76.3%), (n = 43; 86%) of the cases were younger than 59 years, (n = 37; 74%) of the cases were economically active population (14 to 65 years of age) and (n = 30; 60%) of the cases were female. Conclusion: This study has shown the ease with which arboviral diseases such as Zika can be introduced, spread and have an impact on the public health of the population, the health system and become established in the regions where these health events occur. Further studies strengthened epidemiological surveillance and consideration of risk factors are needed to ensure the sustainability of health interventions and to reduce the social and economic impact of this arbovirosis. (provided by Infomedic International)

Madariaga and Venezuelan equine encephalitis virus seroprevalence in rodent enzootic hosts in Eastern and Western Panama.

While rodents are primary reservoirs of Venezuelan equine encephalitis virus (VEEV), their role in Madariaga virus (MADV) transmission remains uncertain, particularly given their overlapping geographic distribution. This study explores the interplay of alphavirus prevalence, rodent diversity, and land use within Darien and Western Panama provinces. A total of three locations were selected for rodent sampling in Darien province: Los Pavitos, El Real de Santa Maria and Santa Librada. Two sites were selected in Western Panama province: El Cacao and Cirí Grande. We used plaque reduction neutralization tests to assess MADV and VEEV seroprevalences in 599 rodents of 16 species across five study sites. MADV seroprevalence was observed at higher rates in Los Pavitos (Darien province), 9.0%, 95% CI: 3.6-17.6, while VEEV seroprevalence was elevated in El Cacao (Western Panama province), 27.3%, 95% CI: 16.1-40.9, and El Real de Santa María (Darien province), 20.4%, 95% CI: 12.6-29.7. Species like Oryzomys coesi, 23.1%, 95% CI: 5.0-53.8, and Transandinomys bolivaris, 20.0%, 95% CI: 0.5-71.6 displayed higher MADV seroprevalences than other species, whereas Transandinomys bolivaris, 80.0%, 95% CI: 28.3-99.4, and Proechimys semispinosus, 27.3%, 95% CI: 17.0-39.6, exhibited higher VEEV seroprevalences. Our findings provide support to the notion that rodents are vertebrate reservoirs of MADV and reveal spatial variations in alphavirus seropositivity among rodent species, with different provinces exhibiting distinct rates for MADV and VEEV. Moreover, specific rodent species are linked to unique seroprevalence patterns for these viruses, suggesting that rodent diversity and environmental conditions might play a significant role in shaping alphavirus distribution.

Natural malaria infection in anophelines vectors and their incrimination in local malaria transmission in Darién, Panama.

BACKGROUND: More than 85% of the malaria cases in Panama occur in poor, rural and indigenous regions like Darien Province. Vector diversity, infection rate and spatial distribution are important entomological parameters of malaria transmission dynamics. Their understanding is crucial for the development of effective disease control strategies. The objective of this study was to determine the composition of Anopheles species, their natural infection rate and their geographic distribution to better understand the malaria transmission dynamics in Darién, Panama. METHODS: Anophelines mosquitoes were captured during the rainy and dry season of 2016. We selected five communities where adult anophelines were collected using CDC light-traps, and through protective human-baited traps. Detection of natural infection and Plasmodium genotype were detected via nested PCR through the amplification of ssrRNA and the circumsporozoite protein gene (csp), respectively. RESULTS: A total of 1,063 mosquitoes were collected mosquitoes were collected for the detection of natural infection with Plasmodium spp. Nine Anophelines species were identified, with the predominant species being: An. (Nys.) darlingi (45.0%) and An. (Nys.) albimanus (42.6%). Natural infection in An. (Nys.) albimanus with P. vivax was detected in one mosquito pool from the community Pueblo Tortuga (0.6%), three from Marraganti (1.7%), two from Bajo Chiquito (1.1%) and three pools from Alto Playona 3 (1.7%). For An. (Nys.) darlingi mosquitoes, we detected seven positive pools from the community Bajo Chiquito (4.0%), two pools from Marraganti (1.1%) and two pools from Alto Playona (1.1%). The P. vivax allelic variant VK210 was detected in infected mosquitoes. CONCLUSION: The results from this study provide new information on the transmission dynamics associated with anophelines vectors in the Darién region. This is the first report of natural P. vivax infection in An. (Nys.) darlingi and its incrimination as a potential malaria vector in this region of Panama. Additional studies are necessary to expand our knowledge and determine crucial parameters in malaria transmission in Darién, which in turn will aid the National Malaria Program in attaining an adequate malaria control strategy towards malaria elimination.

Study of the epidemiological behavior of malaria in the Darien Region, Panama. 2015-2017.

BACKGROUND: Malaria is endemic in Darién and an assessment of the different factors affecting its epidemiology is crucial for the development of adequate strategies of surveillance, prevention, and disease control. The objective of this study was to determine the main characteristics of the epidemiological behavior of malaria in the Darien region. METHODS: This research was comprised of a retrospective analysis to determine the incidence and malaria distribution in the Darien region from 2015 to 2017. We evaluated malaria indicators, disease distribution, incidence (by age group and sex), diagnostic methods, treatment, and control measures. In addition, we examined the cross-border migration activity and its possible contribution to the maintenance and distribution of malaria. RESULTS: During the period of 2015-2017, we examined 41,141 thick blood smear samples, out of which 501 tested positive for malaria. Plasmodium vivax was responsible for 92.2% of those infections. Males comprised 62.7% of the total diagnosed cases. Meanwhile, a similar percentage, 62.7%, of the total cases were registered in economically active ages. The more frequent symptoms included fever (99.4%) and chills (97.4%), with 53.1% of cases registering between 2,000 and 6,000 parasites/µl of blood. The annual parasitic incidence (API) average was 3.0/1,000 inhabitants, while the slide positivity rate (SPR) was 1.2% and the annual blood examination rate (ABER) 22.5%. In Darién there is a constant internal and cross-border migration movement between Panama and Colombia. Malaria control measures consisted of the active and passive search of suspected cases and of the application of vector control measures. CONCLUSION: This study provides an additional perspective on malaria epidemiology in Darién. Additional efforts are required to intensify malaria surveillance and to achieve an effective control, eventually moving closer to the objective of malaria elimination. At the same time, there is a need for more eco-epidemiological, entomological and migratory studies to determine how these factors contribute to the patterns of maintenance and dissemination of malaria.

Mercadeo Virus: A Novel Mosquito-Specific Flavivirus from Panama.

Viruses in the genus Flavivirus (family Flaviviridae) include many arthropod-borne viruses of public health and veterinary importance. However, during the past two decades an explosion of novel insect-specific flaviviruses (ISFs), some closely related to vertebrate pathogens, have been discovered. Although many flavivirus pathogens of vertebrates have been isolated from naturally infected mosquitoes in Panama, ISFs have not previously been reported from the country. This report describes the isolation and characterization of a novel ISF, tentatively named Mercadeo virus (MECDV), obtained from Culex spp. mosquitoes collected in Panama. Two MECDV isolates were sequenced and cluster phylogenetically with cell-fusing agent virus (CFAV) and Nakiwogo virus (NAKV) to form a distinct lineage within the insect-specific group of flaviviruses.

Impacto operacional del uso de insecticidas en larvas de Aedes aegypti en La Habana / Operational impact of the use of insecticidal products on Aedes aegypti larvae in Havana province

INTRODUCCIÓN: a pesar de los enormes esfuerzos que realiza el programa de erradicación de Aedes aegypti en Cuba, persisten en algunas regiones del país determinados índices de infestación que favorecen el desarrollo de epidemias o brotes de dengue. En este negativo indicador se destaca la provincia La Habana, donde desempeña un papel importante el uso de insecticidas. OBJETIVOS: evaluar el impacto del uso de insecticidas, por el programa de erradicación de Ae. aegypti, en el desarrollo de resistencia en esta especie en La Habana. MÉTODOS: se utilizaron 15 cepas de Ae. aegypti, procedentes de los 15 municipios de La Habana, colectados en 2008. El nivel de susceptibilidad a insecticidas se determinó mediante bioensayos recomendados por la Organización Mundial de la Salud. RESULTADOS: 60 por ciento de las cepas mostró susceptibilidad a clorpirifos; de los piretroides evaluados, se observó mayor resistencia a cipermetrina, seguido por lambdacialotrina y ciflutrina. CONCLUSIONES: el insecticida clorpirifos es un buen candidato a utilizar con los piretroides, de forma rotacional, para retardar el desarrollo de la resistencia a los piretroides en Ae. aegypti de La Habana.

INTRODUCTION: in spite of the huge efforts of the Aedes aegypti eradication program in Cuba, there are still certain infestation indexes favoring the development of outbreaks or epidemics in some regions of the country. Havana province holds a leading position in this negative indicator, in which the use of insecticides plays an important role. OBJECTIVES: to evaluate the impact of the use of insecticides in the development of drug resistance by this species in Havana. METHODS: fifteen Ae. aegypti strains from the fifteen municipalities of the province were used. They were all collected in 2008. The level of susceptibility to insecticides was measured by means of the WHO-recommended bioassays. RESULTS: sixty percent of the strains were susceptible to chlorpirifos; more resistance to pyrethroid cypermethrin was observed followed by lambdacyalothrin and cifluthrin. CONCLUSIONS: the insecticide Chlorpirifos is a good candidate to be used with pyrethroids, on a rotational scheme, to delay the development of resistance to pyrethroids in Ae. aegypti vectors in Havana province.

Impacto operacional del uso de insecticidas en larvas de Aedes aegypti en La Habana / Operational impact of the use of insecticidal products on Aedes aegypti larvae in Havana province

INTRODUCCIÓN: a pesar de los enormes esfuerzos que realiza el programa de erradicación de Aedes aegypti en Cuba, persisten en algunas regiones del país determinados índices de infestación que favorecen el desarrollo de epidemias o brotes de dengue. En este negativo indicador se destaca la provincia La Habana, donde desempeña un papel importante el uso de insecticidas. OBJETIVOS: evaluar el impacto del uso de insecticidas, por el programa de erradicación de Ae. aegypti, en el desarrollo de resistencia en esta especie en La Habana. MÉTODOS: se utilizaron 15 cepas de Ae. aegypti, procedentes de los 15 municipios de La Habana, colectados en 2008. El nivel de susceptibilidad a insecticidas se determinó mediante bioensayos recomendados por la Organización Mundial de la Salud. RESULTADOS: 60 por ciento de las cepas mostró susceptibilidad a clorpirifos; de los piretroides evaluados, se observó mayor resistencia a cipermetrina, seguido por lambdacialotrina y ciflutrina. CONCLUSIONES: el insecticida clorpirifos es un buen candidato a utilizar con los piretroides, de forma rotacional, para retardar el desarrollo de la resistencia a los piretroides en Ae. aegypti de La Habana(AU)

INTRODUCTION: in spite of the huge efforts of the Aedes aegypti eradication program in Cuba, there are still certain infestation indexes favoring the development of outbreaks or epidemics in some regions of the country. Havana province holds a leading position in this negative indicator, in which the use of insecticides plays an important role. OBJECTIVES: to evaluate the impact of the use of insecticides in the development of drug resistance by this species in Havana. METHODS: fifteen Ae. aegypti strains from the fifteen municipalities of the province were used. They were all collected in 2008. The level of susceptibility to insecticides was measured by means of the WHO-recommended bioassays. RESULTS: sixty percent of the strains were susceptible to chlorpirifos; more resistance to pyrethroid cypermethrin was observed followed by lambdacyalothrin and cifluthrin. CONCLUSIONS: the insecticide Chlorpirifos is a good candidate to be used with pyrethroids, on a rotational scheme, to delay the development of resistance to pyrethroids in Ae. aegypti vectors in Havana province(AU)

[Operational impact of the use of insecticidal products on Aedes aegypti larvae in Havana province]. / Impacto operacional del uso de insecticidas en larvas de Aedes aegypti en La Habana.

INTRODUCTION: In spite of the huge efforts of the Aedes aegypti eradication program in Cuba, there are still certain infestation indexes favoring the development of outbreaks or epidemics in some regions of the country. Havana province holds a leading position in this negative indicator, in which the use of insecticides plays an important role. OBJECTIVES: To evaluate the impact of the use of insecticides in the development of drug resistance by this species in Havana. METHODS: Fifteen Ae. aegypti strains from the fifteen municipalities of the province were used. They were all collected in 2008. The level of susceptibility to insecticides was measured by means of the WHO-recommended bioassays. RESULTS: Sixty percent of the strains were susceptible to chlorpirifos; more resistance to pyrethroid cypermethrin was observed followed by lambdacyalothrin and cifluthrin. CONCLUSIONS: The insecticide Chlorpirifos is a good candidate to be used with pyrethroids, on a rotational scheme, to delay the development of resistance to pyrethroids in Ae. aegypti vectors in Havana province.