Phylogenetic Analysis of Hepatitis B Virus Genotypes Circulating in Different Risk Groups of Panama, Evidence of the Introduction of Genotype A2 in the Country.

The Hepatitis B Virus (HBV) can cause acute or chronic infection it is also associated with the development of liver cancer, thousands of new infections occur on a yearly basis, and many of these cases are located in certain areas of the Caribbean and Latin America. In these areas, the HBV prevalence is still high which makes this virus a serious public health concern to the entire region. Studies performed in Panama suggest a complex pattern in the distribution of HBV among the country's different risk groups. We use phylogenetic analysis in order to determine which HBV genotypes were circulating in these specific groups; for this we used a fragment of the PreS2/2 region of the HBV genome. Subsequently whole HBV genome sequences were used for Bayesian analysis of phylodynamics and phylogeography. Two main genotypes were found: genotype A (54.5%) and genotype F (45.5%). There was a difference in the distribution of genotypes according to risk groups: 72.9% of high risk groups were associated to genotype A, and 55.0% of samples of genotype F were associated to the low risk group (p<0.002). The Bayesian analysis of phylogeny-traits association revealed a statistically significant geographical association (p<0.0001) with both genotypes and different regions of the country. The Bayesian time of most recent common ancestor analysis (tMRCA) revealed a recent tMRCA for genotype A2 circulating in Panama (1997, 95% HPD: 1986-2005), when it is compared with Panamanian genotype F1c sequences (1930, 95% HPD: 1810 - 2005). These results suggest a possible change in the distribution of HBV genotypes in Panama and Latin America as a whole. They also serve to encourage the implementation of vaccination programs in high-risk groups, in order to prevent an increase in the number of new HBV cases in Latin America and worldwide.

High diversity of hepatitis B virus genotypes in Panamanian blood donors: a molecular analysis of new variants.

Hepatitis B Virus (HBV) is an infectious agent that causes more than half of the cases of liver disease and cancer in the world. Globally there are around 250 million people chronically infected with this virus. Despite 16% of the cases of liver disease in Central America are caused by HBV, the information regarding its genetic diversity, genotypes and circulation is scarce. The purpose of this study was to evaluate the genetic variability of the HBV genotypes from HBV-DNA positive samples obtained from screening blood donors at the Social Security System of Panama and to estimate its possible origin. From 59,696 blood donors tested for HBV infection during 2010-2012, there were 74 HBV-DNA positive subjects. Analysis of the partial PreS2-S region of 27 sequences shows that 21% of the infections were caused by genotype A, 3% by genotype D and 76% by genotype F. In addition, we were able to confirm circulation of six sub-genotypes A1, A2, A3, D4, F3, F1 and a proposed new sub-genotype denominated F5pan. We found a confinement of sub-genotypes F1 and F5pan to the western area of Panama. The tMRCA analysis suggests a simultaneous circulation of previously described sub-genotypes rather than recent introductions of the Panamanian sub-genotypes in the country. Moreover, these results highlight the need of more intensive research of the HBV strains circulating in the region at the molecular level. In conclusion, Panama has a high HBV genotype diversity that includes a new proposed sub-genotype, an elevated number of PreCore-Core mutations, and confinement of these variants in a specific geographical location.

Condiciones sanitarias e infraestructura de vivienda relacionado con la incidencia de infecciones respiratorias agudas en menores de 05 años - Asentamiento Humano Pedro Castro, Chachapoyas, 2006 / Health conditions of housing and infrastructure related to the incidence of acute respiratory infections in children under 05 years - Human Settlement Pedro Castro, Chachapoyas, 2006

El objetivo de la presente investigación fue determinar la relación que existe entre las condiciones sanitarias e infraestructura de la vivienda con la incidencia de las Infecciones Respiratorias Agudas (IRAs) en niños menos de 5 años del Asentamiento Humano Pedro Castro, Chachapoyas, 2006; para lo cual se consideró el total de la población de madres y viviendas de los 47 niños con infección respiratoria aguda del Asentamiento Humano Pedro Castro, Chachapoyas; cuya metodología fue del tipo descriptivo-correlacional, método inductivo-deductivo; para la decisión estadística se utilizó la prueba estadística no paramétrica Ji cuadrada, con un nivel de confianza de 95%. Los resultados muestran que el 53% de los menores de 5 años del Asentamiento Humano Pedro Castro tienen una condición sanitaria mala, seguida de un 51% con una rustica infraestructura de la vivienda (adobe), ocasionando un 49% de incidencia de la IRAs en los menores de 5 años con más de 3 episodios por cada niño, prevaleciendo más en las no neumonías; además, los resultados obtenidos determinaron la relación significativa entre las condiciones sanitarias e infraestructura de la vivienda con la incidencia de las IRAs en los menores de 5 años del Asentamiento Humano Pedro Castro, por lo que al contar con malas condiciones sanitarias e infraestructura inadecuada de la vivienda existirá una alta incidencia de las IRAs en los niños menores de 5 años.

The aim of this investigation was to determine the relationship between health conditions and infrastructure of the housing with the incidence of Acute Respiratory Infections (ARIs) in children under 05 years of human settlement Pedro Castro, Chachapoyas, 2006, for what which was considered the total population of mothers and homes of 47 children with acute respiratory infection of human settlement Pedro Castro, Chachapoyas, whose methodology was descriptive-correlation, inductive-deductive method, for the decision statistic was used nonparametric statistical test Chi-square, with a confidence level of 95%. The results show that 53% of children under 5 years of human settlement Pedro Castro have a bad health condition, followed by 51% with a rustic housing infrastructure (adobe), causing a 49% incidence of IRAs children under 5 years with more than 3 episodes per child, not more prevalent in pneumonia, in addiction, results identified a significant relation between sanitation and infrastructure conditions of the apartment with the incidence of ARIs in children under 5 years of human settlement Pedro Castro, so to have poor sanitary conditions and inadequate infrastructure of housing there is a high incidence of ARIs in chilren under 5 years.

Outbreak of hantavirus pulmonary syndrome, Los Santos, Panama, 1999-2000.

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.

High seroprevalence of hantavirus infection on the Azuero peninsula of Panama.

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.

Efectos de la campaña de promoción y prevención de la infección por virus hanta en Los Santos, Panamá 2001 / Campaign effects of promotion and infection for virus hanta prevention in Los Santos, Panama 2001

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

Evaluación de los valores hematológicos de una población suburbana / Evaluation of hematologic values in a suburban population

Se estudió el estado nutricional y la condición económica de la población de las comunidades de San Juan y de Sabanitas, en el corregimiento de Colón, y se practicó la determinación de los índices hemáticos para comprobar si unos resultados correlacionaban con los otros. Se demostró que las personas con nutrición normal tenían cifras normales de hemoglobina, de hematócrito, y concentración media de hemoglobina corpuscular; y que también tenían cifras séricas normales de hierro sérico, de saturación férrica, de vitamina B12 y de ácido fólico