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Tuñon A, García J, Carrera LC, Chaves LF, Lenhart AE, Loaiza JR. Chemical control of medically important arthropods in Panama: A systematic literature review of historical efforts. Acta Trop 2024; 255:107217. [PMID: 38677361 DOI: 10.1016/j.actatropica.2024.107217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/22/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
Vector-borne diseases are a major source of morbidity in Panama. Herein, we describe historical usage patterns of synthetic insecticides to control arthropod disease vectors in this country. We examine the influence of interventions by vector control programs on the emergence of insecticide resistance. Chemical control has traditionally focused on two mosquito species: Anopheles albimanus, a major regional malaria vector, and Aedes aegypti, a historical vector of yellow fever, and current vector of dengue, chikungunya, and Zika. Countrywide populations of An. albimanus depict hyperirritability to organochlorine insecticides administered by indoor residual spraying, although they appear susceptible to these insecticides in bioassays settings, as well as to organophosphate and carbamate insecticides in field tests. Populations of Ae. aegypti show resistance to pyrethroids, particularly in areas near Panama City, but the spread of resistance remains unknown in Ae. aegypti and Aedes albopictus. A One Health approach is needed in Panama to pinpoint the insecticide resistance mechanisms including the frequency of knockdown mutations and behavioral plasticity in populations of Anopheles and Aedes mosquitoes. This information is necessary to guide the sustainable implementation of chemical control strategies and the use of modern vector control technologies such as genetically modified mosquitoes, and endosymbiont Wolbachia-based biological control.
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Affiliation(s)
- Anyi Tuñon
- Programa Centroamericano de Maestría en Entomología, Vicerrectoría de Investigación y Postgrado, Universidad de Panamá, República de Panamá; Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Apartado 0816-02593, Panama
| | - Joel García
- Programa Centroamericano de Maestría en Entomología, Vicerrectoría de Investigación y Postgrado, Universidad de Panamá, República de Panamá; Instituto de Investigaciones Científicas & Servicios de Alta Tecnología, Edificio 219, Clayton, PO 0843-01103, Ciudad del Saber, República de Panamá
| | - Lorenzo Cáceres Carrera
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Apartado 0816-02593, Panama
| | - Luis Fernando Chaves
- Department of Environmental and Occupational Health, School of Public Health and Department of Geography, Indiana University, Bloomington, IN, USA
| | - Audrey E Lenhart
- Entomology Branch, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, Atlanta, GA, 30329, USA
| | - Jose R Loaiza
- Programa Centroamericano de Maestría en Entomología, Vicerrectoría de Investigación y Postgrado, Universidad de Panamá, República de Panamá; Smithsonian Tropical Research Institute, Panama City, Panama; Instituto de Investigaciones Científicas & Servicios de Alta Tecnología, Edificio 219, Clayton, PO 0843-01103, Ciudad del Saber, República de Panamá.
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Chaves LF, Friberg MD, Pascual M, Calzada JE, Luckhart S, Bergmann LR. Community-serving research addressing climate change impacts on vector-borne diseases. Lancet Planet Health 2024; 8:e334-e341. [PMID: 38729673 DOI: 10.1016/s2542-5196(24)00049-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/29/2024] [Accepted: 03/25/2024] [Indexed: 05/12/2024]
Abstract
The impacts of climate change on vector-borne diseases are uneven across human populations. This pattern reflects the effect of changing environments on the biology of transmission, which is also modulated by social and other inequities. These disparities are also linked to research outcomes that could be translated into tools for transmission reduction, but are not necessarily actionable in the communities where transmission occurs. The transmission of vector-borne diseases could be averted by developing research that is both hypothesis-driven and community-serving for populations affected by climate change, where local communities interact as equal partners with scientists, developing and implementing research projects with the aim of improving community health. In this Personal View, we share five principles that have guided our research practice to serve the needs of communities affected by vector-borne diseases.
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Affiliation(s)
- Luis Fernando Chaves
- Department of Environmental and Occupational Health, School of Public Health and Department of Geography, Indiana University, Bloomington, IN, USA; Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panama.
| | - Mariel D Friberg
- Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA; Earth Science Division, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Mercedes Pascual
- Department of Biology and Department of Environmental Studies, New York University, New York, NY, USA
| | - Jose E Calzada
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panama
| | - Shirley Luckhart
- Department of Entomology, Plant Pathology and Nematology and Department of Biological Sciences, University of Idaho, Moscow, ID, USA
| | - Luke R Bergmann
- Department of Geography, University of British Columbia, Vancouver, BC, Canada
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Cumbrera A, Calzada JE, Chaves LF, Hurtado LA. Spatiotemporal Analysis of Malaria Transmission in the Autonomous Indigenous Regions of Panama, Central America, 2015-2022. Trop Med Infect Dis 2024; 9:90. [PMID: 38668551 PMCID: PMC11054363 DOI: 10.3390/tropicalmed9040090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
Despite ongoing efforts for elimination, malaria continues to be a major public health problem in the Republic of Panama. For effective elimination, it is key that malaria foci and areas of high transmission are identified in a timely manner. Here, we study malaria transmission records for the 2015-2022 period, a time when cases have increased by a factor of ten. Using several methods to study spatial and spatiotemporal malaria confirmed case clusters at the level of localities, including LISA and scan, we found that cases are clustered across indigenous villages located within the autonomous indigenous regions of Ngäbe-Buglé, Guna Yala, and Embera, with the latter on the eastern border of Panama (with Colombia). We discuss the different factors that might be shaping the marked increase in malaria transmission associated with these clusters, which include an inflow of malaria-exposed migrating populations hoping to reach the USA, insufficient health services, and the lack of culturally sensitive actionable tools to reduce malaria exposure among the ethnically diverse and impoverished indigenous populations of Panama.
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Affiliation(s)
- Alberto Cumbrera
- Dirección de Investigación y Desarrollo Tecnológico, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City 0816-02593, Panama;
| | - José Eduardo Calzada
- Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City 0816-02593, Panama;
- Facultad de Medicina Veterinaria, Universidad de Panamá, Panamá City 0816-03366, Panama
| | - Luis Fernando Chaves
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN 47408, USA
- Department of Geography, Indiana University, Bloomington, IN 47408, USA
| | - Lisbeth Amarilis Hurtado
- Departamento de Análisis Epidemiológico y Bioestadística, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City 0816-02593, Panama
- Facultad de Ciencias Naturales y Exactas, Universidad de Panamá, Panamá City 0816-03366, Panama
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Armién B, Muñoz C, Cedeño H, Salazar JR, Salinas TP, González P, Trujillo J, Sánchez D, Mariñas J, Hernández A, Cruz H, Villarreal LY, Grimaldo E, González S, Nuñez H, Hesse S, Rivera F, Edwards G, Chong R, Mendoza O, Meza M, Herrera M, Kant R, Esquivel R, Estripeaut D, Serracín D, Denis B, Robles E, Mendoza Y, Gonzalez G, Tulloch F, Pascale JM, Dunnum JL, Cook JA, Armién AG, Gracia F, Guerrero GA, de Mosca I. Hantavirus in Panama: Twenty Years of Epidemiological Surveillance Experience. Viruses 2023; 15:1395. [PMID: 37376694 DOI: 10.3390/v15061395] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Twenty years have passed since the emergence of hantavirus zoonosis in Panama at the beginning of this millennium. We provide an overview of epidemiological surveillance of hantavirus disease (hantavirus pulmonary syndrome and hantavirus fever) during the period 1999-2019 by including all reported and confirmed cases according to the case definition established by the health authority. Our findings reveal that hantavirus disease is a low-frequency disease, affecting primarily young people, with a relatively low case-fatality rate compared to other hantaviruses in the Americas (e.g., ANDV and SNV). It presents an annual variation with peaks every 4-5 years and an interannual variation influenced by agricultural activities. Hantavirus disease is endemic in about 27% of Panama, which corresponds to agroecological conditions that favor the population dynamics of the rodent host, Oligoryzomys costaricensis and the virus (Choclo orthohantavirus) responsible for hantavirus disease. However, this does not rule out the existence of other endemic areas to be characterized. Undoubtedly, decentralization of the laboratory test and dissemination of evidence-based surveillance guidelines and regulations have standardized and improved diagnosis, notification at the level of the primary care system, and management in intensive care units nationwide.
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Affiliation(s)
- Blas Armién
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
- Sistema Nacional de Investigación (SNI), Secretaria Nacional de Ciencia y Tecnología (SENACYT), Panama City 0816-02852, Panama
| | - Carlos Muñoz
- Department of Epidemiology, Health Region of Los Santos, Ministry of Health, Las Tablas, Los Santos 0816-06812, Panama
| | - Hector Cedeño
- National Department of Epidemiology, Ministry of Health, Panama City 0816-06812, Panama
| | - Jacqueline R Salazar
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - Tybbyssay P Salinas
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - Publio González
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - José Trujillo
- Hospital Gustavo Nelson Collado, Caja de Seguro Social, Chitre, Herrera 0816-06808, Panama
| | - Deyanira Sánchez
- Hospital Rural de Tonosí, Ministerio de Salud, Tonosi, Los Santos 0816-06812, Panama
| | - Jamileth Mariñas
- Hospital Rural de Tonosí, Ministerio de Salud, Tonosi, Los Santos 0816-06812, Panama
| | - Ayvar Hernández
- Hospital Rural de Tonosí, Ministerio de Salud, Tonosi, Los Santos 0816-06812, Panama
| | - Harmodio Cruz
- Hospital Rural de Tonosí, Ministerio de Salud, Tonosi, Los Santos 0816-06812, Panama
| | | | - Elba Grimaldo
- Hospital Joaquín Pablo Franco Sayas, Ministry of Health, Las Tablas, Los Santos 0816-06812, Panama
| | - Samuel González
- Hospital Gustavo Nelson Collado, Caja de Seguro Social, Chitre, Herrera 0816-06808, Panama
| | - Heydy Nuñez
- Hospital Ezequiel Abadía, Caja de Seguro Social, Soná, Veraguas 0816-06808, Panama
- Department of Epidemiology, Caja de Seguro Social, Santiago, Veraguas 0816-06808, Panama
| | - Susana Hesse
- Hospital Dr. Luis Chicho Fábrega, Ministry of Health, Santiago, Veraguas 0816-06812, Panama
| | - Fernando Rivera
- Hospital Dr. Luis Chicho Fábrega, Ministry of Health, Santiago, Veraguas 0816-06812, Panama
| | - George Edwards
- Hospital Dr. Luis Chicho Fábrega, Ministry of Health, Santiago, Veraguas 0816-06812, Panama
| | - Ricardo Chong
- Department of Epidemiology, Health Region of Veraguas, Ministry of Health, Santiago, Veraguas 0816-06812, Panama
| | - Ovidio Mendoza
- Department of Epidemiology, Health Region of Veraguas, Ministry of Health, Santiago, Veraguas 0816-06812, Panama
| | - Martín Meza
- Department of Epidemiology, Health Region of Herrera, Ministry of Health, Chitre, Herrera 0816-06812, Panama
| | - Milagro Herrera
- Hospital Regional Rafael Estevez, Caja de Seguro Social, Aguadulce, Coclé 0816-06808, Panama
| | - Rudick Kant
- Department of Epidemiology of the Caja de Seguro Social, Panama City 0816-06808, Panama
| | - Raul Esquivel
- Hospital del Niño José Renal Esquivel, Panama City 0816-00383, Panama
| | - Dora Estripeaut
- Sistema Nacional de Investigación (SNI), Secretaria Nacional de Ciencia y Tecnología (SENACYT), Panama City 0816-02852, Panama
- Hospital del Niño José Renal Esquivel, Panama City 0816-00383, Panama
| | - Demetrio Serracín
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - Bernardino Denis
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - Esthefani Robles
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - Yaxelis Mendoza
- Sistema Nacional de Investigación (SNI), Secretaria Nacional de Ciencia y Tecnología (SENACYT), Panama City 0816-02852, Panama
- Department of Genomics and Proteomics, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - Gloria Gonzalez
- Department of Genomics and Proteomics, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | | | - Juan Miguel Pascale
- Department of Genomics and Proteomics, Gorgas Memorial Institute of Health Studies, Panama City 0816-02593, Panama
| | - Jonathan L Dunnum
- Department of Biology and Museum of Southwestern Biology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Joseph A Cook
- Department of Biology and Museum of Southwestern Biology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Anibal G Armién
- California Animal Health & Food Safety Laboratory System (CAHFS), School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | | | | | - Itza de Mosca
- National Department of Epidemiology, Ministry of Health, Panama City 0816-06812, Panama
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Ning F, Xin L, Quan W, Xiaohui L, Xiaoping D. A preliminary research on transcultural capacity in global public health: from the view of public health professionals. BMC Public Health 2023; 23:465. [PMID: 36899364 PMCID: PMC10007795 DOI: 10.1186/s12889-023-15312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/23/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Transcultural capacity is a key component of consolidated global public health assistance cooperation (GPHAC). The aim of this study is to investigate the transcultural capacity perceptions of public health professionals from China's disease control and prevention system after relative training in order to provide a reference for enhancing transcultural capacity during the practice of GPHAC. METHODS A cross sectional qualitative survey in which self-administrated questionnaire with 5 open ended questions was used. The questionnaire was disseminated on the completion of an online training for China's senior public health professions on transcultural capacity in GPHAC. Descriptive statistics, word frequency analysis and content analysis were used to analyze the questionnaire data. RESULTS Totally, 45 participants took part in this training, 25 of them voluntarily participated in this survey. The participants demonstrated the need for transcultural competence in public health services and suggested improvement in the course content arising from their wealth of knowledge and practical experience in the field. 96% of the participants considered that the training course was "very necessary" and "meaningful". The most interested topics were "Overview of transcultural adaptation and GPHAC", "Transcultural adaptation and response" and "African culture and health". The contents about "Country-specific analysis on cultural factors in public health", "rapid transcultural adaptation" and "more specific practical experiences in diverse cultural backgrounds" were suggested to be added in future training. The participants considered that transcultural capacity ensured the smooth progress of GPHAC and they both could complement each other, transcultural adaptation was the premise of gaining trust and reaching cooperation, it can be conducive to the health assistance professionals to integrate into local cultural life, facilitating their foreign assistance work to be effective and efficient, and impart experiences well. The participants hoped to put the concept into action. CONCLUSION The importance of transcultural competence in GPHAC is becoming a consensus of public health professionals. Enhanced transcultural competence reflected in the attitude of public health as well as other health workers would promote GPHAC and would foster efficient emergency health response management among many countries.
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Affiliation(s)
- Feng Ning
- Center for Global Public Health, Chinese Center for Disease Control and Prevention, Room 211, 155 Changbai Road, Changping District, 102206, Beijing, P. R. China
| | - Liu Xin
- Jiangsu Provincial Center for Disease Control and Prevention, 122 Maihua Road, Qixia District, 210028, Nanjing, Jiangsu Province, China
| | - Wang Quan
- School of Public Health, Wuhan University, 115 Donghu Road, Wuchang District, 430078, Wuhan, Hubei Province, P. R. China
| | - Liang Xiaohui
- School of Public Health, Wuhan University, 115 Donghu Road, Wuchang District, 430078, Wuhan, Hubei Province, P. R. China.
| | - Dong Xiaoping
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, 102206, Beijing, P. R. China.
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Ávila MI, Vajda ÉA, Jeffrey Gutiérrez E, Gibson D, Renteria MM, Presley N, O'Reilly D, Tatarsky A, Lobo NF. Entomological Surveillance Planning Tool (ESPT)-generated actionable evidence on human and vector behaviours optimizes present interventions and reduces exposure to Anopheles vectors in two communities of Guna Yala, Panamá. Malar J 2023; 22:26. [PMID: 36698147 PMCID: PMC9875519 DOI: 10.1186/s12936-023-04453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although most of Panamá is free from malaria, localized foci of transmission persist, including in the Guna Yala region. Government-led entomological surveillance using an Entomological Surveillance Planning Tool (ESPT) sought to answer programmatically relevant questions on local entomological drivers of transmission and gaps in protection to guide local vector control decision-making. METHODS The ESPT was used to design a sampling plan to answer priority programmatic questions about the appropriateness of Long Lasting Insecticidal Nets (LLINs) and spaces and times where humans remain exposed to Anopheles bites (gaps in protection) in the communities of Permé and Puerto Obaldía, Guna Yala. Adult Anopheles were sampled at three time points via human landing catches (HLCs) during the rainy and dry seasons (2018/2019). Human behaviour observations (HBOs) were conducted alongside HLCs to examine intervention use, indoor versus outdoor activity, and sleeping patterns. HLC and HBO data were integrated to evaluate HBO-adjusted human biting rate (HBR). RESULTS A total of 7,431 adult Anopheles were collected across both sites. Of the 450 specimens molecularly confirmed to species-level, 75.5% (n = 340) were confirmed as Anopheles Nyssorhynchus albimanus, followed by Anopheles (Ny.) aquasalis. Anopheles host seeking activity was demonstrated to be primarily exophagic throughout all sampling periods and in both communities. When adjusted with HBOs, exposure to mosquito bites was predominantly indoors and overnight in Permé (Nov, Mar), compared to predominantly outdoors in Puerto Obaldía (Nov, Mar, Jul). Differences in site-specific human-vector exposure profiles were due to contrasting cultural and lifestyle practices between Permé and Puerto Obaldía (possibly partly influenced by the absence of electricity in Permé), and lower LLIN use in Permé. This evidence supported a previously planned LLIN campaign alongside a social behaviour change communication (SBCC) strategy in the Guna Yala Comarca (Jul 2019), which increased LLIN use. In turn, this led to a reduction of indoor exposure to mosquito bites, and a shift to predominant outdoor exposure to mosquito bites. CONCLUSION ESPT-based question-driven planning and the integration of HBOs, intervention, and HLC data generated evidence towards answering the programmatic questions. This evidence enabled the characterization of site-specific human-vector exposure profiles, and the quantification of remaining gaps in protection. These data also provide important insights into remaining gaps in protection that must be addressed to further reduce human exposure to mosquito bites at these sites.
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Affiliation(s)
- Mario I Ávila
- Ministerio de Salud de Panamá (MINSA), Panama City, Panama
| | - Élodie A Vajda
- Malaria Elimination Initiative (MEI), University of California, San Francisco (UCSF), San Francisco, USA.
| | - Eileen Jeffrey Gutiérrez
- Malaria Elimination Initiative (MEI), University of California, San Francisco (UCSF), San Francisco, USA
| | - Daragh Gibson
- Clinton Health Access Initiative (CHAI), Panama City, Panama
| | | | - Nicolas Presley
- Clinton Health Access Initiative (CHAI), Panama City, Panama
| | | | - Allison Tatarsky
- Malaria Elimination Initiative (MEI), University of California, San Francisco (UCSF), San Francisco, USA
| | - Neil F Lobo
- Malaria Elimination Initiative (MEI), University of California, San Francisco (UCSF), San Francisco, USA
- Eck Institute for Global Health, University of Notre Dame (UND), Notre Dame, IN, USA
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Fuehrer HP, Campino S, Sutherland CJ. The primate malaria parasites Plasmodium malariae, Plasmodium brasilianum and Plasmodium ovale spp.: genomic insights into distribution, dispersal and host transitions. Malar J 2022; 21:138. [PMID: 35505317 PMCID: PMC9066925 DOI: 10.1186/s12936-022-04151-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/05/2022] [Indexed: 01/04/2023] Open
Abstract
During the twentieth century, there was an explosion in understanding of the malaria parasites infecting humans and wild primates. This was built on three main data sources: from detailed descriptive morphology, from observational histories of induced infections in captive primates, syphilis patients, prison inmates and volunteers, and from clinical and epidemiological studies in the field. All three were wholly dependent on parasitological information from blood-film microscopy, and The Primate Malarias” by Coatney and colleagues (1971) provides an overview of this knowledge available at that time. Here, 50 years on, a perspective from the third decade of the twenty-first century is presented on two pairs of primate malaria parasite species. Included is a near-exhaustive summary of the recent and current geographical distribution for each of these four species, and of the underlying molecular and genomic evidence for each. The important role of host transitions in the radiation of Plasmodium spp. is discussed, as are any implications for the desired elimination of all malaria species in human populations. Two important questions are posed, requiring further work on these often ignored taxa. Is Plasmodium brasilianum, circulating among wild simian hosts in the Americas, a distinct species from Plasmodium malariae? Can new insights into the genomic differences between Plasmodium ovale curtisi and Plasmodium ovale wallikeri be linked to any important differences in parasite morphology, cell biology or clinical and epidemiological features?
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Affiliation(s)
- Hans-Peter Fuehrer
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Susana Campino
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Colin J Sutherland
- Department of Infection Biology, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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Ávila MI, Vajda ÉA, Gutiérrez EJ, Gibson DA, Renteria MM, Presley N, O'Reilly D, Burton TA, Tatarsky A, Lobo NF. Anopheles drivers of persisting malaria transmission in Guna Yala, Panamá: an operational investigation. Malar J 2021; 20:443. [PMID: 34819092 PMCID: PMC8611962 DOI: 10.1186/s12936-021-03972-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background Though most of Panamá is free from malaria, localized foci of transmission persist, including in the Guna Yala region. Government-led entomological surveillance using an entomological surveillance planning tool (ESPT) sought to answer programmatically-relevant questions that would enhance the understanding of both local entomological drivers of transmission and gaps in protection that result in persisting malaria transmission to guide local vector control decision-making. Methods The ESPT was used to design a sampling plan centered around the collection of minimum essential indicators to investigate the relevance of LLINs and IRS in the communities of Permé and Puerto Obaldía, Guna Yala, as well as to pinpoint any remaining spaces and times where humans are exposed to Anopheles bites (gaps in protection). Adult Anopheles were collected at three time points via human landing catches (HLCs), CDC Light Traps (LT), and pyrethrum spray catches (PSCs) during the rainy and dry seasons. Mosquitoes were identified to species via molecular methods. Insecticide susceptibility testing of the main vector species to fenitrothion was conducted. Results In total, 7537 adult Anopheles were collected from both sites. Of the 493 specimens molecularly confirmed to species, two thirds (n = 340) were identified as Nyssorhynchus albimanus, followed by Anopheles aquasalis. Overall Anopheles human biting rates (HBRs) were higher outdoors than indoors, and were higher in Permé than in Puerto Obaldía: nightly outdoor HBR ranged from 2.71 bites per person per night (bpn) (Puerto Obaldía), to 221.00 bpn (Permé), whereas indoor nightly HBR ranged from 0.70 bpn (Puerto Obaldía) to 81.90 bpn (Permé). Generally, peak biting occurred during the early evening. The CDC LT trap yields were significantly lower than that of HLCs and this collection method was dropped after the first collection. Pyrethrum spray catches resulted in only three indoor resting Anopheles collected. Insecticide resistance (IR) of Ny. albimanus to fenitrothion was confirmed, with only 65.5% mortality at the diagnostic time. Conclusion The early evening exophagic behaviour of Anopheles vectors, the absence of indoor resting behaviours, and the presence of resistance to the primary intervention insecticide demonstrate limitations of the current malaria strategy, including indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs), and point to both gaps in protection and to the drivers of persisting malaria transmission in Guna Yala. These findings highlight the need for continued and directed entomological surveillance, based on programmatic questions, that generates entomological evidence to inform an adaptive malaria elimination strategy.
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Affiliation(s)
- Mario I Ávila
- Ministerio de Salud de Panamá (MINSA), Panama City, República de Panamá
| | - Élodie A Vajda
- Malaria Elimination Initiative (MEI), University of California, San Francisco (UCSF), USA.
| | | | - Daragh A Gibson
- Clinton Health Access Initiative (CHAI), Panama City, Panama
| | | | | | - Daniel O'Reilly
- Ministerio de Salud de Panamá (MINSA), Panama City, República de Panamá
| | - Timothy A Burton
- Eck Institute for Global Health, University of Notre Dame (UND), Notre Dame, IN, USA
| | - Allison Tatarsky
- Malaria Elimination Initiative (MEI), University of California, San Francisco (UCSF), USA
| | - Neil F Lobo
- Malaria Elimination Initiative (MEI), University of California, San Francisco (UCSF), USA.,Eck Institute for Global Health, University of Notre Dame (UND), Notre Dame, IN, USA
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Plasmodium vivax Genetic Diversity in Panama: Challenges for Malaria Elimination in Mesoamerica. Pathogens 2021; 10:pathogens10080989. [PMID: 34451452 PMCID: PMC8401434 DOI: 10.3390/pathogens10080989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
Panama and all nations within the Mesoamerican region have committed to eliminate malaria within this decade. With more than 90% of the malaria cases in this region caused by Plasmodium vivax, an efficient national/regional elimination plan must include a comprehensive study of this parasite's genetic diversity. Here, we retrospectively analyzed P. vivax genetic diversity in autochthonous and imported field isolates collected in different endemic regions in Panama from 2007 to 2020, using highly polymorphic markers (csp, msp-1, and msp-3α). We did the analysis using molecular techniques that are cost-effective for malaria molecular surveillance within Mesoamerica. Thus, we used molecular analyses that are feasible for malaria molecular surveillance within the region, and that can provide useful information for policy and decision making about malaria elimination. We also evaluated if haplotypes established by combining the genotypes found in these genes were associated with relevant epidemiological variables and showed structure across the transmission foci that have been observed in Panama. Ten different haplotypes were identified, some of them strongly associated with geographical origin, age, and collection year. Phylogenetic analysis of csp (central repeat domain) revealed that both major variant types (vk210 and vk247) were circulating in Panama. Variant vk247 was restricted to the eastern endemic regions, while vk210 was predominant (77.3%) and widespread, displaying higher diversity (14 alleles) and geographically biased alleles. The regional implications of these molecular findings for the control of P. vivax malaria to achieve elimination across Mesoamerica are discussed.
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Buyon LE, Santamaria AM, Early AM, Quijada M, Barahona I, Lasso J, Avila M, Volkman SK, Marti M, Neafsey DE, Obaldia III N. Population genomics of Plasmodium vivax in Panama to assess the risk of case importation on malaria elimination. PLoS Negl Trop Dis 2020; 14:e0008962. [PMID: 33315861 PMCID: PMC7769613 DOI: 10.1371/journal.pntd.0008962] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/28/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022] Open
Abstract
Malaria incidence in Panama has plateaued in recent years in spite of elimination efforts, with almost all cases caused by Plasmodium vivax. Notwithstanding, overall malaria prevalence remains low (fewer than 1 case per 1000 persons). We used selective whole genome amplification to sequence 59 P. vivax samples from Panama. The P. vivax samples were collected from two periods (2007-2009 and 2017-2019) to study the population structure and transmission dynamics of the parasite. Imported cases resulting from increased levels of human migration could threaten malaria elimination prospects, and four of the samples evaluated came from individuals with travel history. We explored patterns of recent common ancestry among the samples and observed that a highly genetically related lineage (termed CL1) was dominant among the samples (47 out of 59 samples with good sequencing coverage), spanning the entire period of the collection (2007-2019) and all regions of the country. We also found a second, smaller clonal lineage (termed CL2) of four parasites collected between 2017 and 2019. To explore the regional context of Panamanian P. vivax we conducted principal components analysis and constructed a neighbor-joining tree using these samples and samples collected worldwide from a previous study. Three of the four samples with travel history clustered with samples collected from their suspected country of origin (consistent with importation), while one appears to have been a result of local transmission. The small number of Panamanian P. vivax samples not belonging to either CL1 or CL2 clustered with samples collected from Colombia, suggesting they represent the genetically similar ancestral P. vivax population in Panama or were recently imported from Colombia. The low diversity we observe in Panama indicates that this parasite population has been previously subject to a severe bottleneck and may be eligible for elimination. Additionally, while we confirmed that P. vivax is imported to Panama from diverse geographic locations, the lack of impact from imported cases on the overall parasite population genomic profile suggests that onward transmission from such cases is limited and that imported cases may not presently pose a major barrier to elimination.
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Affiliation(s)
- Lucas E. Buyon
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- The Broad Institute, Cambridge, Massachusetts, United States of America
| | | | - Angela M. Early
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- The Broad Institute, Cambridge, Massachusetts, United States of America
| | - Mario Quijada
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
| | | | | | | | - Sarah K. Volkman
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- The Broad Institute, Cambridge, Massachusetts, United States of America
- Simmons University, College of Natural, Behavioral and Health Sciences, Boston, Massachusetts, United States of America
| | | | - Daniel E. Neafsey
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- The Broad Institute, Cambridge, Massachusetts, United States of America
- * E-mail: (DEN); (NO)
| | - Nicanor Obaldia III
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- University of Glasgow, Glasgow, United Kingdom
- * E-mail: (DEN); (NO)
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Santamaría AM, Vásquez V, Rigg C, Moreno D, Romero L, Justo C, Chaves LF, Saldaña A, Calzada JE. Plasmodium falciparum Genetic Diversity in Panamá Based on glurp, msp-1 and msp-2 Genes: Implications for Malaria Elimination in Mesoamerica. Life (Basel) 2020; 10:E319. [PMID: 33260605 PMCID: PMC7760695 DOI: 10.3390/life10120319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 12/26/2022] Open
Abstract
Panamá, together with all the nations in Mesoamerica, has committed to eliminate malaria from the region by 2020. As these countries approach malaria elimination and local transmission decreases, an active molecular surveillance to identify genotypes circulating along the border areas is particularly needed to accurately infer infection origin, drug resistance and disease propagation patterns in the region. This study evaluated the genetic diversity and allele frequencies of msp-1, msp-2 and glurp genes using different molecular analyses (nested PCR, PCR-restriction fragment length polymorphism (RFLP) and sequencing) from 106 autochthonous and imported P. falciparum isolates collected from different endemic areas in Panamá between 2003 and 2019. We also explored if P. falciparum genotypes assessed with these molecular markers were associated with relevant malaria epidemiological parameters using a multiple correspondence analysis. A strong association of certain local haplotypes with their geographic distribution in endemic areas, but also with parasite load and presence of gametocytes, was evidenced. Few multiclonal infections and low genetic diversity among locally transmitted P. falciparum samples were detected, consequent with the low transmission intensity of this parasite in Panamá, a pattern likely to be extended across Mesoamerica. In addition, several imported cases were genetically dissimilar to local infections and representative of more diverse extra-continental lineages.
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Affiliation(s)
- Ana María Santamaría
- Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (A.M.S.); (V.V.); (C.R.); (A.S.)
- Facultades de Ciencias Naturales Exactas y Ciencias de la Salud, Universidad de Panamá, Panamá 4 3366, Republic of Panama
| | - Vanessa Vásquez
- Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (A.M.S.); (V.V.); (C.R.); (A.S.)
| | - Chystrie Rigg
- Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (A.M.S.); (V.V.); (C.R.); (A.S.)
| | - Dianik Moreno
- Laboratorio Central de Referencia en Salud Publica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (D.M.); (L.R.); (C.J.)
| | - Luis Romero
- Laboratorio Central de Referencia en Salud Publica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (D.M.); (L.R.); (C.J.)
| | - Carlos Justo
- Laboratorio Central de Referencia en Salud Publica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (D.M.); (L.R.); (C.J.)
| | - Luis Fernando Chaves
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos 4-2250, Cartago 1, Costa Rica;
| | - Azael Saldaña
- Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (A.M.S.); (V.V.); (C.R.); (A.S.)
- Facultades de Ciencias Naturales Exactas y Ciencias de la Salud, Universidad de Panamá, Panamá 4 3366, Republic of Panama
| | - José E. Calzada
- Departamento de Investigación en Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá 0816-02593, Republic of Panama; (A.M.S.); (V.V.); (C.R.); (A.S.)
- Facultades de Ciencias Naturales Exactas y Ciencias de la Salud, Universidad de Panamá, Panamá 4 3366, Republic of Panama
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