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Erausquin JT, Sánchez J, Yu Pon A, Jhangimal M, Millender E, Peña Y, Ng W, Reina A, Nakad C, Quintana J, Herrera Veces R, Vistica G, Pinzón-Espinosa J, Cabezas-Talavero G, Katz J, Pascale JM, Rodríguez-Álvarez F, Gabster A. Sexual and reproductive health and access: Results of a rapid epidemiological assessment among migrant peoples in transit through Darién, Panamá. Front Reprod Health 2022; 4:953979. [PMID: 36523789 PMCID: PMC9745017 DOI: 10.3389/frph.2022.953979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/31/2022] [Indexed: 07/29/2023] Open
Abstract
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.
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Affiliation(s)
- Jennifer Toller Erausquin
- Department of Public Health Education, School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, United States
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Joanne Sánchez
- Complejo Hospitalario Arnufo Arias de Madrid, Panamá City, Panamá
| | - Anyi Yu Pon
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Mónica Jhangimal
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Eugenia Millender
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Yudith Peña
- Community Development Network of the Americas, Panamá City, Panamá
| | - Winroy Ng
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Adelys Reina
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
| | - Candy Nakad
- Instituto de Medicina Tropical, Laboratorio de Protozoarios de Biología Molecular, Universidad Central de Venezuela, Caracas, Venezuela
| | - Joselid Quintana
- Community Development Network of the Americas, Panamá City, Panamá
| | | | - Grace Vistica
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Justo Pinzón-Espinosa
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
- Sant Pau Mental Health Group, Institut d’Investigació Biomèdica Sant Pau (IBB-San Pau), Hospital de la San Creu i Sant Pau, Universisat Autònoma de Barcelona, Barcelona, Spain
- Department of Medicine, School of Medicine, University of Barcelona, Barcelona, Spain
- Department of Clinical Psychiatry, School of Medicine, University of Panamá, Panamá City, Panamá
- Institut d’Investigació i Innovació Parc Tauli (I3PT), Sabadell, Spain
| | | | - Jennifer Katz
- Community Development Network of the Americas, Panamá City, Panamá
| | - Juan Miguel Pascale
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
- Faculty of Medicine, University of Panamá, Panamá City, Panamá
| | | | - Amanda Gabster
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, United States
- Gorgas Memorial Institute of Health Studies, Panamá City, Panamá
- National Research System of Panamá (SNI), Panamá, Panamá
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Agudelo-Higuita N, Suarez JA, Millender E, Garcia-Creighton E, Corbisiero MF, Freites CO, Cordero JH, Kousari A, Unterborn R, Marcos LA, Henao-Martinez AF, Jhangimal M, Pon AY, Tuells J, Diaz EG, Franco-Paredes C, Erausquin JT, Pinzon-Espinoza J, Baird M, Pachar M, Ordaz M, Cabezas-Talavero G, Katz J, Gonzalez JA, Obando R, Rodriguez F, Naranjo L, Madrid A, Pecchio I, Vistica G, Nakad C, Reina A, Diaz Y, Cheng R, Meng M, Alvarado YW, Baranyi S, Sanchez J, Rincὁn T, Viquez D, Owen D, Pascale JM, Gabster A. U.S. bound journey of migrant peoples InTransit across Dante's Inferno and Purgatory in the Americas. Travel Med Infect Dis 2022; 47:102317. [PMID: 35342009 DOI: 10.1016/j.tmaid.2022.102317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
Rapid rise of population migration is a defining feature of the 21st century due to the impact of climate change, political instability, and socioeconomic downturn. Over the last decade, an increasing number of migrant peoples travel across the Americas to reach the United States seeking asylum or cross the border undocumented in search of economic opportunities. In this journey, migrant people experience violations of their human rights, hunger, illness, violence and have limited access to medical care. In the 'Divine Comedy', the Italian poet Dante Alighieri depicts his allegorical pilgrimage across Hell and Purgatory to reach Paradise. More than 700 years after its publication, Dante's poem speaks to the present time and the perilious journey of migrant peoples to reach safehavens. By exploring the depths and heights of the human condition, Dante's struggles resonate with the multiple barriers and the unfathomable experiences faced by migrant peoples in transit across South, Central, and North America to reach the United States. Ensuring the safety of migrant peoples across the Americas and elsewhere, and attending to their health needs during their migratory paths represent modern priorities to reduce social injustices and achieving health equity.
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Affiliation(s)
- Nelson Agudelo-Higuita
- Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Science Center, USA
| | - Jose Antonio Suarez
- Investigador SNI Senacyt Panamá, Clinical Research Department, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Eugenia Millender
- Center of Population Sciences for Health Equity, USA; College of Nursing, Florida State Univ, USA; College of Social Work, Dept of Behavioral Science and Social Medicine, College of Medicine, Florida State University, USA
| | | | | | - Christian Olivo Freites
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, California, USA
| | - Jose Henao Cordero
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Denver, CO, USA
| | - Arianna Kousari
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Denver, CO, USA
| | - Rebecca Unterborn
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Denver, CO, USA
| | - Luis A Marcos
- Division of Infectious Diseases, Department of Medicine and Department of Microbiology and Immunology, Stony Brook University, New York, USA
| | - Andres F Henao-Martinez
- Division of Infectious Diseases, University of Colorado, Anschutz Medical Campus, Denver, CO, USA
| | - Monica Jhangimal
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Anyi Yu Pon
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Jose Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690, Alicante, Spain
| | | | - Carlos Franco-Paredes
- Investigador SNI Senacyt Panamá, Clinical Research Department, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama; Hospital Infantil de México, Federico Gómez, México City, Mexico.
| | | | - Justo Pinzon-Espinoza
- Department of Public Health Education, University of North Carolina at Greensboro, NC, USA; Department of Mental Health, Parc Tauli, University Hospital, Sabadell Barcelona, Spain; Department of Medicine, School of Medicine, University of Barcelona, Spain; Department of Clinica Psychiatry, University of Panama, Republic of Panama
| | | | - Monica Pachar
- Hospital Santo Tomas, Panama City, Republic of Panama
| | - Michelle Ordaz
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | | | - Jennifer Katz
- Community Development Network of the Americas, Panama City, Republic of Panama
| | | | - Rosela Obando
- Hospital de Especialidades Pediátricas, Panama City, Republic of Panama
| | - Fatima Rodriguez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Laura Naranjo
- GlaxoSmithKline Vacccines CARICAM, Investigador I SNI-Senacyt Panamá, Republic of Panama
| | - Alexandra Madrid
- Universidad de Panama, Centro Regional Universitario de Veraguas, Facultad de Farmacia, Republic of Panama
| | - Itabe Pecchio
- Universidad de Panama, Centro Regional Universitario de Veraguas, Facultad de Farmacia, Republic of Panama
| | - Grace Vistica
- University of Tulane School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development New Orleans, LA, USA
| | - Candy Nakad
- Instituto de Medicina Tropical, Laboratorio de Protozoarios de Biología Molecular, Universidad Central de Venezuela, Caracas, Venezuela
| | - Adelys Reina
- Departmento de Investigación en Virología y Biotecnología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Yamilka Diaz
- Departmento de Investigación en Virología y Biotecnología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Roderick Cheng
- Ministerio de Salud de Panamá, Dirección Nacional de Dispositivos Médicos, Republic of Panama
| | - Michael Meng
- Ministerio de Salud de Panamá, Dirección Nacional de Dispositivos Médicos, Republic of Panama
| | | | | | - Joanne Sanchez
- Complejo Hospitalario Dr. Arnulfo Arias Madrid, Panama City, Republic of Panama
| | - Tomas Rincὁn
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Daniel Viquez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | | | - Juan Miguel Pascale
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Amanda Gabster
- Investigador SNI Senacyt Panamá, Clinical Research Department, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
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Gabster A, Jhangimal M, Erausquin JT, Suárez JA, Pinzón-Espinosa J, Baird M, Katz J, Beltran-Henríquez D, Cabezas-Talavero G, Henao-Martínez AF, Franco-Paredes C, Agudelo-Higuita NI, Pachar M, González JA, Rodriguez F, Pascale JM. Rapid health evaluation in migrant peoples in transit through Darien, Panama: protocol for a multimethod qualitative and quantitative study. Ther Adv Infect Dis 2021; 8:20499361211066190. [PMID: 34925828 PMCID: PMC8679050 DOI: 10.1177/20499361211066190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/22/2021] [Indexed: 11/15/2022] Open
Abstract
Background: The world is currently unprepared to deal with the drastic increase in global
migration. There is an urgent need to develop programs to protect the
well-being and health of migrant peoples. Increased population movement is
already evident throughout the Americas as exemplified by the rising number
of migrant peoples who pass through the Darien neotropical moist broadleaf
forest along the border region between Panama and Colombia. The transit of
migrant peoples through this area has an increase in the last years. In
2021, an average of 9400 people entered the region per month compared with
2000–3500 people monthly in 2019. Along this trail, there is no access to
health care, food provision, potable water, or housing. To date, much of
what is known about health needs and barriers to health care within this
population is based on journalistic reports and anecdotes. There is a need
for a comprehensive approach to assess the health care needs of migrant
peoples in transit. This study aims to describe demographic characteristics,
mental and physical health status and needs, and experiences of host
communities, and to identify opportunities to improve health care provision
to migrant peoples in transit in Panama. Study design and methods: This multimethod study will include qualitative (n = 70) and
quantitative (n = 520) components. The qualitative
component includes interviews with migrant peoples in transit, national and
international nongovernmental organizations and agencies based in Panama.
The quantitative component is a rapid epidemiological study which includes a
questionnaire and four clinical screenings: mental health, sexual and
reproductive health, general and tropical medicine, and nutrition. Conclusion: This study will contribute to a better understanding of the health status and
needs of migrant peoples in transit through the region. Findings will be
used to allocate resources and provide targeted health care interventions
for migrant peoples in transit through Darien, Panama.
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Affiliation(s)
- Amanda Gabster
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Ave Justo Arosemena, Calle 36 Ciudad de Panamá, Panama City, Panamá
| | - Monica Jhangimal
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panamá
| | | | | | | | | | - Jennifer Katz
- Community Development Network of the Americas, Panama City, Panamá
| | | | | | | | | | | | | | | | - Fátima Rodriguez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panamá
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