1
|
DeAntonio R, Hess-Holtz M, Abrego L, Capitan-Barrios Z, Donoso LH, De León T, Sáez Llorens X, Moreno B, Weil JG. Norovirus in children under 2 years of age: an epidemiological study in Panama during the COVID-19 pandemic. Front Pediatr 2024; 12:1292967. [PMID: 38425667 PMCID: PMC10902054 DOI: 10.3389/fped.2024.1292967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Norovirus infection is a common cause of acute gastroenteritis (AGE). Surveillance activities are important to aid investigation into effective norovirus control strategies, including vaccination. Here, we report ancillary findings related to the incidence, prevalence, and etiology of AGE caused by norovirus in Panama after adjustment of study methodology to comply with national coronavirus disease 2019 (COVID-19) mandates. Methods In January 2020, children aged <2 years began enrolling into an epidemiological study in Panama to estimate the burden of norovirus in preparation for evaluating upcoming prevention strategies. This included an observational, longitudinal, community-based AGE surveillance study and a hospital-based AGE surveillance study. For the longitudinal study, healthy children aged 5-18 months were enrolled from January 6 through March 23, 2020, with a follow-up of approximately 6 months. The last participant was contacted on September 23, 2020. For the hospital-based study, starting on January 21, 2020, children aged <2 years who were admitted to the Hospital del Niño Dr. José Renán Esquivel in Panama City due to AGE were evaluated. The last sample was collected on September 29, 2020. Collected stool samples were tested for norovirus as well as astrovirus, sapovirus, and various enteropathogens. Unfortunately, this study was disrupted by the subsequent implementation of disease transmission control procedures for the COVID-19 pandemic, and the study methodology was revised to comply with COVID-19 mandates. Results In the longitudinal surveillance cohort [N = 400 (Chiriquí, n = 239; Panama, n = 161)], a total of 185 AGE episodes were documented (Chiriquí, n = 85; Panama, n = 100) resulting in an overall AGE incidence of 11.6 (95% CI: 9.99-13.4) episodes per 100 child-months. The norovirus-related AGE incidence was 0.3 (95% CI: 0.10-0.73) episodes per 100 child-months (5/185 AGE episodes) and the prevalence of norovirus was 4.6% (13/282 stool samples collected). In the hospital-based surveillance cohort, at least one pathogen was detected in 50% of samples (44/88 stool samples collected) and norovirus prevalence was 6.8% (6/88 stool samples collected). Discussion This report demonstrates how the occurrence of the COVID-19 pandemic hindered the conduct of clinical trials. However, this also created unique research opportunities to investigate the potential impact of pandemic control measures on the etiology of infectious diarrheal disease.
Collapse
Affiliation(s)
- Rodrigo DeAntonio
- Centro de Vacunación e Investigación CEVAXIN, The Panama Clinic, Panama City, Panama
| | - Morgan Hess-Holtz
- Centro de Vacunación e Investigación CEVAXIN, The Panama Clinic, Panama City, Panama
| | - Leyda Abrego
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Departamento de Investigacion en Virologia y Biotecnologia, Panama City, Panama
- Departamento de Microbiología y Parasitología, Facultad de Ciencias Naturales, Exactas y Tecnología, Universidad de Panama, Panama City, Panama
| | - Zeuz Capitan-Barrios
- Departamento de Microbiología y Parasitología, Facultad de Ciencias Naturales, Exactas y Tecnología, Universidad de Panama, Panama City, Panama
| | | | - Tirza De León
- Centro de Vacunación e Investigación CEVAXIN, The Panama Clinic, Panama City, Panama
- Hospital Materno Infantil José Domingo de Obaldia, David, Panama
| | - Xavier Sáez Llorens
- Centro de Vacunación e Investigación CEVAXIN, The Panama Clinic, Panama City, Panama
- Infectious Disease Department, Hospital del Niño Dr José Renán Esquivel, Panama City, Panama
| | - Brechla Moreno
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Departamento de Investigacion en Virologia y Biotecnologia, Panama City, Panama
| | | |
Collapse
|
2
|
Rivera LF, Lezcano-Coba C, Galué J, Rodriguez X, Juarez Y, de Souza WM, Capitan-Barrios Z, Valderrama A, Abrego L, Cedeño H, Jackman C, Waggoner JJ, Aguilar PV, Guzman H, Weaver SC, Tesh RB, López-Vèrges S, Donnelly CA, Estofolete CF, Nogueira ML, Faria NR, Vasilakis N, Vittor AY, Smith DR, Carrera JP. Clinical and epidemiological characteristics of Madariaga and Venezuelan equine encephalitis virus infections. medRxiv 2024:2024.02.02.24302220. [PMID: 38352566 PMCID: PMC10863014 DOI: 10.1101/2024.02.02.24302220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Madariaga virus (MADV) and Venezuelan equine encephalitis virus (VEEV) are emerging arboviruses affecting rural and remote areas of Latin America. However, there are limited clinical and epidemiological reports available, and outbreaks are occurring at an increasing frequency. We addressed this gap by analyzing all the available clinical and epidemiological data of MADV and VEEV infections recorded since 1961 in Panama. A total of 168 of human alphavirus encephalitis cases were detected in Panama from 1961 to 2023. Here we describe the clinical signs and symptoms and epidemiological characteristics of these cases, and also explored signs and symptoms as potential predictors of encephalitic alphavirus infection when compared to those of other arbovirus infections occurring in the region. Our results highlight the challenges clinical diagnosis of alphavirus disease in endemic regions with overlapping circulation of multiple arboviruses.
Collapse
Affiliation(s)
- Luis Felipe Rivera
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Carlos Lezcano-Coba
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Josefrancisco Galué
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Xacdiel Rodriguez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Yelissa Juarez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | | | - Zeuz Capitan-Barrios
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
- Universidad de Panamá, Ciudad de Panamá
| | - Anayansi Valderrama
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
| | - Leyda Abrego
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
- Universidad de Panamá, Ciudad de Panamá
| | | | | | | | | | - Hilda Guzman
- The University of Texas Medical Branch, Galveston, TX, USA
| | | | - Robert B. Tesh
- The University of Texas Medical Branch, Galveston, TX, USA
| | | | | | - Cassia F. Estofolete
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo Brazil
| | - Mauricio L. Nogueira
- The University of Texas Medical Branch, Galveston, TX, USA
- Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo Brazil
| | - Nuno R. Faria
- Imperial College London, London, United Kingdom
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Jean-Paul Carrera
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darién, Panama
- University of Oxford, Oxford, United Kingdom
| |
Collapse
|
3
|
Gutierrez L, Sáenz V, Franco D, Moreno B, Fuentes-Campos E, Capitan-Barrios Z, Rivera LF, Carrera JP, Castillo J, Castillo M, Pascale JM, López-Vergès S, Sosa N, Ábrego L. Detection of parechovirus A in respiratory, gastrointestinal, and neurological clinical samples of pediatric patients from Panama (2014-2015). Virol J 2023; 20:302. [PMID: 38115118 PMCID: PMC10731877 DOI: 10.1186/s12985-023-02268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
Parechovirus A (PeV-A, Parechovirus, Picornaviridae) are human pathogens associated with mild to severe gastrointestinal and respiratory diseases in young children. While several studies have investigated the association of PeV-A with human disease, little is known about its epidemiology or detection in Latin America. Between the years 2014 and 2015, a total of 200 samples were collected from Panamanian pediatric patients aged < 16 years old exhibiting symptoms associated with respiratory (n = 64), gastrointestinal (n = 68), or neurological (n = 68) diseases. These samples were gathered from patients who had previously received negative diagnoses for the main respiratory viruses, rotavirus, and neurological viruses like herpes virus, enterovirus, and cytomegalovirus. The presence of PeV-A was analyzed by real time RT-PCR.Eight positive PeV-A infections (4.0%, 95% CI: 1.7 to 7.7) were detected: two in respiratory samples (3.0%, 95% CI: 0.3 to 10.8), five in gastrointestinal samples (7.3%, 95% CI: 2.4 to 16.3), and one in cerebrospinal fluid (1.5%, 95% CI: 1.4 to 7.9). The study provides evidence of PeV-A circulation in Panama and the data collectively, remarked on the importance of considering PeV-A in the Panamanian pediatric diagnostic landscape, especially when conventional testing for more common viruses yields negative results.
Collapse
Affiliation(s)
- Lizette Gutierrez
- The University of Texas at El Paso (UTEP), El Paso, TX, 79968, US
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Viridiana Sáenz
- The University of Texas at El Paso (UTEP), El Paso, TX, 79968, US
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Danilo Franco
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Brechla Moreno
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Ediner Fuentes-Campos
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Zeuz Capitan-Barrios
- Facultad de Ciencias Naturales, Exactas y Tecnología, Departamento de Microbiología y Parasitología, Universidad de Panamá, Panamá, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darien, Panama
| | - Luis Felipe Rivera
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darien, Panama
| | - Jean-Paul Carrera
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darien, Panama
| | - Juan Castillo
- Department Research in Genomic and Proteomic, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Marlene Castillo
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Juan Miguel Pascale
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Sandra López-Vergès
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Néstor Sosa
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Division of Infectious Diseases, University of New Mexico Hospital, Albuquerque, NM, US
| | - Leyda Ábrego
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama.
- Facultad de Ciencias Naturales, Exactas y Tecnología, Departamento de Microbiología y Parasitología, Universidad de Panamá, Panamá, Panama.
- Carson Centre for Research in Environment and Emerging Infectious Diseases, La Peñita, Darien, Panama.
| |
Collapse
|
4
|
Carrera JP, Araúz D, Rojas A, Cardozo F, Stittleburg V, Morales Claro I, Galue J, Lezcano-Coba C, Romero Rebello Moreira F, -Rivera LF, Chen-Germán M, Moreno B, Capitan-Barrios Z, López-Vergès S, Pascale JM, Sabino EC, Valderrama A, Hanley KA, Donnelly CA, Vasilakis N, Faria NR, Waggoner JJ. Real-time RT-PCR for Venezuelan equine encephalitis complex, Madariaga, and Eastern equine encephalitis viruses: application in human and mosquito public health surveillance in Panama. J Clin Microbiol 2023; 61:e0015223. [PMID: 37982611 PMCID: PMC10729654 DOI: 10.1128/jcm.00152-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/08/2023] [Indexed: 11/21/2023] Open
Abstract
Eastern equine encephalitis virus (EEEV), Madariaga virus (MADV), and Venezuelan equine encephalitis virus complex (VEEV) are New World alphaviruses transmitted by mosquitoes. They cause febrile and sometimes severe neurological diseases in human and equine hosts. Detecting them during the acute phase is hindered by non-specific symptoms and limited diagnostic tools. We designed and clinically assessed real-time reverse transcription polymerase chain reaction assays (rRT-PCRs) for VEEV complex, MADV, and EEEV using whole-genome sequences. Validation involved 15 retrospective serum samples from 2015 to 2017 outbreaks, 150 mosquito pools from 2015, and 118 prospective samples from 2021 to 2022 surveillance in Panama. The rRT-PCRs detected VEEV complex RNA in 10 samples (66.7%) from outbreaks, with one having both VEEV complex and MADV RNAs. VEEV complex RNA was found in five suspected dengue cases from disease surveillance. The rRT-PCR assays identified VEEV complex RNA in three Culex (Melanoconion) vomerifer pools, leading to VEEV isolates in two. Phylogenetic analysis revealed the VEEV ID subtype in positive samples. Notably, 11.9% of dengue-like disease patients showed VEEV infections. Together, our rRT-PCR validation in human and mosquito samples suggests that this method can be incorporated into mosquito and human encephalitic alphavirus surveillance programs in endemic regions.
Collapse
Affiliation(s)
- Jean-Paul Carrera
- Department of Biology, University of Oxford, Oxford, United Kingdom
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Viral Emerging Disease Dynamics Group, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Dimelza Araúz
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Alejandra Rojas
- Departamento de Producción, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Fátima Cardozo
- Departamento de Producción, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Victoria Stittleburg
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Ingra Morales Claro
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- MRC Centre for Global Infectious Disease Analysis (MRC-GIDA), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Josefrancisco Galue
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Viral Emerging Disease Dynamics Group, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Carlos Lezcano-Coba
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Viral Emerging Disease Dynamics Group, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Filipe Romero Rebello Moreira
- MRC Centre for Global Infectious Disease Analysis (MRC-GIDA), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luis Felipe -Rivera
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Viral Emerging Disease Dynamics Group, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Maria Chen-Germán
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Brechla Moreno
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Zeuz Capitan-Barrios
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Viral Emerging Disease Dynamics Group, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Departamento de Microbiología y Parasitología, Facultad de Ciencias Naturales, Exactas y Tecnología, Universidad de Panamá, Ciudad de Panamá, Panama
| | - Sandra López-Vergès
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Juan Miguel Pascale
- Clinical of Tropical Diseases and Research Unit, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Ester C. Sabino
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Anayansi Valderrama
- Viral Emerging Disease Dynamics Group, Gorgas Memorial Institute of Health Studies, Panama City, Panama
- Department of Medical Entomology, Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | - Kathryn A. Hanley
- Department of Biology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Christl A. Donnelly
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- MRC Centre for Global Infectious Disease Analysis (MRC-GIDA), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- Department of Statistics, University of Oxford, Oxford, United Kingdom
| | - Nikos Vasilakis
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, USA
- Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, Texas, USA
- Center for Biodefense and Emerging Infectious Diseases, The University of Texas Medical Branch, Galveston, Texas, USA
- Center for Vector-Borne and Zoonotic Diseases, The University of Texas Medical Branch, Galveston, Texas, USA
- Center for Tropical Diseases, The University of Texas Medical Branch, Galveston, Texas, USA
- Institute for Human Infection and Immunity, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Nuno R. Faria
- Department of Biology, University of Oxford, Oxford, United Kingdom
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- MRC Centre for Global Infectious Disease Analysis (MRC-GIDA), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jesse J. Waggoner
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
5
|
Gonzalez K, De León SS, Pineda V, Samudio F, Capitan-Barrios Z, Suarez JA, Weeden A, Ortiz B, Rios M, Moreno B, Gundacker ND, Pascale JM, López-Vergès S, Sosa N, Saldaña A, Ábrego LE. Detection of Leishmania RNA Virus 1 in Leishmania (Viannia) panamensis Isolates, Panama. Emerg Infect Dis 2023; 29:1250-1253. [PMID: 37209675 DOI: 10.3201/eid2906.220012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
We detected Leishmania RNA virus 1 (LRV1) in 11 isolates of Leishmania (Viannia) panamensis collected during 2014-2019 from patients from different geographic areas in Panama. The distribution suggested a spread of LRV1 in L. (V.) panamensis parasites. We found no association between LRV1 and an increase in clinical pathology.
Collapse
|
6
|
Miranda ADC, González KA, Samudio F, Pineda VJ, Calzada JE, Capitan-Barrios Z, Jiménez A, Castillo J, Mendoza Y, Suárez JA, Ortiz B, Méndez J, Pascale JM, Grögl M, Sosa N, Saldaña A. Molecular Identification of Parasites Causing Cutaneous Leishmaniasis in Panama. Am J Trop Med Hyg 2021; 104:1326-1334. [PMID: 33432903 DOI: 10.4269/ajtmh.20-1336] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/27/2020] [Indexed: 02/03/2023] Open
Abstract
Isolates from 475 cutaneous leishmaniasis (CL) patients from three endemic regions were studied by three typing techniques. The molecular analysis from lesion scrapings based on hsp70 PCR-RFLP showed that 78.1% (371/475) restriction patterns corresponded to Leishmania (Viannia) panamensis, 19% (90/475) to Leishmania (Viannia) guyanensis, and 3.0% (14/475) to Leishmania (Viannia) braziliensis. Promastigotes isolated by culture from lesions of 228 patients (48.0%, 228/475) were identified by multi-locus enzyme electrophoresis. Of them, 95.2% (217/228) were typified as L. (V.) panamensis, 1.3% (3/228) as L. (V.) guyanensis, 2.2% (5/228) as L. (V.) braziliensis, and 1.3% (3/228) as hybrids (L. [V.] braziliensis/L. [V.] panamensis). However, a partial sequencing analysis of the hsp70 gene from 77 selected samples showed 16.9% (13/77) typified as L. (V.) panamensis, 68.8% (53/77) as Leishmania (V.) sp., 1, 3.9% (3/77) as L. (V.) guyanensis, 1.3% (1/77) as L. (V.) braziliensis outlier, 2.6% (2/77) as Leishmania (Viannia) naiffi, 2.6% as (2/77) Leishmania (V.) sp., and 2 and 3.9% (3/77) hybrid isolates of L. (V.) braziliensis/L. (V.) guyanensis. These results confirm L. (V.) panamensis as the predominant species and cause of CL lesions in Panama and that L. (V.) guyanensis, L. (V.) braziliensis, and L. (V.) naiffi are circulating to a lower degree. Furthermore, the determination of parasite isolates belonging to atypical clusters and hybrid isolates suggests the circulation of genetic variants with important implications for the epidemiology and clinical follow-up of CL in Panama. No evidence of the existence of parasites of the Leishmania (Leishmania) mexicana complex in Panamanian territory was found in this study.
Collapse
Affiliation(s)
| | - Kadir A González
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Franklyn Samudio
- Facultad de Ciencias Naturales, Exactas y Tecnología, Universidad de Panamá, Panama, Panama.,Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Vanessa J Pineda
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - José E Calzada
- Facultad de Medicina Veterinaria, Universidad de Panamá, Panama, Panama.,Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | | | - Ana Jiménez
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Juan Castillo
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Yaxelis Mendoza
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - José A Suárez
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Betsi Ortiz
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Juan Méndez
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Juan M Pascale
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Max Grögl
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Néstor Sosa
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Azael Saldaña
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama.,Centro de Investigación y Diagnóstico de Enfermedades Parasitarias (CIDEP), Facultad de Medicina, Universidad de Panamá, Panama, Panama
| |
Collapse
|