ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Mandell GL , Douglas RG , Bennett JE , 2015. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Philadelphia, PA: Elsevier/Saunders.
-
2.
Costa F , Hagan JE , Calcagno J , Kane M , Torgerson P , Martinez-Silveira MS , Stein C , Abela-Ridder B , Ko AI , 2015. Global morbidity and mortality of leptospirosis: a systematic review. PLoS Negl Trop Dis 9: e0003898.
-
3.
World Health Organization , 2011. Report of the Second Meeting of the Leptospirosis Burden Epidemiology Reference Group. Geneva, Switzerland: WHO.
-
4.
Instituto Nacional de Estadística y Censo. Contraloría General de la República de Panamá, 2021. Instituto Nacional de Estadística y Censo. Panamá. Panamá en Cifras: Años 2014–2018. Available at: https://inec.gob.pa/publicaciones/Default3.aspx?ID_PUBLICACION=990&ID_CATEGORIA=17& ID_SUBCATEGORIA=45. Accessed August 23, 2022.
-
5.
Ministerio de Medio Ambiente y Cambio Climático. Primera Comunicación sobre Cambio Climático, 2000. República de el Salvador. Available at: https://cidoc.marn.gob.sv/documentos/primera-comunicacion-nacional-sobre-cambio-climatico/.
-
6.
The World Bank Group. Global Facility for Disaster Reduction and Recovery, 2011. Climate Risk and Adaptation Country Profile - Panama. Vulnerability, Risk Reduction, and Adaptation to Climate Change. Available at: https://reliefweb.int/report/panama/climate-risk-and-adaptation-country-profile-panama-april-2011.
-
7.
Embassy of the Kingdom of the Netherlands in Panama, 2018. Report Agriculture in Panama Challenges and Opportunities 2018. The Hague, The Netherlands. Ministry of Foreign Affairs. Available at: https://www.rvo.nl/sites/default/files/2018/03/agriculture-in-panama-challenges-and-opportunities-2018.pdf.
-
8.
United Nations Statistics Division, 2015. Millennium Development Goals Indicators, The Official UN Side of MDG Indicators. Series data, Panama. Available at: https://mdgs.un.org/unsd/mdg/Default.aspx.
-
9.
Joint Monitoring Programme for Water Supply Sanitation and Hygiene, 2017. A Snapshot of Drinking Water, Sanitation and Hygiene in the UNICEF Latin America & Caribbean Region. Geneva, Switzerland: WHO/UNICEF.
-
10.
Takafuji ET , Kirkpatrick JW , Miller RN , Karwacki JJ , Kelley PW , Gray MR , McNeill KM , Timboe HL , Kane RE , Sanchez JL , 1984. An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. N Engl J Med 310: 497–500.
-
11.
Wolff JW , Heirman AL , Bohlander HJ , 1960. A survey of the occurrence of leptospirosis in a dairy herd in the Republic of Panama. Trop Geogr Med 12: 82–90.
-
12.
Gale NB , 1963. Leptospires isolated in the Panama Canal Zone. Am J Trop Med Hyg 12: 895.
-
13.
Gale NB , Alexander AD , Evans LB , Yager RH , Matheney RG , 1966. An outbreak of leptospirosis among U. S. army troops in the Canal Zone. Am J Trop Med Hyg 15: 64–70.
-
14.
de Vries SG et al., 2018. Leptospirosis among returned travelers: a GeoSentinel site survey and multicenter analysis: 1997–2016. Am J Trop Med Hyg 99: 127–135.
-
15.
Rodriguez E, Salazar K, Miranda K, Ruiz F, Muñoz C, González D, Moreno D, Armien B, 2019. Hantavirus: 20 años de investigación: Identification of Leptospira serogroups in rural communities of the republic of Panama. Rev Med Panama 39: 18–19.
-
16.
Mayo Di Bello M, Ulloa E, Barahona de Mosca I, 2018. Guia Nacional de Epidemiologia. Leptospirosis, 3rd ed. Panama City, Panama. Ministerio de Salud. 144–147.
-
17.
Vazquez Guillamet L, Araúz AB, Suarez J. Gonzalez E, Domingo de Obaldia J, Moreno D, Henostroza G, Armien B, 2021. Suspected and confirmed cases of leptospirosis in a tertiary hospital in Panama, 2013–2018. figshare. Dataset. Available at: https://doi.org/10.6084/m9.figshare.14608302.v1. Accessed August 23, 2022.
-
18.
Panaphut T , Domrongkitchaiporn S , Vibhagool A , Thinkamrop B , Susaengrat W , 2003. Ceftriaxone compared with sodium penicillin G for treatment of severe leptospirosis. Clin Infect Dis 36: 1507–1513.
-
19.
Phimda K et al., 2007. Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus. Antimicrob Agents Chemother 51: 3259–3263.
-
20.
Suputtamongkol Y , Niwattayakul K , Suttinont C , Losuwanaluk K , Limpaiboon R , Chierakul W , Wuthiekanun V , Triengrim S , Chenchittikul M , White NJ , 2004. An open, randomized, controlled trial of penicillin, doxycycline, and cefotaxime for patients with severe leptospirosis. Clin Infect Dis 39: 1417–1424.
-
21.
Cedeño H , Leptospirosis: Panama: Epidemiology Department, Ministry of Health; Analysis PAHO.
-
22.
Haake DA , Levett PN , 2015. Leptospirosis in humans. Curr Top Microbiol Immunol 387: 65–97.
-
23.
Lau CL , Smythe LD , Craig SB , Weinstein P , 2010. Climate change, flooding, urbanisation and leptospirosis: fuelling the fire? Trans R Soc Trop Med Hyg 104: 631–638.
-
24.
Schneider MC , Leonel DG , Hamrick PN , de Caldas EP , Velasquez RT , Mendigana Paez FA , Gonzalez Arrebato JC , Gerger A , Maria Pereira M , Aldighieri S , 2017. Leptospirosis in Latin America: exploring the first set of regional data. Rev Panam Salud Publica 41: e81.
-
25.
Hochedez P et al., 2015. Factors associated with severe leptospirosis, Martinique, 2010–2013. Emerg Infect Dis 21: 2221–2224.
-
26.
Tubiana S , Mikulski M , Becam J , Lacassin F , Lefevre P , Gourinat AC , Goarant C , D’Ortenzio E , 2013. Risk factors and predictors of severe leptospirosis in New Caledonia. PLoS Negl Trop Dis 7: e1991.
-
27.
Brett-Major DM, Coldren R. Antibiotics for leptospirosis. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD008264.
-
28.
Batista H, Amarielsy T, Dominguez C, Juan G, Justo C, Moreno D, Quinzada M, 2009. Diagnóstico de Leptospirosis mediante la Prueba de Microaglutinación (MAT) en muestras de pacientes con síndrome febril - Laboratorio Central de Referencia en Salud Pública del Instituto Conmemorativo Gorgas de Estudio de la Salud, de enero-junio 2009. 1st ed. Panamá: Universidad.
-
29.
Taylor AJ , Paris DH , Newton PN , 2015. A systematic review of the mortality from untreated leptospirosis. PLoS Negl Trop Dis 9: e0003866.
-
30.
Sokhna C , Mediannikov O , Fenollar F , Bassene H , Diatta G , Tall A , Trape JF , Drancourt M , Raoult D , 2013. Point-of-care laboratory of pathogen diagnosis in rural Senegal. PLoS Negl Trop Dis 7: e1999.
-
31.
Calero C , Reinhard KR , Owen CR , 1957. Leptospirosis of man in the Isthmus of Panama: preliminary serological and epidemiological studies. Am J Trop Med Hyg 6: 1054–1060.
-
32.
Alexander AD , 1960. The distribution of leptospirosis in Latin America. Bull World Health Organ 23: 113–125.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1740 | 1031 | 186 |
| Full Text Views | 202 | 87 | 3 |
| PDF Downloads | 135 | 22 | 3 |
Leptospirosis: Epidemiological and Clinical Characteristics at the National Reference Hospital in Panama
Laia J. Vazquez Guillamet
Laia J. Vazquez Guillamet
William Crawford Gorgas Center for Geographic Medicine, University of Alabama at Birmingham, Birmingham, Alabama;
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Ana Belen Arauz
Ana Belen Arauz
Department of Infectious Diseases, Hospital Santo Tomas, Panama City, Panama;
Department of Medicine, University of Panama, Panama City, Panama;
National Research System, National Secretary of Research, Technology and Innovation, Panama City, Panama;
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Department of Medicine, University of Panama, Panama City, Panama;
National Research System, National Secretary of Research, Technology and Innovation, Panama City, Panama;
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Jose A. Suárez
Jose A. Suárez
Gorgas Memorial Institute for Health Studies, Panama City, Panama;
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Emma González
Emma González
Hospital Regional Nicolas A. Solano, La Chorrera, Panama;
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Jose Domingo de Obaldía
Jose Domingo de Obaldía
Gorgas Memorial Institute for Health Studies, Panama City, Panama;
Hospital Aquilino Tejeira, Cocle, Panama
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Hospital Aquilino Tejeira, Cocle, Panama
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Dianik Moreno
Dianik Moreno
Gorgas Memorial Institute for Health Studies, Panama City, Panama;
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German Henostroza
German Henostroza
William Crawford Gorgas Center for Geographic Medicine, University of Alabama at Birmingham, Birmingham, Alabama;
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Blas Armién
Blas Armién
National Research System, National Secretary of Research, Technology and Innovation, Panama City, Panama;
Gorgas Memorial Institute for Health Studies, Panama City, Panama;
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Gorgas Memorial Institute for Health Studies, Panama City, Panama;
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ABSTRACT.
Leptospirosis represents a public health problem in Panama, with an incidence rate of 1 in 100,000 inhabitants in 2014. Despite active surveillance and reports of outbreaks in the news, publications about human leptospirosis in Panama are scarce. The objective of this study was to describe the epidemiological and clinical features of leptospirosis in a cohort of patients admitted to the national reference hospital from January 2013 to December 2018. A total of 188 patients with suspected leptospirosis were identified, but only 56.9% (107 of 188) of the medical records could be retrieved. Microagglutination assays were completed in 45% (48 of 107) of the patients, confirming leptospirosis in 29.2% (14 of 48) of the patients. The most prevalent serogroup identified was Leptospira interrogans icterohemorrhagiae (4 of 14, 28.6%). The majority of patients with confirmed disease were middle-aged (36.4 ± 15.7 years), male (11 of 14, 78.6%), and symptomatic for 6.8 ± 0.7 days before admission. The predominant clinical presentation was fever (13 of 14, 92.9%), abdominal pain (7 of 14, 50%), and jaundice (8 of 14, 57.1%). Respiratory failure (8 of 14, 57.1%), elevated creatinine levels on admission (8 of 14, 57.1%), transfusion of blood-derived products (6 of 14, 42.9%), and required use of vasopressors (4 of 14, 28.6%) were common complications. Mortality was 28.6% (4 of 14). Empiric antibiotic therapy was initiated in almost all patients (10 of 12, 83.3%), and was appropriate in 90% (9 of 10) of them. Our study highlights the high prevalence of severe disease and reveals the diagnostic challenges concealing the true burden of leptospirosis in Panama. However, the small number of confirmed patients limits the generalization of these findings.
Author Notes
These authors contributed equally to this work.
Financial support: The work was supported by the Department of Research in Emerging and Zoonotic Diseases, the Ministry of Economy and Finance of Panama (project no. 111130150.501, awarded to B. A.), and a 2018 Gorgas Research Scholarship from the Gorgas Memorial Institute awarded to L. J. V. G.
Disclosure: G. H., coauthor of this study, serves as director of the William Crawford Gorgas Center for Geographic Medicine, and oversees the Gorgas Scholarship Award.
Authors’ addresses: Laia J. Vazquez Guillamet and German Henostroza, William Crawford Gorgas Center for Geographic Medicine, University of Alabama at Birmingham, Birmingham, AL, E-mails: laia.vazquez@isglobal.org and ghenostroza@uabmc.edu. Ana Belen Arauz, Department of Infectious Diseases, Hospital Santo Tomas, Panama City, Panama, Department of Medicine, University of Panama, Panama City, Panama, and National Research System, National Secretary of Research, Technology and Innovation, Panama City, Panama, E-mail: anabelenarauz@gmail.com. Jose A. Suárez and Dianik Moreno, Gorgas Memorial Institute for Health Studies, Panama City, Panama, E-mails: jasuarez05@gmail.com and dmoreno@gorgas.gob.pa. Emma González, Hospital Regional Nicolas A. Solano, La Chorrera, Panama, E-mail: draemmagonzalez@hotmail.com. Jose Domingo de Obaldía, Gorgas Memorial Institute for Health Studies, Panama City, Panama, and Hospital Aquilino Tejeira, Cocle, Panama, E-mail: josedomingo3088@gmail.com. Blas Armién, National Research System, National Secretary of Research, Technology and Innovation, Panama City, Panama, and Gorgas Memorial Institute for Health Studies, Panama City, Panama, E-mail: barmien@gorgas.gob.pa.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Mandell GL , Douglas RG , Bennett JE , 2015. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Philadelphia, PA: Elsevier/Saunders.
-
2.
Costa F , Hagan JE , Calcagno J , Kane M , Torgerson P , Martinez-Silveira MS , Stein C , Abela-Ridder B , Ko AI , 2015. Global morbidity and mortality of leptospirosis: a systematic review. PLoS Negl Trop Dis 9: e0003898.
-
3.
World Health Organization , 2011. Report of the Second Meeting of the Leptospirosis Burden Epidemiology Reference Group. Geneva, Switzerland: WHO.
-
4.
Instituto Nacional de Estadística y Censo. Contraloría General de la República de Panamá, 2021. Instituto Nacional de Estadística y Censo. Panamá. Panamá en Cifras: Años 2014–2018. Available at: https://inec.gob.pa/publicaciones/Default3.aspx?ID_PUBLICACION=990&ID_CATEGORIA=17& ID_SUBCATEGORIA=45. Accessed August 23, 2022.
-
5.
Ministerio de Medio Ambiente y Cambio Climático. Primera Comunicación sobre Cambio Climático, 2000. República de el Salvador. Available at: https://cidoc.marn.gob.sv/documentos/primera-comunicacion-nacional-sobre-cambio-climatico/.
-
6.
The World Bank Group. Global Facility for Disaster Reduction and Recovery, 2011. Climate Risk and Adaptation Country Profile - Panama. Vulnerability, Risk Reduction, and Adaptation to Climate Change. Available at: https://reliefweb.int/report/panama/climate-risk-and-adaptation-country-profile-panama-april-2011.
-
7.
Embassy of the Kingdom of the Netherlands in Panama, 2018. Report Agriculture in Panama Challenges and Opportunities 2018. The Hague, The Netherlands. Ministry of Foreign Affairs. Available at: https://www.rvo.nl/sites/default/files/2018/03/agriculture-in-panama-challenges-and-opportunities-2018.pdf.
-
8.
United Nations Statistics Division, 2015. Millennium Development Goals Indicators, The Official UN Side of MDG Indicators. Series data, Panama. Available at: https://mdgs.un.org/unsd/mdg/Default.aspx.
-
9.
Joint Monitoring Programme for Water Supply Sanitation and Hygiene, 2017. A Snapshot of Drinking Water, Sanitation and Hygiene in the UNICEF Latin America & Caribbean Region. Geneva, Switzerland: WHO/UNICEF.
-
10.
Takafuji ET , Kirkpatrick JW , Miller RN , Karwacki JJ , Kelley PW , Gray MR , McNeill KM , Timboe HL , Kane RE , Sanchez JL , 1984. An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. N Engl J Med 310: 497–500.
-
11.
Wolff JW , Heirman AL , Bohlander HJ , 1960. A survey of the occurrence of leptospirosis in a dairy herd in the Republic of Panama. Trop Geogr Med 12: 82–90.
-
12.
Gale NB , 1963. Leptospires isolated in the Panama Canal Zone. Am J Trop Med Hyg 12: 895.
-
13.
Gale NB , Alexander AD , Evans LB , Yager RH , Matheney RG , 1966. An outbreak of leptospirosis among U. S. army troops in the Canal Zone. Am J Trop Med Hyg 15: 64–70.
-
14.
de Vries SG et al., 2018. Leptospirosis among returned travelers: a GeoSentinel site survey and multicenter analysis: 1997–2016. Am J Trop Med Hyg 99: 127–135.
-
15.
Rodriguez E, Salazar K, Miranda K, Ruiz F, Muñoz C, González D, Moreno D, Armien B, 2019. Hantavirus: 20 años de investigación: Identification of Leptospira serogroups in rural communities of the republic of Panama. Rev Med Panama 39: 18–19.
-
16.
Mayo Di Bello M, Ulloa E, Barahona de Mosca I, 2018. Guia Nacional de Epidemiologia. Leptospirosis, 3rd ed. Panama City, Panama. Ministerio de Salud. 144–147.
-
17.
Vazquez Guillamet L, Araúz AB, Suarez J. Gonzalez E, Domingo de Obaldia J, Moreno D, Henostroza G, Armien B, 2021. Suspected and confirmed cases of leptospirosis in a tertiary hospital in Panama, 2013–2018. figshare. Dataset. Available at: https://doi.org/10.6084/m9.figshare.14608302.v1. Accessed August 23, 2022.
-
18.
Panaphut T , Domrongkitchaiporn S , Vibhagool A , Thinkamrop B , Susaengrat W , 2003. Ceftriaxone compared with sodium penicillin G for treatment of severe leptospirosis. Clin Infect Dis 36: 1507–1513.
-
19.
Phimda K et al., 2007. Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus. Antimicrob Agents Chemother 51: 3259–3263.
-
20.
Suputtamongkol Y , Niwattayakul K , Suttinont C , Losuwanaluk K , Limpaiboon R , Chierakul W , Wuthiekanun V , Triengrim S , Chenchittikul M , White NJ , 2004. An open, randomized, controlled trial of penicillin, doxycycline, and cefotaxime for patients with severe leptospirosis. Clin Infect Dis 39: 1417–1424.
-
21.
Cedeño H , Leptospirosis: Panama: Epidemiology Department, Ministry of Health; Analysis PAHO.
-
22.
Haake DA , Levett PN , 2015. Leptospirosis in humans. Curr Top Microbiol Immunol 387: 65–97.
-
23.
Lau CL , Smythe LD , Craig SB , Weinstein P , 2010. Climate change, flooding, urbanisation and leptospirosis: fuelling the fire? Trans R Soc Trop Med Hyg 104: 631–638.
-
24.
Schneider MC , Leonel DG , Hamrick PN , de Caldas EP , Velasquez RT , Mendigana Paez FA , Gonzalez Arrebato JC , Gerger A , Maria Pereira M , Aldighieri S , 2017. Leptospirosis in Latin America: exploring the first set of regional data. Rev Panam Salud Publica 41: e81.
-
25.
Hochedez P et al., 2015. Factors associated with severe leptospirosis, Martinique, 2010–2013. Emerg Infect Dis 21: 2221–2224.
-
26.
Tubiana S , Mikulski M , Becam J , Lacassin F , Lefevre P , Gourinat AC , Goarant C , D’Ortenzio E , 2013. Risk factors and predictors of severe leptospirosis in New Caledonia. PLoS Negl Trop Dis 7: e1991.
-
27.
Brett-Major DM, Coldren R. Antibiotics for leptospirosis. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD008264.
-
28.
Batista H, Amarielsy T, Dominguez C, Juan G, Justo C, Moreno D, Quinzada M, 2009. Diagnóstico de Leptospirosis mediante la Prueba de Microaglutinación (MAT) en muestras de pacientes con síndrome febril - Laboratorio Central de Referencia en Salud Pública del Instituto Conmemorativo Gorgas de Estudio de la Salud, de enero-junio 2009. 1st ed. Panamá: Universidad.
-
29.
Taylor AJ , Paris DH , Newton PN , 2015. A systematic review of the mortality from untreated leptospirosis. PLoS Negl Trop Dis 9: e0003866.
-
30.
Sokhna C , Mediannikov O , Fenollar F , Bassene H , Diatta G , Tall A , Trape JF , Drancourt M , Raoult D , 2013. Point-of-care laboratory of pathogen diagnosis in rural Senegal. PLoS Negl Trop Dis 7: e1999.
-
31.
Calero C , Reinhard KR , Owen CR , 1957. Leptospirosis of man in the Isthmus of Panama: preliminary serological and epidemiological studies. Am J Trop Med Hyg 6: 1054–1060.
-
32.
Alexander AD , 1960. The distribution of leptospirosis in Latin America. Bull World Health Organ 23: 113–125.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1740 | 1031 | 186 |
| Full Text Views | 202 | 87 | 3 |
| PDF Downloads | 135 | 22 | 3 |