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Interactions Among Urogenital, Intestinal, Skin, and Oral Infections in Pregnant and Lactating Panamanian Ngäbe Women: A Neglected Public Health Challenge
Doris González-Fernández
Doris González-Fernández
Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
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Kristine G. Koski
Kristine G. Koski
Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
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Odalis Teresa Sinisterra
Odalis Teresa Sinisterra
Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
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Emérita del Carmen Pons
Emérita del Carmen Pons
Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
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Enrique Murillo
Enrique Murillo
Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
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Marilyn E. Scott
Marilyn E. Scott
Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne de Bellevue, Quebec, Canada; Department of Biochemistry, University of Panamá, Panamá City, Panamá; Department of Nutritional Health, Ministry of Health, Panamá City, Panamá
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Interrelationships among bacteria, protozoa, helminths, and ectoparasites were explored in a cross-sectional survey of 213 pregnant and 99 lactating indigenous women. Prevalences in pregnancy and lactation, respectively, were: vaginitis (89.2%; 46.8%), vaginal trichomoniasis (75.3%; 91.1%), bacterial vaginosis (BV; 60.6%; 63.3%), hookworm (56.6%; 47.8%), asymptomatic bacteriuria/urinary tract infection (AB/UTI; 56.2%; 36.2%), cervicitis (33.3%; 6.3%), vaginal yeast (24.9%; 11.4%), Ascaris (32.5%; 17.4%), vaginal diplococci (20.4%; 31.6%), caries (19.7%; 18.2%), scabies (17.4%; 8.1%), and Trichuris (12.5%; 8.7%). Multiple regressions revealed positive associations during pregnancy (trichomoniasis and AB/UTI; diplococci and Ascaris) and lactation (yeast and scabies). Negative associations were detected in pregnancy (BV and trichomoniasis; hookworm and diplococci) and lactation (BV and yeast). Vaginal Lactobacillus reduced odds of diplococci in pregnancy and lactation, but increased Ascaris eggs per gram (epg) and odds of trichomoniasis in pregnancy and yeast in lactation. These associations raised a concern that treatment of one condition may increase the risk of another.
Author Notes
Financial support: This research was funded by the Panamanian “Secretaría Nacional de Ciencia, Tecnología e Innovación” (SENACYT COL08-009). Research at the Institute of Parasitology, McGill University is supported by the Fonds FQRNT.
Authors' addresses: Doris González-Fernández and Marilyn E. Scott, Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University (Macdonald Campus), Ste-Anne de Bellevue, Quebec, Canada, E-mails: doris.gonzalez-fernandez@mail.mcgill.ca and marilyn.scott@mcgill.ca. Kristine G. Koski, School of Dietetics and Human Nutrition and Centre for Host-Parasite Interactions, McGill University (Macdonald Campus), Ste-Anne de Bellevue, Quebec, Canada, E-mail: kris.koski@mcgill.ca. Odalis Teresa Sinisterra, Department of Nutritional Health, Provision of Health Services Direction, Ministry of Health, Republic of Panamá, E-mail: odalisin@gmail.com. Emérita del Carmen Pons, Coordination of Nutritional Biochemistry for Research, Department of Nutritional Health, Provision of Health Services Direction, Ministry of Health, Republic of Panamá, E-mail: emeritapons@gmail.com. Enrique Murillo, Department of Biochemistry, Faculty of Natural, Exact Sciences and Technology, University of Panamá, Panamá, E-mail: emurillo29@hotmail.com.
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