title: A survey of intestinal parasites including associated risk factors in humans in Panama.
abstract: BACKGROUND
  Intestinal parasitic infections are among the most common infections worldwide, leading to illness with serious and long lasting implications in children and immunocompromised people. Transmission of intestinal parasites is more frequent in tropical and sub-tropical areas where sanitation is poor and socioeconomic conditions are deficient. Panama is a country where climate and social conditions could be reflected in a high number of people infected with intestinal parasites. The presence, prevalence, and distribution of intestinal parasites in this country have been approached to date only in very restricted areas and population groups, but the impact of intestinal parasite infections at the national level is unknown.
  
  
  RESULTS
  We conducted a cross-sectional survey between 2008 and 2010 to determine the prevalence of intestinal parasites across Panama. Overall, 14 municipalities in seven provinces of Panama were surveyed. The presence of eggs, cysts, and larvae was assessed by microscopy in 1123 human fecal samples using a concentration technique. A questionnaire to identify risk factors associated with the frequency of intestinal parasites in the study population was also prepared and performed. Overall, 47.4% of human samples presented parasites. Variables including community type, age group, occupation, co-presence of commensals and socioeconomic factors (use of shoes and type of sanitation) were significantly associated with intestinal parasites (p<0.05).
  
  
  CONCLUSIONS
  The preliminary data obtained in the current study, showing a high prevalence of fecal-oral transmitted parasites in Panama, place intestinal parasitism as a major health problem in this country. Specific interventions should be planned for the indigenous population, the group most afflicted by intestinal parasites.
authors.affiliation: Laboratorio de Investigaciones en Parasitología Ambiental (LIPAAM), Universidad de Panamá, Panamá, Panama. Electronic address: ndsandoval@hotmail.com.
authors.forename: Nidia R
authors.initials: NR
authors.lastname: Sandoval
authors.affiliation: Laboratorio de Investigaciones en Parasitología Ambiental (LIPAAM), Universidad de Panamá, Panamá, Panama.
authors.forename: Nivia
authors.initials: N
authors.lastname: Ríos
authors.affiliation: Laboratorio de Investigaciones en Parasitología Ambiental (LIPAAM), Universidad de Panamá, Panamá, Panama.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mena
authors.affiliation: Laboratorio de Investigaciones en Parasitología Ambiental (LIPAAM), Universidad de Panamá, Panamá, Panama.
authors.forename: Rigoberto
authors.initials: R
authors.lastname: Fernández
authors.affiliation: Laboratorio de Investigaciones en Parasitología Ambiental (LIPAAM), Universidad de Panamá, Panamá, Panama.
authors.forename: Milixa
authors.initials: M
authors.lastname: Perea
authors.affiliation: Laboratorio de Parasitología, Instituto de Recursos Naturales y Agrobiología de Salamanca, Consejo Superior de Investigaciones Científicas, Salamanca, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Manzano-Román
authors.affiliation: Departamento de Sanidad Animal, Facultad de Veterinaria, Madrid, Spain.
authors.forename: José A Ruiz
authors.initials: JA
authors.lastname: Santa-Quiteria
authors.affiliation: Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220 Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Hernández-Gonzalez
authors.affiliation: Laboratorio de Parasitología, Instituto de Recursos Naturales y Agrobiología de Salamanca, Consejo Superior de Investigaciones Científicas, Salamanca, Spain. Electronic address: mmar.siles@irnasa.csic.es.
authors.forename: Mar
authors.initials: M
authors.lastname: Siles-Lucas
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D001196:Ascariasis / Q000453:epidemiology; D001447:Balantidiasis / Q000453:epidemiology; D016776:Blastocystis Infections / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002947:Cities; D002980:Climate; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology*; D005260:Female; D005873:Giardiasis / Q000453:epidemiology; D006373:Helminthiasis / Q000453:epidemiology*; D006725:Hookworm Infections / Q000453:epidemiology; D006801:Humans; D006925:Hymenolepiasis / Q000453:epidemiology; D016867:Immunocompromised Host; D007223:Infant; D007231:Infant, Newborn; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology*; D007814:Larva; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D010176:Panama / Q000453:epidemiology; D010271:Parasites; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012499:Sanitation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013322:Strongyloidiasis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014257:Trichuriasis / Q000453:epidemiology; D055815:Young Adult
keywords: Intestinal parasites; Panama; Population groups; Prevalence; Risk factors