title: Interactions among urogenital, intestinal, skin, and oral infections in pregnant and lactating Panamanian Ngäbe women: a neglected public health challenge.
abstract: 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.
authors.affiliation: 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
authors.forename: Doris
authors.initials: D
authors.lastname: González-Fernández
authors.affiliation: 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
authors.forename: Kristine G
authors.initials: KG
authors.lastname: Koski
authors.affiliation: 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
authors.forename: Odalis Teresa
authors.initials: OT
authors.lastname: Sinisterra
authors.affiliation: 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
authors.forename: Emérita
authors.initials: E
authors.lastname: Del Carmen Pons
authors.affiliation: 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
authors.forename: Enrique
authors.initials: E
authors.lastname: Murillo
authors.affiliation: 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 marilyn.scott@mcgill.ca.
authors.forename: Marilyn E
authors.initials: ME
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology*; D006801:Humans; D007197:Indians, Central American / Q000706:statistics & numerical data*; D007410:Intestinal Diseases / Q000150:complications / Q000453:epidemiology*; D007411:Intestinal Diseases, Parasitic / Q000150:complications / Q000453:epidemiology*; D007774:Lactation; D009059:Mouth Diseases / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D010176:Panama / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology; D015995:Prevalence; D012874:Skin Diseases, Infectious / Q000150:complications / Q000453:epidemiology*; D014626:Vaginal Smears; D055815:Young Adult
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