title: Characterization of a recent malaria outbreak in the autonomous indigenous region of Guna Yala, Panama.
abstract: BACKGROUND
  This study aims to describe the epidemiological and entomological factors associated with a recent malaria outbreak that occurred in 2012 in a socially marginalized population from Guna Yala Comarca in Panama.
  
  
  METHODS
  A descriptive and observational study was conducted by analysing demographic and epidemiological data from all malaria cases registered during 2012 in the Comarca Guna Yala, Panama. Malaria intensity indicators were calculated during the study period. Entomological evaluations were performed monthly, from October to December 2012, in the three communities that presented the most intense malaria transmission during the first semester of 2012. Anopheles breeding habitats were also characterized.
  
  
  RESULTS
  During the studied period, 6754 blood smears were examined (17.8 % of the total population), and 143 were confirmed as positive for Plasmodium vivax. A significant increase of malaria transmission risk indicators (API: 3.8/1000, SPR: 2.1 %) was observed in Guna Yula, when compared with previous years, and also in comparison with estimates from the whole country. Anopheles albimanus was the most abundant and widespread (877; 72.0 %) vector species found in the three localities, followed by Anopheles punctimacula (231; 19.0 %) and Anopheles aquasalis (110; 9.0 %). Three An. albimanus pools were positive for P. vivax, showing an overall pooled prevalence estimate of 0.014.
  
  
  CONCLUSIONS
  Data analysis confirmed that during 2012 a malaria epidemic occurred in Guna Yala. Panama. This study provides baseline data on the local epidemiology of malaria in this vulnerable region of Panamá. This information will be useful for targeting control strategies by the National Malaria Control Programme.
authors.affiliation: Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama. jcalzada@gorgas.gob.pa.
authors.forename: José E
authors.initials: JE
authors.lastname: Calzada
authors.affiliation: Departamento de Entomología Médica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama. ricardo.marquez64@gmail.com.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Marquez
authors.affiliation: Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama. chrigg@gorgas.gob.pa.
authors.forename: Chystrie
authors.initials: C
authors.lastname: Rigg
authors.affiliation: Programa Nacional de Malaria del Ministerio de Salud, Panama, Panama. carlosenriquevictoria@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Victoria
authors.affiliation: Departamento de Entomología Médica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama. geografo22@yahoo.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: De La Cruz
authors.affiliation: Institute of Tropical Medicine (NEKKEN), Nagasaki University, 852-8523 Sakamoto 1-12-4, Nagasaki, Japan. lchaves@nagasaki-u.ac.jp.|Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica. lchaves@nagasaki-u.ac.jp.
authors.forename: Luis F
authors.initials: LF
authors.lastname: Chaves
authors.affiliation: Departamento de Entomología Médica, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama. lcaceres@gorgas.gob.pa.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cáceres
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000852:Anopheles / Q000145:classification / Q000254:growth & development*; D002648:Child; D002675:Child, Preschool; D003710:Demography; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007303:Insect Vectors / Q000145:classification / Q000254:growth & development*; D016780:Malaria, Vivax / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010176:Panama / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult