Publications by authors named "Juan-Miguel Pascale"

Background: The prevalence of HIV in Panama is estimated to be 1.0%; only 71% of individuals on antiretroviral treatment (ART) were virally suppressed in 2022. This study aimed to describe the prevalence of suboptimal adherence (≥1 missed doses in previous four weeks) and limited retention in HIV care (≥1 missed HIV care appointments in previous 12 months) among adults (aged ≥18 years) who attended the most populous urban ART Clinic in Panama City.

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  • - Panama has experienced endemic Dengue virus (DENV) transmission since 1993, with all four serotypes present but no local DENV-4 cases reported since 2000, despite its ongoing circulation in nearby countries.
  • - In the last four months of 2023, DENV-4 was detected in Panama, coinciding with a rise in dengue cases during the typically dry season, which is unusual since outbreaks are usually seen during the rainy season.
  • - Analysis of complete DENV-4 genomes revealed that the recent cases were due to genotype IIb, the same as what was seen 23 years ago, showing the need for ongoing surveillance of dengue serotypes and genotypes to catch emerging variants early.
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  • Syphilis is a growing public health problem worldwide, particularly among people living with HIV (PLHIV), and there's limited data on its prevalence in Panama.
  • A study conducted with 378 adults attending an antiretroviral clinic found a 32.3% overall prevalence of syphilis antibodies, with significant differences between genders.
  • High-titer active syphilis was identified in 24.6% of those with positive antibodies, and younger age and homosexual identity were linked to higher rates of active syphilis.
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The Comarca Ngäbe-Buglé (CNB), home to >200,000 Indigenous people, is one of the poorest regions in Panama. We describe transactional sex (TS) behaviours, normative beliefs and factors associated with TS among Indigenous adolescents(14-19years) in the CNB. We conducted a mixed-methods study in the CNB between January and November 2018, which included a qualitative study with participant observation and semi-structured interviews that focused on descriptive norms related to TS; and a cross-sectional study among public-school-going adolescents using self-administered questionnaire to report sexual behaviour and injunctive norms related to TS.

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  • Parechovirus A (PeV-A) is linked to various diseases in young children, but its epidemiology in Latin America is not well understood.* -
  • A study collected 200 samples from children in Panama with respiratory, gastrointestinal, or neurological symptoms from 2014 to 2015, all previously tested negative for common infections.* -
  • The study found PeV-A in 8 samples, suggesting its presence in Panama and highlighting the need for awareness of this virus in pediatric diagnostics when other tests are negative.*
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  • Eastern equine encephalitis virus (EEEV), Madariaga virus (MADV), and Venezuelan equine encephalitis virus complex (VEEV) are mosquito-borne viruses that cause febrile and neurological diseases in humans and horses.
  • Researchers developed real-time reverse transcription PCR assays to detect these viruses using whole-genome sequences and validated them with various samples collected during outbreaks and surveillance in Panama.
  • The assays successfully identified VEEV complex RNA in a significant number of samples, revealing its presence even in suspected dengue cases, indicating their potential use for surveillance in endemic areas.
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While rodents are primary reservoirs of Venezuelan equine encephalitis virus (VEEV), their role in Madariaga virus (MADV) transmission remains uncertain, particularly given their overlapping geographic distribution. This study explores the interplay of alphavirus prevalence, rodent diversity, and land use within Darien and Western Panama provinces. A total of three locations were selected for rodent sampling in Darien province: Los Pavitos, El Real de Santa Maria and Santa Librada.

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  • Researchers studied 78 recently diagnosed, ART-naïve HIV subjects to investigate low-frequency mutations linked to drug resistance and virologic failure (VF).
  • Using next-generation sequencing (NGS), they detected rare resistance mutations in 13 of 22 subjects who experienced VF, which were previously missed by conventional Sanger sequencing.
  • No mutations were found against Integrase Strand Transfer Inhibitors (INSTIs), marking the study as a pioneering effort to identify pre-existing drug resistance in minority variants among ART-naïve individuals in the country.
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Twenty years have passed since the emergence of hantavirus zoonosis in Panama at the beginning of this millennium. We provide an overview of epidemiological surveillance of hantavirus disease (hantavirus pulmonary syndrome and hantavirus fever) during the period 1999-2019 by including all reported and confirmed cases according to the case definition established by the health authority. Our findings reveal that hantavirus disease is a low-frequency disease, affecting primarily young people, with a relatively low case-fatality rate compared to other hantaviruses in the Americas (e.

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The Costa Rican pygmy rice rat () is the primary reservoir of (CHOV), the causal agent of hantavirus disease, pulmonary syndrome, and fever in humans in Panama. Since the emergence of CHOV in early 2000, we have systematically sampled and archived rodents from >150 sites across Panama to establish a baseline understanding of the host and virus, producing a permanent archive of holistic specimens that we are now probing in greater detail. We summarize these collections and explore preliminary habitat/virus associations to guide future wildlife surveillance and public health efforts related to CHOV and other zoonotic pathogens.

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Background: Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV.

Methods: We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14-19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469).

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Background: The foot transit of migrant peoples originating from the Caribbean, South America, Asia, and Sub-Saharan Africa through the Darién Forest (DF) in Eastern Panamá towards North America has increased in recent years from approximately 30,000 people/year to >133,000 in 2021. In the DF, there is no food/housing provision nor healthcare access. Very little is known of sexual and reproductive health (SRH) among this population.

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Introduction: Studies conducted in 1984 demonstrated the presence of in the Darien and Colon provinces. Since then, there have not been further reports of this parasitic infection in Panama.

Methodology: We conducted a cross-sectional assessment of peripheral blood samples of individuals across Panama over a 4-year period (2013-2016) as part of malaria surveillance activities.

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Background: Respiratory viruses remain a key cause of early childhood illness, hospitalization, and death globally.The recent pandemic has rekindled interest in the control of respiratory viruses among paediatric populations. We estimate the burden of such viruses among children <2 years.

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Introduction: Panama's HIV epidemic is far from under control. One of the populations with the fastest-growing epidemic among the Indigenous peoples of the Comarca Ngäbe-Buglé (CNB). The CNB is an administratively autonomous Indigenous region in Western Panama that is home to over 200,000 individuals of Ngäbe and Buglé ethnicities.

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Rapid rise of population migration is a defining feature of the 21st century due to the impact of climate change, political instability, and socioeconomic downturn. Over the last decade, an increasing number of migrant peoples travel across the Americas to reach the United States seeking asylum or cross the border undocumented in search of economic opportunities. In this journey, migrant people experience violations of their human rights, hunger, illness, violence and have limited access to medical care.

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Background: The world is currently unprepared to deal with the drastic increase in global migration. There is an urgent need to develop programs to protect the well-being and health of migrant peoples. Increased population movement is already evident throughout the Americas as exemplified by the rising number of migrant peoples who pass through the Darien neotropical moist broadleaf forest along the border region between Panama and Colombia.

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The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a major international public health concern. The World Health Organization (WHO) declared the pandemic of coronavirus disease 2019 (COVID-19) on March 11, 2020. In Panama, the first SARS-CoV-2 infection was confirmed on March 9, 2020, and the first fatal case associated to COVID-19 was reported on March 10.

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The present analysis uses the data of confirmed incidence of dengue cases in the metropolitan region of Panama from 1999 to 2017 and climatic variables (air temperature, precipitation, and relative humidity) during the same period to determine if there exists a correlation between these variables. In addition, we compare the predictive performance of two regression models (SARIMA, SARIMAX) and a recurrent neural network model (RNN-LSTM) on the dengue incidence series. For this data from 1999-2014 was used for training and the three subsequent years of incidence 2015-2017 were used for prediction.

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Background: We established cohorts to assess associations between viral influenza and cognitive development to inform the value proposition of vaccination.

Methods: From 2014 through 2017, we called women seeking care at four prenatal clinics in Panama and El Salvador to identify acute respiratory illnesses (ARIs). Within 2 weeks of childbirth, mothers were asked to enroll their neonates in the cognitive development study.

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Introduction: Influenza A and B viruses constantly evolve and cause seasonal epidemics and sporadic outbreaks. Therefore, epidemiological surveillance is critical for monitoring their circulation pattern. Trivalent and quadrivalent vaccine formulations are available in Panama (until and since 2016, respectively).

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Objective: To describe reported changes in sexual behaviours, including virtual sex (sexting and cybersex), and access to HIV/STI testing and care during COVID-19 measures in Panama.

Methods: We conducted an online cross-sectional survey from 8 August to 12 September 2020 among adults (≥18 years) residing in Panama. Participants were recruited through social media.

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We report a case of reinfection by SARS-CoV-2 with the second virus harboring amino acid changes in the Spike protein (141-143del, D215A, ins215AGY, L452R, D614G), orf1a, helicase, orf3a, and Nucleocapside. The virus associated with the reinfection, from an endemic lineage containing the S:L452R immune escape mutation, was circulating in Panama at the time.

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The recently enriched genomic history of Indigenous groups in the Americas is still meager concerning continental Central America. Here, we report ten pre-Hispanic (plus two early colonial) genomes and 84 genome-wide profiles from seven groups presently living in Panama. Our analyses reveal that pre-Hispanic demographic events contributed to the extensive genetic structure currently seen in the area, which is also characterized by a distinctive Isthmo-Colombian Indigenous component.

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