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Geographical Locations - Panama
 The WWW Virtual Library: Public Health
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- (Statistical) Number of Inhabitants per Doctor: 840
- CIA - World Factbook: Panama
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National Policy and Related Documents
Reports, Guidelines, and Projects
- Disseminated Histoplasmosis in Patients with AIDS in Panama: A Review of 104 Cases
We identified the incidence and primary clinical characteristics of histoplasmosis in patients with acquired immunodeficiency syndrome (AIDS) in our hospital. Disseminated histoplasmosis is a common and severe disease among patients with AIDS in Panama and should be suspected for patients with a CD4 cell count of <100 cells/µL, fever, respiratory symptoms, weight loss, and diarrhea. [author summary] [Clinical Infectious Diseases 2005; 40: 1199–1202]
- Health in the Americas 2007: Panama
As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Panama addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Panama, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]
- History of Bioethics in Panama
Since 1998, bioethics in Panama has accumulated legal texts, teaching and clinical experiences. After the presentation of antecedents of bioethics in Panama, we present bioethics in public services and in the private sector, education and the laws on bioethics. And we conclude with considerations about the future of bioethics in the country. [author abstract] [Bioethikos, 2007; 1(2): 12-23]
- Overexposure of radiation therapy patients in Panama: problem recognition and follow-up measures
This report summarizes and analyzes the responses of various organizations that provided assistance to the National Oncology Institute (Instituto Oncológico Nacional, ION) of Panama following the overexposure of 28 radiation therapy patients at the ION in late 2000 and early 2001. The report also looks at the long-term measures that were adopted at the ION in response to the overexposure incident, as well as implications that the incident has for other cancer treatment centers worldwide. In March 2001, the director of the ION was notified of serious overreactions in patients undergoing radiation therapy for cancer treatment. Of the 478 patients treated for pelvic cancers between August 2000 and March 2001, 3 of them had died, possibly from an overdose of radiation. In response, the Government of Panama invited international experts to carry out a full investigation of the situation. Medical physicists from the Pan American Health Organization (PAHO) were among those invited. They ascertained that 56 patients treated with partially blocked teletherapy fields for cancers of the uterine cervix, endometrium, prostate, or rectum, had had their treatment times calculated using a computerized treatment planning system. PAHO’s medical physicists calculated the absorbed doses received by the patients and found that, of these 56 patients, only 11 had been treated with acceptable errors of ±5%. The doses received by 28 of the 56 patients had errors ranging from +10 to +105%. These are the patients identified by ION physicists as overexposed. Twenty-three of the 28 overexposed patients had died by September 2005, with at least 18 of the deaths being from radiation effects, mostly rectal complications. The clinical, psychological, and legal consequences of the overexposures crippled cancer treatments in Panama and prompted PAHO to assess radiation oncology practices in the countries of Latin American and the Caribbean. ION clinicians evaluated the outcome of 125 nonoverexposed patients who had been treated in the same time period and for the same cancer sites as the overexposed patients. The clinicians uncovered a larger recurrence of cervical cancers than expected. The finding prompted PAHO to launch an initiative for the accreditation of radiation oncology centers in Latin America and the Caribbean, working in collaboration with professional societies for radiation oncologists, medical physicists, and radiotherapy technologists. The Latin American Association for Radiation Oncology (Asociación Latinoamericana de Terapia Radiante Oncológica) has established an accreditation commission. Accreditation will require that centers implement a comprehensive radiation oncology quality assurance program that follows international guidelines. Statistical data on patient outcomes will be collected in order to document needs in radiotherapy centers in Latin America and the Caribbean and to define future strategies for cancer treatment. [author abstract] [Rev Panam Salud Publica. 2006; 20(2/3): 173–187]
- Poverty in Indigenous Populations in Panama: A Study Using LSMS Data
Although "ethnicity" is a broad concept, relating to language, culture, and territory, survey analysis in Latin America has generally adopted one of three operational indicators to define indigenous people, depending on the availability of data, including: language spoken, geographic concentration and self-perception.' The Panama LSMS was designed to include "identifiers" for the first two indicators, namely language (maternal, second) and geographic concentration. Most of the analysis reported in the Poverty Assessment uses geographica rea to distinguish between residents of indigenous, non-indigenous rural, and urban areas. These are mutually exclusive categories that are applied based on census classifications of each survey cluster. Geographic classifications have certain advantages, including simplicity of analysis and of future policy applications (e.g., geographic targeting). They are limited, however, in that they do not distinguish between distinct indigenous groups or between indigenous populations living within and outside indigenous areas. This paper seeks to conduct a more in depth study of indigenous poverty using language indicators of ethnic origin rather than geographic criteria. The objective is to analyse the living conditions of the main indigenous groups, both within and outside the official census demarcations of indigenous areas. These include the Ngobe-Buglé, the Kuna, and the Embera-Wounan. The study seeks to paint a portrait of indigenous poverty and to examine the various assets of the indigenous, including labor, human capital, physical assets, financial assets, and social capital. The determinants of indigenous poverty are also analysed using multi-variate regression techniques. [publication preface] [World Bank, LCSHD Paper Series 55, January 2000]
- Prevalence and Incidence of Multiple Sclerosis in Panama (2000–2005)
Background: The first cases of multiple sclerosis (MS) in Panama were notified in the 1980s and it was considered a low-risk region for this disease. Between 2000 and 2005, a prevalence study was conducted to characterize MS in Panama. Methods: An instrument was developed to gather information from clinical files and interviews with previous informed consent. The diagnosis was confirmed by neurologists applying the Poser and McDonald criteria as per the inclusion period. Results: 178 patients from the public and private health sectors were captured between 1970 and 2005. The prevalence rate was 5.24/100,000 inhabitants, and the incidence was between 0.28 and 0.61/100,000 inhabitants. The disease was predominant among women, the mean age ± SD being 34.76 ± 10.909 years (1st crisis), and the average number of crises was 2.88. The most common clinical findings were motor, optic neuritis, sensitive and cerebellous. 52.4% presented monosymptomatic manifestations, 71.6% were clinically defined according to Poser’s criteria and 55.6% had MS according to McDonald’s criteria. 77.8% had their debut with the relapsing-remitting type and presented an Expanded Disability Status Scale score of 2.7 after the first crisis. Conclusion: MS is in Panama a neurological pathology with a low prevalence and the results of this investigation improved early treatment and diagnosis of this disease. [author abstract] [Neuroepidemiology 2009; 32: 287–293]
- The Nutrition Intervention Improved Adult Human Capital and Economic Productivity
This article reviews key findings about the long-term impact of a nutrition intervention carried out by the Institute of Nutrition of Central America and Panama from 1969 to 1977. Results from follow-up studies in 1988–89 and 2002–04 show substantial impact on adult human capital and economic productivity. The 1988–89 study showed that adult body size and work capacity increased for those provided improved nutrition through age 3 y, whereas the 2002–04 follow-up showed that schooling was increased for women and reading comprehension and intelligence increased in both men and women. Participants were 26–42 y of age at the time of the 2002–04 follow-up, facilitating the assessment of economic productivity. Wages of men increased by 46% in those provided with improved nutrition through age 2 y. Findings for cardiovascular disease risk factors were heterogeneous; however, they suggest that improved nutrition in early life is unlikely to increase cardiovascular disease risk later in life and may indeed lower risk. In conclusion, the substantial improvement in adult human capital and economic productivity resulting from the nutrition intervention provides a powerful argument for promoting improvements in nutrition in pregnant women and young children. [author abstract] [Journal of Nutrition, 2009]
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