Rural Panama Research Articles

Chlorine Water Taste Threshold and Acceptability among Indigenous and Non-Indigenous Populations in Rural Panama.

Although gains in access to water services over the past two decades have been large, more than two billion people still lack access to safely managed drinking water. This study examines and compares free chlorine taste and acceptability thresholds of rural Indigenous Ngäbe and rural Latino Panamanians to study if taste aversion may be a limiting factor in chlorination of community systems in Panama using the three-alternative forced choice test methodology. This study is the first to establish a best-estimate taste threshold for a rural Indigenous group and the only study in Latin America to report best-estimate taste thresholds using those methods. Median taste thresholds were 0.87 mg/L Cl2 for Indigenous Ngäbe participants (n = 82) and 1.64 mg/L Cl2 for Latino participants (n = 64), higher than both the minimum concentration for biologically safe water (0.2 mg/L) and the recommended concentration range in Panama (0.3-0.8 mg/L). Median acceptability thresholds were established much higher than taste thresholds at 3.45 mg/L Cl2. The results show that the ability to accurately taste chlorine may not be the limiting factor for adoption of safe water initiatives in remote and Indigenous communities.

Preschool child growth attainment and velocity during an agriculture intervention in rural Panama may be diminished by soil-transmitted helminths.

Agricultural interventions are often recommended to address undernutrition in subsistence farming communities. However, intensified agriculture exposure can increase soil transmitted helminth (STH) infections, which are linked with poor child growth. This study examined impacts of the VERASAN public health and agricultural intervention program on preschool child growth attainment (HAZ and WAZ) and relative growth velocity over 7 months [change in height-for-age (∆HAD) and weight-for-age (∆WAD) difference]. VERASAN was initiated in 15 subsistence farming communities in rural Panama experiencing chronic undernutrition. Activities targeted improved household food security, preschool child diets and growth by intensifying and diversifying household agriculture. Our objectives were to explore the relationship between VERASAN and preschool child growth attainment (HAZ and WAZ) and velocity (∆HAD and ∆WAD) during one agricultural cycle in 238 households. We compared those new to VERASAN with those involved for 1 or 5 years, and identified if agricultural practices, food security, diet diversity and treatment of pre-existing STH infection were associated with growth attainment or velocity. Prior participation in VERASAN did not directly influence WAZ, HAZ or ΔHAD but VERASAN-related benefits had an indirect influence. ΔHAD was positively associated with VERASAN-associated improvements in diet diversity and food security. HAZ and WAZ during land preparation were positively associated with diet diversity and HAZ with food security during harvest. HAZ was negatively associated with children visiting the agricultural plot, consuming leafy green vegetables and pre-existing hookworm infections. Both agricultural season and STH influenced ΔWAD. Children in VERASAN for 1 or 5 years experienced growth faltering between land preparation and growing season, but not those new to VERASAN. In contrast, between growing and harvest, ∆WAD declined in children new to VERASAN compared to children in VERASAN for longer. ΔWAD from land preparation to harvest was higher with pre-existing Ascaris infection whereas it was lower between growing season and harvest for pre-existing hookworm infection. In a context of preschool child growth faltering, malnutrition and STH infections, improved food security, agricultural production and diet diversity associated with VERASAN were associated with improved growth. In contrast, STH infections were negatively associated with some, but not all, growth outcomes.

Esperanza Speaks: Confronting a Century of Global Change in Rural Panama by GloriaRudolf. Toronto: University of Toronto Press, 2021. 195 pp.

Esperanza Speaks: Confronting a Century of Global Change in Rural Panama by GloriaRudolf. Toronto: University of Toronto Press, 2021. 195 pp.

Surveillance and genotype characterization of zoonotic trypanosomatidae in Didelphis marsupialis in two endemic sites of rural Panama.

Didelphis marsupialis has been reported as a competent reservoir for trypanosomatid parasites infections. The aim of this study was to measure Trypanosoma cruzi, T. rangeli, and Leishmania spp. infection rates and to characterize discrete typing units (DTUs) of T. cruzi in D. marsupialis from two Chagas disease endemic sites in Panama. Blood from 57 wild-caught D. marsupialis were examined from two rural communities, Las Pavas (N = 18) and Trinidad de las Minas (N = 39). Twenty-two (38.60%) opossums were positive for flagellates by general hemoculture. T. cruzi infection was confirmed by positive hemoculture and/or kDNA based PCR performed in 31/57 (54.39%) blood samples from opossums. T. rangeli infection was confirmed by hemoculture and/or TrF/R2-Primer PCR assay applied on 12/57 (21.05%) blood samples. Nine (15.79%) D. marsupialis harbored T. cruzi/T. rangeli coinfections. All opossums tested negative for Leishmania spp. by PCR assays based on kDNA and HSP70 gene amplification. There was a significant association between T. cruzi infection and site (Fisher exact test, p = 0.02), with a higher proportion of T. cruzi infected opossums in Las Pavas (77.78%, n = 14/18) compared to Trinidad de las Minas (43.59%, n = 17/39). A significant association was found between habitat type and T. cruzi infection in opossums across both communities, (X2 = 6.91, p = 0.01, df = 1), with a higher proportion of T. cruzi infection in opossums captured in forest remnants (76%, 19/25) compared to peridomestic areas (37.5%, 12/32). T. rangeli detection, but not T. cruzi detection, may be improved by culture followed by PCR. TcI was the only DTU detected in 22 T. cruzi samples using conventional and real-time PCR. Eight T. rangeli positive samples were characterized as KP1(-)/lineage C. Trypanosome infection data from this common synanthropic mammal provides important information for improved surveillance and management of Chagas disease in endemic regions of Panama.

Trafficking as settler colonialism in eastern Panama: Linking the Americas via illicit commerce, clientelism, and land cover change

Rural spaces are garnering new attention in illicit economies. At the confluence of the American continents, illicit commodities are being moved through rural Panama’s communities and iconic Darién forests. Over the last decade, the international media have focused on the uptick in human “migration” while the Panamanian press has chronicled dramatic illegal logging. Less acknowledged is the surge in drug smuggling and arms trafficking. Using media reports and mapping over the last twenty years, we ask how multi-commodity trafficking and human exploitation are remaking rural space. We provide the first synthetic and spatial overview of eastern Panama’s multiple trafficking, showing how it is altering social and environmental relationships. Media reports, many based on government seizures, indicate trafficking routes throughout the region, implying the involvement of much of the local population and resulting in new clientelistic social relationships between traffickers, residents, and the state. Increasingly, trafficking is driving land cover change, diminishing forest cover in private lands, protected areas, and indigenous lands and connecting them via a growing road network. Indigenous peoples’ conservation of forests hampers surveillance and makes their lands ideal for trafficking. This also means that they are the only ethnicity frequently named in the media, threatening indigenous sovereignty and land legalization efforts. We conclude that trafficking is a form of settler colonialism, continuing processes of taking that began in this area of the American mainland centuries ago. Rather than incidentally holding indigenous residents culpable, maligning them in trafficking’s transit area is fundamental to capitalist expansion, integrating it with the country’s dollarized economy, highly developed banking sector, and the canal’s global commerce. The continued transit of people and illegal commodities in eastern Panama is quickly transforming conservation, indigenous sovereignty, and sustainable development.

Capabilities and aspirations: A multi‐theory approach to information and communications technology for development in rural Panama

AbstractLarge national development projects often overlook site‐specific theoretical approaches to information and communications technology for development (ICT4D). To address this dilemma, we created a unique multi‐theoretical lens by combining a capabilities approach with an aspirations‐based approach. We use this combination to present an abductive analysis of our ethnographic study in a Black/Afro‐Caribbean community (Basti) in Bocas del Toro, Panama. The study highlights a community/computer center (Infoplaza) that is part of an initiative to close Panama's digital divide. The study objectives were to identify major barriers to post‐secondary education and computer access in Basti, and to assess how the Infoplaza might affect those barriers and people's education and life aspirations. We conclude that while beneficial, the Infoplaza's impact on education, computer access, and influence on education and life aspirations is minimal. This article emphasizes aspirations requiring digital literacy, and it suggests that the Infoplaza (and local schools) prioritize literacy, typing and internet knowledge as a development strategy to increase digital literacy and people's opportunities. Analyzing this study using our combined approach uncovers nuanced inequality in Basti and reveals limited capabilities for people to actualize what they value doing or being. This unique study and analysis is valuable to the Infoplaza initiative and to similar ICT4D research.

Sugar-Sweetened Beverage Consumption and Diabetes in Rural Panama

Diabetes is one of the greatest global epidemics, with increased prevalence in low and middle-income nations. Identifying risk factors may aid the development of effective health interventions.

Using a Macro Lens for Anterior Segment Imaging in Rural Panama.

Background: Visual impairment, specifically anterior segment pathology, presents a significant burden of disease in the world. Introduction: Inexpensive tools are necessary to improve eye health of residents in developing countries where care is difficult to access. Our study aimed at determining whether a $5 macro lens attached to a smartphone camera is an effective anterior segment imaging method for screening diseases. Materials and Methods: Fifty four (n = 54) patients had anterior segment imaging performed by using an Easy Macro lens and an iPhone. Imaging was performed at the Floating Doctors' mobile clinic sites in Panama. Images were sent back and graded by two board-certified ophthalmologists using a modified version of the FOTO-ED scale. Statistical analysis was performed by using a Wilcoxon signed-rank test to compare grades between the two imaging modalities. Results: There was no significant difference in overall clinical utility of images obtained by the iPhone versus Easy Macro lens. The iPhone was significantly superior in imaging of the lens and conjunctiva, whereas the Easy Macro lens was superior in regards to the anterior chamber, iris, and lens. Discussion: The imaging modality that best captures pathology is dependent on what part of the anterior segment is being examined. An imaging protocol with a pair of images, one from a smartphone and one from a macro lens, would have significant clinical utility. Conclusion: Our study demonstrates how minimally trained users can deliver effective eye screening via a telemedicine-based approach in a resource-deprived setting. Future directions would be to develop a telemedicine protocol and determine whether it improves clinically measurable outcomes in patients.

High Prevalence of Sexually Transmitted Infections, and High-Risk Sexual Behaviors Among Indigenous Adolescents of the Comarca Ngäbe-Buglé, Panama.

There is scant information on sexually transmitted infection (STI) prevalence and risk factors among Latin American indigenous populations. We investigated STI prevalence and risk factors among adolescents of the Comarca Ngäbe-Buglé indigenous region of Panama. A population-based cross-sectional study was conducted among school-going adolescents aged 14 to 19 years. Eligible consenting participants self-completed a questionnaire and provided blood and urine samples. Female participants provided additional self-administered genital swabs. Seroprevalences of human immunodeficiency virus (HIV), syphilis, hepatitis B (HBsAg, anti-HBc), and herpes simplex virus type 2 (HSV-2) were determined in all participants; genital Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) by PCR among participants who reported sexual experience or were seropositive for HIV/syphilis/HSV2/HBsAg; high-risk human papillomavirus (HPV) by qualitative DNA assay and bacterial vaginosis (BV) by Gram-stain among female participants. Risk factors were identified by estimating adjusted odds ratios (AOR) using random-effects logistic regression. We enrolled 700 participants (median age, 17 years [female participants]; 18 years [male participants]) from 20 schools. Sexual experience was reported by 536 participants (76.6%). The HIV/STI prevalences among females and males were: HIV 0.4% and 1.0%, high-titer active syphilis 1.3% and 6.6%, HSV-2 16.1% and 16.1%, HBsAg 1.3% and 1.4%, anti-HBc 3.2% and 1.4%, NG 1.8% and 1.7%, CT 17.5% and 10.7%; among females: BV 42.9% and HPV 33.2%. CT was independently associated with being female (AOR, 2.02; 95% confidence interval [CI], 1.20-3.41); high-titer active syphilis with being male (AOR, 4.51; 95% CI, 1.17-17.40). Bacterial vaginosis was associated with sexual behavior (≥3 lifetime sex partners: AOR, 3.81; 95% CI, 1.29-11.26), HPV with sexual experience (AOR, 4.05; 95% CI, 1.62-10.09). School-going indigenous adolescents in rural Panama have substantial STI burden. Targeted STI screening is required.

Production, Consumption, and Culture of Upland Rice in Swiddens: a Case Study of a campesino Community in Panama

Although livelihoods in rural Panama have changed significantly in recent times, and purchasing rice has become common, swidden rice cultivation has continued. I explore small-scale farmers’ preferences regarding swidden rice production and consumption in a campesino community through semi-structured interviews with 55 households and participant observation of food production and consumption. The rice farmers cultivated an average of 6,217 m2 of swidden and harvested 344 kg of unhulled rice per year. With decreasing rice production and poor economic efficiency, people enjoy the particular taste of swidden rice, arroz nuevo, and colored rice, which symbolizes the cultural identity, tradition, and dignity of rural life.

Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama.

Dehydration and its associated symptoms are among the most common chief complaints of children in rural Panama. Previous studies have shown that intravascular volume correlates to the ratio of the diameters of the inferior vena cava (IVC) to the aorta (Ao). Our study aims to determine if medical students can detect pediatric dehydration using ultrasound on patients in rural Panama. This was a prospective, observational study conducted in the Bocas del Toro region of rural Panama. Children between the ages of 1 to 15 years presenting with diarrhea, vomiting, or parasitic infection were enrolled in the study. Ultrasound measurements of the diameters of the IVC and abdominal aorta were taken to assess for dehydration. A total of 59 patients were enrolled in this study. Twenty-four patients were clinically diagnosed with dehydration and 35 were classified to have normal hydration status. Of the 24 patients with dehydration, half (n=12) of these patients had an IVC/Ao ratio below the American threshold of 0.8. Of the remaining asymptomatic subjects, about half (n=18) of these subjects also had an IVC/Ao ratio below the American threshold of 0.8. Our study did not support previous literature showing that the IVC/Ao ratio is lower in children with dehydration. It is possible that the American standard for evaluating clinical dehydration is not compatible with the rural pediatric populations of Panama.

Screening for Diabetes Mellitus and Gestational Diabetes in a Resource-Poor Setting—Implementing a Selective Protocol

Background: Screening for diabetes mellitus and gestational diabetes in resource-poor settings requires efficiency. To make the best use of resources, we proposed a selective diabetes screening protocol for patients in rural Panama as a cost-effective solution for diabetes screening in resource-limited settings. We proposed to screen adults aged 35 years or above and pregnant women of all ages. Methods: Patients that attended a three-day clinic in Bocas del Toro, Panama established by the non-for-profit organization Floating Doctors were screened for non-fasting blood glucose levels. The proposed selective diabetes screening protocol was applied to determine whether it identified patients that were diabetic or prediabetic. Criteria for diabetes and prediabetes were based on existing American Diabetes Association guidelines: patients with a non-fasting blood glucose concentration of ≥200 mg/dl were considered diabetic and patients with a non-fasting blood glucose concentration of ≥140 mg/dl but < 200 mg/dl were considered prediabetic. Results: Of 84 patients that attended clinic, 2 were diabetic (2.3%) and 55 were prediabetic (65.5%). The sub-group of 41 patients (48.8%) met the selective screening protocol criteria of being at or above the age of 35 years and/or pregnant. This group included 2 patients that screened positive for diabetes (4.9%) and consisted of 16 patients with prediabetes (39.0%). The group excluded by the proposed protocol (51.2%) consisted of no patients with diabetes and 17 with prediabetes (39.5%). Conclusion: The proposed selective diabetes screening protocol effectively identified all patients with diabetes but only about half the patients with prediabetes, suggesting this protocol may have utility in diagnosing diabetes for treatment purposes. However, because a significant number of prediabetic individuals were excluded, other strategies are necessary for preventative efforts. Disclosure K.A. Cabrera: None. A. Pendi: None. N. Lashkari: None. E. El-Tobgy: None. B.B. LaBrot: None.

Testing the water, challenging the narratives of sustainable development: student volunteer research promoting public health in rural Panama in the shadow of an "eco-playground"

This article describes challenges faced by a team of interns and students working for a not-for-profit sister company of a private U.S.-based land development company planning to build a "sustainable city" in the Panamanian forest. Testing the contaminated water of a nearby village, the team demonstrated that residents have been living with water-related illness. Despite the indifference and conflicting aims of the parent company, potentially impactful social capital connections were made. The author reflects on these efforts within the critique of student "voluntourism." He also explores the role of social media in the production of narratives of sustainable development within the context of a poorly regulated land market.Keywords: water access and water-related illness; sustainable development; medical anthropology; public health; tourism; voluntourism; social capital; social media narratives

Feasibility study of minimally trained medical students using the Rural Obstetrical Ultrasound Triage Exam (ROUTE) in rural Panama.

Maternal and infant mortality rates reported in rural Panama are greater than those in urban regions. Bocas del Toro is a region of Panama inhabited by indigenous people at greater risk for pregnancy-related complications and deaths due to geographic isolation and limited access to health care. Portable ultrasound training programs have recently been implemented in low-resource settings to increase access to diagnostic imaging. The goal of this study is to determine the feasibility of teaching first-year medical students the Rural Obstetrical Ultrasound Triage Exam (ROUTE) to help identify pathology in pregnant women of the Bocas del Toro region of Panama. Eight first-year medical students completed ROUTE training sessions. After training, the students were compared to professional sonographers to evaluate their accuracy in performing the ROUTE. Students then performed the ROUTE in mobile clinics within Bocas del Toro. They enrolled women pregnant in their 2nd or 3rd trimesters and measured biparietal diameter, head circumference, amniotic fluid index, fetal lie and placental position. Any abnormal measurement would be further analyzed by the lead physician for a potential hospital referral. A total of 60 women were enrolled in the study. Four women were detected as having a possible high-risk pregnancy and thus referred to a hospital for further evaluation. Based on our data, first-year medical students with additional training can use the ROUTE to identify complications in pregnancy using ultrasound in rural Panama. Additional studies are required to determine the optimal amount of training required for proficiency.

Sustainability-inspired composting latrine design

In support of the Millennium Development Goals to provide improved sanitation to the world, a sustainability-inspired composting latrine design based on work in rural Panama, but also applicable to similar situations, is offered here. The design is based on the three aspects of sustainability namely economic, social, and technical. The new design will allow for improved health for current and future generations. The design is less costly (economic), is based on concepts to improve the likelihood of use based on interviews with potential users (social), and provides better quality compost through ammonia-based treatment (technical). The design consists of two ferrocement compost vaults to save money over conventional vaults, urine storage tanks to improve ammonia conditions in the compost, urine control valves for urine control, a water-washing bidet for personal washing (as preferred by the users), and a handwashing station within the latrine superstructure for convenience.

C-reactive protein is differentially modulated by co-existing infections, vitamin deficiencies and maternal factors in pregnant and lactating indigenous Panamanian women

BackgroundThe usefulness of C-reactive protein (CRP) as a non-specific marker of inflammation during pregnancy and lactation is unclear in impoverished populations where co-existing infections and vitamin deficiencies are common.MethodsThis cross-sectional study in Panama recruited 120 pregnant and 99 lactating Ngäbe-Buglé women from 14 communities in rural Panama. Obstetric history, indoor wood smoke exposure, fieldwork, BMI, vitamins A, B12, D, and folic acid, and inflammation markers (CRP, neutrophil/lymphocyte ratio (NLR), plateletcrit and cytokines) were measured. Multiple regressions explored both associations of CRP with other inflammatory markers and associations of CRP and elevated CRP based on trimester-specific cut-offs with maternal factors, infections and vitamin deficiencies.ResultsCRP was higher in pregnancy (51.4 ± 4.7 nmol/L) than lactation (27.8 ± 3.5 nmol/L) and was elevated above trimester specific cut-offs in 21% of pregnant and 30% of lactating women. Vitamin deficiencies were common (vitamin A 29.6%; vitamin D 68.5%; vitamin B12 68%; folic acid 25.5%) and over 50% of women had two or more concurrent deficiencies as well as multiple infections. Multiple regression models highlighted differences in variables associated with CRP between pregnancy and lactation. In pregnancy, CRP was positively associated with greater indoor wood smoke exposure, caries and hookworm and negatively associated with Ascaris and vaginal Lactobacillus and Bacteroides/Gardnerella scores. Consistent with this, greater wood smoke exposure, caries as well as higher diplococcal infection score increased the odds of trimester-elevated CRP concentrations whereas longer gestational age lowered the likelihood of a trimester-elevated CRP. During lactation, folic acid deficiency was associated with higher CRP whereas parity, number of eosinophils and Mobiluncus score were associated with lower CRP. Also, a higher BMI and Trichomonas vaginalis score increased the likelihood of an elevated CRP whereas higher parity and number of eosinophils were associated with lower likelihood of an elevated CRP.ConclusionsInfections both raise and lower CRP concentrations in pregnant and lactating mothers. Only folic acid deficiency during lactation was associated with higher CRP concentrations. Caution is required when interpreting CRP concentrations in pregnant and lactating women who have co-existing nutrient deficiencies and multiple infections.

Diet, Nutritional Indicators, Infections and Inflammation Are Associated with Mean Arterial Pressure (MAP) in Indigenous Pregnant and Lactating Women in Rural Panama

BackgroundHypertensive disorders of pregnancy (HDPs) are the leading cause of maternal mortality in Latin‐America. Mean arterial pressure (MAP) has been used as an early indicator of HDPs. However, to understand its usefulness in early detection of HDPs, it is important to understand the range of factors associated with MAP in resource poor environments.ObjectiveWe explored associations of MAP or elevated MAP (eMAP) with wood smoke exposure, multiple nutrient deficiencies, infections and inflammation in indigenous Panamanian pregnant and lactating women living in extreme poverty.MethodsA cross‐sectional study recruited 213 pregnant and 99 lactating indigenous women from the Ngäbe‐Buglé Comarca in rural Panama. Information on systolic and diastolic blood pressure (SBP, DBP), environmental and dietary factors, measures of inflammation (C‐reactive protein and cytokines), nutritional status (serum retinol binding protein ‐ RBP, folic acid, vitamins B12, A and D), and several infections (skin, oral, urogenital and intestinal nematodes) was collected. MAP was defined as DBP + 1/3 (SBP‐DBP). eMAP was defined as blood pressure >87 mmHg between 10–18 weeks of gestation, >84 mmHg in weeks 18–34, >86 mmHg after week 34; and ≥95 in lactating women. Bivariate comparisons were followed by adjusted linear and logistic regression models for MAP and eMAP, respectively.ResultsPrevalence of eMAP was 11.2% in pregnancy and 12.1% in lactation. Bivariate comparisons: In pregnancy, MAP was higher in women with folic acid<10 nmol/L, urinary specific gravity (USG)>1020 and hookworm infection, and lower in women with vaginal diplococcal infection and Ascaris. In lactation, MAP was higher in women with USG>1020, intake of animal source foods ≥7/wk and bacteriuria. Regression models: In pregnancy, wood smoke exposure, RBP<30 mg/L, presence of hookworm and TNF‐α were positively associated with MAP whereas basophil numbers, diplococcal infection score and presence of Ascaris were negatively associated with MAP. RBP<30 mg/L, folate deficiency, Trichuris and higher IL‐6 increased the odds of eMAP. During lactation, vitamins B12 and A and bacteriuria were positively associated with MAP whereas animal source foods and bacteriuria increased the odds of eMAP.ConclusionGiven that we identified both positive and negative associations of infections and nutrient deficiencies with MAP and eMAP during pregnancy and lactation, a strategy that simultaneously reduces all infections and all nutrient deficiencies may not be advisable. Rather, a reduction in eMAP may be achieved by reducing wood smoke exposure, treating intestinal nematodes, addressing folate and protein deficiencies in pregnancy, and by treating bacteriuria during lactation.Support or Funding InformationSENACYT (Panama), McGill Vitamin Fund

Community renewable energy in Panama: a sustainability assessment of the “Boca de Lura” PV-Wind-Battery hybrid power system

This paper presents a case study of a community renewable energy project implemented in the community of “Boca de Lura” located in rural Panama. This is a 2.17 kW stand-alone PV-Wind-Battery hybrid power system supplying energy to a local school also serving as a community facility. A novel sustainability assessment framework is used to examine the Boca de Lura experience and future perspectives for the power system and the project as a whole. The main challenges for Boca de Lura are discussed and recommendations to overcome some of the obstacles encountered are provided. Findings suggest that, even though the project was successfully implemented, its long-term operation is jeopardized due to non-technical aspects rather than technical ones. A potential solution is upgrading the stand-alone system into a minigrid; however, more studies and external advice are required to understand the implications for Boca de Lura, local institutions and possible national and international sponsors.

Epiphytes in human settlements in rural Panama

Background: An ever-increasing proportion of tropical ecosystems are affected by on-going land-use changes, stressing the importance of understanding how organisms cope with biotic and abiotic challenges outside their natural habitat. An important group in the tropics are vascular epiphytes, whose response to human disturbance is poorly understood.Aims: Creating a baseline data set of epiphyte diversity in human settlements and assessing differences with assemblages of less disturbed habitats.Methods: We surveyed the vascular epiphyte assemblages in 25 settlements of south-west Panama along a rainfall gradient. We tested how epiphyte assemblages were affected by human disturbance and climate by comparing our data to that of pastures and forest.Results: Almost half (238 of 499) of all studied trees hosted at least one epiphyte. Altogether, 10,700 epiphytes of 56 species were found. Rainfall strongly affected both composition and diversity of epiphyte assemblages, whereas geographic proximity did not. In settlements, the species pool was considerably smaller than in pastures and undisturbed forest; however, settlements’ diversity was only significantly lower compared to pastures.Conclusions: Epiphyte assemblages in settlements had a diminished species pool but diversity per tree was comparable to less disturbed habitats. Unsurprisingly, rainfall seems to be the main determinant of epiphyte diversity in rural settlements.

Distribution of Spotted Fever Group Rickettsiae in Hard Ticks (Ixodida: Ixodidae) from Panamanian Urban and Rural Environments (2007-2013).

Tick-borne rickettsiosis is an important emerging disease in Panama; to date, there have been 12 confirmed cases, including eight fatalities. To evaluate the distribution of rickettsiae in Panamanian ticks, we collected questing and on-host ticks in urban and rural towns in elevations varying between 0 and 2300m. A total of 63 sites (13 urban and 50 rural towns) were used to develop models of spatial distributions. We found the following tick species: Rhipicephalus sanguineus s.l. (present in 54 of 63 towns and cities), Amblyomma mixtum (45/63), Dermacentor nitens (40/63), A. ovale (37/63), Rhipicephalus microplus (33/63), A. oblongoguttatum (33/63), Ixodes affinis (3/63), and Ixodes boliviensis (2/63). Rhipicephalus sanguineus s.l. was present in urban and rural towns, and other species were present only in rural towns. DNA was extracted from 408 R. sanguineus s.l., 387 A. mixtum, 103 A. ovale, and 11 A. oblongoguttatum and later tested for rickettsiae genes using PCR. Rickettsia DNA was detected in ticks from 21 of 63 localities. Rickettsia rickettsii was detected in five A. mixtum (1.29%), and Candidatus "Rickettsia amblyommii" was found in 138 A. mixtum (35%), 14 R. sanguineus (3.4%), and one A. ovale (0.9%). These results suggest that much of rural Panama is suitable for the expansion of tick populations and could favor the appearance of new tick-borne rickettsiosis outbreaks.