A total of 123 DNA samples from Panamanian patients with cutaneous leishmaniasis (CL) lesions were evaluated. These samples were previously confirmed with CL by a specific KDNA-Viannia PCR but had a negative parasitological diagnosis (Group A). Epidemiological variables, such as age, sex, geographic origin, evolution time, and the number and location of the lesions, were analyzed. No significant differences (p < 0.05) were found when these variables were evaluated against a control panel of 123 CL lesion samples from CL patients with positive parasitological diagnoses (Group B). Of the 123 samples (Group A), 67% (82/123) gave positive results when re-analyzed by PCR-hsp70. An analysis of 69 of these samples via PCR-hsp70-RFLP showed that 59.4% (41/69) of the found restriction patterns corresponded to Leishmania (Viannia) panamensis and 40.6% (28/69) to Leishmania (Viannia) guyanensis. Finally, the sequence and phylogenetic analysis of 32 of the samples confirmed the species in 21 (65.6%, 21/32) samples, originally characterized as L. (V.) panamensis. However, 11 samples (34.4%, 11/32), initially identified via RFLP-Hsp70 as L. (V.) guyanensis, matched the sequence of a genetic variant known as Leishmania sp.1. These results point out the species/genetic variants of Leishmania in the case of CL lesions with an apparently low parasite load.

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. This study used rapid epidemiological methods to describe the SRH situation among migrant peoples in transit through the DF.Methods: This cross-sectional study randomly selected migrant people in transit (men and women) at a Migrant Reception Station in Darién, Panamá, between January 4–11, 2022. Data collection included a self-applied questionnaire (≥18 years); clinical screening (≥12 years); and HCG, treponemal antibodies, and HIV(I/II) lateral-flow tests with blood samples (≥12 years). Descriptive analyses were used to report findings.Results: In all, 69 men and 55 women participated in the self-applied questionnaire, 70 men and 51 women in clinical screening; 78 men and 63 women in HCG, treponemal antibody and HIV testing. Overall, 26.1% (18/69) men and 36.4% (20/55) women reported sexual intercourse within the past month. The last sex partner was casual among 43.0% (21/49) of men and 27.8% (10/36) of women; of those, 42.9% (9/21) of men and 80.0% (8/10) of women reported this sex was condomless. Among women, 20.0% (11/55) tested positive for pregnancy; 5 of these pregnancies were planned. Of those screened, a reproductive tract infection symptom was reported by 5.7% (4/70) of men and 58.8% (30/51) of women. A total of 32.7% (18/55) of men and 18.2% (8/44) of women reported no prior HIV testing. Of 78 men, HIV and treponemal antibodies were found among 1.3% (n = 1) and 2.6% (n = 2), and among 63 women, 3.2% (n = 2) and 3.2% (n = 2), respectively.Conclusions: This rapid epidemiological assessment found high recent sexual activity, low condom use with casual partners, and a need for increased HIV and syphilis testing and treatment. There is a need for increased testing, condom provision, and SRH healthcare access at migrant reception stations that receive migrant peoples in transit through Panamá.

Cutaneous leishmaniasis (CL) is a vector-borne zoonotic disease affecting the skin and mucous membranes of animals and humans. While CL is commonly diagnosed and studied in humans in Panama, limited information exists on its occurrence in domestic animals and their potential role as reservoirs. In this study, samples from twelve domestic animals (ten dogs and two horses) with suspected CL lesions were collected between 2021 and 2025 in endemic regions of Panama and evaluated using multiple diagnostic methods. Leishmania infection was confirmed in six of them (50%): five dogs and one horse. Three dogs were infected with Leishmania (Viannia) braziliensis, representing the first molecularly confirmed cases of this species in dogs from Panama and Central America. Two dogs tested positive for Leishmania (Leishmania) infantum, though epidemiological evidence suggests these were imported cases. Notably, Leishmania (Mundinia) martiniquensis was identified in a horse, marking the first report of this species in equines in Central America. These findings indicate a broader diversity of Leishmania species circulating in domestic animals than previously recognized and highlight their potential role in sustaining transmission cycles. The study underscores the need for enhanced surveillance of animal reservoirs to better understand the epidemiology and public health risks of CL in Panama.

Understanding why people adopt or ignore vector-borne disease (VBD) preventive measures is key to better risk assessment and control. However, little is known about why some households adopt preventive practices while others do not, which is particularly striking in this era of One Health’s attention to human, environmental, and animal health. We examined what household factors are linked to practices that may reduce exposure to disease vectors, with a focus on Chagas disease (CD) and American Cutaneous Leishmaniasis (ACL) vectors. We surveyed 204 households in 12 rural communities in Coclé Province, Republic of Panama, between March 2022 and December 2023. We used logistic regression models to explore the association between household contextual elements, such as respondents’ sex, wealth (consumer goods and agricultural), knowledge about ACL and CD, feelings about insects, and perceptions of control over health outcomes, and personal (use of repellents, and hand protection before touching a CD vector) and property-based behaviors (use of insecticides in the house, use of windows/doors screens, and cleaning peridomestic debris) that may reduce exposure to disease vectors. We found mixed associations between protective behaviors and the contextual household elements. Participants who reported feeling bothered by insects were more likely to use repellents (Odds Ratio [OR]: 2.97 95% Confidence Interval [95%CI]: 1.47-6.20), whereas those who reported being in control of their health were less likely to use protection before touching a CD vector (OR = 0.8, CI: 0.67-0.95). Window/door screens were associated with more household consumer goods wealth (OR: 1.44; CI: 1.23-1.71), while households with a history of ACL cases were more likely to have peridomestic debris accumulation (OR: 2.33; CI: 1.17-4.75). Additionally, householders bothered by insects were less likely to have peridomestic debris (OR: 0.42; CI: 0.20-0.84), as well as those who believe health outcomes happen by chance (OR: 0.89; CI: 0.82-0.98). Our findings emphasize the importance of considering a more comprehensive household background and attention to cultural values to foster context-sensitive strategies for vector-borne pathogen prevention and control.

Dogs are important sentinels and potential reservoirs of Leishmania (Viannia) panamensis and Trypanosoma cruzi, etiologic agents of American cutaneous leishmaniasis and Chagas disease, respectively. Accurate serological tools are essential for surveillance in endemic regions where both diseases co-occur, yet no single gold standard diagnostic test exists. We evaluated the performance of blood-based assays used to detect exposure to L. panamensis and T. cruzi in 311 owned dogs from 185 households across 12 rural communities in Coclé Province, Panama. We evaluated exposure to L. panamensis using enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence antibody test (IFAT). We assessed T. cruzi exposure with IFAT, western blot (WB), multiplex microsphere immunoassay (MIA), and the Chagas Stat-Pak rapid immunochromatographic test. Agreement among assays was measured with Cohen's kappa coefficient, and diagnostic accuracy was estimated using Bayesian latent class models to account for conditional dependence in the absence of a gold standard. ELISA showed the highest accuracy for L. panamensis (sensitivity = 0.85; specificity = 0.87). The combination of MIA and the Chagas Stat-Pak test achieved the greatest diagnostic performance for T. cruzi (both sensitivity and specificity ≈ 0.90). However, because MIA is costly and not currently available in-country, the combination of WB and Chagas Stat-Pak rapid immunochromatographic test provides the most practical approach for T. cruzi diagnosis in this setting, with Chagas Stat-Pak rapid immunochromatographic test sensitivities ranging from 0.84 to 0.91 and specificities ranging from 0.74 to 0.75; and WB sensitivities ranging from 0.90 to 0.91 and specificity consistent at 0.97. Slight agreement between L. panamensis IFAT and T. cruzi assays suggests cross-reactivity between assays. These findings highlight the importance of region-specific assay validation and cost-effective diagnostic strategies to improve surveillance of canine vector-borne infections in Central America.