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SUMMARYThe eco-epidemiology of T. cruzi infection was investigated in the Eastern border of the Panama Canal in Central Panama. Between 1999 and 2000, 1110 triatomines were collected: 1050 triatomines (94.6%) from palm trees, 27 (2.4%) from periurban habitats and 33 (3.0%) inside houses. All specimens were identified as R. pallescens. There was no evidence of vector domiciliation. Salivary glands from 380 R. pallescens revealed a trypanosome natural infection rate of 7.6%, while rectal ampoule content from 373 triatomines was 45%. Isoenzyme profiles on isolated trypanosomes demonstrated that 85.4% (n = 88) were T. cruzi and 14.6% (n = 15) were T. rangeli. Blood meal analysis from 829 R. pallescens demonstrated a zoophilic vector behavior, with opossums as the preferential blood source. Seroprevalence in human samples from both study sites was less than 2%. Our results demonstrate that T. cruzi survives in the area in balanced association with R. pallescens, and with several different species of mammals in their natural niches. However, the area is an imminent risk of infection for its population, consequently it is important to implement a community educational program regarding disease knowledge and control measures.

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Abstract. The Panamanian Ministry of Health, through the Interamerican Development Bank, contracted the Gorgas Memorial Laboratory to conduct epidemiologic studies on leishmaniasis and malaria in eastern Panama from July 1984 through June 1985. Preliminary results of the biomedical and entomologic teams investigating the epidemiology of cutaneous leishmaniasis in the eastern part of the country are presented in this short report. The principal findings of the study revealed 1) a large disparity in the incidence and prevalence of the disease among the five communities investigated; 2) the appearance of self-cures without the benefit of effective treatment; 3) a relatively high percentage of subclinical cases; and 4) determination of the sandfly vector species for each community. Also reported here is a case of a double infection with two distinct species of Leishmania, L. mexicana and L. amazonensis, in a single individual.The present study investigated epidemiologic parameters of cutaneous leishmaniasis among five communities in eastern Panama in which week-long surveys were conducted. This study was reviewed and approved by the Panamanian Ministry of Health. Four of these study sites (San Miguel, Torti, Santa Fe, and Meteti) are adjacent to the Interamerican Highway (Figure 1). The fifth community (Boca de Sabalo) is located in the extreme southeastern part of the country, and was accessed by boat via an extensive river system (Figure 1). Although the primitive working conditions in the communities precluded isolation and characterization of the parasite, it was assumed that all of the cases of leishmaniasis encountered were due to Leishmania panamensis since it has been the predominant species identified from human cases in Panama. However, several months after the termination of the project, one of the investigators (JLP) developed a lesion from which a biopsy specimen was obtained and found to be caused by L. amazonensis. 1 The locality in which the infection occurred could not be determined since this investigator traveled extensively throughout Panama during the study period.In 1977, several U.S. soldiers conducting jungle exercises near the Caribbean entrance to the Panama Canal developed leishmaniasis identified by personnel at Gorgas Memorial Laboratory (GML) as caused by L. amazonensis.1,2 In October 1986, the first indigenous case of infection with L. mexicana in Panama was isolated from one of two lesions from a young mestizo individual involved in hunting and agriculture in the northern and eastern part of the country. 1 Eight subsequent clones of parasites from each lesion revealed a double infection with L. mexicana and L. amazonensis. A new species, L. colombiensis, was isolated from four sand flies and a sloth in Panama, and from two humans and a sand fly in Colombia. 3 With regard to the remaining two species indigenous to Panama, L. hertigi appears to be host-specific for the porcupine Coendou rothschildi, and L. aristidesi is known only from a single focus in a coastal forest in eastern Panam...

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