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Panama Women Health Information
– Reported, March 28, 2012
1% of women aged 5069 years have undergone a breast examination or mammography compared to 75% in the UK and 3% of women aged 2069 years have undergone cervical cancer screening.
Anaemia
There is a high risk of anaemia in people from this country (estimated prevalence in non-pregnant women >40%). Be alert to this possibility in recently arrived migrants, particularly for women and pre-school children.
Vitamin D deficiency
Sunlight is the major source of vitamin D and dark skinned individuals or those who for cultural or religious reasons cover their whole bodies when outdoors are at risk of deficiency, as are those whose diets (vegetarian/vegan) do not contain an adequate vitamin D supply.
Vitamin A deficiency
There may be a risk of vitamin A deficiency in this country.
Iodine deficiency
People from this country may be at risk of iodine induced hyperthyroidism due to excessive intake.
TB
There is a high incidence of TB in this country (40 499 cases/100,000).
Offer chest X ray to all unless;
under 11 years of age
possibility of pregnancy
recent chest X ray
Offer Mantoux test if;
under 11 years of age
possibility of pregnancy
normal chest X ray but less than 36 years of age
Offer gamma interferon blood test if;
Mantoux test >6mm (no prior BCG)
Mantoux test >15mm (prior BCG)
Refer to TB services promptly if screening is positive.
Maintain long term vigilance for symptoms of TB even if initial screening is negative.
TB is a notifiable disease.
HIV and sexually transmitted infections
This country has a low rate of HIV.
Test all sexually active patients under the age of 25 for chlamydia.
In a high prevalence PCT (=2/1000) all newly registering patients should be offered an HIV test regardless of country of origin.
In a low prevalence PCT (less than 2/1000) patients in the following groups should be offered an HIV test:
pregnant women
patients presenting with an indicator disease or another STI.
men disclosing sexual contact with other men
patients reporting a history of injecting drug use
patients reporting sexual contact with someone at increased risk of HIV infection
Hepatitis B
This country has a low prevalance of hepatitis B.
All pregnant women should be offered screening for hepatitis B infection during each pregnancy.
Babies born to mothers who are hepatitis B positive should be appropriately immunised and followed-up accordingly.
Hepatitis C
This country has the same or lower prevalence of hepatitis C than the UK.
Ascertain any risk factors for HCV infection that may indicate the need for screening.
Malaria
There is a risk of malaria in some areas of this country predominantly due to P. vivax.
Any unwell patient with a history of arrival from or a visit to affected areas of this country in the last year must be tested for malaria.
Enteric fever
There is a risk of typhoid infection in this country.
Helminths
There is a risk of helminth infections including soil transmitted helminthiasis in this country.
Chagas disease
There is a risk of chronic Chagas disease in migrants from this country.
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