Cecilio Niño

Panama has the lowest overall prevalence of tobacco use in the Americas. However, rates were higher in 3 health areas compared with the national average. Since most people who smoke started during adolescence, this population must be a target of health interventions. This study assesses the current tobacco use prevalence in Bocas del Toro, Ngäbe-Buglé, Guna Yala and nationwide. The national prevalence of any tobacco product consumption was 8.5% (95% confidence intervals: 6.9%–10.6%). Ngäbe-Buglé health region had the largest prevalence of any current tobacco use 16.9% (95% confidence intervals: 14.2%–19.9%), while both in Bocas del Toro and in Guna Yala was 10.9%. There is still a need for more indigenous-specific data to improve tobacco control and reduce tobacco and novel products use among vulnerable populations.

Introducción: La multimorbilidad, definida como la coexistencia de dos o más condiciones crónicas en un individuo, ha surgido como un desafío significativo de salud pública a nivel mundial. La multimorbilidad se asocia con una disminución de la calidad de vida, un mayor uso de la atención médica y tasas más altas de mortalidad. Objetivo: Evaluar la prevalencia de multimorbilidad y posibles factores de riesgo en adultos mayores de Panamá. Materiales y Métodos: Utilizando datos de la Encuesta Nacional de Salud de Panamá (ENSPA) 2019, un estudio transversal, incluimos participantes que se dividieron en dos grupos: 40-59 años (n: 1,377; N: 250,354) y aquellos ≥ 60 años (n: 1,001; N: 213,624). Treinta y una morbilidades fueron auto reportadas; pero para la hipertensión, diabetes, obesidad y enfermedad renal crónica también se utilizaron mediciones objetivas (presión arterial, antropometría o pruebas de laboratorio). Se seleccionaron las variables demográficas mediante un análisis de la literatura actual usando un gráfico acíclico dirigido realizado por el modelo lenguaje de gran tamaño "Claude 3.5 Sonnet". La multimorbilidad se evaluó mediante modelos crudos y ajustados de regresión logística utilizando las variables sociodemográficas sugeridas que generan razones de momio (RM) con sus respectivos intervalos de confianza (IC) del 95%. Resultados: La prevalencia ponderada de multimorbilidad en participantes ≥ 60 años fue del 75,2% (IC del 95%: 70,9%-79,5%). Los participantes ≥ 60 años tienen mayor riesgo de desarrollar multimorbilidad (OR: 3,45; IC del 95%: 2,45-4,85) que los participantes de 40 a 59 años, al igual que las mujeres (OR: 2,38; IC del 95%: 1,74-2,35). El área indígena tuvo menor riesgo (OR: 0,21; IC del 95%: 0,12-0,37) que la urbana. Conclusiones: Este estudio describe la prevalencia de multimorbilidad en adultos mayores en Panamá. Identificar la multimorbilidad mejora la atención médica de los pacientes con un uso racional de los recursos.

Diabetes mellitus (DM) represents an important global burden of disease. In Panama, DM was investigated in 1 study utilizing questionnaires and in another using biomarkers, but at subnational level. Using data from a recent cross-sectional country-wide population-based study that included biomarkers, we estimated the prevalence of DM, its awareness, and control; evaluating possible risk factors. We used data from 4400 participants aged 18 years or older from the National Health Study of Panama (ENSPA) study conducted in 2019 at a national level. Weighted prevalence and 95% confidence intervals for DM, awareness, and control were estimated by sociodemographic factors, family history of DM, tobacco and alcohol use, nutritional status, and hypertension. Odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression models to assess the possible risk factors associated with DM prevalence and awareness. We generated OR estimates by pooling ENSPA data with a previous regional study, prevalence of cardiovascular risk factors. The prevalence of DM was estimated to be 12.4% (10.9%–14.05%). In both men and women, age, family history of diabetes (OR in men: 4.0 ([2.4–6.7]; OR in women 3.5 [2.5–4.8]), and obesity (OR in men: 2.6 [1.4–5.1]; OR in women: 2.0 [0.9–4.5]) were associated with DM. Diagnosed and controlled hypertension was associated with DM only in women (OR: 2.1 [1.2–3.6]). DM awareness was estimated to be 62.6% (56.3%–68.9%). In both men and women, DM awareness was associated with age and a family history of diabetes (OR in men: 6.6 [2.4–18.4]; OR in women 1.9 ([1.1–3.6]). In women, having secondary education (OR: 1.9 [0.9–3.9]) and being diagnosed with uncontrolled hypertension (OR: 3.3 [1.2–9.5]) was also associated to DM awareness. Men in the ENSPA study were less likely to be aware of DM than those in the prevalence of cardiovascular risk factors (OR: 0.2 [0.0–0.7]). Less than half of the individuals diagnosed with DM had their condition controlled (39.6% [31.4%–47.8%]). This study revealed that the prevalence, awareness, and control of DM were similar to recent estimates reported in other Latin American countries. It also provides a baseline regarding DM and associated risk factors in Panama at a country-level knowledge that is essential for health policy development and useful in clinical practice.