Gallstone Ultrasound Screening in the Ngobe Population of Rural Panama

Introduction: The objective of this research study is to quantify the prevalence of gallstones in the Ngobe population of rural Panama and investigate potentially significant risk factors in this population. Although increased... [ view full abstract ]

Introduction: The objective of this research study is to quantify the prevalence of gallstones in the Ngobe population of rural Panama and investigate potentially significant risk factors in this population. Although increased incidence of gallstones in certain central and south American populations has been previously noted, these studies are outdated and broad in terms of population cohort. By focusing on the indigenous Ngobe communities located off the northeast coast of Panama, it is possible to characterize the prevalence of gallstones in a specific demographic using modern ultrasound technology. Similar studies focusing on particular population groups have found prevalence rates of gallstones between 5.9% in Ghana (Gyedu et. al, 2015) and 15% in Sweden (Muhrbreck et. al, 1995). Studying the Ngobe population and assessing dietary and lifestyle factors unique to their communities can elucidate what the prevalence rate is and what factors potentially influence it.

Methods: The ultrasound and survey data used for this study was obtained by University of California, Irvine medical students working with Floating Doctors, a non-profit organization that provides healthcare to indigenous Ngobe communities. The primary outcome of interest is the prevalence of gallstones within the Ngobe population. The secondary concern is potential risk factors associated with gallstone development. Each patient who was given an ultrasound scan also answered a set of questions determining their age, weight, height, BMI, sex, diet, family history, pregnancy status, ongoing symptoms (nausea/vomiting) and physical exam findings (including Murphy’s sign).

Results: There were a total of 80 participants. 70% were females. Mean age was 39 years ± 14 years and the mean BMI was 30.8 ± 5.5. Prevalence of cholelithiasis was 11.25%, a rate higher than many populations studied previously. Females had a higher prevalence compared to males (14.28 vs. 4.16), and we found gallstones to be associated with symptoms of nausea and vomiting, positive Murphy’s sign, family history of gallstones or hyperlipidemia, and women with a history of spontaneous abortion.

Conclusion: Our study had shortcomings including a small and biased sample population, however our preliminary observations were promising. With further investigation during the summer of 20161, we hope to improve our understanding of cholelithiasis in the Ngobe population and improve the quality of healthcare they are provided. This is an on-going project that will be completed by the World Conference date, but complete findings will not be available by the cut-off date for abstract submission.