Central America and the Caribbean > Panama > Health

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% immunized 1-year-old children > DPT3	89		[101st of 187]
% immunized 1-year-old children > Measles	79		[124th of 186]
DEFINITION: Health - % immunized 2002 1-year-old children - Measles
SOURCE: UNICEF
% immunized 1-year-old children > Polio3	85		[114th of 187]
DEFINITION: Health - % immunized 2002 1-year-old children - Polio3
SOURCE: UNICEF
% immunized 1-year-old children > TB	92		[81st of 153]
DEFINITION: Health - % immunized 2002 1-year-old children - TB
SOURCE: UNICEF
% of population using adequate sanitation facilities > Rural	83		[55th of 140]
DEFINITION: Health - % of population using adequate sanitation facilities 2000 - Rural
SOURCE: UNICEF
% of population using adequate sanitation facilities > Total	92		[56th of 144]
DEFINITION: Health - % of population using adequate sanitation facilities 2000 - Total
SOURCE: UNICEF
% of population using adequate sanitation facilities > Urban	99		[43rd of 141]
DEFINITION: Health - % of population using adequate sanitation facilities 2000 - Urban
SOURCE: UNICEF
% of population using improved drinking water sources > Rural	79		[66th of 146]
DEFINITION: Health - % of population using improved drinking water sources 2000 - Rural.
SOURCE: UNICEF
% of population using improved drinking water sources > Total	90		[63rd of 150]
DEFINITION: Health - % of population using improved drinking water sources 2000 - Total
SOURCE: UNICEF
% of population using improved drinking water sources > Urban	99		[43rd of 147]
DEFINITION: Health - % of population using improved drinking water sources 2000 - Urban
SOURCE: UNICEF
% of routine EPI vaccines financed by government > Total	100		[49th of 133]
DEFINITION: Health - % of routine EPI vaccines financed by government 2002 - Total
SOURCE: UNICEF
Abortion law > North & Central America > Mental Health	No
DEFINITION:
SOURCE: UNICEF
Access to sanitation	97%		[35th of 129]
DEFINITION: The percentage of the total population with access to sanitation facilities
SOURCE: Wikipedia: Abortion law
Adolescent fertility rate > births per 1,000 women ages 15-19	85.16 births		[44th of 184]
DEFINITION: Adolescent fertility rate is the number of births per 1,000 women ages 15-19.		View time series
SOURCE: CIA World Factbook, December 2003
Birth rate, crude > per 1,000 people	21.57 per 1,000 people		[86th of 195]
DEFINITION: Crude birth rate indicates the number of live births occurring during the year, per 1,000 population estimated at midyear. Subtracting the crude death rate from the crude birth rate provides the rate of natural increase, which is equal to the population growth rate in the absence of migration.		View time series
SOURCE: World Development Indicators database
Births attended by skilled health staff > % of total	92.5 %		[27th of 76]
DEFINITION: Births attended by skilled health staff are the percentage of deliveries attended by personnel trained to give the necessary supervision, care, and advice to women during pregnancy, labor, and the postpartum period; to conduct deliveries on their own; and to care for newborns.		View time series
SOURCE: World Development Indicators database
Births with health staff	90%		[47th of 116]
DEFINITION: Births attended by skilled health staff. Definitions of skilled health staff may vary across countries. Data refer to the most recent year available during the period specified or to a running average for a series of years surrounding the period 1995 to 2000.
SOURCE: World Development Indicators database
Children living with AIDS	800		[56th of 80]
DEFINITION: People living with HIV/AIDS, children (age 0-14)
SOURCE: WHO 2002a
Contraceptive prevalence > % of women ages 15-49	61 %		[4th of 57]
DEFINITION: Contraceptive prevalence rate is the percentage of women who are practicing, or whose sexual partners are practicing, any form of contraception. It is usually measured for married women ages 15-49 only.		View time series
SOURCE: UNHDR
Dependency ratio per 100	58		[96th of 166]
DEFINITION: Dependency ratio (per 100), 2003
SOURCE: World Development Indicators database
Drinking water availability %	90%		[62nd of 147]
DEFINITION: Coverage estimates shown are derived from information collected from two main sources: assessment questionnaires and household surveys. Assessment questionnaires were sent to all WHO country representatives, to be completed in liaison with local UNICEF st
SOURCE: World Health Organization
Drug access	80%		[72nd of 163]
DEFINITION: Population with access to essential drugs 2000. The data on access to essential drugs are based on statistical estimates received from World Health Organization (WHO) country and regional offices and regional advisers and through the World Drug Situation Survey carried out in 1998-99. These estimates represent the best information available to the WHO Department of Essential Drugs and Medicines Policy to date and are currently being validated by WHO member states. The department assigns the estimates to four groupings: very low access (0-49%), low access (50-79%), medium access (80-94%) and good access (95-100%). These groupings, used here in presenting the data, are often employed by the WHO in interpreting the data, as the actual estimates may suggest a higher level of accuracy than the data afford. b.
SOURCE: World Health Organization (WHO) and United Nations Children's Fund (UNICEF), Global Water Supply and Sanitation Assessment 2000 Report and updates provided by UNICEF to the United Nations Millennium Indicator Database
expenditure per capita > current US$	342.7 $		[58th of 186]
DEFINITION: Total health expenditure is the sum of public and private health expenditures as a ratio of total population. It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation. Data are in current U.S. dollars.		View time series
SOURCE: WHO (World Health Organization). 2001. Correspondence on access to essential drugs. Department of Essential Drugs and Medecines Policy. February. Geneva
expenditure, private > % of GDP	2.55 %		[79th of 187]
DEFINITION: Private health expenditure includes direct household (out-of-pocket) spending, private insurance, charitable donations, and direct service payments by private corporations.		View time series
SOURCE: World Development Indicators database
expenditure, public > % of GDP	5.15 %		[47th of 187]
DEFINITION: Public health expenditure consists of recurrent and capital spending from government (central and local) budgets, external borrowings and grants (including donations from international agencies and nongovernmental organizations), and social (or compulsory) health insurance funds.		View time series
SOURCE: World Development Indicators database
expenditure, total > % of GDP	7.7 %		[48th of 187]
DEFINITION: Total health expenditure is the sum of public and private health expenditure. It covers the provision of health services (preventive and curative), family planning activities, nutrition activities, and emergency aid designated for health but does not include provision of water and sanitation.		View time series
SOURCE: World Development Indicators database
External resources for health > % of total expenditure on health	0.2 %		[129th of 141]
DEFINITION: External resources for health are funds or services in kind that are provided by entities not part of the country in question. The resources may come from international organizations, other countries through bilateral arrangements, or foreign nongovernmental organizations. These resources are part of total health expenditure.		View time series
SOURCE: World Development Indicators database
External resources for health as % of total expenditure on health	0.9%		[106th of 179]
DEFINITION: External resources for health as % of total expenditure on health, 2002
SOURCE: World Development Indicators database
Female adults with HIV > % of population ages 15+ with HIV	25.29 %		[90th of 112]
DEFINITION: Female adults with HIV refers to the percentage of women of those ages 15-49 infected with HIV.		View time series
SOURCE: World Health Organization
Fertility rate, total > births per woman	2.62 births per woman		[85th of 194]
DEFINITION: Total fertility rate represents the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with current age-specific fertility rates.		View time series
SOURCE: World Development Indicators database
Healthy life expectancy at birth, years > Females	68		[45th of 186]
DEFINITION: Healthy life expectancy at birth (years) 2002 - Females
SOURCE: World Development Indicators database
Healthy life expectancy at birth, years > Males	64.3		[39th of 186]
DEFINITION: Healthy life expectancy at birth (years) 2002 - Males
SOURCE: World Health Organization
Healthy life expectancy at birth, years > Total population	66.2		[40th of 186]
DEFINITION: Healthy life expectancy at birth (years) 2002 - Total population
SOURCE: World Health Organization
HIV AIDS > Women living with aids 15-49	1.5		[43rd of 114]
DEFINITION: People living with HIV/AIDS, women (age 15-49)
SOURCE: World Health Organization
HIVAIDS > Adult prevalence rate 15-49 years,	1.5		[43rd of 145]
DEFINITION: Health - HIV/AIDS - Adult prevalence rate (15-49 years), end-2001
SOURCE: United Nations, Demographic Yearbook, 1997
HIVAIDS > children orphaned by AIDS 0-14 years,	8,000		[56th of 82]
DEFINITION: Health - HIV/AIDS - children orphaned by AIDS (0-14 years), 2001
SOURCE: UNICEF
Hospital beds > per 1,000 people	2.5 per 1,000 people		[39th of 149]
DEFINITION: Hospital beds include inpatient beds available in public, private, general, and specialized hospitals and rehabilitation centers. In most cases beds for both acute and chronic care are included.		View time series
SOURCE: UNICEF
Immunization, DPT > % of children ages 12-23 months	85 %		[129th of 190]
DEFINITION: Child immunization measures the percentage of children ages 12-23 months who received vaccinations before 12 months or at any time before the survey. A child is considered adequately immunized against diphtheria, pertussis (or whooping cough), and tetanus (DPT) after receiving three doses of vaccine.		View time series
SOURCE: World Development Indicators database
Immunization, measles > % of children ages 12-23 months	99 %		[22nd of 190]
DEFINITION: Child immunization measures the percentage of children ages 12-23 months who received vaccinations before 12 months or at any time before the survey. A child is considered adequately immunized against measles after receiving one dose of vaccine.		View time series
SOURCE: World Development Indicators database
Improved sanitation facilities > % of population with access	73 %		[82nd of 167]
DEFINITION: Access to improved sanitation facilities refers to the percentage of the population with at least adequate access to excreta disposal facilities that can effectively prevent human, animal, and insect contact with excreta. Improved facilities range from simple but protected pit latrines to flush toilets with a sewerage connection. To be effective, facilities must be correctly constructed and properly maintained.		View time series
SOURCE: World Development Indicators database
Improved sanitation facilities, rural > % of rural population with access	51 %		[91st of 167]
DEFINITION: Access to improved sanitation facilities refers to the percentage of the population with at least adequate access to excreta disposal facilities that can effectively prevent human, animal, and insect contact with excreta. Improved facilities range from simple but protected pit latrines to flush toilets with a sewerage connection. To be effective, facilities must be correctly constructed and properly maintained.		View time series
SOURCE: World Development Indicators database
Improved sanitation facilities, urban > % of urban population with access	89 %		[82nd of 173]
DEFINITION: Access to improved sanitation facilities refers to the percentage of the population with at least adequate access to excreta disposal facilities that can effectively prevent human, animal, and insect contact with excreta. Improved facilities range from simple but protected pit latrines to flush toilets with a sewerage connection. To be effective, facilities must be correctly constructed and properly maintained.		View time series
SOURCE: World Development Indicators database
Improved water source > % of population with access	90 %		[86th of 176]
DEFINITION: Access to an improved water source refers to the percentage of the population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, and rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Reasonable access is defined as the availability of at least 20 liters a person a day from a source within one kilometer of the dwelling.		View time series
SOURCE: World Development Indicators database
Improved water source, rural > % of rural population with access	79 %		[89th of 174]
DEFINITION: Access to an improved water source refers to the percentage of the population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, and rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Reasonable access is defined as the availability of at least 20 liters a person a day from a source within one kilometer of the dwelling.		View time series
SOURCE: World Development Indicators database
Improved water source, urban > % of urban population with access	99 %		[59th of 181]
DEFINITION: Access to an improved water source refers to the percentage of the population with reasonable access to an adequate amount of water from an improved source, such as a household connection, public standpipe, borehole, protected well or spring, and rainwater collection. Unimproved sources include vendors, tanker trucks, and unprotected wells and springs. Reasonable access is defined as the availability of at least 20 liters a person a day from a source within one kilometer of the dwelling.		View time series
SOURCE: World Development Indicators database
Incidence of tuberculosis > per 100,000 people	45.4 per 100,000 people		[114th of 200]
DEFINITION: Incidence of tuberculosis is the estimated number of new pulmonary, smear positive, and extra-pulmonary tuberculosis cases.		View time series
SOURCE: World Development Indicators database
Infant mortality rate	20.95		[93rd of 179]
DEFINITION: The number of deaths of infants under one year old in a given year per 1,000 live births in the same year. This rate is often used as an indicator of the level of health in a country
SOURCE: World Development Indicators database
Intestinal diseases death rate	5.14%		[89th of 141]
DEFINITION: Death rate from intestinal infectious diseases Units: Deaths/100,000 Population Units: The final number is based on an aggregation of deaths recorded for WHO code B01 for all age groups by sex. These were then combined with UN Population Division population data for the country in that particular year. The death rates were standardized utilizing the age structure for the population of Canada. See page 22 of the2001 ESI report for more details on the methodology.
SOURCE: CIA World Factbook, 28 July 2005
Investment in water and sanitation with private participation > current US$	25,000,000 $		[11th of 19]
DEFINITION: Investment in water and sanitation projects with private participation covers infrastructure projects in water and sanitation that have reached financial closure and directly or indirectly serve the public. Movable assets, incinerators, and standalone solid waste projects are excluded. The types of projects included are operations and management contracts, operations and management contracts with major capital expenditure, greenfield projects (in which a private entity or a public-private joint venture builds and operates a new facility), and divestitures. Investment commitments are the sum of investments in facilities and investments in government assets. Investments in facilities are the resources the project company commits to invest during the contract period either in new facilities or in expansion and modernization of existing facilities. Investments in government assets are the resources the project company spends on acquiring government assets such as state-owned enterprises, rights to provide services in a specific area, or the use of specific radio spectrums. Data are in current U.S. dollars.		View time series
SOURCE: World Health Organisation. 1997-1999 World Health Statistics Annual. Geneva: WHO, 2000
Investment in water and sanitation with private participation > current US$ (per $ GDP)	2.287 $ per $1,000 of GDP		[20th of 44]
View time series
life expectancy > Date of information	2006 est.
DEFINITION:
SOURCE: World Development Indicators database
Life expectancy at birth, female > years	77.89 years		[51st of 194]
DEFINITION: Life expectancy at birth indicates the number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life.		View time series
SOURCE: Wikipedia: List of countries by life expectancy
Life expectancy at birth, male > years	72.71 years		[47th of 194]
DEFINITION: Life expectancy at birth indicates the number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life.		View time series
SOURCE: World Development Indicators database
Life expectancy at birth, total > years	75.24 years		[47th of 194]
DEFINITION: Life expectancy at birth indicates the number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life.		View time series
SOURCE: World Development Indicators database
Life expectancy at birth, years > Females	78		[44th of 186]
DEFINITION: Life expectancy at birth (years) 2003 - Females
SOURCE: World Development Indicators database
Life expectancy at birth, years > Males	73		[36th of 186]
DEFINITION: Life expectancy at birth (years) 2003 - Males
SOURCE: World Health Organization
Life expectancy at birth, years > Total population	75		[41st of 186]
DEFINITION: Life expectancy at birth (years) 2003 - Total population
SOURCE: World Health Organization
Major infectious diseases > Degree of risk	intermediate
DEFINITION: This entry lists major infectious diseases likely to be encountered in countries where the risk of such diseases is assessed to be very high as compared to the United States. These infectious diseases represent risks to US government personnel traveling to the specified country for a period of less than three years. The degree of risk is assessed by considering the foreign nature of these infectious diseases, their severity, and the probability of being affected by the diseases present. The diseases listed do not necessarily represent the total disease burden experienced by the local population. The risk to an individual traveler varies considerably by the specific location, visit duration, type of activities, type of accommodations, time of year, and other factors. Consultation with a travel medicine physician is needed to evaluate individual risk and recommend appropriate preventive measures such as vaccines. Diseases are organized into the following six exposure categories shown in italics and listed in typical descending order of risk. Note - The sequence of exposure categories listed in individual country entries may vary according to local conditions. food or waterborne diseases acquired through eating or drinking on the local economy: Hepatitis A - viral disease that interferes with the functioning of the liver; spread through consumption of food or water contaminated with fecal matter, principally in areas of poor sanitation; victims exhibit fever, jaundice, and diarrhea; 15% of victims will experience prolonged symptoms over 6-9 months; vaccine available. Hepatitis E - water-borne viral disease that interferes with the functioning of the liver; most commonly spread through fecal contamination of drinking water; victims exhibit jaundice, fatigue, abdominal pain, and dark colored urine. Typhoid fever - bacterial disease spread through contact with food or water contaminated by fecal matter or sewage; victims exhibit sustained high fevers; left untreated, mortality rates can reach 20%. vectorborne diseases acquired through the bite of an infected arthropod: Malaria - caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito; parasites multiply in the liver attacking red blood cells resulting in cycles of fever, chills, and sweats accompanied by anemia; death due to damage to vital organs and interruption of blood supply to the brain; endemic in 100, mostly tropical, countries with 90% of cases and the majority of 1.5-2.5 million estimated annual deaths occurring in sub-Saharan Africa. Dengue fever - mosquito-borne (Aedes aegypti) viral disease associated with urban environments; manifests as sudden onset of fever and severe headache; occasionally produces shock and hemorrhage leading to death in 5% of cases. Yellow fever - mosquito-borne viral disease; severity ranges from influenza-like symptoms to severe hepatitis and hemorrhagic fever; occurs only in tropical South America and sub-Saharan Africa, where most cases are reported; fatality rate is less than 20%. Japanese Encephalitis - mosquito-borne (Culex tritaeniorhynchus) viral disease associated with rural areas in Asia; acute encephalitis can progress to paralysis, coma, and death; fatality rates 30%. African Trypanosomiasis - caused by the parasitic protozoa Trypanosoma; transmitted to humans via the bite of bloodsucking Tsetse flies; infection leads to malaise and irregular fevers and, in advanced cases when the parasites invade the central nervous system, coma and death; endemic in 36 countries of sub-Saharan Africa; cattle and wild animals act as reservoir hosts for the parasites. Cutaneous Leishmaniasis - caused by the parasitic protozoa leishmania; transmitted to humans via the bite of sandflies; results in skin lesions that may become chronic; endemic in 88 countries; 90% of cases occur in Iran, Afghanistan, Syria, Saudi Arabia, Brazil, and Peru; wild and domesticated animals as well as humans can act as reservoirs of infection. Plague - bacterial disease transmitted by fleas normally associated with rats; person-to-person airborne transmission also possible; recent plague epidemics occurred in areas of Asia, Africa, and South America associated with rural areas or small towns and villages; manifests as fever, headache, and painfully swollen lymph nodes; disease progresses rapidly and without antibiotic treatment leads to pneumonic form with a death rate in excess of 50%. Crimean-Congo hemorrhagic fever - tick-borne viral disease; infection may also result from exposure to infected animal blood or tissue; geographic distribution includes Africa, Asia, the Middle East, and Eastern Europe; sudden onset of fever, headache, and muscle aches followed by hemorrhaging in the bowels, urine, nose, and gums; mortality rate is approximately 30%. Rift Valley fever - viral disease affecting domesticated animals and humans; transmission is by mosquito and other biting insects; infection may also occur through handling of infected meat or contact with blood; geographic distribution includes eastern and southern Africa where cattle and sheep are raised; symptoms are generally mild with fever and some liver abnormalities, but the disease may progress to hemorrhagic fever, encephalitis, or ocular disease; fatality rates are low at about 1% of cases. Chikungunya - mosquito-borne (Aedes aegypti) viral disease associated with urban environments, similar to Dengue Fever; characterized by sudden onset of fever, rash, and severe joint pain usually lasting 3-7 days, some cases result in persistent arthritis. water contact diseases acquired through swimming or wading in freshwater lakes, streams, and rivers: Leptospirosis - bacterial disease that affects animals and humans; infection occurs through contact with water, food, or soil contaminated by animal urine; symptoms include high fever, severe headache, vomiting, jaundice, and diarrhea; untreated, the disease can result in kidney damage, liver failure, meningitis, or respiratory distress; fatality rates are low but left untreated recovery can take months. Schistosomiasis - caused by parasitic trematode flatworm Schistosoma; fresh water snails act as intermediate host and release larval form of parasite that penetrates the skin of people exposed to contaminated water; worms mature and reproduce in the blood vessels, liver, kidneys, and intestines releasing eggs, which become trapped in tissues triggering an immune response; may manifest as either urinary or intestinal disease resulting in decreased work or learning capacity; mortality, while generally low, may occur in advanced cases usually due to bladder cancer; endemic in 74 developing countries with 80% of infected people living in sub-Saharan Africa; humans act as the reservoir for this parasite. aerosolized dust or soil contact disease acquired through inhalation of aerosols contaminated with rodent urine: Lassa fever - viral disease carried by rats of the genus Mastomys; endemic in portions of West Africa; infection occurs through direct contact with or consumption of food contaminated by rodent urine or fecal matter containing virus particles; fatality rate can reach 50% in epidemic outbreaks. respiratory disease acquired through close contact with an infectious person: Meningococcal meningitis - bacterial disease causing an inflammation of the lining of the brain and spinal cord; one of the most important bacterial pathogens is Neisseria meningitidis because of its potential to cause epidemics; symptoms include stiff neck, high fever, headaches, and vomiting; bacteria are transmitted from person to person by respiratory droplets and facilitated by close and prolonged contact resulting from crowded living conditions, often with a seasonal distribution; death occurs in 5-15% of cases, typically within 24-48 hours of onset of symptoms; highest burden of meningococcal disease occurs in the hyperendemic region of sub-Saharan Africa known as the "Meningitis Belt" which stretches from Senegal east to Ethiopia. animal contact disease acquired through direct contact with local animals: Rabies - viral disease of mammals usually transmitted through the bite of an infected animal, most commonly dogs; virus affects the central nervous system causing brain alteration and death; symptoms initially are non-specific fever and headache progressing to neurological symptoms; death occurs within days of the onset of symptoms.		View time series
SOURCE: World Health Organization
Major infectious diseases > Food or waterborne diseases bacterial diarrhea and hepatitis A
DEFINITION: This entry lists major infectious diseases likely to be encountered in countries where the risk of such diseases is assessed to be very high as compared to the United States. These infectious diseases represent risks to US government personnel traveling to the specified country for a period of less than three years. The degree of risk is assessed by considering the foreign nature of these infectious diseases, their severity, and the probability of being affected by the diseases present. The diseases listed do not necessarily represent the total disease burden experienced by the local population. The risk to an individual traveler varies considerably by the specific location, visit duration, type of activities, type of accommodations, time of year, and other factors. Consultation with a travel medicine physician is needed to evaluate individual risk and recommend appropriate preventive measures such as vaccines. Diseases are organized into the following six exposure categories shown in italics and listed in typical descending order of risk. Note - The sequence of exposure categories listed in individual country entries may vary according to local conditions. food or waterborne diseases acquired through eating or drinking on the local economy: Hepatitis A - viral disease that interferes with the functioning of the liver; spread through consumption of food or water contaminated with fecal matter, principally in areas of poor sanitation; victims exhibit fever, jaundice, and diarrhea; 15% of victims will experience prolonged symptoms over 6-9 months; vaccine available. Hepatitis E - water-borne viral disease that interferes with the functioning of the liver; most commonly spread through fecal contamination of drinking water; victims exhibit jaundice, fatigue, abdominal pain, and dark colored urine. Typhoid fever - bacterial disease spread through contact with food or water contaminated by fecal matter or sewage; victims exhibit sustained high fevers; left untreated, mortality rates can reach 20%. vectorborne diseases acquired through the bite of an infected arthropod: Malaria - caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito; parasites multiply in the liver attacking red blood cells resulting in cycles of fever, chills, and sweats accompanied by anemia; death due to damage to vital organs and interruption of blood supply to the brain; endemic in 100, mostly tropical, countries with 90% of cases and the majority of 1.5-2.5 million estimated annual deaths occurring in sub-Saharan Africa. Dengue fever - mosquito-borne (Aedes aegypti) viral disease associated with urban environments; manifests as sudden onset of fever and severe headache; occasionally produces shock and hemorrhage leading to death in 5% of cases. Yellow fever - mosquito-borne viral disease; severity ranges from influenza-like symptoms to severe hepatitis and hemorrhagic fever; occurs only in tropical South America and sub-Saharan Africa, where most cases are reported; fatality rate is less than 20%. Japanese Encephalitis - mosquito-borne (Culex tritaeniorhynchus) viral disease associated with rural areas in Asia; acute encephalitis can progress to paralysis, coma, and death; fatality rates 30%. African Trypanosomiasis - caused by the parasitic protozoa Trypanosoma; transmitted to humans via the bite of bloodsucking Tsetse flies; infection leads to malaise and irregular fevers and, in advanced cases when the parasites invade the central nervous system, coma and death; endemic in 36 countries of sub-Saharan Africa; cattle and wild animals act as reservoir hosts for the parasites. Cutaneous Leishmaniasis - caused by the parasitic protozoa leishmania; transmitted to humans via the bite of sandflies; results in skin lesions that may become chronic; endemic in 88 countries; 90% of cases occur in Iran, Afghanistan, Syria, Saudi Arabia, Brazil, and Peru; wild and domesticated animals as well as humans can act as reservoirs of infection. Plague - bacterial disease transmitted by fleas normally associated with rats; person-to-person airborne transmission also possible; recent plague epidemics occurred in areas of Asia, Africa, and South America associated with rural areas or small towns and villages; manifests as fever, headache, and painfully swollen lymph nodes; disease progresses rapidly and without antibiotic treatment leads to pneumonic form with a death rate in excess of 50%. Crimean-Congo hemorrhagic fever - tick-borne viral disease; infection may also result from exposure to infected animal blood or tissue; geographic distribution includes Africa, Asia, the Middle East, and Eastern Europe; sudden onset of fever, headache, and muscle aches followed by hemorrhaging in the bowels, urine, nose, and gums; mortality rate is approximately 30%. Rift Valley fever - viral disease affecting domesticated animals and humans; transmission is by mosquito and other biting insects; infection may also occur through handling of infected meat or contact with blood; geographic distribution includes eastern and southern Africa where cattle and sheep are raised; symptoms are generally mild with fever and some liver abnormalities, but the disease may progress to hemorrhagic fever, encephalitis, or ocular disease; fatality rates are low at about 1% of cases. Chikungunya - mosquito-borne (Aedes aegypti) viral disease associated with urban environments, similar to Dengue Fever; characterized by sudden onset of fever, rash, and severe joint pain usually lasting 3-7 days, some cases result in persistent arthritis. water contact diseases acquired through swimming or wading in freshwater lakes, streams, and rivers: Leptospirosis - bacterial disease that affects animals and humans; infection occurs through contact with water, food, or soil contaminated by animal urine; symptoms include high fever, severe headache, vomiting, jaundice, and diarrhea; untreated, the disease can result in kidney damage, liver failure, meningitis, or respiratory distress; fatality rates are low but left untreated recovery can take months. Schistosomiasis - caused by parasitic trematode flatworm Schistosoma; fresh water snails act as intermediate host and release larval form of parasite that penetrates the skin of people exposed to contaminated water; worms mature and reproduce in the blood vessels, liver, kidneys, and intestines releasing eggs, which become trapped in tissues triggering an immune response; may manifest as either urinary or intestinal disease resulting in decreased work or learning capacity; mortality, while generally low, may occur in advanced cases usually due to bladder cancer; endemic in 74 developing countries with 80% of infected people living in sub-Saharan Africa; humans act as the reservoir for this parasite. aerosolized dust or soil contact disease acquired through inhalation of aerosols contaminated with rodent urine: Lassa fever - viral disease carried by rats of the genus Mastomys; endemic in portions of West Africa; infection occurs through direct contact with or consumption of food contaminated by rodent urine or fecal matter containing virus particles; fatality rate can reach 50% in epidemic outbreaks. respiratory disease acquired through close contact with an infectious person: Meningococcal meningitis - bacterial disease causing an inflammation of the lining of the brain and spinal cord; one of the most important bacterial pathogens is Neisseria meningitidis because of its potential to cause epidemics; symptoms include stiff neck, high fever, headaches, and vomiting; bacteria are transmitted from person to person by respiratory droplets and facilitated by close and prolonged contact resulting from crowded living conditions, often with a seasonal distribution; death occurs in 5-15% of cases, typically within 24-48 hours of onset of symptoms; highest burden of meningococcal disease occurs in the hyperendemic region of sub-Saharan Africa known as the "Meningitis Belt" which stretches from Senegal east to Ethiopia. animal contact disease acquired through direct contact with local animals: Rabies - viral disease of mammals usually transmitted through the bite of an infected animal, most commonly dogs; virus affects the central nervous system causing brain alteration and death; symptoms initially are non-specific fever and headache progressing to neurological symptoms; death occurs within days of the onset of symptoms.		View time series
SOURCE: All CIA World Factbooks 18 December 2003 to 18 December 2008
Major infectious diseases > Water contact disease	leptospirosis
DEFINITION: This entry lists major infectious diseases likely to be encountered in countries where the risk of such diseases is assessed to be very high as compared to the United States. These infectious diseases represent risks to US government personnel traveling to the specified country for a period of less than three years. The degree of risk is assessed by considering the foreign nature of these infectious diseases, their severity, and the probability of being affected by the diseases present. The diseases listed do not necessarily represent the total disease burden experienced by the local population. The risk to an individual traveler varies considerably by the specific location, visit duration, type of activities, type of accommodations, time of year, and other factors. Consultation with a travel medicine physician is needed to evaluate individual risk and recommend appropriate preventive measures such as vaccines. Diseases are organized into the following six exposure categories shown in italics and listed in typical descending order of risk. Note - The sequence of exposure categories listed in individual country entries may vary according to local conditions. food or waterborne diseases acquired through eating or drinking on the local economy: Hepatitis A - viral disease that interferes with the functioning of the liver; spread through consumption of food or water contaminated with fecal matter, principally in areas of poor sanitation; victims exhibit fever, jaundice, and diarrhea; 15% of victims will experience prolonged symptoms over 6-9 months; vaccine available. Hepatitis E - water-borne viral disease that interferes with the functioning of the liver; most commonly spread through fecal contamination of drinking water; victims exhibit jaundice, fatigue, abdominal pain, and dark colored urine. Typhoid fever - bacterial disease spread through contact with food or water contaminated by fecal matter or sewage; victims exhibit sustained high fevers; left untreated, mortality rates can reach 20%. vectorborne diseases acquired through the bite of an infected arthropod: Malaria - caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito; parasites multiply in the liver attacking red blood cells resulting in cycles of fever, chills, and sweats accompanied by anemia; death due to damage to vital organs and interruption of blood supply to the brain; endemic in 100, mostly tropical, countries with 90% of cases and the majority of 1.5-2.5 million estimated annual deaths occurring in sub-Saharan Africa. Dengue fever - mosquito-borne (Aedes aegypti) viral disease associated with urban environments; manifests as sudden onset of fever and severe headache; occasionally produces shock and hemorrhage leading to death in 5% of cases. Yellow fever - mosquito-borne viral disease; severity ranges from influenza-like symptoms to severe hepatitis and hemorrhagic fever; occurs only in tropical South America and sub-Saharan Africa, where most cases are reported; fatality rate is less than 20%. Japanese Encephalitis - mosquito-borne (Culex tritaeniorhynchus) viral disease associated with rural areas in Asia; acute encephalitis can progress to paralysis, coma, and death; fatality rates 30%. African Trypanosomiasis - caused by the parasitic protozoa Trypanosoma; transmitted to humans via the bite of bloodsucking Tsetse flies; infection leads to malaise and irregular fevers and, in advanced cases when the parasites invade the central nervous system, coma and death; endemic in 36 countries of sub-Saharan Africa; cattle and wild animals act as reservoir hosts for the parasites. Cutaneous Leishmaniasis - caused by the parasitic protozoa leishmania; transmitted to humans via the bite of sandflies; results in skin lesions that may become chronic; endemic in 88 countries; 90% of cases occur in Iran, Afghanistan, Syria, Saudi Arabia, Brazil, and Peru; wild and domesticated animals as well as humans can act as reservoirs of infection. Plague - bacterial disease transmitted by fleas normally associated with rats; person-to-person airborne transmission also possible; recent plague epidemics occurred in areas of Asia, Africa, and South America associated with rural areas or small towns and villages; manifests as fever, headache, and painfully swollen lymph nodes; disease progresses rapidly and without antibiotic treatment leads to pneumonic form with a death rate in excess of 50%. Crimean-Congo hemorrhagic fever - tick-borne viral disease; infection may also result from exposure to infected animal blood or tissue; geographic distribution includes Africa, Asia, the Middle East, and Eastern Europe; sudden onset of fever, headache, and muscle aches followed by hemorrhaging in the bowels, urine, nose, and gums; mortality rate is approximately 30%. Rift Valley fever - viral disease affecting domesticated animals and humans; transmission is by mosquito and other biting insects; infection may also occur through handling of infected meat or contact with blood; geographic distribution includes eastern and southern Africa where cattle and sheep are raised; symptoms are generally mild with fever and some liver abnormalities, but the disease may progress to hemorrhagic fever, encephalitis, or ocular disease; fatality rates are low at about 1% of cases. Chikungunya - mosquito-borne (Aedes aegypti) viral disease associated with urban environments, similar to Dengue Fever; characterized by sudden onset of fever, rash, and severe joint pain usually lasting 3-7 days, some cases result in persistent arthritis. water contact diseases acquired through swimming or wading in freshwater lakes, streams, and rivers: Leptospirosis - bacterial disease that affects animals and humans; infection occurs through contact with water, food, or soil contaminated by animal urine; symptoms include high fever, severe headache, vomiting, jaundice, and diarrhea; untreated, the disease can result in kidney damage, liver failure, meningitis, or respiratory distress; fatality rates are low but left untreated recovery can take months. Schistosomiasis - caused by parasitic trematode flatworm Schistosoma; fresh water snails act as intermediate host and release larval form of parasite that penetrates the skin of people exposed to contaminated water; worms mature and reproduce in the blood vessels, liver, kidneys, and intestines releasing eggs, which become trapped in tissues triggering an immune response; may manifest as either urinary or intestinal disease resulting in decreased work or learning capacity; mortality, while generally low, may occur in advanced cases usually due to bladder cancer; endemic in 74 developing countries with 80% of infected people living in sub-Saharan Africa; humans act as the reservoir for this parasite. aerosolized dust or soil contact disease acquired through inhalation of aerosols contaminated with rodent urine: Lassa fever - viral disease carried by rats of the genus Mastomys; endemic in portions of West Africa; infection occurs through direct contact with or consumption of food contaminated by rodent urine or fecal matter containing virus particles; fatality rate can reach 50% in epidemic outbreaks. respiratory disease acquired through close contact with an infectious person: Meningococcal meningitis - bacterial disease causing an inflammation of the lining of the brain and spinal cord; one of the most important bacterial pathogens is Neisseria meningitidis because of its potential to cause epidemics; symptoms include stiff neck, high fever, headaches, and vomiting; bacteria are transmitted from person to person by respiratory droplets and facilitated by close and prolonged contact resulting from crowded living conditions, often with a seasonal distribution; death occurs in 5-15% of cases, typically within 24-48 hours of onset of symptoms; highest burden of meningococcal disease occurs in the hyperendemic region of sub-Saharan Africa known as the "Meningitis Belt" which stretches from Senegal east to Ethiopia. animal contact disease acquired through direct contact with local animals: Rabies - viral disease of mammals usually transmitted through the bite of an infected animal, most commonly dogs; virus affects the central nervous system causing brain alteration and death; symptoms initially are non-specific fever and headache progressing to neurological symptoms; death occurs within days of the onset of symptoms.		View time series
SOURCE: All CIA World Factbooks 18 December 2003 to 18 December 2008
Malaria cases > per 100,000	36		[68th of 94]
DEFINITION: Malaria cases (per 100,000 people)
SOURCE: All CIA World Factbooks 18 December 2003 to 18 December 2008
Malnutrition prevalence, height for age > % of children under 5	18.2 %		[11th of 52]
DEFINITION: Prevalence of child malnutrition (height for age) is the percentage of children under five whose height for age is more than two standard deviations below the median for the international reference population ages 0 to 59 months. For children up to two years of age, height is measured by recumbent length. For older children, height is measured by stature while standing. The reference population adopted by the WHO in 1983, is based on children from the United States, who are assumed to be well nourished.		View time series
SOURCE: UNHDR
Malnutrition prevalence, weight for age > % of children under 5	8.1 %		[15th of 63]
DEFINITION: Prevalence of child malnutrition (weight for age) is the percentage of children under five whose weight for age is more than two standard deviations below the median reference standard for their age as established by the World Health Organization, the U.S. Centers for Disease Control and Prevention, and the U.S. National Center for Health Statistics. Figures are based on children under age three, four, and five years of age, depending on the country.		View time series
SOURCE: World Development Indicators database
Maternal mortality	70 per 100,000		[72nd of 136]
DEFINITION: Maternal mortality reported per 100,000 births 1985-1999. The maternal mortality data are those reported by national authorities. UNICEF and the World Health Organization periodically evaluate these data and make adjustments to account for the well-documented problems of under-reporting and misclassification of maternal deaths and to develop estimates for countries with no data (for details on the most recent estimates see Hill, AbouZahr and Wardlaw 2001). Data refer to the most recent year available during the period specified.
SOURCE: World Development Indicators database
Measles immunization	90		[78th of 168]
DEFINITION: Children 1 year old immunized against measles (%)
SOURCE: UNICEF (United Nations Children?s Fund). 2002. Official Summary: The State of the World's Children 2002. New York: Oxford University Press.
Nutrition > % of children who are still breastfeeding 20-23 months	21		[76th of 105]
DEFINITION: Health - Nutrition - % of children (1995-2002) who are: still breastfeeding (20-23 months)
SOURCE: UNICEF
Nutrition > % of children who are   exclusively breastfed 6 months	25		[69th of 125]
DEFINITION: Health - Nutrition - % of children (1995-2002) who are:   exclusively breastfed (<6 months)
SOURCE: UNICEF
Nutrition > % of households consuming iodized salt	95		[12th of 112]
DEFINITION: Health - Nutrition - % of households consuming iodized salt (1997-2002)
SOURCE: UNICEF
Nutrition > % of under-fives suffering from stunting moderate & severe	14		[92nd of 132]
DEFINITION: Health - Nutrition - % of under-fives (1995-2002) suffering from: stunting moderate & severe
SOURCE: UNICEF
Nutrition > % of under-fives suffering from underweight moderate & severe	7		[103rd of 137]
DEFINITION: Health - Nutrition - % of under-fives (1995-2002) suffering from: underweight moderate & severe
SOURCE: UNICEF
Nutrition > % of under-fives suffering from wasting moderate & severe	1		[126th of 128]
DEFINITION: Health - Nutrition - % of under-fives (1995-2002) suffering from: wasting moderate & severe
SOURCE: UNICEF
Oral rehydration rate %	7		[67th of 73]
DEFINITION: Health - Oral rehydration rate (%) 1994-2002
SOURCE: UNICEF
Out-of-pocket expenditure as % of private health expenditure	81.8%		[122nd of 185]
DEFINITION: Out-of-pocket expenditure on health as % of private expenditure on health, 2002
SOURCE: UNICEF
Out-of-pocket health expenditure > % of private expenditure on health	82.5 %		[110th of 185]
DEFINITION: Out of pocket expenditure is any direct outlay by households, including gratuities and in-kind payments, to health practitioners and suppliers of pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups. It is a part of private health expenditure.		View time series
SOURCE: World Health Organization
Per capita government expenditure on health in international dollars	413		[52nd of 185]
DEFINITION: Per capita government expenditure on health in international dollars, 2002
SOURCE: World Development Indicators database
Per capita total expenditure on health in international dollars	576		[56th of 185]
DEFINITION: Per capita total expenditure on health in international dollars, 2002
SOURCE: World Health Organization
Physicians > per 1,000 people	1.5 per 1,000 people		[56th of 148]
DEFINITION: Physicians are defined as graduates of any facility or school of medicine who are working in the country in any medical field (practice, teaching, research).		View time series
SOURCE: World Health Organization
Population suffering from undernourishment in 1990-1992	21 %		[55th of 106]
DEFINITION:
SOURCE: World Development Indicators database
Population suffering from undernourishment in 2001-2003	25 %		[35th of 108]
DEFINITION:
SOURCE: Wikipedia: List of countries by percentage of population suffering from undernourishment
Pregnant women receiving prenatal care > %	72.2 %		[15th of 62]
DEFINITION: Pregnant women receiving prenatal care are the percentage of women attended at least once during pregnancy by skilled health personnel for reasons related to pregnancy.		View time series
SOURCE: Wikipedia: List of countries by percentage of population suffering from undernourishment
Prepaid plans as % of private expenditure on health	18.2%		[31st of 159]
DEFINITION: Prepaid plans as % of private expenditure on health, 2002
SOURCE: World Development Indicators database
Prevalence of HIV, total > % of population ages 15-49	0.89 %		[61st of 148]
DEFINITION: Prevalence of HIV refers to the percentage of people ages 15-49 who are infected with HIV.		View time series
SOURCE: World Health Organization
Prevalence of undernourishment > % of population	23 %		[43rd of 172]
DEFINITION: Population below minimum level of dietary energy consumption (also referred to as prevalence of undernourishment) shows the percentage of the population whose food intake is insufficient to meet dietary energy requirements continuously. Data showing as 2.5 signifies a prevalence of undernourishment below 2.5%.		View time series
SOURCE: World Development Indicators database
Private expenditure on health as % of total expenditure on health	28.3%		[131st of 185]
DEFINITION: Private expenditure on health as % of total expenditure on health, 2002
SOURCE: World Development Indicators database
Probability of dying before 5 > Females	22 per 1,000 people		[109th of 187]
DEFINITION: Probability of females dying before reaching the age of 5. (2003)
SOURCE: World Health Organization
Probability of not reaching 40	6.4%		[89th of 111]
DEFINITION: Probability at birth of not reaching the age of 40.
SOURCE: The World Health Report 2001
Probability of reaching 65 > Female	83.5%		[48th of 159]
DEFINITION: Probability at birth of reaching the age of 65.
SOURCE: UN 2001 via backone.pdf
Probability of reaching 65 > Male	76%		[34th of 159]
DEFINITION: Probability at birth of reaching the age of 65.
SOURCE: UN (United Nations). 2001. World Population Prospects 1950-2050: The 2000 Revision. Database. Department of Economic and Social Affairs, Population Division. New York.
Respiratory disease child death rate	48.82 (est)
DEFINITION: Child death rate from respiratory diseases Units: Deaths/100,000 Population Aged 0-14 Units: The final number is based on an aggregation of deaths recorded for WHO codes B31 and B320, and B321, by sex and by age. These were then combined with UN Population Division population data broken down by age group to produce rates. See page 22 of the 2001 ESI report for more details on the methodology.
SOURCE: UN (United Nations). 2001. World Population Prospects 1950-2050: The 2000 Revision. Database. Department of Economic and Social Affairs, Population Division. New York
Smoking prevalence, females > % of adults	6.1 %		[15th of 43]
DEFINITION: Prevalence of smoking, female is the percentage of women who smoke cigarettes. The age range varies among countries but in most is 18 and older or 15 and older.		View time series
SOURCE: World Health Organisation. 1997-1999 World Health Statistics Annual. Geneva: WHO, 2000
Smoking prevalence, males > % of adults	19.7 %		[19th of 42]
DEFINITION: Prevalence of smoking, male is the percentage of men who smoke cigarettes. The age range varies among countries but in most is 18 and older or 15 and older.		View time series
SOURCE: World Development Indicators database
Spending > Per person	246		[43rd of 133]
DEFINITION: Spending per capita (PPP) in $US 1998.
SOURCE: World Development Indicators database
Spending > Private	2.3		[63rd of 141]
DEFINITION: Private expenditure on health as a percentage of GDP 1998.
SOURCE: World Bank. 2002. World Development Indicators 2002. CD-ROM. Washington, DC
Spending > Public	4.9%
DEFINITION: World Bank. 2002. World Development Indicators 2002. CD-ROM. Washington, DC.
SOURCE: World Bank. 2002. World Development Indicators 2002. CD-ROM. Washington, DC
Suicide rate > Gender ratio	6.6 per 100,000 people		[3rd of 76]
DEFINITION: Suicide rates per 100,000 people
Tobacco > Adult female smokers	20		[41st of 114]
DEFINITION: Total adult females smoking
SOURCE: annual figures:WHO databank, National Bureaus of Statistics. Department of Economic and Social Information and Policy Analysis Population Division (1995). World population prospects. The 1994 revision. New York: United Nations. Partly computations: Department of Clinical Psychology, Psychiatric Clinic, University of W?rzburg, Germany
Tobacco > Adult male smokers	56		[21st of 115]
DEFINITION: Total adult males smoking
SOURCE: World Health Organization
Tobacco > Cigarette consumption	244		[90th of 106]
DEFINITION: Approximate average number of cigarettes smoked per adult per year
SOURCE: World Health Organization
Tobacco > Total adult smokers	38		[20th of 121]
DEFINITION: Total adults smoking
SOURCE: World Health Organization
Total expenditure on health as % of GDP	8.9%		[29th of 185]
DEFINITION: Total expenditure on health as % of GDP, 2002
SOURCE: World Health Organization2005
Total fertility rate	2.7		[89th of 166]
DEFINITION: Total fertility rate, 2003
SOURCE: World Health Organization
Tuberculosis cases > Per 100,000	28		[100th of 165]
DEFINITION: Tuberculosis cases (per 100,000 people)
SOURCE: World Health Organization
Tuberculosis cases detected under DOTS > %	131.19 %		[3rd of 178]
DEFINITION: DOTS detection rate is the percentage of estimated new infectious tuberculosis cases detected under the directly observed treatment, short course case detection and treatment strategy.		View time series
SOURCE: UNHDR
Tuberculosis immunisation	99%		[14th of 134]
SOURCE: World Development Indicators database
Tuberculosis treatment success rate > % of registered cases	78.28 %		[99th of 171]
DEFINITION: Tuberculosis treatment success rate is the percentage of new, registered smear-positive (infectious) cases that were cured or in which a full course of treatment was completed.		View time series
SOURCE: UNICEF
Water availability	51,814 cubic meters		[21st of 169]
DEFINITION: Water resources: total renewable per capita (m3/capita year)
SOURCE: World Development Indicators database

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