Central America

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The Centers for Disease Control and Prevention (CDC) formally established the Central America Regional (CAR) office, based in Guatemala, in 2005. In addition to Guatemala the regional office also covers Panama, Belize, El Salvador, Costa Rica, Honduras, and Nicaragua. CAR also manages projects in the Dominican Republic for CDC’s Division of Global Health Protection. Initially focusing on parasitic diseases, CDC has collaborated with public health institutions in Central America since the 1960s. CDC continues to work with the ministries of health (MOH) and the Council of Ministers of Health of Central America (COMISCA) to respond to public health threats addressing HIV, tuberculosis, dengue, and Zika virus as well as strengthening surveillance, laboratory and workforce development.

Central America Region map

CDC CENTRAL AMERICA REGIONAL OFFICE INCLUDES:
Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama

What CDC is Doing in Central America

HIV is a leading cause of death and a health threat to millions worldwide. As a key implementer of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC has partnered with the region’s ministries of health and COMISCA to build a sustainable, high-impact national HIV response program. CDC’s collaboration with these regional partners is focused on strengthening strategic information and prevention strategies, targeting key populations, as well as improving the quality of HIV and tuberculosis treatment services for people living with these infectious diseases.

Helping countries respond to public health threats quickly and effectively within their borders is critical to prevent the spread of disease regionally and around the world. A CDC Global Disease Detection Regional Center was established in Guatemala in 2006 and coordinates activities with local, regional, and global public health organizations to support disease outbreak response, surveillance, laboratory systems, and workforce development.

In 2018, CDC began partnerships with Brigham and Women’s Hospital, Baylor College of Medicine, Washington State University, and Universidad del Valle de Guatemala, to strengthen epidemiological surveillance for acute febrile illnesses (sudden fever in a patient that may last for several days) and antimicrobial resistance in the Dominican Republic, Belize and Guatemala. Activities include surveillance of febrile illnesses in humans; community-based surveillance for vector-borne diseases using a One Health approach (which recognizes that the health of people is connected to the health of animals and the environment), as well as surveillance of community and hospital-acquired infections and antimicrobial resistance.

CDC provides direct technical assistance and training to develop laboratory capacity in the region. CDC works with the Red Regional de Laboratorios Nacionales de Salud Pública. Objectives include working toward laboratory proficiency testing certification, supporting laboratory biosafety programs, and developing laboratory preparedness plans for disease outbreaks.

CDC’s Field Epidemiology Training Program (FETP) supports strengthening the capacity of the public health workforce to investigate and respond to disease outbreaks. FETP trains field epidemiologists—or disease detectives—to identify and contain outbreaks before they become epidemics. A hands-on approach allows trainees to develop the skills for gathering critical data and turning it into evidence-based action. Three levels of training (frontline, intermediate, and advanced) help develop national, regional, and local capabilities to stop diseases at their source. COMISCA, with MOHs, coordinate FETP activities among countries.

CDC works with national zoonosis programs and MOHs to control canine rabies, particularly in Guatemala and Dominican Republic. The goal is to strengthen communication and coordination for rabies surveillance and response, strengthen laboratory testing, make evidence-based recommendations, and evaluate national vaccination campaign strategies.

Zika, a mosquito-borne and sexually transmitted virus, was first detected in the region in November 2015 by the Ministry of Public Health and Social Assistance of Guatemala (MSPAS). As Zika spread in the region, CDC supported surveillance, vector control activities, and other strategies to reduce transmission. In collaboration with U.S. Agency for International Development (USAID), CDC worked with MSPAS to increase knowledge about Zika and improve public health policy and practice in Guatemala. CDC, Universidad del Valle de Guatemala, and MSPAS conducted a research study, titled ZINC, to better understand the impact of Zika in Coatepeque city among pregnant women and their babies. The study helped public health officials better understand the toll of Zika, dengue, chikungunya, toxoplasmosis, HIV, and other pathogens that affect pregnant women and their babies.

CDC Impact in Central America
  • CDC has participated in research investigations of diseases that affect many countries, like measles, rabies, and Zika virus. These investigations help the global medical and scientific community better understand these pathogens.
  • Guatemala was the first country to integrate a rapid recency assay into HIV testing services in all PEPFAR countries. Data are used to identify potential infection clusters to better align resources and maximize investment and impact.
  • Baseline HIV drug-resistance surveys were conducted in Guatemala, Nicaragua, and Honduras in October 2018. The results helped make the decision to change treatment regimens for patients showing elevated HIV drug resistance levels.
  • As of December 2018, over 1,200 fellows have graduated from the FETP frontline-level program, more than 250 from the intermediate level, and 73 from the advanced level.
  • Four MOH clinics in three countries implemented the rapid antiretroviral treatment initiation strategy (initiation within 7 days from time of HIV diagnosis), resulting in a viral load reduction in 4 weeks.
  • CDC confirmed two pathogens recently discovered in Guatemala. Rickettsia felis is an emerging insect-borne pathogen that causes flea-borne spotted fever. Burkholderia pseudomallei is a bacteria that can cause melioidosis or Whitemore’s disease found in water and soil.
  • CDC has supported laboratory biosafety activities in Guatemala, El Salvador and Honduras.
CDC Staff in Central America
  • 4 U.S. Assignees
  • 17 Locally Employed
Central America Country Facts Table
Data facts of countries in region
BELIZE COSTA RICA EL SALVADOR GUATEMALA
Population >380 thousand >4 million >6 million >4 million
Per Capita Income $7,890 $16,100 $7,540 $8,000
Life Expectancy at Birth F 77/M 71 years F 83/M 78 years F 77/M 68 years F 76/M 69 years
Infant Mortality Rate 9/1,000 live births 8/1,000 live births 17/1,000 live births 28/1,000 live births
Top 10 Causes of Death
  1. Cardiovascular diseases
  2. Diabetes & kidney
    diseases
  3. Neoplasm
  4. Maternal & neonatal
  5. Self-harm & violence
  6. Mental disorders
  7. Other non-
    communicable diseases
  8. Unintentional injuries
  9. Musculoskeletal
    disorders
  10. Neurological disorders
  1. Neoplasms
  2. Cardiovascular diseases
  3. Musculoskeletal
    disorders
  4. Mental disorders
  5. Neurological disorders
  6. Diabetes & kidney
    diseases
  7. Other non-
    communicable diseases
  8. Digestive diseases
  9. Self-harm & violence
  10. Maternal & neonatal
  1. Self- harm & violence
  2. Cardiovascular diseases
  3. Diabetes & kidney
    diseases
  4. Neoplasms
  5. Neurological disorders
  6. Mental disorders
  7. Other non-
    communicable diseases
  8. Musculoskeletal
    disorders
  9. Maternal & neonatal
  10. Digestive Diseases
    1. Respiratory infections & TB
    2. Maternal & neonatal
    3. Self-harm & violence
    4. Diabetes & kidney
      diseases
    5. Cardiovascular diseases
    6. Neoplasms
    7. Digestive diseases
    8. Other non-
      communicable diseases
    9. Unintentional injuries

    10    Mental disorders

Health Information for Travelers Health Information for Travelers to Belize Health Information for Travelers to Costa Rica Health Information for Travelers to El Salvador Health Information for Travelers to Guatemala
Data facts of countries in region
HONDURAS NICARAGUA PANAMA
Population 9,265,067 6,217,581 4,098,587
Per Capita Income $4,630 $5,680 $21,890
Life Expectancy at Birth F 77/M 71 years F 78/M 72 years F 81/M 75 years
Infant Mortality Rate 25/1,000 live births 18/1,000 live births 14/1,000 live births
Top 10 Causes of Death
  1. Cardiovascular diseases
  2. Self-harm & violence
  3. Maternal & neonatal
  4. Digestive diseases
  5. Neoplasms
  6. Neurological disorders
  7. Other non-
    communicable diseases
  8. Mental disorders
  9. Musculoskeletal
    disorders
  10. Diabetes & kidney
    diseases
  1. Diabetes & kidney
    diseases
  2. Cardiovascular diseases
  3. Maternal & neonatal
  4. Neoplasms
  5. Mental disorders
  6. Other non-
    communicable diseases
  7. Musculoskeletal
    disorders
  8. Neurological disorders
  9. Digestive diseases
  10. Self-harm & violence
  1. Cardiovascular diseases
  2. Neoplasms
  3. Diabetes & kidney
    diseases
  4. Other non-
    communicable diseases
  5. Mental disorders
  6. Neurological disorders
  7. Maternal & neonatal
  8. Musculoskeletal
    disorders
  9. Self-harm & violence
  10. Respiratory infections & TB
Health Information for Travelers Health Information for Travelers to Honduras Health Information for Travelers to Nicaragua Health Information for Travelers to Panama

Sources:
World Bank 2018, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
Population Reference Bureau 2018, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
GBD Compare 2018, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama

Country Facts

Population: 374,681 (2017)

Per Capita Income: $7,890

Life Expectancy at Birth: F 77/M 71 years

Infant Mortality Rate: 9/1,000 live births

Top 10 Causes of Death:

  1. Ischemic heart disease
  2. Diabetes
  3. Stroke
  4. Lower respiratory infections
  5. Interpersonal violence
  6. Chronic kidney disease
  7. HIV/AIDS
  8. Road injuries
  9. Neonatal disorders
  10. Alzheimer’s disease

Health Information for Travelers to Belize

Population: 4,905,769 (2017)

Per Capita Income: $16,100

Life Expectancy at Birth: F 83/M 78 years

Infant Mortality Rate: 8/1,000 live births

Top 10 Causes of Death

  1. Ischemic heart disease
  2. Stroke
  3. Alzheimer’s disease
  4. Chronic kidney disease
  5. Chronic obstructive pulmonary disease
  6. Cirrhosis
  7. Stomach cancer
  8. Road injuries
  9. Colorectal cancer
  10. Hypertensive heart disease

Health Information for Travelers to Costa Rica

Population: 6,377,853 (2017)

Per Capita Income: $7,540

Life Expectancy at Birth: F 78 /M 69 years

Infant Mortality Rate: 17/1,000 live births

Top 10 Causes of Death:

  1. lschemic heart disease
  2. Chronic kidney disease
  3. Interpersonal violence
  4. Lower respiratory infections
  5. Alzheimer’s disease
  6. Diabetes
  7. Stroke
  8. Cirrhosis
  9. Road injuries
  10. Chronic obstructive pulmonary disease

Health Information for Travelers to El Salvador

Population: 16,913,503 (2017)

Per Capita Income: $8,000

Life Expectancy at Birth: F 76/M 69 years

Infant Mortality Rate: 28/1,000 live births

Top 10 Causes of Death:

  1. Lower respiratory infections
  2. Ischemic heart disease
  3. Interpersonal violence
  4. Diabetes
  5. Chronic kidney disease
  6. Cirrhosis
  7. Stroke
  8. Neonatal disorders
  9. Diarrheal diseases
  10. Road injuries

Health Information for Travelers to Guatemala

Population: 9,265,067 (2017)

Per Capita Income: $4,630

Life Expectancy at Birth:  F 76/M 71 years

Infant Mortality Rate: 25/1,000 live births

Top 10 Causes of Death:

  1. Ischemic heart disease
  2. Interpersonal violence
  3. Stroke
  4. Alzheimer’s disease
  5. Cirrhosis
  6. Chronic obstructive pulmonary disease
  7. Neonatal disorders
  8. Road injuries
  9. Diarrheal diseases
  10. Diabetes

Health Information for Travelers to Honduras

Population: 6,217,581 (2017)

Per Capita Income:  $5,680

Life Expectancy at Birth:  F 78/M 72 years

Infant Mortality Rate:  18/1,000 live births

Top 10 Causes of Death:

  1. lschemic heart disease
  2. Chronic kidney disease
  3. Stroke
  4. Diabetes
  5. Alzheimer’s disease
  6. Cirrhosis
  7. Lower respiratory infections
  8. Neonatal disorders
  9. Chronic obstructive pulmonary disease
  10. Road injuries

Health Information for Travelers to Nicaragua

Population: 4,098,587 (2017)

Per Capita Income: $21,890

Life Expectancy at Birth:  F 81/M 75 years

Infant Mortality Rate:  14/1,000 live births

Top 10 Causes of Death:

  1. Ischemic heart disease
  2. Stroke
  3. Alzheimer’s disease
  4. Diabetes
  5. Chronic kidney disease
  6. Lower respiratory infections
  7. Interpersonal violence
  8. Chronic obstructive pulmonary disease
  9. HIV/AIDS
  10. Road injuries

Health Information for Travelers to Panama

Sources:
World Bank 2018, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
Population Reference Bureau 2018, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama
GBD Compare 2018, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama

Page last reviewed: March 5, 2020
Content source: Global Health