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Ursine RL, Dias JVL, Morais HA, Pires HHR. Human and canine visceral leishmaniasis in an emerging focus in Araçuaí, Minas Gerais: spatial distribution and socio-environmental factors. Mem Inst Oswaldo Cruz 2017; 111:505-11. [PMID: 27384080 PMCID: PMC4981116 DOI: 10.1590/0074-02760160133] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/07/2016] [Indexed: 12/02/2022] Open
Abstract
This study aimed to analyse the spatial distribution of human (2007-2013) and canine (2013) visceral leishmaniasis (VL) in the city of Araçuaí, Minas Gerais, Brazil, and identify the socio-environmental factors related to their occurrence. The spatial distribution of human and canine cases was analysed by kernel density estimation (KDE) and the K function. The KDE values were analysed for correlation between human and canine LV and for normalised difference vegetation index (NDVI). Socio-environmental aspects of household structures and surroundings were evaluated. The spatial distribution of human and canine VL cases exhibited a significant aggregated pattern in distances greater than 350 and 75 m, respectively. The higher occurrence of human and canine infection occurred in the central area of the city. A positive correlation between the densities of human and canine cases was observed, as well as a negative correlation between NDVI and densities of human and canine cases. Socio-environmental analysis revealed that the large amount of animals, organic material from trees and deficiencies in environmental sanitation are possibly contributing to the continuation of the transmission cycle of Leishmania infantum in Araçuaí. These results can contribute to the planning by competent agencies to reduce the incidence of infection in the city.
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Affiliation(s)
- Renata Luiz Ursine
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - João Victor Leite Dias
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - Harriman Aley Morais
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - Herton Helder Rocha Pires
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
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Morgado FN, Cavalcanti ADS, Miranda LHD, O'Dwyer LH, Silva MRLD, Menezes RC, Andrade da Silva AV, Boité MC, Cupolillo E, Porrozzi R. Hepatozoon canis and Leishmania spp. coinfection in dogs diagnosed with visceral leishmaniasis. ACTA ACUST UNITED AC 2016; 25:450-458. [PMID: 27925060 DOI: 10.1590/s1984-29612016065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/23/2016] [Indexed: 11/22/2022]
Abstract
This study describes the occurrence of dogs naturally co-infected with Hepatozoon canis and two Leishmania species: L. infantum or L. braziliensis. Four dogs serologically diagnosed with Visceral Leishmaniasis were euthanized. Liver and spleen samples were collected for histopathological analysis and DNA isolation. H. canis meronts were observed in tissues from all four dogs. H. canis infection was confirmed by PCR followed by sequencing of a fragment of 18S rRNA gene. Leishmania detection and typing was confirmed by ITS1' PCR-RFLP and parasite burden was calculated using ssrRNA quantitative qPCR. A DPP - Dual Path platform test was performed. One out (Dog #2) of four animals was asymptomatic. Dogs #1 and #4 were infected by L. infantum and were DPP test positive. Dogs #2 and #3 were infected by L. braziliensis and were DPP test negative. Furthermore, visceral dissemination was observed in Dogs #2 and #3, since L. braziliensis was detected in liver and spleen samples. The visceral dissemination of L. braziliensis associated with systemic signs suggested that this co-infection could influence the parasite burden and disease progression.
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Affiliation(s)
- Fernanda Nazaré Morgado
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
| | - Amanda Dos Santos Cavalcanti
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
| | - Luisa Helena de Miranda
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
| | - Lúcia Helena O'Dwyer
- Departamento de Parasitologia, Instituto de Biociências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, São Paulo, SP, Brasil
| | - Maria Regina Lucas da Silva
- Departamento de Parasitologia, Instituto de Biociências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, São Paulo, SP, Brasil
| | - Rodrigo Caldas Menezes
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto Nacional de Infectologia, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
| | - Aurea Virgínia Andrade da Silva
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
| | - Mariana Côrtes Boité
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
| | - Elisa Cupolillo
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
| | - Renato Porrozzi
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ, Brasil
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Genome-Wide Association Study of Cell-Mediated Response in Dogs Naturally Infected by Leishmania infantum. Infect Immun 2016; 84:3629-3637. [PMID: 27736777 DOI: 10.1128/iai.00486-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 10/03/2016] [Indexed: 12/20/2022] Open
Abstract
A genome-wide association study (GWAS) could unravel the complexity of the cell-mediated immunity (CMI) to canine leishmaniasis (CanL). Therefore, we scanned 110,165 single-nucleotide polymorphisms (SNPs), aiming to identify chromosomal regions associated with the leishmanin skin test (LST), lymphocyte proliferation assay (LPA), and cytokine responses to further understand the role played by CMI in the outcome of natural Leishmania infantum infection in 189 dogs. Based on LST and LPA, four CMI profiles were identified (LST-/LPA-, LST+/LPA-, LST-/LPA+, and LST+/LPA+), which were not associated with subclinically infected or diseased dogs. LST+/LPA+ dogs showed increased interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) levels and mild parasitism in the lymph nodes, whereas LST-/LPA+ dogs, in spite of increased IFN-γ, also showed increased interleukin-10 (IL-10) and transforming growth factor β (TGF-β) levels and the highest parasite load in lymph nodes. Low T cell proliferation under low parasite load suggested that L. infantum was not able to induce effective CMI in the early stage of infection. Altogether, genetic markers explained 87%, 16%, 15%, 11%, 0%, and 0% of phenotypic variance in TNF-α, TGF-β, LST, IL-10, IFN-γ, and LPA, respectively. GWAS showed that regions associated with TNF-α include the following genes: IL12RB1, JAK3, CCRL2, CCR2, CCR3, and CXCR6, involved in cytokine and chemokine signaling; regions associated with LST, including COMMD5 and SHARPIN, involved in regulation of NF-κB signaling; and regions associated with IL-10, including LTBP1 and RASGRP3, involved in T regulatory lymphocytes differentiation. These findings pinpoint chromosomic regions related to the cell-mediated response that potentially affect the clinical complexity and the parasite replication in canine L. infantum infection.
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Alves EB, Costa CHN, de Carvalho FAA, Pires E Cruz MDS, Werneck GL. Risk Profiles for Leishmania infantum Infection in Brazil. Am J Trop Med Hyg 2016; 94:1276-81. [PMID: 27114290 DOI: 10.4269/ajtmh.15-0513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 03/07/2016] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to characterize risk profiles for Leishmania infantum infection in a population living in an area endemic for visceral leishmaniasis. A cohort study was conducted between January 2004 and December 2006 with the participation of 430 individuals living in the city of Teresina, northeast Brazil, who were initially negative for the Montenegro test. Data analysis was performed using the classification and regression tree method. The cumulative incidence (CI) of Montenegro's test conversion was 35% at 18-month follow-up. Eight different risk profiles for L. infantum infection were identified. The profile with the highest risk (CI = 75%) comprised individuals with less than 4 years of education who had never lived outside Teresina. The profile with the lowest risk (CI = 5%) included highly educated subjects who had owned a dog for 5 years or more and lived in areas that received some type of intervention. These results show that there is a high degree of complexity involved in the risk for L. infantum infection and point out the need of developing new studies to perform a comprehensive analysis focused on investigating the interrelation between risk factors rather than their isolated roles on the determination of infection levels in urban areas.
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Affiliation(s)
- Erika Barretto Alves
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Carlos Henrique Nery Costa
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Fernando Aécio Amorim de Carvalho
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Maria do Socorro Pires E Cruz
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Guilherme Loureiro Werneck
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
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Maia Z, Viana V, Muniz E, Gonçalves LO, Mendes CMC, Mehta SR, Badaro R. Risk Factors Associated with Human Visceral Leishmaniasis in an Urban Area of Bahia, Brazil. Vector Borne Zoonotic Dis 2016; 16:368-76. [PMID: 27074100 DOI: 10.1089/vbz.2015.1880] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The early diagnosis of asymptomatic, acute, and subclinical Leishmania infections remains a challenge for controlling visceral leishmaniasis (VL). Individuals with acute VL represent <1% of Leishmania infections occurring in active transmission endemic areas. In this cross-sectional study with a prospective follow-up, we explored the risk factors associated with acquisition of Leishmania infection in an area with newly identified endemic VL. MATERIALS AND METHODS Ninety-four households were randomly selected from the study area, which included a population of 213 individuals (10% of the total population of Pé de Areia, Bahia, Brazil). Clinical and epidemiological surveys were prospectively performed to detect cases of asymptomatic infections, acute VL, and subclinical VL, using the leishmanin skin test (LST), and serological response to two Leishmania-specific antigens: rK39 and rK26. RESULTS Within the 92 households included in the study, the prevalence of Leishmania infection in individuals detected by positive serology was 91/197 (46.2%; 95% CI: 0.3937-0.5316) and by LST was 29/114 (25.4%; 95% CI: 0.1834-0.3414). Reactivity to both antigens was detected in 64/197 individuals (32.5%; 95% CI: 0.2634-0.3931). Among 89 individuals diagnosed with leishmaniasis, we found acute VL in one (1%), subclinical VL in 20 (22.5%), and asymptomatic Leishmania infection in 68 (76.4%) subjects. Use of repellents and bed nets showed no significant protection (prevalence ratio [PR] = 1.01, p = 1.0). Interestingly, individuals residing in houses with a sand backyard had significant protection against Leishmania infection (PR = 1.24, p = 0.049) compared to those with a different type or no backyard. Moreover, the presence of cat or dog at home was also not a risk factor (dog: PR = 1.14, 95% CI: 0.80-1.64; and cat: PR = 1.19, 95% CI: 0.78-1.81). We conclude that in newly discovered areas of transmission of L. infantum infection with sylvatic reservoirs, periodic surveys may be helpful in identifying risk factors for infection and optimizing prevention guidelines.
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Affiliation(s)
- Zuinara Maia
- 1 Department of Medicine, Federal University of Bahia , Salvador, Brazil
| | - Vivian Viana
- 1 Department of Medicine, Federal University of Bahia , Salvador, Brazil
| | - Eduardo Muniz
- 1 Department of Medicine, Federal University of Bahia , Salvador, Brazil
| | | | | | - Sanjay R Mehta
- 3 Division of Infectious Diseases, University of California , San Diego, California
| | - Roberto Badaro
- 1 Department of Medicine, Federal University of Bahia , Salvador, Brazil
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Risk factors, representations and practices associated with emerging urban human visceral leishmaniasis in Posadas, Argentina. BIOMEDICA 2016; 36:51-63. [PMID: 27622625 DOI: 10.7705/biomedica.v36i2.2953] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/09/2015] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Visceral leishmaniasis is an often overlooked disease with high lethality rates about which there is need of additional local studies to inform the design of effective control strategies. The urbanization of its transmission has already been verified in America, with domestic dogs being the primary reservoirs and vectors of the disease. Socio-economic conditions, demographics and practices of domestic groups typically present in urban settings may play a specific role in the transmission of the infection, which is still poorly understood. OBJECTIVE To analyze the sociodemographic characteristics, risk factors and overall practices concerning prevention and coping strategies of visceral leishmaniasis, in both human beings and canines. MATERIALS AND METHODS This study utilized a cross-sectional case-control design. Cases were defined as a domestic group where the Public Health Ministry had at least one record of a member with human visceral leishmaniasis. Control cases were defined as a domestic group without a clinical record of the disease. The populations were characterized demographically and socially using primary information sources. Measures of household quality and a ranking of knowledge and attitudes towards visceral leishmaniasis were constructed, and practices associated with the presence, and the risk for canine visceral leishmaniasis were described. RESULTS Low household quality (p≤0.001), a member of the domestic group out of the household after 6:00 pm (OR=4.4; 95% CI: 1.69-12.18), the uncontrolled racial breeding of dogs (OR=15.7; 95% CI: 3.91-63.2), and the presence of infected dogs infected in the household (OR=120.3; 95% CI: 18.51-728.3) were variables positively associated with the risk of infection. CONCLUSION We observed certain social risk factors, primarily low household quality and overcrowding, associated with structural poverty that could increase human-vector contact probability. The most important risk factor for human visceral leishmaniasis was the possession of infected dogs in the household.
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Arruda MMD, Figueiredo FB, Marcelino AP, Barbosa JR, Werneck GL, Noronha EF, Romero GAS. Sensitivity and specificity of parallel or serial serological testing for detection of canine Leishmania infection. Mem Inst Oswaldo Cruz 2016; 111:168-73. [PMID: 26910354 PMCID: PMC4804499 DOI: 10.1590/0074-02760150364] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/25/2016] [Indexed: 11/22/2022] Open
Abstract
In Brazil, human and canine visceral leishmaniasis (CVL) caused by Leishmania infantum has undergone urbanisation since 1980, constituting a public health problem, and serological tests are tools of choice for identifying infected dogs. Until recently, the Brazilian zoonoses control program recommended enzyme-linked immunosorbent assays (ELISA) and indirect immunofluorescence assays (IFA) as the screening and confirmatory methods, respectively, for the detection of canine infection. The purpose of this study was to estimate the accuracy of ELISA and IFA in parallel or serial combinations. The reference standard comprised the results of direct visualisation of parasites in histological sections, immunohistochemical test, or isolation of the parasite in culture. Samples from 98 cases and 1,327 noncases were included. Individually, both tests presented sensitivity of 91.8% and 90.8%, and specificity of 83.4 and 53.4%, for the ELISA and IFA, respectively. When tests were used in parallel combination, sensitivity attained 99.2%, while specificity dropped to 44.8%. When used in serial combination (ELISA followed by IFA), decreased sensitivity (83.3%) and increased specificity (92.5%) were observed. Serial testing approach improved specificity with moderate loss in sensitivity. This strategy could partially fulfill the needs of public health and dog owners for a more accurate diagnosis of CVL.
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Affiliation(s)
| | - Fabiano Borges Figueiredo
- Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Carranza-Tamayo CO, Werneck GL, Romero GAS. Are opossums a relevant factor associated with asymptomatic Leishmania infection in the outskirts of the largest Brazilian cities? Braz J Infect Dis 2016; 20:119-26. [PMID: 26867473 PMCID: PMC9427581 DOI: 10.1016/j.bjid.2015.11.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 11/17/2015] [Indexed: 11/25/2022] Open
Abstract
A population survey was conducted to explore the prevalence and factors associated with Leishmania infection in the Fercal region of the Federal District. The Fercal region is a group of neighborhoods in Brasília in which the first cases of visceral leishmaniasis were described. Leishmania infection was established by a positive leishmanin test. Although other tests were performed in the study (an immunochromatographic assay (Kalazar detect®) and a molecular assay), only the leishmanin skin test provided sufficient results for the measurement of the disease prevalence. Data on the epidemiological, clinical and environmental characteristics of individuals were collected along with the diagnostic tests. After sampling and enrollment, seven hundred people from 2 to 14 years of age were included in the study. The prevalence of Leishmania infection was 33.28% (95% CI 29.87–36.84). The factors associated with Leishmania infection according to the multivariate analysis were age of more than seven years and the presence of opossums near the home. Age is a known factor associated with Leishmania infection; however, the presence of wild animals, as described, is an understudied factor. The presence of opossums, which are known reservoirs of Leishmania, in peri-urban areas could be the link between the rural and urban occurrence of visceral leishmaniasis in the outskirts of largest Brazilian cities, as suggested by previous studies.
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Affiliation(s)
- César Omar Carranza-Tamayo
- Núcleo de Medicina Tropical, Universidade de Brasília (UnB), Campus Universitário Darcy Ribeiro, Brasília, DF, Brazil.
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Gustavo Adolfo Sierra Romero
- Núcleo de Medicina Tropical, Universidade de Brasília (UnB), Campus Universitário Darcy Ribeiro, Brasília, DF, Brazil
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dos Santos PL, de Oliveira FA, Santos MLB, Cunha LCS, Lino MTB, de Oliveira MFS, Bomfim MOM, Silva AM, de Moura TR, de Jesus AR, Duthie MS, Reed SG, de Almeida RP. The Severity of Visceral Leishmaniasis Correlates with Elevated Levels of Serum IL-6, IL-27 and sCD14. PLoS Negl Trop Dis 2016; 10:e0004375. [PMID: 26814478 PMCID: PMC4729473 DOI: 10.1371/journal.pntd.0004375] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/18/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a severe disease caused by infection with protozoa of the genus Leishmania. Classic VL is characterized by a systemic infection of phagocytic cells and an intense activation of the inflammatory response. It is unclear why 90% of infected individuals do not develop the disease while a minority develop the classical form. Furthermore, among those that develop disease, a small group progresses to more severe form that is unresponsive to treatment. The presence of inflammatory mediators in serum could theoretically help to control the infection. However, there is also a release of anti-inflammatory mediators that could interfere with the control of parasite multiplication. In this study, we took advantage of the spectrum of outcomes to test the hypothesis that the immune profile of individuals infected with Leishmania (L.) infantum is associated with the development and severity of disease. METHODOLOGY/PRINCIPAL FINDINGS Sera from patients with confirmed diagnosis of VL were evaluated for the presence of numerous molecules, and levels compared with healthy control and asymptomatic infected individuals. CONCLUSIONS/PRINCIPAL FINDINGS Although differences were not observed in LPS levels, higher levels of sCD14 were detected in VL patients. Our data suggest that L. infantum may activate the inflammatory response via CD14, stimulating a generalized inflammatory response with production of several cytokines and soluble molecules, including IFN-γ, IL-27, IL-10, IL-6 and sCD14. These molecules were strongly associated with hepatosplenomegaly, neutropenia and thrombocytopenia. We also observed that IL-6 levels greater than 200 pg/ml were strongly associated with death. Together our data reinforce the close relationship of IFN-γ, IL-10, IL-6, TNF-α and IL-27 in the immune dynamics of VL and suggest the direct participation of sCD14 in the activation of the immune response against L. infantum.
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Affiliation(s)
- Priscila L. dos Santos
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Fabrícia A. de Oliveira
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Micheli Luize B. Santos
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Luana Celina S. Cunha
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Michelle T. B. Lino
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Michelle F. S. de Oliveira
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Manuela O. M. Bomfim
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Angela Maria Silva
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Tatiana R. de Moura
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Amélia R. de Jesus
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
| | - Malcolm S. Duthie
- Infectious Diseases Research Institute (IDRI), Seattle, Washington, United States of America
| | - Steven G. Reed
- Infectious Diseases Research Institute (IDRI), Seattle, Washington, United States of America
| | - Roque P. de Almeida
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
- * E-mail:
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Salomón OD, Feliciangeli MD, Quintana MG, Afonso MMDS, Rangel EF. Lutzomyia longipalpis urbanisation and control. Mem Inst Oswaldo Cruz 2015; 110:831-46. [PMID: 26517497 PMCID: PMC4660613 DOI: 10.1590/0074-02760150207] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 09/01/2015] [Indexed: 11/22/2022] Open
Abstract
Since the description of Lutzomyia longipalpis by Lutz and Neiva
more than 100 years ago, much has been written in the scientific literature about
this phlebotomine species. Soares and Turco (2003) and Lainson and Rangel (2005) have
written extensive reviews focused on vector-host-parasite interactions and American
visceral leishmaniasis ecology. However, during the last two decades, the success of
Lu. longipalpis in colonising urban environments and its
simultaneous geographical spreading have led to new theoretical and operational
questions. Therefore, this review updates the general information about this species
and notes the more challenging topics regarding the new scenario of
urbanisation-spreading and its control in America. Here, we summarise the literature
on these issues and the remaining unsolved questions, which pose recommendations for
operational research.
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Affiliation(s)
| | - María Dora Feliciangeli
- Centro Nacional de Referencia de Flebótomos y Otros Vectores, Facultad de Ciencias de la Salud, Universidad de Carabobo, Maracay, Venezuela
| | | | | | - Elizabeth Ferreira Rangel
- Laboratório de Transmissores de Leishmanioses, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Carlsen ED, Liang Y, Shelite TR, Walker DH, Melby PC, Soong L. Permissive and protective roles for neutrophils in leishmaniasis. Clin Exp Immunol 2015; 182:109-18. [PMID: 26126690 DOI: 10.1111/cei.12674] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 12/11/2022] Open
Abstract
Leishmania parasites are the causative agents of leishmaniasis, a neglected tropical disease that causes substantial morbidity and considerable mortality in many developing areas of the world. Recent estimates suggest that roughly 10 million people suffer from cutaneous leishmaniasis (CL), and approximately 76,000 are afflicted with visceral leishmaniasis (VL), which is universally fatal without treatment. Efforts to develop therapeutics and vaccines have been greatly hampered by an incomplete understanding of the parasite's biology and a lack of clear protective correlates that must be met in order to achieve immunity. Although parasites grow and divide preferentially in macrophages, a number of other cell types interact with and internalize Leishmania parasites, including monocytes, dendritic cells and neutrophils. Neutrophils appear to be especially important shortly after parasites are introduced into the skin, and may serve a dual protective and permissive role during the establishment of infection. Curiously, neutrophil recruitment to the site of infection appears to continue into the chronic phase of disease, which may persist for many years. The immunological impact of these cells during chronic leishmaniasis is unclear at this time. In this review we discuss the ways in which neutrophils have been observed to prevent and promote the establishment of infection, examine the role of anti-neutrophil antibodies in mouse models of leishmaniasis and consider recent findings that neutrophils may play a previously unrecognized role in influencing chronic parasite persistence.
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Affiliation(s)
- E D Carlsen
- Department of Internal Medicine, Division of Infectious Diseases, MD-PhD Combined Degree Program.,Department of Microbiology and Immunology
| | - Y Liang
- Department of Microbiology and Immunology
| | | | | | - P C Melby
- Department of Microbiology and Immunology.,Department of Pathology.,Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - L Soong
- Department of Microbiology and Immunology.,Department of Pathology
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Lara-Silva FDO, Michalsky ÉM, Fortes-Dias CL, Fiuza VDOP, Pessanha JEM, Regina-Silva S, de Avelar DM, Silva MA, Lima ACVMDR, da Costa AJA, Machado-Coelho GLL, Dias ES. Epidemiological aspects of vector, parasite, and domestic reservoir in areas of recent transmission and no reported human cases of visceral leishmaniasis in Brazil. Acta Trop 2015; 148:128-36. [PMID: 25882769 DOI: 10.1016/j.actatropica.2015.04.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 03/04/2015] [Accepted: 04/06/2015] [Indexed: 12/31/2022]
Abstract
About 97% of the human cases of the American visceral leishmaniasis (VL) occur in Brazil. In the last few years, the disease expanded to medium- and large-sized cities, in which surveillance and control actions have been intensified, in an effort to control VL spreading. Our two-year study was conducted in Belo Horizonte, the sixth most populous city in Brazil, which is endemic for VL. We focused in two particular districts of recent transmission of the disease, with no reported human cases and submitted to minor surveillance and control actions. Our aim was to draw an epidemiological profile of the local situation concerning Lutzomyia vector, Leishmania parasites, and the main domestic reservoirs (dogs). Lutzomyia longipalpis comprised 96.5% of the total phlebotomine sand flies captured and displayed an expressive minimal infection rate by Leishmania infantum (16.7%). Positive correlations were found between the population densities of L. longipalpis, rainfall and temperature. L. infantum was also detected in the cortelezzii complex and, for the first time, in Lutzomyia lloydi. Leishmania braziliensis, an etiological agent of the American cutaneous leishmaniasis, was also identified in L. longipalpis. Among the 1408 dogs serologically tested by standard enzyme-linked and fluorescence immune assays (ELISA/IFA) 3.6% were positive for VL. L. infantum DNA and Leishmania parasites were identified in 100% and 72.5% of the seropositive dogs, respectively. The co-positivity of other diagnostic tests for VL-Leishmania-nested PCR, imprint and myeloculture-was compared to the standard serology. Both symptomatic or asymptomatic dogs displayed an equal average number of positive diagnostic tests for VL. The districts studied display favorable conditions for the rapid spreading of human infection, in terms of L. longipalpis population density, and presence of L. infantum in both vector and main reservoir.
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Affiliation(s)
| | - Érika Monteiro Michalsky
- Laboratório de Leishmanioses, Centro de Pesquisas René Rachou/Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Shara Regina-Silva
- Laboratório de Leishmanioses, Centro de Pesquisas René Rachou/Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Daniel Moreira de Avelar
- Laboratório de Leishmanioses, Centro de Pesquisas René Rachou/Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Maiara Alves Silva
- Laboratório de Leishmanioses, Centro de Pesquisas René Rachou/Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Edelberto Santos Dias
- Laboratório de Leishmanioses, Centro de Pesquisas René Rachou/Fiocruz, Belo Horizonte, Minas Gerais, Brazil.
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63
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SPR analysis of the interaction between a recombinant protein of unknown function in Leishmania infantum immobilised on dendrimers and antibodies of the visceral leishmaniasis: A potential use in immunodiagnosis. Biosens Bioelectron 2015; 70:275-81. [DOI: 10.1016/j.bios.2015.03.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/05/2015] [Accepted: 03/16/2015] [Indexed: 12/11/2022]
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Casanova C, Colla-Jacques FE, Hamilton JGC, Brazil RP, Shaw JJ. Distribution of Lutzomyia longipalpis chemotype populations in São Paulo state, Brazil. PLoS Negl Trop Dis 2015; 9:e0003620. [PMID: 25781320 PMCID: PMC4363371 DOI: 10.1371/journal.pntd.0003620] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 02/13/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND American visceral leishmaniasis (AVL) is an emerging disease in the state of São Paulo, Brazil. Its geographical expansion and the increase in the number of human cases has been linked to dispersion of Lutzomyia longipalpis into urban areas. To produce more accurate risk maps we investigated the geographic distribution and routes of expansion of the disease as well as chemotype populations of the vector. METHODOLOGY/PRINCIPAL FINDINGS A database, containing the annual records of municipalities which had notified human and canine AVL cases as well as the presence of the vector, was compiled. The chemotypes of L. longipalpis populations from municipalities in different regions of São Paulo State were determined by Coupled Gas Chromatography - Mass Spectrometry. From 1997 to June 2014, L. longipalpis has been reported in 166 municipalities, 148 of them in the Western region. A total of 106 municipalities were identified with transmission and 99 were located in the Western region, where all 2,204 autochthonous human cases occurred. Both the vector and the occurrence of human cases have expanded in a South-easterly direction, from the Western to central region, and from there, a further expansion to the North and the South. The (S)-9-methylgermacrene-B population of L. longipalpis is widely distributed in the Western region and the cembrene-1 population is restricted to the Eastern region. CONCLUSION/SIGNIFICANCE The maps in the present study show that there are two distinct epidemiological patterns of AVL in São Paulo State and that the expansion of human and canine AVL cases through the Western region has followed the same dispersion route of only one of the two species of the L. longipalpis complex, (S)-9-methylgermacrene-B. Entomological vigilance based on the routes of dispersion and identification of the chemotype population could be used to identify at-risk areas and consequently define the priorities for control measures.
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Affiliation(s)
- Claudio Casanova
- Superintendência de Controle de Endemias, Secretaria de Estado da Saúde, Mogi Guaçu, São Paulo, Brazil
| | | | - James G. C. Hamilton
- Centre for Applied Entomology and Parasitology, School of Life Sciences, Keele University, Keele, United Kingdom
| | - Reginaldo P. Brazil
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jeffrey J. Shaw
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
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Mashayekhi-Ghoyonlo V, Kiafar B, Rohani M, Esmaeili H, Erfanian-Taghvaee MR. Correlation between Socioeconomic Status and Clinical Course in Patients with Cutaneous Leishmaniasis. J Cutan Med Surg 2015; 19:40-4. [PMID: 25775662 DOI: 10.2310/7750.2014.13216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Leishmaniasis has long been known as a poverty-associated disease, which is particularly prevalent in developing and less developed countries. The role of socioeconomic status in the clinical course of the disease is less clearly defined. In this study, we investigated the potential relationship between the clinical course of cutaneous leishmaniasis in terms of its evolution into chronic forms and the socioeconomic status of the patients. METHODS A total of 140 patients attending the dermatology clinic in Imam Reza Hospital, Mashhad, Iran, were enrolled. The patients were grouped into high, medium, and low socioeconomic classes according to a comprehensive questionnaire. They received routine treatment protocols for leishmaniasis and were followed up for 1 year. RESULTS We found a statistically significant relationship between the clinical course of the disease and socioeconomic status. CONCLUSION Poverty might prolong the course of cutaneous leishmaniasis for many different reasons.
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Affiliation(s)
- Vahid Mashayekhi-Ghoyonlo
- Cutaneous Leishmaniasis Research Center, Imam Reza Hospital, School of MedicineHealth Center, Faculty of MedicineHealth Sciences Research Center, Department of Biostatistics and Epidemiology, School of HealthDepartment of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bita Kiafar
- Cutaneous Leishmaniasis Research Center, Imam Reza Hospital, School of MedicineHealth Center, Faculty of MedicineHealth Sciences Research Center, Department of Biostatistics and Epidemiology, School of HealthDepartment of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboubeh Rohani
- Cutaneous Leishmaniasis Research Center, Imam Reza Hospital, School of MedicineHealth Center, Faculty of MedicineHealth Sciences Research Center, Department of Biostatistics and Epidemiology, School of HealthDepartment of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaeili
- Cutaneous Leishmaniasis Research Center, Imam Reza Hospital, School of MedicineHealth Center, Faculty of MedicineHealth Sciences Research Center, Department of Biostatistics and Epidemiology, School of HealthDepartment of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Reza Erfanian-Taghvaee
- Cutaneous Leishmaniasis Research Center, Imam Reza Hospital, School of MedicineHealth Center, Faculty of MedicineHealth Sciences Research Center, Department of Biostatistics and Epidemiology, School of HealthDepartment of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Abstract
Leishmania infantum is the obligatory intracellular parasite of mammalian macrophages and causes zoonotic visceral leishmaniasis (ZVL). The presence of infected dogs as the main reservoir host of ZVL is regarded as the most important potential risk for human infection. Thus the prevention of canine visceral leishmaniasis (CVL) is essential to stop the current increase of the Mediterranean visceral leishmaniasis. Recently considerable advances in achieving protective immunization of dogs and several important attempts for achieving an effective vaccine against CVL lead to attracting the scientists trust in its important role for eradication of ZVL. This paper highlights the recent advances in vaccination against canine visceral leishmaniasis from 2007 until now.
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67
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Teixeira-Neto RG, da Silva ES, Nascimento RA, Belo VS, de Oliveira CDL, Pinheiro LC, Gontijo CMF. Canine visceral leishmaniasis in an urban setting of Southeastern Brazil: an ecological study involving spatial analysis. Parasit Vectors 2014; 7:485. [PMID: 25326767 PMCID: PMC4209036 DOI: 10.1186/s13071-014-0485-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/08/2014] [Indexed: 11/14/2022] Open
Abstract
Background The physical characteristics of the environment influence the composition, distribution and behavior of the vectors and mammalian hosts involved in the transmission of visceral leishmaniasis (VL), thereby affecting the epidemiology of the disease. In Brazil, urbanization of human VL is a recent phenomenon and represents an issue of particular concern to local health authorities. The present study aimed to establish the degree of spatial dependency between canine and human VL in the municipality of Divinópolis, Minas Gerais, Brazil, and to identify priority risk areas in which stricter control measures should be implemented. Methods The selected canine population comprised 3,652 dogs distributed within 11 strata and 1,247 urban blocks. Serum samples were collected between March 2013 and February 2014. Serodiagnosis of dogs was performed using the enzyme-linked immunosorbent assay and the indirect fluorescent-antibody test. The blocks sampled for canine VL and the addresses of the 16 confirmed cases of human VL notified in Divinópolis during the period 2007–2013 were georeferenced. Spatial analysis of the data was performed using Kernel density estimation, Ripley’s bivariate K-function and directional distribution methods. Results The overall prevalence of seropositive animals was 4.63% (range 3.95 - 5.31) (n =169) and varied in different strata between 0.9 (range 0.0 - 1.91) and 8.73% (range 5.65 - 11.81). A positive spatial dependency was detected between human and canine VL in which the occurrence of human cases of the disease tended to concentrate in locations that were close to areas with a higher incidence of canine VL. The priority risk area could be clearly distinguished from Kernel density estimation and standard deviational ellipse plots in which the human VL ellipse was totally enclosed within the canine VL ellipse. Conclusions The results presented herein will enable the Municipal Health Office of Divinópolis to devise a more effective management plan for human VL in which specific strategies would be applied to areas presenting different levels of risk. This spatial evaluation of leishmaniasis model could be applied in other urban areas of Brazil.
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Affiliation(s)
- Rafael Gonçalves Teixeira-Neto
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil. .,Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Eduardo Sérgio da Silva
- Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Renata Aparecida Nascimento
- Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Vinícius Silva Belo
- Escola Nacional de Saúde Pública, FIOCRUZ, Rua Leopoldo Bulhões 1480, Manguinhos, 21041-210, Rio de Janeiro, RJ, Brazil. .,Universidade Federal de Juiz de Fora, Campus Governador Valadares, Rua Israel Pinheiro 2000, 35020-220, Governador Valadares, MG, Brazil.
| | - Cláudia di Lorenzo de Oliveira
- Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Letícia Cavalari Pinheiro
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil.
| | - Célia Maria Ferreira Gontijo
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil.
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68
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Awan F, Ali MM, Iqbal U, Khattak I, Mushtaq MH. Some challenges in progressive control of livestock originated zoonotic diseases in Pakistan–a pilot survey. Asian Pac J Trop Biomed 2014. [DOI: 10.12980/apjtb.4.2014apjtb-2014-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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69
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Mansueto P, Seidita A, Vitale G, Cascio A. Leishmaniasis in travelers: a literature review. Travel Med Infect Dis 2014; 12:563-81. [PMID: 25287721 DOI: 10.1016/j.tmaid.2014.09.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 05/17/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum ranges from asymptomatic infection to fatal visceral leishmaniasis. Over the last decades, an increase in imported leishmaniasis cases in developed, non-endemic countries, have been pointed-out from a review of the international literature. Among the possible causes are increasing international tourism, influx of immigrants from endemic regions and military operations. The main area for the acquisition of cutaneous leishmaniasis, especially for adventure travelers on long-term trips in highly-endemic forested areas, is represented from South America, whereas popular Mediterranean destinations are emerging as the main areas to acquire visceral variant. Leishmaniasis should be considered in the diagnostic assessment of patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years before. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas, should receive counseling regarding leishmaniasis and appropriate protective measures.
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Affiliation(s)
- Pasquale Mansueto
- Department of Internal Medicine and Biomedicine, University of Palermo, Italy.
| | - Aurelio Seidita
- Department of Internal Medicine and Biomedicine, University of Palermo, Italy
| | - Giustina Vitale
- Department of Internal Medicine and Biomedicine, University of Palermo, Italy
| | - Antonio Cascio
- Department of Human Pathology, University of Messina, Italy
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Castro-Júnior JG, Freire ML, Campos SPS, Scopel KKG, Porrozzi R, Da Silva ED, Colombo FA, da Silveira RDCV, Marques MJ, Coimbra ES. Evidence of Leishmania (Leishmania) infantum infection in dogs from Juiz de Fora, Minas Gerais State, Brazil, based on immunochromatographic dual-path platform (DPP®) and PCR assays. Rev Inst Med Trop Sao Paulo 2014; 56:225-9. [PMID: 24879001 PMCID: PMC4085865 DOI: 10.1590/s0036-46652014000300008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/24/2013] [Indexed: 11/23/2022] Open
Abstract
In Brazil, domestic dogs are branded as the primary reservoir for zoonotic
visceral leishmaniasis, due to the clear positive correlation observed between human
and canine infection rates. This study aimed to carry out a serological survey of
canine visceral leishmaniasis (CVL) in dogs housed at a public kennel in the
municipality of Juiz de Fora, Minas Gerais State, Brazil, using the
immunochromatographic TR DPP® CVL rapid test. Additionally, conventional
and/or real time PCR assay was used to detect and confirm L.
infantum infection in the DPP positive dogs only. Of the 400 dogs
studied, most did not present clinical signs for CVL (p < 0.05),
and fifteen (3.8%) were seropositive in the DPP test. There was no statistically
significant difference between the DPP seropositive dogs and the clinical signs of
the disease (p > 0.05). Both conventional and real time PCR tests
confirmed L. infantum infection in nine (75.0%) of the twelve DPP
seropositive dogs that remained alive during the follow-up period. This study is the
first seroepidemiologic survey of CVL held in the city of Juiz de Fora, and the
results reinforce the idea that this disease is currently in a process of expansion
and urbanization in Brazil. Furthermore, this study highlights the use of the DPP
test as an alternative for diagnosing CVL in large and mid-sized cities, due to its
ease of implementation.
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Affiliation(s)
- José Geraldo Castro-Júnior
- Programa de Pós-graduação em Saúde Brasileira, Universidade Federal de Juiz de Fora, Minas Gerais, Brazil
| | - Mariana Lourenço Freire
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Samantha Priscila Silva Campos
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Kezia K G Scopel
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Renato Porrozzi
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil
| | | | - Fabio A Colombo
- Laboratório de Parasitologia, Departamento de Patologia e Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brazil
| | - Rita de Cássia Viveiros da Silveira
- Laboratório de Parasitologia, Departamento de Patologia e Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brazil
| | - Marcos José Marques
- Laboratório de Parasitologia, Departamento de Patologia e Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brazil
| | - Elaine Soares Coimbra
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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Belo VS, Struchiner CJ, Barbosa DS, Nascimento BWL, Horta MAP, da Silva ES, Werneck GL. Risk factors for adverse prognosis and death in American visceral leishmaniasis: a meta-analysis. PLoS Negl Trop Dis 2014; 8:e2982. [PMID: 25058582 PMCID: PMC4109848 DOI: 10.1371/journal.pntd.0002982] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 05/14/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In the current context of high fatality rates associated with American visceral leishmaniasis (VL), the appropriate use of prognostic factors to identify patients at higher risk of unfavorable outcomes represents a potential tool for clinical practice. This systematic review brings together information reported in studies conducted in Latin America, on the potential predictors of adverse prognosis (continued evolution of the initial clinical conditions of the patient despite the implementation of treatment, independent of the occurrence of death) and death from VL. The limitations of the existing knowledge, the advances achieved and the approaches to be used in future research are presented. METHODS/PRINCIPAL FINDINGS The full texts of 14 studies conforming to the inclusion criteria were analyzed and their methodological quality examined by means of a tool developed in the light of current research tools. Information regarding prognostic variables was synthesized using meta-analysis. Variables were grouped according to the strength of evidence considering summary measures, patterns and heterogeneity of effect-sizes, and the results of multivariate analyses. The strongest predictors identified in this review were jaundice, thrombocytopenia, hemorrhage, HIV coinfection, diarrhea, age <5 and age >40-50 years, severe neutropenia, dyspnoea and bacterial infections. Edema and low hemoglobin concentration were also associated with unfavorable outcomes. The main limitation identified was the absence of validation procedures for the few prognostic models developed so far. CONCLUSIONS/SIGNIFICANCE Integration of the results from different investigations conducted over the last 10 years enabled the identification of consistent prognostic variables that could be useful in recognizing and handling VL patients at higher risk of unfavorable outcomes. The development of externally validated prognostic models must be prioritized in future investigations.
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Affiliation(s)
- Vinícius Silva Belo
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
- Departamento Básico—Área da Saúde—Campus Governador Valadares, Universidade Federal de Juiz de Fora, Governador Valadares, Minas Gerais, Brasil
- * E-mail:
| | - Claudio José Struchiner
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | - David Soeiro Barbosa
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Marco Aurélio Pereira Horta
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janiero, Brasil
| | - Eduardo Sérgio da Silva
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del Rei, Divinópolis, Minas Gerais, Brasil
| | - Guilherme Loureiro Werneck
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brasil
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72
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Schubach EYP, Figueiredo FB, Romero GAS. Accuracy and reproducibility of a rapid chromatographic immunoassay for the diagnosis of canine visceral leishmaniasis in Brazil. Trans R Soc Trop Med Hyg 2014; 108:568-74. [PMID: 25015665 DOI: 10.1093/trstmh/tru109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is a major public health concern in Brazil and the domestic dog is the main source of infection. In this study, we aimed to evaluate the accuracy and reliability of a rapid chromatographic immunoassay based on a dual-path platform for the diagnosis of canine visceral leishmaniasis (CVL). METHODS Sampling consisted of 428 domestic dogs selected from two neighborhoods in the municipality of Fortaleza, Ceara state, Brazil. The reference standard was composed of three parasitological tests and was applied samples from 333 dogs. The rapid test was used to analyse whole blood and serum samples. RESULTS Accuracy of the rapid test in whole blood samples through visual reading (n=305), serum samples through electronic reading (n=333) and serum samples through visual reading (n=333), yielded sensitivities of 87.5% (21/24; 95% CI: 66.5 to 96.7), 88% (22/25; 95% CI: 67.5 to 96.8) and 88% (22/25; 95% CI: 67.5 to 96.8), and specificities of 73.3% (206/281; 95% CI: 67.7 to 78.4), 68.2% (210/308; 95% CI: 62.2 to 74.3) and 69.2% (213/308; 95% CI: 63.7 to 74.3), respectively. Agreement between the visual and electronic readings in 428 serum samples were classified as almost perfect (Kappa Index=0.88; 95% CI: 0.83 to 0.93). The positive predictive value of the test using whole blood samples was 21.9% for the 7.9% prevalence detected by the reference standard in the study sample. A sensitivity analysis of the positive predictive value revealed that it remained below 50% in scenarios with a prevalence of up to 20%. CONCLUSIONS The similarity of the accuracy values of the rapid test using whole blood or serum samples, together with its reliable performance in sera through visual and electronic reading, suggests that it may contribute as a screening test for routine use under field-conditions. However, future studies need to improve the accuracy of the test so that it can be successfully implemented in public health programs.
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Affiliation(s)
- Edvar Y P Schubach
- Núcleo de Medicina Tropical, Universidade de Brasília, Distrito Federal, Brazil
| | - Fabiano B Figueiredo
- Instituto de Pesquisas Evandro Chagas, Fundação Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Gustavo A S Romero
- Núcleo de Medicina Tropical, Universidade de Brasília, Distrito Federal, Brazil Instituto de Avaliação de Tecnologias em Saúde, IATS/INCT/CNPq, Porto Alegre, Rio Grande do Sul, Brazil Fundação de Amparo à Pesquisa do Estado do Amazonas, FAPEAM, Amazonas, Brazil
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Martins-Melo FR, Lima MDS, Ramos AN, Alencar CH, Heukelbach J. Mortality and case fatality due to visceral leishmaniasis in Brazil: a nationwide analysis of epidemiology, trends and spatial patterns. PLoS One 2014; 9:e93770. [PMID: 24699517 PMCID: PMC3974809 DOI: 10.1371/journal.pone.0093770] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 03/07/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a significant public health problem in Brazil and several regions of the world. This study investigated the magnitude, temporal trends and spatial distribution of mortality related to VL in Brazil. METHODS We performed a study based on secondary data obtained from the Brazilian Mortality Information System. We included all deaths in Brazil from 2000 to 2011, in which VL was recorded as cause of death. We present epidemiological characteristics, trend analysis of mortality and case fatality rates by joinpoint regression models, and spatial analysis using municipalities as geographical units of analysis. RESULTS In the study period, 12,491,280 deaths were recorded in Brazil. VL was mentioned in 3,322 (0.03%) deaths. Average annual age-adjusted mortality rate was 0.15 deaths per 100,000 inhabitants and case fatality rate 8.1%. Highest mortality rates were observed in males (0.19 deaths/100,000 inhabitants), <1 year-olds (1.03 deaths/100,000 inhabitants) and residents in Northeast region (0.30 deaths/100,000 inhabitants). Highest case fatality rates were observed in males (8.8%), ≥ 70 year-olds (43.8%) and residents in South region (17.7%). Mortality and case fatality rates showed a significant increase in Brazil over the period, with different patterns between regions: increasing mortality rates in the North (Annual Percent Change--APC: 9.4%; 95% confidence interval--CI: 5.3 to 13.6), and Southeast (APC: 8.1%; 95% CI: 2.6 to 13.9); and increasing case fatality rates in the Northeast (APC: 4.0%; 95% CI: 0.8 to 7.4). Spatial analysis identified a major cluster of high mortality encompassing a wide geographic range in North and Northeast Brazil. CONCLUSIONS Despite ongoing control strategies, mortality related to VL in Brazil is increasing. Mortality and case fatality vary considerably between regions, and surveillance and control measures should be prioritized in high-risk clusters. Early diagnosis and treatment are fundamental strategies for reducing case fatality of VL in Brazil.
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Affiliation(s)
| | | | - Alberto Novaes Ramos
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Carlos Henrique Alencar
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Jorg Heukelbach
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil; Anton Breinl Centre for Public Health and Tropical Medicine, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
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