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Vieira-Duarte R, Araújo VEMD, Veloso GA, Cardoso DT, Ker FTO, Barbosa DS, Malta DC, Nagavi M, Carneiro M, Coura-Vital W. Mortality due to visceral leishmaniasis in Brazil by municipalities, 2001-2018: a spatial-temporal analysis of estimates from the Global Burden of Disease study. Public Health 2024; 234:58-63. [PMID: 38954883 DOI: 10.1016/j.puhe.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/10/2024] [Accepted: 06/04/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES In the American regions, Brazil accounts for 97% of visceral leishmaniasis (VL) cases, with a case fatality rate of approximately 10%. This study aimed to investigate the VL mortality distribution in Brazil and identify high-priority and high-risk areas for intervention strategies. STUDY DESIGN This was an ecological study that analysed the spatial-temporal patterns of VL mortality in Brazilian municipalities. METHODS Age-standardised VL mortality rates from the Global Burden of Disease study from 2001 to 2018 were used. The distribution of mortality in the municipalities was assessed, and subsequently the Local Index of Spatial Autocorrelation (LISA) analysis was conducted to identify contiguous areas with high mortality rates. Scan analysis identified clusters of high spatial-temporal risks. RESULTS The highest mortality rates and clusters were in municipalities located in the Northeast region and in the states of Tocantins and Roraima (North region), Mato Grosso do Sul (Central-West region), and Minas Gerais (Southeast region). According to LISA, there was an increase in the number of municipalities classified as high priority from the first 3-year period (n = 434) to the last 3-year period (n = 644). The spatio-temporal analysis identified 21 high-risk clusters for VL mortality. CONCLUSION Areas with a high risk of VL mortality should prioritise preventing transmission, invest in early diagnosis and treatment, and promote the training of healthcare professionals.
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Affiliation(s)
- R Vieira-Duarte
- Graduate Program in Biological Sciences, Centre for Research in Biological Sciences, Universidade Federal de Ouro Preto, Minas Gerais, Brazil
| | - V E M de Araújo
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Ministry of Health, Health Surveillance Secretariat and Environment, Department of Epidemiological Analysis and Surveillance of Noncommunicable Diseases, Brasília, DF, Brazil
| | - G A Veloso
- Mathematics and Statistics Institute - Statistics Department, Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil
| | - D T Cardoso
- Parasitology Postgraduate Programme, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - F T O Ker
- Postgraduate Programme in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - D S Barbosa
- Parasitology Postgraduate Programme, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil; Postgraduate Programme in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - D C Malta
- Department of Maternal-Infant Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - M Nagavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - M Carneiro
- Parasitology Postgraduate Programme, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Brazil; Postgraduate Programme in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - W Coura-Vital
- Graduate Program in Biological Sciences, Centre for Research in Biological Sciences, Universidade Federal de Ouro Preto, Minas Gerais, Brazil; Postgraduate Programme in Pharmaceutical Sciences, School of Pharmacy, Universidade Federal de Ouro Preto, Minas Gerais, Brazil.
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Getnet M, Minaye Dejen A, Abebaw D, Fentahun GG, Birhanu E. Diagnostic accuracy of serological rk-39 test for visceral Leishmaniasis: Systematic review and meta-analysis. PLoS Negl Trop Dis 2024; 18:e0011938. [PMID: 38446789 PMCID: PMC10917292 DOI: 10.1371/journal.pntd.0011938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL), or kala-azar, is a vector-borne tropical disease caused by a group of intracellular hemoflagellate protozoa belonging to the family of Trypanosomatide and the genus Leishmania. The disease is distributed around the world and transmitted via the bite of infected female Phlebotomine sandflies, and there is variation in the diagnostic accuracy. Therefore, this systematic review and meta-analysis aimed to determine the pooled global sensitivity and specificity of the rk-39 test and to evaluate if there is a difference between the different parts of the world. METHODS A systematic review and meta-analysis have been conducted on the diagnostic accuracy of dermoscopy. After setting eligibility criteria, literature was searched in four databases and one searching engine. Articles were screened, critically appraised, and extracted independently by two reviewers, and any disagreements were resolved with the involvement of a third person. The quality of the included studies had been assessed by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS 2) tool. Pooled sensitivity and specificity were determined by bivariate random effect analysis. Heterogeneity was assessed by Higgins's I2, and when it was present, mitigation was conducted by using sensitivity analysis. RESULT A total of 409 studies were identified, and finally 18 articles were eligible for the review with a total sample size of 5, 253. The bivariate random effect meta-analysis of the 7 diagnostic accuracy studies showed a pooled sensitivity of 0.89 (0.76-0.95) and specificity of 0.86 (0.72-0.94). The +LR was 6.32 (95% CI: 2.85-14.02), the-LR was 0.13 (95% CI: 0.06-0.30), and the diagnostic odds ratio (DOR) was 47.8 (95% CI: 11.3-203.2). Abdel-Latif (2018) was both an outlier and influential for sensitivity, and Walter (2011) was both an outlier and influential for specificity, and removing them from sensitivity and specificity, respectively, was beneficial for reducing the heterogeneity. CONCLUSION Rk-39 is found to have highly accurate measures in the diagnosis of visceral leishmaniasis. Both sensitivity and specificity were found to be highly accurate in the diagnosis of leishmaniasis, with a pooled sensitivity of 0.91 (0.88-0.93) and a pooled specificity of 0.89 (0.85-0.91). ETHICAL CONSIDERATION As we will use secondary data for the systematic review and meta-analysis, ethical concerns are not necessary.
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Affiliation(s)
- Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Addisu Minaye Dejen
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Pathology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Gedefaw Fentahun
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Emebet Birhanu
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chiyo L, Dos Santos AG, de Souza AB, Rivas AV, Valle SB, Sevá ADP, Viana KF. Cross-sectional spatial and epidemiological analysis of canine visceral leishmaniasis cases in the triple border region, Brazil, Argentina and Paraguay, between 2015 and 2020. Acta Trop 2023; 239:106811. [PMID: 36608750 DOI: 10.1016/j.actatropica.2022.106811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
Visceral Leishmaniasis is one of the most important vector-borne zoonoses in the world. In 2013, the first autochthonous canine case of the disease in the state of Paraná, southern region of Brazil, was reported in Foz do Iguaçu, on the triple border between Brazil, Argentina and Paraguay. In 2015, the first human case was related. Once the endemic was confirmed, the Zoonoses Control Center (ZCC), an agency of the Municipal Health Department, started actions to implement the Human Visceral Leishmaniasis (HVL) Surveillance and Control Program (VLSCP), of the Ministry of Health. Between 2015 and 2020, 12,205 dog samples were analyzed for the diagnosis of the disease. A prevalence of 37.94% (4,630 samples) was found: 2016 had the highest prevalence, with 46.25%, and the year with the lowest prevalence was 2020, with 25.98%. Possible risk factors for dogs were analyzed, and the results obtained were: whether the request for the exam was performed by the ZCC was a significant protective factor, with a lower prevalence (37.5%) than dogs coming from private clinics (OR = 0.89, p-value = 0.016). Males were significantly more infected than females, with 41.1% and 35.7% positivity, respectively (OR = 1.24, p < 0.0001). Companion dogs and mixed breed dogs were significantly less affected than the other groups tested (OR = 0.44, p < 0.001; OR = 0.79, p = 0.012, respectively). The dogs' dark coat color was a significant risk factor with respect to the other color categories. Short and medium coat sizes were significantly considered risk factors, with 41.3% and 31.3% positivity. Long-haired dogs had only 22.7% positivity. In univariate analyses, giant, large and medium dogs were significantly more affected than small dogs. Dogs up to four years of age were significantly less affected than those in other age groups. There was a coincidence of human and canine cases in the spatial distribution. However, according to the literature, a higher incidence would be expected in humans, due to the high prevalence found in dogs. Therefore, further studies should be carried out to understand the dynamics of the disease in this region.
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Affiliation(s)
- Luciana Chiyo
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil; Centro de Controle de Zoonoses, Prefeitura Municipal de Foz do Iguaçu, Foz do Iguaçu, Paraná, Brazil
| | - Angelo Gabriel Dos Santos
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil
| | - Adrieli Barboza de Souza
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil
| | - Açucena Veleh Rivas
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil; Centro de Medicina Tropical da Tríplice Fronteira, Foz do Iguaçu, Paraná, Brazil
| | | | | | - Kelvinson Fernandes Viana
- Universidade Federal da Integração Latino-Americana, Programa de Pós-graduação em Biociências, Foz do Iguaçu, Paraná, Brazil.
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Silva AR, Costa AM, Jain S, Severino P, Scher R, Nunes RS, Souto EB, Dolabella SS. 3-Carene-loaded poloxamer micelles against Leishmania: Development, characterization and in vitro proof-of-concept. J Drug Deliv Sci Technol 2023. [DOI: 10.1016/j.jddst.2023.104376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Lopes EADO, Florencio-Henschel P, Jordão FT, Sperança MA, Martins LPA, Suzuki RB. Leishmania infantum (syn. Leishmania chagasi) detection in blood donors living in an endemic area. Parasitol Res 2023; 122:671-674. [PMID: 36567398 DOI: 10.1007/s00436-022-07770-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022]
Abstract
Human visceral leishmaniasis (HVL) is a neglected disease that occurs in 98 countries on five continents, and it is endemic in tropical and subtropical regions. In South America, the etiological agent of HVL is Leishmania infantum (syn. Leishmania chagasi), mainly transmitted through the bite of an infected sandfly female from the genus Lutzomyia. In American HVL endemic areas, the occurrence of asymptomatic infection is common, which contributes to the possibility of L. infantum transmission during a blood transfusion. To know the prevalence of L. infantum asymptomatic infection in blood donors from the microregion of Adamantina, we investigated 324 peripheral blood samples from donors through immunofluorescence (IFAT) and PCR-RFLP techniques. Seven blood samples (2.16%) tested positive for Leishmania by IFAT, and from those, six presented positive results by PCR (85.71%), which were later identified as L. infantum by RFLP. The presence of L. infantum in the peripheral blood of blood donors supported the hypothesis of transmission by blood transfusion and points to the need to include tests for visceral leishmaniasis in blood bank screening tests and pre-storage measures, especially in endemic areas to prevent the exponential increase of HVL by blood transfusion.
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Affiliation(s)
| | | | - Felipe Trovalim Jordão
- Center for Natural and Human Sciences, Federal University of ABC, São Bernardo Do Campo, SP, Brazil
| | | | | | - Rodrigo Buzinaro Suzuki
- Faculty of Medicine, University of Marília, Avenida Hygino Muzzy Filho, Zip Code: 17.525-902, Marília, SP, 1001, Brazil.
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Epidemiological profile, spatial patterns and priority areas for surveillance and control of leishmaniasis in Brazilian border strip, 2009–2017. Acta Trop 2023; 237:106704. [DOI: 10.1016/j.actatropica.2022.106704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
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Debash H, Ebrahim H, Bisetegn H. Epidemiological and clinical characteristics of cutaneous leishmaniasis among patients attending at Tefera Hailu Memorial Hospital, Sekota, Northeast Ethiopia: A five-year trend analysis (2016-2020). SAGE Open Med 2022; 10:20503121221129720. [PMID: 36246535 PMCID: PMC9558864 DOI: 10.1177/20503121221129720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This study was designed to determine the epidemiological and clinical characteristics of cutaneous leishmaniasis among patients attending at Tefera Hailu Memorial Hospital, Sekota, Northeast Ethiopia over the last 5 years. Methods A 5-year retrospective study was conducted at Tefera Hailu Memorial Hospital, Northeast Ethiopia. Data were summarized and analysed using Microsoft Excel and SPSS 26 version software, respectively. To present the data and evaluate the patterns in cutaneous leishmaniasis cases across the 5 years, months, and seasons, descriptive statistics were utilized. In multivariable logistic regression analysis of determinants in relation to cutaneous leishmaniasis positivity, p-value less than 0.05 was considered as statistically significant. Result The overall positivity rate of cutaneous leishmaniasis was 31.1% (452 out of 1455) over the last 5 years at Tefera Hailu Memorial Hospital. The result showed a fluctuating yet declining trend in cutaneous leishmaniasis infections. The highest number of cases was registered in 2016, while the lowest was in 2020. Males and the age group of 15-49 years, accounted 78.5% and 79.9% of the patients, respectively, were the hardest hit by cutaneous leishmaniasis in the area. Similarly, the highest number of cases was observed in Dehana district (268). From all registered confirmed cases, 54 (10.7%) were previously treated cases. Moreover, the majority of cases, 423 (93.6%) were localized cutaneous leishmaniasis and most of the lesions were on the face. Conclusion Although the results indicate a fluctuating yet declining trend, the positivity rate of confirmed cutaneous leishmaniasis cases in the area remains alarming and indicates a major public health burden. Therefore, efforts are required to reduce the disease burden through continuous monitoring and evaluation of control measures in the study area.
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Affiliation(s)
- Habtu Debash
- Habtu Debash, Department of Medical
Laboratory Sciences, College of Medicine and Health Sciences, Wollo University,
Dessie, Ethiopia.
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Lin Y, Fang K, Zheng Y, Wang HL, Wu J. Global burden and trends of neglected tropical diseases from 1990 to 2019. J Travel Med 2022; 29:6541668. [PMID: 35238925 DOI: 10.1093/jtm/taac031] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND An updated analysis of neglected tropical diseases (NTDs) from a global perspective is missing from the literature. We aimed to assess the global burden and trends of NTDs from 1990 to 2019. METHODS Yearly incident case, mortality and disability-adjusted life years (DALYs) data for NTDs were extracted from the Global Burden of Disease Study 2019 (GBD 2019) based on global, regional, country, social development index (SDI), age and sex categories. The age-standardized rate (ASR) and number of incident cases, mortality and DALYs were computed from 1990 to 2019. The estimated annual percentage change (EAPC) in the ASR was calculated to quantify the changing trend. RESULTS Globally, the age-standardized incidence rate (ASIR) and the number of incident cases of total NTDs increased between 1990 and 2019, whereas the age-standardized mortality rate (ASMR), mortality, age-standardized DALY rate and DALYs of total NTDs decreased. Although tropical Latin America, South Asia, Southeast Asia and Oceania had the highest ASIR for total NTDs in 2019, tropical Latin America was the only region to experience a decreasing trend in ASIR from 1673.5 per 100 000 in 2010 to 1059.2 per 100 000 in 2019. The middle, high-middle and high SDI regions experienced increasing ASIR trends between 1990 and 2019, whereas the low-middle SDI region remained stable, and the low SDI region presented a decreasing trend. Children and older adults were vulnerable to dengue, rabies and leishmaniasis (cutaneous and mucocutaneous). Females had a higher ASIR but a lower ASMR and age-standardized DALY rate than males. CONCLUSIONS NTDs still represent a serious problem for public health, and the increasing ASIR and incident cases globally may require more targeted strategies for prevention, control and surveillance, especially among specific populations and endemic areas.
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Affiliation(s)
- Yushi Lin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kailu Fang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hong-Liang Wang
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Predictive modeling of sand fly distribution incriminated in the transmission of Leishmania (Viannia) braziliensis and the incidence of Cutaneous Leishmaniasis in the state of Paraná, Brazil. Acta Trop 2022; 229:106335. [PMID: 35101414 DOI: 10.1016/j.actatropica.2022.106335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/14/2022] [Accepted: 01/27/2022] [Indexed: 11/22/2022]
Abstract
Southern Brazil concentrates a considerable number of cases of cutaneous leishmaniasis reported since 1980, and Paraná is the state that most records CL cases in the region. The main sand fly species incriminated as vectors of Leishmania (Viannia) braziliensis (Vianna,1911) are Migonemyia (Migonemyia) migonei (França, 1920), Nyssomyia (Nyssomyia) neivai (Pinto, 1926) and Nyssomyia (Nyssomyia) whitmani (Antunes & Coutinho, 1936). In this study, we evaluated areas with climatic suitability for the distribution of these vectors and correlated these data with CL incidence in the state. The occurrence points of Mg. migonei, Ny. neivai, and Ny. whitmani were extracted from a literature review and field data. For CL analysis in the state of Paraná, data were obtained from the Informatics Department of the Unified Health System of Brazil (DATASUS), covering the period from 2001 to 2019. The layers of bioclimatic variables from the WorldClim database were used in the study. Species distribution modeling was developed using the MaxEnt Software version 3.4.4. ArcGIS software version 10.5 was used to develop suitability maps and the graphical representation of disease incidence. The AUC values were acceptable for all models (> 0,8). Bioclimatic variables BIO13 and BIO14 were the most influential in the distribution of Mg. migonei, while BIO19 and BIO6 were the variables that most influenced the distribution of Ny. neivai, and Ny. whitmani was most influenced by variables BIO5 and BIO9. During 19 years, 4992 cases of CL were reported in the state by 286 municipalities (71,6%). Northern Paraná showed the highest number of areas with very high and high climatic suitability for the occurrence of these species, coinciding with the highest number of CL cases. The modeling tools allowed analyzing the association between climatic variables and the geographical distribution of CL in the state. Moreover, they provided a better understanding of the climatic conditions related to the distribution of different species, favoring the monitoring of risk areas, the implementation of preventive measures, risk awareness, early and accurate diagnosis, and consequent timely treatment.
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de Faria VCS, Gonçalves DU, Soares ARC, Barbosa PH, Saliba JW, de Souza CSA, Cota GF, de Avelar DM. Impact assessment of different DNA extraction methods for non-invasive molecular diagnosis of tegumentary leishmaniasis. Acta Trop 2022; 227:106275. [PMID: 34906549 DOI: 10.1016/j.actatropica.2021.106275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/01/2022]
Abstract
The aim of this study was to evaluate two methods of nucleic acid extraction (spin-column-based method - commercial kit and direct boil - DB) from swab sampling compared to biopsy sampling for the diagnosis of tegumentary leishmaniasis (TL), (cutaneous - CL and mucocutaneous - MCL forms). The impact of these nucleic acid extraction protocols on different types of PCR and LAMP techniques were compared regarding nucleic acid quality, molecular assays accuracy, indirect quantitation, and costs. The evaluated patients were 57 TL cases (36 CL and 21 MCL) and 34 non-cases. Swab samples extracted by the DB method showed a higher DNA degradation rate and worse DNA quality in comparison to the commercial kit. Molecular tests performed on biopsy samples showed identical or higher performance in all analysis, as compared to their own performance on swab samples for TL (CL and MCL). However, only the SSU rRNA TaqMan™ RT-PCR test showed a significant difference between the performance of biopsy and swab samples extracted by commercial kit. The kDNA-cPCR coupled with swab extracted by commercial kit showed the highest accuracy (95.6%) for TL diagnosis. The sensitivity of the LAMP-RT 18S method in swab samples extracted with a commercial kit (82.5%) was close to that found in biopsy samples (86%) for TL diagnosis. The DB extraction method presented the lowest cost. The use of swab as a minimally-invasive sampling method, associated with an efficient nucleic acid extraction protocol, may represent a low-cost alternative for the diagnosis of CL and MCL.
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Aoki V, Abdeladhim M, Li N, Cecilio P, Prisayanh P, Diaz LA, Valenzuela JG. Some Good and Some Bad: Sand Fly Salivary Proteins in the Control of Leishmaniasis and in Autoimmunity. Front Cell Infect Microbiol 2022; 12:839932. [PMID: 35281450 PMCID: PMC8913536 DOI: 10.3389/fcimb.2022.839932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/02/2022] [Indexed: 01/22/2023] Open
Abstract
Sand flies are hematophagous insects responsible for the transmission of vector-borne diseases to humans. Prominent among these diseases is Leishmaniasis that affects the skin and mucous surfaces and organs such as liver and spleen. Importantly, the function of blood-sucking arthropods goes beyond merely transporting pathogens. The saliva of vectors of disease contains pharmacologically active components that facilitate blood feeding and often pathogen establishment. Transcriptomic and proteomic studies have enumerated the repertoire of sand fly salivary proteins and their potential use for the control of Leishmaniasis, either as biomarkers of vector exposure or as anti-Leishmania vaccines. However, a group of specific sand fly salivary proteins triggers formation of cross-reactive antibodies that bind the ectodomain of human desmoglein 1, a member of the epidermal desmosomal cadherins. These cross-reactive antibodies are associated with skin autoimmune blistering diseases, such as pemphigus, in certain immunogenetically predisposed individuals. In this review, we focus on two different aspects of sand fly salivary proteins in the context of human disease: The good, which refers to salivary proteins functioning as biomarkers of exposure or as anti-Leishmania vaccines, and the bad, which refers to salivary proteins as environmental triggers of autoimmune skin diseases.
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Affiliation(s)
- Valeria Aoki
- Department of Dermatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Universidade de Sao Paulo, Sao Paulo, Brazil
- *Correspondence: Valeria Aoki,
| | - Maha Abdeladhim
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Ning Li
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Pedro Cecilio
- Vector Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Phillip Prisayanh
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Luis A. Diaz
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jesus G. Valenzuela
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
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de Carvalho AG, Tiwari A, Luz JGG, Nieboer D, Steinmann P, Richardus JH, Ignotti E. Leprosy and cutaneous leishmaniasis affecting the same individuals: A retrospective cohort analysis in a hyperendemic area in Brazil. PLoS Negl Trop Dis 2021; 15:e0010035. [PMID: 34898634 PMCID: PMC8699965 DOI: 10.1371/journal.pntd.0010035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 12/23/2021] [Accepted: 11/28/2021] [Indexed: 12/15/2022] Open
Abstract
Background Leprosy and cutaneous leishmaniasis (CL) are neglected tropical diseases (NTDs) affecting the skin. Their control is challenging but the integration of skin NTDs control programs is recommended to improve timely detection and treatment. However, little is known about the occurrence of leprosy and CL in the same individuals, and what are the characteristics of such patients. This study aimed to identify and characterize patients diagnosed with both leprosy and CL (i.e., outcome) in the hyperendemic state of Mato Grosso, Brazil. Also, we investigated the demographic risk factors associated with the period between the diagnosis of both diseases. Methodology/principal findings A retrospective cohort study was conducted with patients diagnosed between 2008 and 2017. From the leprosy (n = 28,204) and CL (n = 24,771) databases of the national reporting system, 414 (0.8%; 414/52,561) patients presenting both diseases were identified through a probabilistic linkage procedure. This observed number was much higher than the number of patients that would be expected by chance alone (n = 22). The spatial distribution of patients presenting the outcome was concentrated in the North and Northeast mesoregions of the state. Through survival analysis, we detected that the probability of a patient developing both diseases increased over time from 0.2% in the first year to 1.0% within seven years. Further, using a Cox model we identified male sex (HR: 2.3; 95% CI: 1.7–2.9) and low schooling level (HR: 1.5; 95% CI: 1.2–1.9) as positively associated with the outcome. Furthermore, the hazard of developing the outcome was higher among individuals aged 40–55 years. Conclusions/significance Leprosy and CL are affecting the same individuals in the area. Integration of control policies for both diseases will help to efficiently cover such patients. Measures should be focused on timely diagnosis by following-up patients diagnosed with CL, active case detection, and training of health professionals. Leprosy and cutaneous leishmaniasis (CL) are neglected tropical diseases (NTDs) that usually affect poor populations in the same geographical areas. Both affect the skin and can cause physical disability and disfigurement resulting in discrimination. Both diseases occur at hyperendemic levels in several regions of Brazil. The integration of skin NTDs control programs may be a way to improve timely detection and treatment. However, little is known about the occurrence of leprosy and CL in the same individuals, and what are the characteristics of these patients. For the Brazilian state of Mato Grosso, we identified 414 patients diagnosed with leprosy and CL between 2008 and 2017, spatially concentrated mainly in the North and Northeast mesoregions. The individual probability of developing both diseases increased from 0.2% to 1.0% within seven years. Male sex, being in the 40–55 years age group, and low levels of schooling were the risk factors positively associated with the time interval between the diagnosis of both diseases. These findings may inform the implementation of integrated leprosy and CL control policies focused on timely diagnosis. A sustainable integration requires continuous measures, such as the follow-up of patients, active case detection, training of health professionals, besides financial and political support.
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Affiliation(s)
- Amanda Gabriela de Carvalho
- School of Medicine, Faculty of Health Sciences, Federal University of Rondonópolis, Rondonópolis, Mato Grosso, Brazil
- School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
- * E-mail:
| | - Anuj Tiwari
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - João Gabriel Guimarães Luz
- School of Medicine, Faculty of Health Sciences, Federal University of Rondonópolis, Rondonópolis, Mato Grosso, Brazil
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eliane Ignotti
- School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
- School of Health Sciences, Post-Graduation Program Environment Sciences, State University of Mato Grosso, Cáceres, Mato Grosso, Brazil
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13
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Andrade AWF, Souza CDF, Carmo RF. Temporal and spatial trends in human visceral leishmaniasis in an endemic area in Northeast Brazil and their association with social vulnerability. Trans R Soc Trop Med Hyg 2021; 116:469-478. [PMID: 34664077 DOI: 10.1093/trstmh/trab160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/12/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is a neglected tropical disease of great importance to public health due to its wide distribution and close relationship with social and economic conditions. This study aimed to analyse the spatiotemporal dynamics of human visceral leishmaniasis (HVL) in an endemic state in the Northeast Region of Brazil and its spatial correlation with the Social Vulnerability Index (SVI) and the Municipal Human Development Index (MHDI). METHODS The study included all confirmed cases of HVL in Bahia from 2010 to 2017. A joinpoint regression model was used for trend analysis. Incidence rates were smoothed by a local empirical Bayesian model. Global and local Moran indices and space-time scan statistics were used for identification of spatial clusters. Bivariate and multivariate analyses were carried out to investigate the relationship between HVL incidence and the SVI and MHDI. RESULTS Cases of HVL demonstrated stationary behaviour during the period analysed. A significant association was observed between the HVL incidence rate and social vulnerability, with high-risk clusters concentrated in the central region of the state. CONCLUSIONS HVL has a strong correlation with social vulnerability in the state of Bahia. This study may provide assistance in planning actions and organizing health services to combat HVL.
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Affiliation(s)
- Acácio W F Andrade
- Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Av. José de Sá Maniçoba, sn, Centro, Petrolina, Pernambuco 56304-917, Brazil
| | - Carlos D F Souza
- Faculdade de Medicina, Universidade Federal de Alagoas, Av. Manoel Severino Barbosa, Bom Sucesso, Arapiraca, Alagoas 57309-005, Brazil
| | - Rodrigo F Carmo
- Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Av. José de Sá Maniçoba, sn, Centro, Petrolina, Pernambuco 56304-917, Brazil
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Profiro de Oliveira JH, Arruda IES, Izak Ribeiro de Araújo J, Chaves LL, de La Rocca Soares MF, Soares-Sobrinho JL. Why do few drug delivery systems to combat neglected tropical diseases reach the market? An analysis from the technology's stages. Expert Opin Ther Pat 2021; 32:89-114. [PMID: 34424127 DOI: 10.1080/13543776.2021.1970746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Many drugs used to combat schistosomiasis, Chagas disease, and leishmaniasis (SCL) have clinical limitations such as: high toxicity to the liver, kidneys and spleen; reproductive, gastrointestinal, and heart disorders; teratogenicity. In this sense, drug delivery systems (DDSs) have been described in the literature as a viable option for overcoming the limitations of these drugs. An analysis of the level of development (TRL) of patents can help in determine the steps that must be taken for promising technologies to reach the market. AREAS COVERED This study aimed to analyze the stage of development of DDSs for the treatment of SCL described in patents. In addition, we try to understand the main reasons why many DDSs do not reach the market. In this study, we examined DDSs for drugs indicated by WHO and treatment of SCL, by performing a search for patents. EXPERT OPINION In this present work we provide arguments that support the hypothesis that there is a lack of integration between academia and industry to finance and continue research, especially the development of clinical studies. We cite the translational research consortia as the potential alternative for developing DDSs to combat NTDs.
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Affiliation(s)
| | | | | | - Luise Lopes Chaves
- Department of Pharmacy, Federal University of Pernambuco, Recife, Recife-Pernambuco
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Page B, Lago A, Silva JA, Schriefer A, Lago J, Oliveira L, Guimarães LH, Glesby M, Carvalho EM. Influence of Intestinal Helminth Burden on Clinical Manifestations, Therapeutic Response, and Leishmania braziliensis Load in Patients with New World Cutaneous Leishmaniasis. Am J Trop Med Hyg 2021; 105:1060-1066. [PMID: 34398812 PMCID: PMC8592135 DOI: 10.4269/ajtmh.20-1664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/24/2021] [Indexed: 11/07/2022] Open
Abstract
Leishmania braziliensis is the most important cause of cutaneous leishmaniasis (CL) in the Americas. A Th1-type immune response is required to control Leishmania infection, but an exaggerated inflammatory response leads to the development of ulcers seen in CL. Infection with intestinal helminths has the potential to inhibit the Th1 response in a manner that depends both on the species of helminth present as well as the burden of helminthiasis. We conducted a prospective cohort study of CL patients from an endemic area between January and December 2017 with either negative or high intestinal helminth burden to characterize relationships between helminth burden, L. braziliensis quantification within CL lesions, clinical aspects of CL, and therapeutic response. Of 234 participants with leishmaniasis who underwent stool examination at the time of diagnosis, 45% had detectable helminth infection. The overall cure rate after 90 days was 66%, with a median time to resolution of disease of 40 days (interquartile range: 30-65 days). There was no significant association between the type of helminth infection or the magnitude of intestinal helminth burden at the time of diagnosis and L. braziliensis genomic DNA (gDNA) detected in biopsies from CL lesions. Likewise, there was no association between helminth burden and response to treatment after 90 days. Considering quantification of parasite DNA in CL lesions, participants who were cured at 90 days had a median of 0.017 ng/mg gDNA, and participants who failed therapy had a median of 0.091 ng/mg gDNA (P = 0.03). The results indicate that cutaneous Leishmania load may influence therapeutic response in CL.
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Affiliation(s)
- Brady Page
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusettes
| | - Alex Lago
- Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Juliana Almeida Silva
- Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Albert Schriefer
- Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, CNPq, Ministério de Ciência, Tecnologia e Inovação, Bahia, Brazil
| | - Jamile Lago
- Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | - Lívia Oliveira
- Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil
| | | | - Marshall Glesby
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Edgar M. Carvalho
- Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, CNPq, Ministério de Ciência, Tecnologia e Inovação, Bahia, Brazil
- Instituto Gonçalo Moniz, Fudação Oswaldo Crux (Fiocruz), Salvador, Brazil
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da Silva TAM, Morais MHF, Lopes HMDOR, Gonçalves SA, Magalhães FDC, Amâncio FF, Antunes CMF, Carneiro M. Prognostic factors associated with death from visceral leishmaniasis: a case-control study in Brazil. Trans R Soc Trop Med Hyg 2021; 114:346-354. [PMID: 32118274 DOI: 10.1093/trstmh/traa010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 12/18/2019] [Accepted: 01/24/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to identify the prognostic factors associated with death from visceral leishmaniasis (VL) considering the clinical evolution of patients through a case-control study. METHODS We randomly selected 180 cases (death caused by VL) and 180 controls (cured) from Belo Horizonte's hospitals in Brazil, according to data found in the patients' medical records. Five models of multivariate logistic regression were performed following the chronological order of the variables between the onset of the symptoms and evolution of the VL cases. RESULTS Considering the multivariate models and the stages of clinical evolution of VL, the prognostic factors associated with death are: age >60 y, minor hemorrhagic phenomena, increased abdominal volume, jaundice, dyspnea, malnutrition, TB, billirubin >2 mg/dL, Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) >100 U/L, leukocytes >7000/mm3, hemoglobin <7 g/dL, platelets <50 000/mm3 and infection without defined focus and bleeding. CONCLUSIONS Knowledge regarding the prognostic factors associated with death from VL in different stages of the disease in large Brazilian urban centers such as Belo Horizonte may help optimize patient management strategies and contribute to reduce the high fatality rates in these cities.
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Affiliation(s)
- Thais Almeida Marques da Silva
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Laboratório de Epidemiologia e Bioestatística, Programa de Pós-graduação Stricto Sensu em Medicina e Biomedicina, Instituto de Ensino e Pesquisa Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Stefanne Aparecida Gonçalves
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda do Carmo Magalhães
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Frederico Figueiredo Amâncio
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carlos Maurício Figueiredo Antunes
- Laboratório de Epidemiologia e Bioestatística, Programa de Pós-graduação Stricto Sensu em Medicina e Biomedicina, Instituto de Ensino e Pesquisa Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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17
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Luz JGG, Carvalho AG, Naves DB, Dias JVL, Fontes CJF. Are backyard characteristics relevant factors for the occurrence of human visceral leishmaniasis in Central-Western Brazil? Trans R Soc Trop Med Hyg 2021; 114:276-283. [PMID: 31851365 DOI: 10.1093/trstmh/trz110] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/01/2019] [Accepted: 10/17/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND This retrospective case-control study aimed to investigate the factors associated with the occurrence of human visceral leishmaniasis (VL) in the municipality of Rondonópolis, which is a highly endemic area for VL in Central-Western Brazil. METHODS All VL cases reported in Rondonópolis from 2011 to 2016 were included. For each case, two neighborhood- and age-matched controls with the absence of past and present history of VL and negative rk39-based immunochromatographic test, were recruited. Data were retrospectively collected through interviews that assessed socioeconomic aspects, housing features, backyard characteristics, presence of animals and daily habits. A multivariate conditional logistic regression analysis was used to identify factors associated with human VL. RESULTS During the study period, 81 VL cases were reported in Rondonópolis, of which 37 (45.7%) were included in this study. Seventy controls were also included. The variables associated with VL occurrence were the outdoor location of a bathroom and/or kitchen separated from the rest of the house (OR 7.8; 95% CI 2.1 to 29.5), the presence of a vegetable garden (OR 5.3; 95% CI 1.3 to 21.2) and the presence of decaying fruits (OR 10.7; 95% CI 2.0 to 52.1) in the backyard. CONCLUSIONS Our findings suggest an association between backyard characteristics and VL. This may be useful in guiding preventive and control measures against zoonotic VL worldwide.
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Affiliation(s)
- João Gabriel Guimarães Luz
- School of Medicine, Institute of Exact and Natural Sciences, Federal University of Mato Grosso (UFMT), 5055 dos Estudantes Ave. Rondonópolis, Mato Grosso, 78735-901, Brazil.,School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso (UFMT), 2367 Fernando Corrêa da Costa Ave. Cuiabá, Mato Grosso, 78060-900, Brazil
| | - Amanda Gabriela Carvalho
- School of Medicine, Institute of Exact and Natural Sciences, Federal University of Mato Grosso (UFMT), 5055 dos Estudantes Ave. Rondonópolis, Mato Grosso, 78735-901, Brazil.,School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso (UFMT), 2367 Fernando Corrêa da Costa Ave. Cuiabá, Mato Grosso, 78060-900, Brazil
| | - Danilo Bueno Naves
- School of Medicine, Institute of Exact and Natural Sciences, Federal University of Mato Grosso (UFMT), 5055 dos Estudantes Ave. Rondonópolis, Mato Grosso, 78735-901, Brazil
| | - João Victor Leite Dias
- School of Medicine, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 1 Cruzeiro St. Teófilo Otoni, Minas Gerais, 39803-371, Brazil
| | - Cor Jesus Fernandes Fontes
- School of Medicine, Post-Graduation Program in Health Sciences, Federal University of Mato Grosso (UFMT), 2367 Fernando Corrêa da Costa Ave. Cuiabá, Mato Grosso, 78060-900, Brazil.,School of Medicine, Faculty of Biomedical Sciences of Cacoal (FACIMED), 3087 Cuiabá Ave. Cacoal, Rondônia, 76963-665, Brazil
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Marcolino LMC, Pereira AHC, Pinto JG, Mamone LA, Strixino JF. CELLULAR AND METABOLIC CHANGES AFTER PHOTODYNAMIC THERAPY IN LEISHMANIA PROMASTIGOTES. Photodiagnosis Photodyn Ther 2021; 35:102403. [PMID: 34161856 DOI: 10.1016/j.pdpdt.2021.102403] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/20/2021] [Accepted: 06/11/2021] [Indexed: 01/21/2023]
Abstract
Leishmaniasis is a zoonotic disease, regarded by WHO as a public health problem that has presented a significant increase in the recent years. Conventional treatment is toxic and leads to serious side effects. Photodynamic therapy has been studied as a treatment to cutaneous leishmaniasis. This study aimed to evaluate the cell viability, morphological changes, type of cell death, production of reactive oxygen species, and changes in the mitochondrial membrane and DNA fragmentation in Leishmania braziliensis and Leishmania major promastigotes. Confocal microscopy was used to quantify the fluorescence emitted by JC-1, Annexin V, and propidium iodide reagents. The trypan blue exclusion test was used to evaluate the viability of the cells, the mitochondrial activity was verified with MTT, and the morphological changes were analyzed for SEM and DNA damage using the comet assay. PDT using curcumin at 500, 125, and 31,25 μg/mL decreased the viability of the parasites and induced changes in the mitochondrial membrane potential. The production of reactive oxygen species was dose-dependent and was observed only in the groups submitted to PDT. DNA damage was also observed in the parasite cells. The morphology of the cells was affected mainly at the highest curcumin concentration, resulting in rounded cells with a shortened flagellum. When the type of cell death was analyzed, the prevalence of apoptosis was noted. The results support the use of curcumin as photosensitizer in PDT against Leishmania promastigotes in the treatment for cutaneous leishmaniasis.
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Affiliation(s)
- Luciana Maria Cortez Marcolino
- Photobiology Applied to Health - Universidade do Vale do Paraíba. Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, S.P, Brazil.
| | - André Henrique Correia Pereira
- Photobiology Applied to Health - Universidade do Vale do Paraíba. Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, S.P, Brazil
| | - Juliana Guerra Pinto
- Photobiology Applied to Health - Universidade do Vale do Paraíba. Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, S.P, Brazil
| | - Leandro Ariel Mamone
- Centro de Investigaciones sobre Porfirinas y Porfirias (CIPYP), CONICET and Hospital de Clínicas José de San Martín, Universidad de Buenos Aires. Córdoba 2351 1er subsuelo, Ciudad de Buenos Aires CP1120AAF, Argentina
| | - Juliana Ferreira Strixino
- Photobiology Applied to Health - Universidade do Vale do Paraíba. Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, S.P, Brazil.
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Portella TP, Kraenkel RA. Spatial-temporal pattern of cutaneous leishmaniasis in Brazil. Infect Dis Poverty 2021; 10:86. [PMID: 34134749 PMCID: PMC8207768 DOI: 10.1186/s40249-021-00872-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/04/2021] [Indexed: 11/12/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL) is a vector-borne disease classified by the World Health Organization as one of the most neglected tropical diseases. Brazil has the highest incidence of CL in America and is one of the ten countries in the world with the highest number of cases. Understanding the spatiotemporal dynamics of CL is essential to provide guidelines for public health policies in Brazil. In the present study we used a spatial and temporal statistical approach to evaluate the dynamics of CL in Brazil. Methods We used data of cutaneous leishmaniasis cases provided by the Ministry of Health of Brazil from 2001 to 2017. We calculated incidence rates and used the Mann–Kendall trend test to evaluate the temporal trend of CL in each municipality. In addition, we used Kuldorff scan method to identify spatiotemporal clusters and emerging hotspots test to evaluate hotspot areas and their temporal trends. Results We found a general decrease in the number of CL cases in Brazil (from 15.3 to 8.4 cases per 100 000 habitants), although 3.2% of municipalities still have an increasing tendency of CL incidence and 72.5% showed no tendency at all. The scan analysis identified a primary cluster in northern and central regions and 21 secondary clusters located mainly in south and southeast regions. The emerging hotspots analysis detected a high spatial and temporal variability of hotspots inside the main cluster area, diminishing hotspots in eastern Amazon and permanent, emerging, and new hotspots in the states of Amapá and parts of Pará, Roraima, Acre and Mato Grosso. The central coast the state of Bahia is one of the most critical areas due to the detection of a cluster of the highest rank in a secondary cluster, and because it is the only area identified as an intensifying hotspot. Conclusions Using a combination of statistical methods we were able to detect areas of higher incidence of CL and understand how it changed over time. We suggest that these areas, especially those identified as permanent, new, emerging and intensifying hotspots, should be targeted for future research, surveillance, and implementation of vector control measures. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00872-x.
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Affiliation(s)
- Tatiana P Portella
- Departamento de Ecologia, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil.
| | - Roberto A Kraenkel
- Instituto de Física Teórica, Universidade Estadual Paulista, São Paulo, Brazil
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Staniek ME, Hamilton JGC. Odour of domestic dogs infected with Leishmania infantum is attractive to female but not male sand flies: Evidence for parasite manipulation. PLoS Pathog 2021; 17:e1009354. [PMID: 33735302 PMCID: PMC7971543 DOI: 10.1371/journal.ppat.1009354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/02/2021] [Indexed: 11/18/2022] Open
Abstract
Globally visceral leishmaniasis (VL) causes thousands of human deaths every year. In South America, the etiologic agent, Leishmania infantum, is transmitted from an infected canine reservoir to human hosts by the bite of the sand fly vector; predominantly Lutzomyia longipalpis. Previous evidence from model rodent systems have suggested that the odour of infected hosts is altered by the parasite making them more attractive to the vector leading to an increased biting rate and improved transmission prospects for the pathogen. However, there has been no assessment of the effect of Le infantum infection on the attractiveness of dogs, which are the natural reservoirs for human infection. Hair collected from infected and uninfected dogs residing in a VL endemic city in Brazil was entrained to collect the volatile chemical odours present in the headspace. Female and male Lu. longipalpis sand flies were offered a choice of odour entrained from infected and uninfected dogs in a series of behavioural experiments. Odour of uninfected dogs was equally attractive to male or female Lu. longipalpis when compared to a solvent control. Female Lu. longipalpis were significantly more attracted to infected dog odour than uninfected dog odour in all 15 experimental replicates (average 45.7±0.87 females attracted to infected odour; 23.9±0.82 to uninfected odour; paired T-test, P = 0.000). Male Lu. longipalpis did not significantly prefer either infected or uninfected odour (average 36.1±0.4 males to infected odour; 35.7±0.6 to uninfected odour; paired T-test, P = 0.722). A significantly greater proportion of females chose the infected dog odour compared to the males (paired T-test, P = 0.000). The results showed that the odour of dogs infected with Le. infantum was significantly more attractive to blood-seeking female sand flies than it was to male sand flies. This is strong evidence for parasite manipulation of the host odour in a natural transmission system and indicates that infected dogs may have a disproportionate significance in maintaining infection in the canine and human population.
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Affiliation(s)
- Monica E. Staniek
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancashire, United Kingdom
| | - James G. C. Hamilton
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancashire, United Kingdom
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Fonseca EDS, Guimarães RB, Prestes-Carneiro LE, Tolezano JE, Rodgers MDSM, Avery RH, Malone JB. Predicted distribution of sand fly (Diptera: Psychodidae) species involved in the transmission of Leishmaniasis in São Paulo state, Brazil, utilizing maximum entropy ecological niche modeling. Pathog Glob Health 2021; 115:108-120. [PMID: 33427124 PMCID: PMC8550198 DOI: 10.1080/20477724.2020.1870031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Leishmaniasis is a public health problem worldwide. We aimed to predict ecological niche models (ENMs) for visceral (VL) and cutaneous (CL) leishmaniasis and the sand flies involved in the transmission of leishmaniasis in São Paulo, Brazil. Phlebotomine sand flies were collected between 1985 and 2015. ENMs were created for each sand fly species using Maximum Entropy Species Distribution Modeling software, and 20 climatic variables were determined. Nyssomyia intermedia (Lutz & Neiva, 1912) and Lutzomyia longipalpis (Lutz & Neiva, 1912), the primary vectors involved in CL and VL, displayed the highest suitability across the various regions, climates, and topographies. L. longipalpis was found in the border of Paraná an area currently free of VL. The variables with the greatest impact were temperature seasonality, precipitation, and altitude. Co-presence of multiple sand fly species was observed in the cuestas and coastal areas along the border of Paraná and in the western basalt areas along the border of Mato Grosso do Sul. Human CL and VL were found in 475 of 546 (86.7%) and 106 of 645 (16.4%) of municipalities, respectively. Niche overlap between N. intermedia and L. longipalpis was found with 9208 human cases of CL and 2952 cases of VL. ENMs demonstrated that each phlebotomine sand fly species has a unique geographic distribution pattern, and the occurrence of the primary vectors of CL and VL overlapped. These data can be used by public authorities to monitor the dispersion and expansion of CL and VL vectors in São Paulo state.
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Affiliation(s)
| | - Raul Borges Guimarães
- Geography Department, Faculty of Science and Technology, Paulista State University Julio De Mesquita Filho, Presidente Prudente, SP, Brazil
| | | | - José Eduardo Tolezano
- Center for Parasitology and Mycology, Systemic Parasitic Nucleus, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | | | - Ryan Harry Avery
- Department of Pathobiological Sciences, School of Veterinary Medicine, Baton Rouge, LA, USA
| | - John B. Malone
- Department of Pathobiological Sciences, School of Veterinary Medicine, Baton Rouge, LA, USA
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22
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Aguiar Martins K, Meirelles MHDA, Mota TF, Abbasi I, de Queiroz ATL, Brodskyn CI, Veras PST, Mothé Fraga DB, Warburg A. Effects of larval rearing substrates on some life-table parameters of Lutzomyia longipalpis sand flies. PLoS Negl Trop Dis 2021; 15:e0009034. [PMID: 33476330 PMCID: PMC7870073 DOI: 10.1371/journal.pntd.0009034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 02/08/2021] [Accepted: 12/03/2020] [Indexed: 11/18/2022] Open
Abstract
Sand flies are the insects responsible for transmitting Leishmania parasites, the causative agents of leishmaniasis in humans. However, the effects of sand fly breeding sites on their biology and ecology remain poorly understood. Herein, we studied how larval nutrition associated with putative breeding sites of the sand fly Lutzomyia longipalpis affects their oviposition, development, microbiome, and susceptibility to Leishmania by rearing L. longipalpis on substrates collected from an endemic area for leishmaniasis in Brazil. The results showed that female L. longipalpis select the oviposition site based on its potential to promote larval maturation and while composting cashew leaf litter hindered the development, larvae reared on chicken feces developed rapidly. Typical gut microbial profiles were found in larvae reared upon cashew leaf litter. Adult females from larvae reared on substrate collected in chicken coops were infected with Leishmania infantum, indicating that they were highly susceptible to the parasite. In conclusion, the larval breeding sites can exert an important role in the epidemiology of leishmaniasis. Sand flies are the insect vectors involved in the transmission of many pathogens, however, the transmission of parasites to humans leading to visceral leishmaniasis is currently the most critical threat caused by this insect. Despite the importance of the vector, many aspects of the biology of sand flies are poorly understood, especially their breeding sites. This study was designed to evaluate the oviposition, life span, microbiome, and parasite infections in the main species of sand fly responsible for visceral leishmaniasis in America. Insects were reared on substrates collected from different putative habitats of sand flies in an endemic area for the disease in Brazil. The results showed that female vectors selected an oviposition site depending on the potential offered to their offspring. Furthermore, the development of immature stages varied according to the type of substrate evaluated, with cashew leaves litter delaying larval development, while chicken shelter promoted larval development. The challenge of females emerging from chicken shelter substrate with the parasite indicates that insects reared in such an environment could successfully sustain the infection. These results suggest that the type of breeding site can affect insect biology as well as the epidemiology of the disease.
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Affiliation(s)
| | - Maria Helena de Athayde Meirelles
- Instituto Gonçalo Moniz-Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia-Universidade Federal da Bahia, Salvador, Brazil
| | | | - Ibrahim Abbasi
- Kuvin Center for the Study of Infectious & Tropical Diseases, Department of Microbiology and Molecular Genetics, Institute of Medical Research, Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Claudia Ida Brodskyn
- Instituto Gonçalo Moniz-Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia-Universidade Federal da Bahia, Salvador, Brazil
| | | | - Deborah Bittencourt Mothé Fraga
- Instituto Gonçalo Moniz-Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia-Universidade Federal da Bahia, Salvador, Brazil
| | - Alon Warburg
- Kuvin Center for the Study of Infectious & Tropical Diseases, Department of Microbiology and Molecular Genetics, Institute of Medical Research, Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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23
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Guedes DL, Justo AM, Barbosa Júnior WL, Silva EDD, Aquino SRD, Lima Junior MSDC, Montarroyos U, Bezerra GSN, Vieira AVB, Pereira VRA, Medeiros ZMD. Asymptomatic Leishmania infection in HIV-positive outpatients on antiretroviral therapy in Pernambuco, Brazil. PLoS Negl Trop Dis 2021; 15:e0009067. [PMID: 33476331 PMCID: PMC7853496 DOI: 10.1371/journal.pntd.0009067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 02/02/2021] [Accepted: 12/11/2020] [Indexed: 11/23/2022] Open
Abstract
Background Visceral leishmaniasis (VL) in HIV-positive individuals is a global health problem. HIV-Leishmania coinfection worsens prognosis and mortality risk, and HIV-Leishmania coinfected individuals are more susceptible to VL relapses. Early initiation of antiretroviral therapy can protect against Leishmania infection in individuals living in VL-endemic areas, and regular use of antiretrovirals might prevent VL relapses in these individuals. We conducted a cross-sectional study in Petrolina, Brazil, an VL-endemic area, to estimate the prevalence of asymptomatic Leishmania cases among HIV-positive outpatients. Methods We invited any HIV-positive patients, aged ≥ 18-years-old, under antiretroviral therapy, and who were asymptomatic for VL. Patients were tested for Leishmania with enzyme-linked immunosorbent assays (ELISA)-rK39, immunochromatographic test (ICT)-rK39, direct agglutination test (DAT), latex agglutination test (KAtex), and conventional polymerase chain reaction (PCR). HIV-Leishmania coinfection was diagnosed when at least one VL test was positive. Results A total of 483 patients were included. The sample was predominantly composed of single, < 48-years-old, black/pardo, heterosexual males, with fewer than 8 years of schooling. The prevalence of asymptomatic HIV-Leishmania coinfection was 9.11% (44/483). HIV mono-infected and HIV-Leishmania coinfected groups differed statistically significantly in terms of race (p = 0.045), marital status (p = 0.030), and HIV viral load (p = 0.046). Black/pardo patients, married patients, and those with an HIV viral load up to 100,000 copies/ml presented higher odds for HIV-Leishmania coinfection. Conclusions A considerable number of asymptomatic Leishmania cases were observed among HIV-positive individuals in a VL-endemic area. Given the potential impact on transmission and health costs, as well as the impact on these coinfected individuals, studies of asymptomatic Leishmania carriers can be useful for guiding public health policies in VL-endemic areas aiming to control and eliminate the disease. Every year up to 90,000 new cases of visceral leishmaniasis (VL) occurs globally. One of the most neglected diseases, VL is endemic in 60 countries in four continents. Brazil is one of seven countries in which 90% of all cases in the world occur. When co-occurring with HIV, VL tends to be more severe than in HIV-negative persons, leading to worse prognosis and frequent relapses. In this study HIV-positive outpatients, aged 18 years or older, under antiretroviral therapy, who were asymptomatic for VL, were tested for Leishmania. We observed a prevalence of 9.11% (44/483) of HIV-Leishmania coinfection. For those HIV-positive/Leishmania-negative individuals who live in VL-endemic areas, early initiation of antiretroviral therapy can be a protective factor against Leishmania infection. On the other hand, for HIV-Leishmania coinfected individuals who regularly use antiretrovirals might prevent VL relapses. Studies centering on asymptomatic Leishmania carriers can be useful for guiding public health measures in VL-endemic areas seeking to control and eliminate the disease.
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Affiliation(s)
- Diego Lins Guedes
- Curso de Medicina, Núcleo de Ciências da Vida, Centro Acadêmico do Agreste, Universidade Federal de Pernambuco, Caruaru, Brasil.,Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
| | - Alda Maria Justo
- Núcleo de Pós-Graduação, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brasil
| | | | - Elis Dionísio da Silva
- Departamento de Imunologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil
| | | | | | - Ulisses Montarroyos
- Núcleo de Pós-Graduação, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brasil
| | | | | | | | - Zulma Maria de Medeiros
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Brasil.,Núcleo de Pós-Graduação, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brasil
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24
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Ursine RL, Rocha MF, Sousa JFD, Santos RCD, Soares MD, Gusmão MSF, Leite ME, Vieira TM. American Tegumentary Leishmaniasis in an endemic municipality in the North of Minas Gerais State: spatial analysis and socio-environmental factors. Rev Inst Med Trop Sao Paulo 2021; 63:e2. [PMID: 33503150 PMCID: PMC7816867 DOI: 10.1590/s1678-9946202163002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022] Open
Abstract
American Tegumentary Leishmaniasis (ATL) is endemic in the municipality of Montes Claros, Minas Gerais State. The use of geotechnology such as spatial statistics and remote sensing has contributed to a better understanding of the eco-epidemiology of diseases, and consequently a better definition of control strategies. This study aimed to analyze the spatial distribution of probable sites of cases of ATL infection (2007-2011) in the municipality of Montes Claros and to identify related socio-environmental factors. Data on ATL cases notification were obtained from the Municipal Health Department of Montes Claros. The annual incidence of ATL in the municipality was calculated and the probable sites of infection were georeferenced. Crude Rate and the Local Empirical Bayesian Rate were calculated with census sectors considered as the unit of analysis. The Normalized Difference Vegetation Index (NDVI) was calculated from LANDSAT 5 TM images. The spatial association between the crude rate of ATL and the NDVI of the census tracts was evaluated using the Local Bivariate of Moran I. The socio-environmental aspects of household structures were assessed based on a structured questionnaire. The incidence of ATL in the evaluated period ranged from 6.2 to 16.6 cases/100,000 inhabitants. The highest rates of ATL occurrence were found in the census sectors located in the rural area and in the peripheral census sectors in the city. Through the Empirical Bayes Smoothed Rate map, it was found that in the peripheral areas of the city, the rates of ATL occurrence were lower than in the rural area and their values decreased as they approach the city center. Local Bivariate of Moran I showed a positive correlation between NDVI and crude ATL rates, with significant high-high clusters observed in the rural area and in the census sectors in the Western peripheral area of the city that have experienced an urban expansion concomitant to the period investigated. In most homes of people affected by the disease, there were domestic animals and organic matter in the peridomicile. In addition, a high percentage of individuals affected by ATL reported the presence of rodents circulating near their homes. In conclusion, it is possible that the disorderly expansion process in the city of Montes Claros favored the establishment of the ATL periurban and urban transmission cycle. These regions deserve special attention from health surveillance to combat this zoonosis.
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Affiliation(s)
- Renata Luiz Ursine
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Ciências Biológicas, Diamantina, Minas Gerais, Brazil.,Universidade Estadual de Montes Claros. Programa de Pós-Graduação em Ciências da Saúde, Montes Claros, Minas Gerais, Brazil
| | - Marília Fonseca Rocha
- Universidade Estadual de Montes Claros. Departamento de Saúde Mental e Saúde Coletiva, Montes Claros, Minas Gerais, Brazil.,Prefeitura Municipal de Montes Claros. Centro de Controle de Zoonoses, Montes Claros, Minas Gerais, Brazil
| | - Joel Fontes de Sousa
- Prefeitura Municipal de Montes Claros. Centro de Controle de Zoonoses, Montes Claros, Minas Gerais, Brazil
| | - Ronaldo Cardoso Dos Santos
- Prefeitura Municipal de Montes Claros. Centro de Controle de Zoonoses, Montes Claros, Minas Gerais, Brazil
| | - Marcelo Dias Soares
- Prefeitura Municipal de Montes Claros. Centro de Controle de Zoonoses, Montes Claros, Minas Gerais, Brazil
| | - Maria Suely Fernandes Gusmão
- Universidade Estadual de Montes Claros. Programa de Pós-Graduação em Ciências da Saúde, Montes Claros, Minas Gerais, Brazil.,Prefeitura Municipal de Montes Claros, Secretaria Municipal de Saúde, Montes Claros, Minas Gerais, Brazil
| | - Marcos Esdras Leite
- Universidade Estadual de Montes Claros. Programa de Pós-Graduação em Geografia, Montes Claros, Minas Gerais, Brazil
| | - Thallyta Maria Vieira
- Universidade Estadual de Montes Claros. Programa de Pós-Graduação em Ciências da Saúde, Montes Claros, Minas Gerais, Brazil
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25
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Ribeiro CJN, dos Santos AD, Lima SVMA, da Silva ER, Ribeiro BVS, Duque AM, Peixoto MVS, dos Santos PL, de Oliveira IM, Lipscomb MW, de Araújo KCGM, de Moura TR. Space-time risk cluster of visceral leishmaniasis in Brazilian endemic region with high social vulnerability: An ecological time series study. PLoS Negl Trop Dis 2021; 15:e0009006. [PMID: 33465104 PMCID: PMC7846114 DOI: 10.1371/journal.pntd.0009006] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/29/2021] [Accepted: 11/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Despite visceral leishmaniasis (VL) being epidemic in most Brazilian regions, the Northeast region is responsible for the highest morbidity and mortality outcomes within the country. OBJECTIVE To analyse the spatiotemporal dynamics of VL cases to identify the temporal trends and high-risk areas for VL transmission, as well as the association of the disease with social vulnerability in Brazilian Northeast. METHODS We carried out an ecological time series study employing spatial analysis techniques using all VL confirmed cases of 1,794 municipalities of Brazilian Northeast between the years 2000 to 2017. The Social Vulnerability Index (SVI) was used to represent the social vulnerability. Incidence rates were standardized and smoothed by the Local Empirical Bayesian Method. Time trends were examined through segmented linear regression. Spatiotemporal analysis consisted of uni- and bivariate Global and Local Moran indexes and space-time scan statistics. RESULTS Incidence rate remained stable and ranged from 4.84 to 3.52 cases/100,000 inhabitants. There was higher case prevalence between males (62.71%), children and adolescents (63.27%), non-white (69.75%) and urban residents (62.58%). Increasing trends of new cases were observed among adult male subjects (≥ 40 years old) and urban residents. Importantly, VL incidence showed a direct spatial dependence. Spatial and space-time clusters were identified in sertão and meio-norte sub-regions, overlapping with high social vulnerability areas. CONCLUSIONS VL is a persistent health issue in Brazilian Northeast and associated with social vulnerability. Space-time clustering of VL cases in socially vulnerable municipalities demands intersectoral public policies of surveillance and control, with focus on reducing inequalities and improving living conditions for regional inhabitants.
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Affiliation(s)
- Caique J. N. Ribeiro
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
| | | | - Shirley V. M. A. Lima
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
- Department of Nursing, Federal University of Sergipe, Lagarto, Brazil
| | | | - Bianca V. S. Ribeiro
- Graduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Andrezza M. Duque
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
| | - Marcus V. S. Peixoto
- Department of Speech Therapy and Audiology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Priscila L. dos Santos
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
- Graduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Iris M. de Oliveira
- Department of Functional Biology and Health Sciences, University of Vigo, Pontevedra, Spain
| | - Michael W. Lipscomb
- Department of Biology, Howard University, Washington DC, United States of America
| | - Karina C. G. M. de Araújo
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
- Graduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Tatiana R. de Moura
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
- Graduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, Brazil
- * E-mail:
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26
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Almeida ÂS, Ribeiro CJN, Carlini CC, Santos RS, Dos Santos AD, Tavares DS, De Araújo KCGM, Moura TRD, Santos PLD. Spatial and spatiotemporal dynamics of visceral leishmaniasis in an endemic North-eastern region of Brazil. GEOSPATIAL HEALTH 2021; 15. [PMID: 33461273 DOI: 10.4081/gh.2020.885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/02/2020] [Indexed: 06/12/2023]
Abstract
Visceral Leishmaniasis (VL) is a neglected disease with increasing incidence in Brazil, particularly in the North-eastern. The aim of this study was to analyze the spatial and spatiotemporal dynamics of VL in an endemic region of North-eastern Brazil, between 2009 and 2017. Using spatial analysis techniques, an ecological and time series study was made regarding VL cases in Sergipe filed as notifiable disease events. With data from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IBGE), a digital population and cartographic baseline was established. Segmented linear regression was used to examine the temporal trends. The statistical analysis methods of Global and Local Moran' I, local Bayesian empirical methodology and spatial-temporal scanning were used to produce thematic maps. High instances were found among adults, males, urban residents, non-Whites and persons with low levels of education. A decrease in the recovery rate and an increase in the proportion of urban cases and lethality was found. A heterogeneous VL distribution with spatiotemporal agglomeration on the seaside of the state was seen in Sergipe. To better manage the disease, new research is encouraged together with development of public health strategies. Further, improving health care networks, especially primary care, is suggested as this approach has a key role in health promotion, prevention and monitoring of the most prevalent diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Tatiana Rodrigues de Moura
- Postgraduate in Health Sciences, Federal University of Sergipe, São Cristóvão; Department of Pharmacy, Federal University of Sergipe, Lagarto.
| | - Priscila Lima Dos Santos
- Postgraduate in Applied Health Sciences, Federal University of Sergipe, Lagarto; Postgraduate in Health Sciences, Federal University of Sergipe, São Cristóvão; Department of Health Education, Federal University of Sergipe, Lagarto, Sergipe.
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27
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Salih OAMM, Nail AM, Modawe GA, Swar MO, Ahmed MH, Khalil A, Satti AB, Abuzeid N. Risk Factors of Inpatients Mortality of Visceral Leishmaniasis, Khartoum State, Sudan. J Glob Infect Dis 2020; 12:135-140. [PMID: 33343164 PMCID: PMC7733432 DOI: 10.4103/jgid.jgid_25_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/05/2020] [Accepted: 04/14/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Visceral leishmaniasis (VL) is one of the common infections in Sudan and can be associated with an increase in morbidity and mortality. The aim of this study was to assess the risk factors associated with mortality and morbidity with VL. Materials and Methods: This is a cross-sectional hospital-based study that recruited 150 patients with VL from two centers in Khartoum. Secondary data were extracted from the patient records, and data were analyzed using SPSS version 24.0. Results: The study included 2.5% of infants, 39.4% children, and 58% of adults. Male represents 77.3% of the cohort, and total mortality was 16%. Among the death reported 12.5% in infants, 16.7% were children, and 70.8% were in adults. Laboratory parameters significantly associated with mortality in univariate analysis were low white cell count, low platelets, high creatinine, and high liver enzymes. While risk factors such as infant, male, acquired infection from Eastern Sudan or White Nile, weight loss, morbid diseases, and concomitant bacterial infections were also associated with significant mortality in univariate analysis. Importantly, logistic regression analysis revealed significant association with infant (P = 0.02), concomitant bacterial infections (P = 0.003), comorbid disease (P = 0.001), low total blood cell count (P = 0.018), low platelets (P = 0.013), and high aspartate transaminase/alanine aminotransferase (P = 0.013). Conclusion: Health education and awareness are needed in terms of prevention and control, especially with high mortality seen in the infant. Treatment of underlying co-morbid diseases and bacterial infections are important to enhance survival. Patients with Leishmania are vulnerable; therefore, regular routine blood tests are an essential part of management to manage complications such as renal, hepatic failure, or severe anemia.
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Affiliation(s)
| | - Abdelsalam M Nail
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan
| | - Gad Allah Modawe
- Department of Biochemistry, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan
| | - Mohamed Osman Swar
- Department of Pediatrics and Child Health, School of Medicine, Ahfad University for Women, Sudan
| | - Mohamed H Ahmed
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire, UK
| | - Atif Khalil
- Department of Nephrology, Noble Hospital, Isle of Man, UK
| | - Abdelsalam Basheir Satti
- Department of Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Omdurman, Sudan
| | - Nadir Abuzeid
- Department of Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Omdurman, Sudan
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28
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Aguiar-Soares RDDO, Roatt BM, Mathias FAS, Reis LES, Cardoso JMDO, de Brito RCF, Ker HG, Corrêa-Oliveira R, Giunchetti RC, Reis AB. Phase I and II Clinical Trial Comparing the LBSap, Leishmune ®, and Leish-Tec ® Vaccines against Canine Visceral Leishmaniasis. Vaccines (Basel) 2020; 8:E690. [PMID: 33212786 PMCID: PMC7712644 DOI: 10.3390/vaccines8040690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/08/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022] Open
Abstract
In this study, we performed a phase I and II clinical trial in dogs to evaluate the toxicity and immunogenicity of LBSap-vaccine prototype, in comparison to Leishmune® and Leish-Tec® vaccines. Twenty-eight dogs were classified in four groups: (i) control group received 1 mL of sterile 0.9% saline solution; (ii) LBSap group received 600 μg of Leishmania braziliensis promastigotes protein and 1 mg of saponin adjuvant; (iii) Leishmune®; and (iv) Leish-Tec®. The safety and toxicity of the vaccines were measured before and after three immunizations by clinical, biochemical, and hematological parameters. The clinical examinations revealed that some dogs of LBSap and Leishmune® groups presented changes at the site of vaccination inoculum, such as nodules, mild edema, and local pain, which were transient and disappeared seventy-two hours after vaccination, but these results indicate that adverse changes caused by the immunizations are tolerable. The immunogenicity results demonstrate an increase of B lymphocytes CD21+ regarding the Leishmune® group and monocytes CD14+ concerning LBSap and Leishmune® groups. In the in vitro analyses, an increase in lymphoproliferative activity in LBSap and Leishmune® groups was observed, with an increase of antigen-specific CD4+ and CD8+ T lymphocytes in the LBSap group. A second approach of in vitro assays aimed at evaluating the percentage of antigen-specific CD4+ and CD8+ T lymphocytes producers of IFN-γ and IL-4, where an increase in both IFN-γ producing subpopulations in the LBSap group was observed, also showed an increase in IFN-γ producers in CD8+ lymphocytes in the Leish-Tec® group. Our data regarding immunogenicity indicate that the vaccination process, especially with the LBSap vaccine, generated a protective immune response compatible with L. infantum parasite control. Based on the foregoing, the LBSap vaccine would be suitable for further studies of phase III clinical trial in endemic areas with high prevalence and incidence of canine visceral leishmaniasis (VL) cases.
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Affiliation(s)
- Rodrigo Dian de Oliveira Aguiar-Soares
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
- Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil
| | - Bruno Mendes Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), CEP 40110-040 Salvador, Brazil
| | - Fernando Augusto Siqueira Mathias
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
| | - Levi Eduardo Soares Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
| | - Jamille Mirelle de Oliveira Cardoso
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
| | - Rory Cristiane Fortes de Brito
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
| | - Henrique Gama Ker
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
| | - Rodrigo Corrêa-Oliveira
- Laboratório de Imunologia Celular e Molecular, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz-FIOCRUZ, CEP 30190-009 Belo Horizonte, Brazil;
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Universidade Federal de Minas Gerais, CEP 31270-901 Belo Horizonte, Brazil;
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil; (R.D.d.O.A.-S.); (B.M.R.); (F.A.S.M.); (L.E.S.R.); (J.M.d.O.C.); (R.C.F.d.B.); (H.G.K.)
- Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000 Ouro Preto, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), CEP 40110-040 Salvador, Brazil
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Bezerra JMT, Barbosa DS, Martins-Melo FR, Werneck GL, Braga ÉM, Tauil PL, Carneiro M. Changes in malaria patterns in Brazil over 28 years (1990-2017): results from the Global Burden of Disease Study 2017. Popul Health Metr 2020; 18:5. [PMID: 32993671 PMCID: PMC7526087 DOI: 10.1186/s12963-020-00211-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/22/2020] [Indexed: 12/27/2022] Open
Abstract
Background This study presents the malaria burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), by analyzing disease burden indicators in federated units of the Legal Amazon and Extra-Amazon regions, as well as describing malaria cases according to Plasmodium species occurring in the country. Methods We used estimates from the GBD 2017 to report years of life lost due to premature death (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for malaria in Brazil, grouped by gender, age group, and Brazilian federated unit, from 1990 to 2017. Results are presented as absolute numbers and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UI). Results At the national level, the age-standardized DALYs rate due to malaria decreased by 92.0%, from 42.5 DALYs per 100,000 inhabitants (95% UI 16.6–56.9) in 1990 to 3.4 DALYs per 100,000 inhabitants (95% UI 2.7–4.7) in 2017. The YLLs were the main component of the total DALYs rate for malaria in 1990 (67.3%), and the YLDs were the main component of the metric in 2017 (61.8%). In 2017, the highest sex–age DALYs rate was found among females in the “< 1-year-old” age group, with a 6.4 DALYs per 100,000 inhabitants (95% UI 1.8–14.7) and among males in the age group of “20 to 24 years old”, with a 4.7 DALYs per 100,000 inhabitants (95% UI 3.3–9.9). Within the Brazilian Amazon region, the three federated units with the highest age-standardized DALYs rates in 2017 were Acre [28.4 (95% UI 14.2–39.1)], Roraima [28.3 (95% UI 13.5–40.2)], and Rondônia [24.7 (95% UI 11.4–34.8)]. Concerning the parasite species that caused malaria, 73.5% of the total of cases registered in the period had Plasmodium vivax as the etiological agent. Conclusions The results of the GBD 2017 show that despite the considerable reduction in the DALYs rates between 1990 and 2017, malaria remains a relevant and preventable disease, which in recent years has generated more years of life lost due to disability than deaths. The states endemic for malaria in the Amazon region require constant evaluation of preventive and control measures. The present study will contribute to the direction of current health policies aimed at reducing the burden of malaria in Brazil, as knowing the geographical and temporal distribution of the risk of death and disability of this disease can facilitate the planning, implementation, and improvement of control strategies aimed at eliminating the disease.
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Affiliation(s)
- Juliana Maria Trindade Bezerra
- Laboratory of Epidemiology of Infectious and Parasitic Diseases, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - David Soeiro Barbosa
- Laboratory of Epidemiology of Infectious and Parasitic Diseases, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Francisco Rogerlândio Martins-Melo
- Federal Institute of Education, Science, and Technology of Ceará, Rua Francisco da Rocha Martins, S/N, Pabussu, Caucaia, Ceará, 61609-090, Brazil.,Department of Epidemiology, Social Medicine Institute, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, 20550-013, Brazil
| | - Guilherme Loureiro Werneck
- Institute for Public Health Studies, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, S/N, Ilha do Fundão - Cidade Universitária, Rio de Janeiro, 21941-598, Brazil
| | - Érika Martins Braga
- Laboratory of Malaria, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Pedro Luiz Tauil
- School of Medicine, Postgraduate Program in Tropical Medicine, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília, Distrito Federal, 70910-900, Brazil
| | - Mariângela Carneiro
- Laboratory of Epidemiology of Infectious and Parasitic Diseases, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil. .,Post-Graduation Program in Health Sciences, Infectology and Tropical Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
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30
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Lewgoy B, Mastrangelo A, Beck L. Tanatopolítica e biossegurança: dois regimes de governo da vida para a leishmaniose visceral canina no Brasil. HORIZONTES ANTROPOLÓGICOS 2020. [DOI: 10.1590/s0104-71832020000200006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Apesar de ter sua legitimidade contestada nas últimas décadas por defensores de animais, juristas e veterinários que defendem o direito à vida e ao tratamento, assim como por pesquisadores da área da saúde que duvidam de sua eficácia, a “eutanásia profilática” massiva de cães testados como soropositivos para leishmaniose visceral mantém-se firme como política sanitária no Brasil. A partir da análise de documentos oficiais, revisão da literatura, comentários sobre processos judiciais colhidos na imprensa e da etnografia dos impactos do surto de leishmaniose visceral em Porto Alegre, este artigo visa compreender o que está em jogo nessa controvérsia, considerando seus aspectos discursivos na construção de moralidades e práticas biopolíticas. Sugere-se a existência de dois regimes de governo da vida na gestão dos reservatórios caninos da leishmaniose visceral: um tanatopolítico, ligado ao poder público; o outro, um dispositivo emergente de biossegurança, ligado ao mercado farmacêutico e acessível apenas para tratamento privado.
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Affiliation(s)
| | - Andrea Mastrangelo
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina; Universidad Nacional de San Martín, Argentina
| | - Luiza Beck
- Universidade Federal do Rio Grande do Sul, Brazil
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31
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Application of next generation sequencing (NGS) for descriptive analysis of 30 genomes of Leishmania infantum isolates in Middle-North Brazil. Sci Rep 2020; 10:12321. [PMID: 32704096 PMCID: PMC7378178 DOI: 10.1038/s41598-020-68953-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
Visceral leishmaniasis (VL) is a life-threatening disease caused by the protozoa Leishmania donovani and L. infantum. Likely, L. infantum was introduced in the New World by the Iberic colonizers. Due to recent introduction, the genetic diversity is low. Access to genomic information through the sequencing of Leishmania isolates allows the characterization of populations through the identification and analysis of variations. Population structure information may reveal important data on disease dynamics. Aiming to describe the genetic diversity of L. infantum from the Middle-North, Brazil, next generation sequencing of 30 Leishmania isolates obtained in the city of Teresina, from where the disease dispersed, was performed. The variations were categorized accordingly to the genome region and impact and provided the basis for chromosomal ploidy and population structure analysis. The results showed low diversity between the isolates and the Iberic reference genome JPCM5. Most variations were seen in non-coding regions, with modifying impact. The ploidy number analysis showed aneuploid profile. The population structure analysis revealed the presence of two L. infantum populations identified in Teresina. Further population genetics studies with a larger number of isolates should be performed in order to identify the genetic background associated with virulence and parasite ecology.
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32
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Ehrenberg JP, Zhou XN, Fontes G, Rocha EMM, Tanner M, Utzinger J. Strategies supporting the prevention and control of neglected tropical diseases during and beyond the COVID-19 pandemic. Infect Dis Poverty 2020; 9:86. [PMID: 32646512 PMCID: PMC7347419 DOI: 10.1186/s40249-020-00701-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/15/2020] [Indexed: 02/14/2023] Open
Abstract
Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern. They include a large group of neglected tropical diseases (NTDs), many of which are of zoonotic nature. Coronavirus disease 2019 (COVID-19), another emerging zoonotic disease, has just increased the stakes exponentially. Most NTDs are subject to the impact of some of the very same human-related activities triggering other emerging and re-emerging diseases, including COVID-19, severe acute respiratory syndrome (SARS), bird flu and swine flu. It is conceivable that COVID-19 will exacerbate the NTDs, as it will divert much needed financial and human resources. There is considerable concern that recent progress achieved with control and elimination efforts will be reverted. Future potential strategies will need to reconsider the determinants of health in NTDs in order to galvanize efforts and come up with a comprehensive, well defined programme that will set the stage for an effective multi-sectorial approach. In this Commentary, we propose areas of potential synergies between the COVID-19 pandemic control efforts, other health and non-health sector initiatives and NTD control and elimination programmes.
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Affiliation(s)
- John P Ehrenberg
- Avenida Cedro 9, # 303, Cholul, Merida, Yucatan, Mexico. .,Formerly World Health Organization, Regional Office for the Western Pacific, Manila, The Philippines.
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention & Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China.,School of Global Health, Chinese Center for Tropical Diseases Research - Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Gilberto Fontes
- Laboratory of Parasitology, Central-West Campus, Federal University of São João del Rei, Divinopolis, Minas Gerais, Brazil
| | - Eliana M M Rocha
- Laboratory of Parasitology, Central-West Campus, Federal University of São João del Rei, Divinopolis, Minas Gerais, Brazil
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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33
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Marcili A, Silva RED, Costa VPD, Nieri-Bastos FA, Azevedo RCDFE, Moraes Filho J, Tonhosolo R. Canine Visceral Leishmaniasis in São Paulo, Brazil, the Most Populous City of South America: Isolation, Molecular Diagnosis, and Phylogenetic Inferences. Vector Borne Zoonotic Dis 2020; 20:768-772. [PMID: 32522138 DOI: 10.1089/vbz.2020.2638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives: Canine visceral leishmaniasis affects dogs, the main urban reservoirs, which favor the transmission and expansion of this zoonotic disease in areas with high anthropization process and human density. We investigated the occurence of Leishmania infatum based in molecular diagnosis, and phylogenetic analysis of isolates obtained from dogs in metropolitan region of São Paulo. Methods: A total of 201 dogs were tested by parasitological and molecular diagnosis. Phylogenetic analysis based sequences from SSUrDNA and gGAPDH genes were performed. Results: The parasitological diagnosis revealed 5% (10/201) of positivity, and the sequences obtained from seven isolates were clustered with L. infantum in phylogentic analysis based on SSUrDNA and gGAPDH genes. A total of 24.9% (50/201) of dogs were positive in molecular diagnosis based on cathepsin L-like marker. Interpretation and Conclusion: According to this study, it is necessary to implement a surveillance policy of visceral leishmaniasis, intensifying the actions of diagnosis, prevention, and control of this zoonosis.
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Affiliation(s)
- Arlei Marcili
- Department of Medicine and Animal Welfare, Santo Amaro University, São Paulo, Brazil.,Department of Veterinary Medicine and Animal Health, University of São Paulo, São Paulo, Brazil
| | - Ryan Emiliano da Silva
- Department of Veterinary Medicine and Animal Health, University of São Paulo, São Paulo, Brazil
| | | | - Fernanda A Nieri-Bastos
- Department of Veterinary Medicine and Animal Health, University of São Paulo, São Paulo, Brazil
| | | | - Jonas Moraes Filho
- Department of Medicine and Animal Welfare, Santo Amaro University, São Paulo, Brazil
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Virtual Screening and the In Vitro Assessment of the Antileishmanial Activity of Lignans. Molecules 2020; 25:molecules25102281. [PMID: 32408657 PMCID: PMC7288103 DOI: 10.3390/molecules25102281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 01/25/2023] Open
Abstract
Leishmaniasis is endemic in at least 98 countries. Due to the high toxicity and resistance associated with the drugs, we chose lignans as an alternative, due to their favorable properties of absorption, distribution, metabolism, excretion, and toxicity (ADMET). To investigate their leishmanicidal potential, the biological activities of a set of 160 lignans were predicted using predictive models that were built using data for Leishmania major and L. (Viannia) braziliensis. A combined analysis, based on ligand and structure, and several other computational approaches were used. The results showed that the combined analysis was able to select 11 lignans with potential activity against L. major and 21 lignans against L. braziliensis, with multitargeting effects and low or no toxicity. Of these compounds, four were isolated from the species Justicia aequilabris (Nees) Lindau. All of the identified compounds were able to inhibit the growth of L. braziliensis promastigotes, with the most active compound, (159) epipinoresinol-4-O-β-d-glucopyranoside, presenting an IC50 value of 5.39 µM and IC50 value of 36.51 µM for L. major. Our findings indicated the potential of computer-aided drug design and development and demonstrated that lignans represent promising prototype compounds for the development of multitarget drugs against leishmaniasis.
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Teixeira AIP, Silva DM, de Freitas LRS, Romero GAS. A cross-sectional approach including dog owner characteristics as predictors of visceral leishmaniasis infection in dogs. Mem Inst Oswaldo Cruz 2020; 115:e190349. [PMID: 32348406 PMCID: PMC7184770 DOI: 10.1590/0074-02760190349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 02/11/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is relevant for human and animal public health. Several factors have been associated with the risk of Leishmania infantum infection in dogs. However, dog owner characteristics have been rarely explored. OBJECTIVES To estimate the prevalence and to identify the associated factors for VL infection including dog owners characteristics. METHODS A cross-sectional study was conducted including dogs from an endemic canine visceral leishmaniasis (CVL) region in the Federal District, Brazil. The infection was detected using parasitological, serological, and molecular methods. The associated factors were identified through Poisson regression modelling. FINDINGS The prevalence of infection was 26.25% [95% confidence interval (CI): 20.05 to 33.57]. The associated factors were: short coat prevalence ratio (PR) = 2.33 (95% CI: 1.02 to 5.22); presence of backyard with predominance of soil and/or vegetation PR = 4.15 (95% CI: 1.35 to 12.77); and highest gross family income score PR = 2.03 (95% CI: 1.16 to 3.54). MAIN CONCLUSION This is the first study that relates higher socioeconomic status of dog owners as an independent factor associated with higher prevalence of VL infection, along with other strongly associated factors related to receptive environment for phlebotomines. Our findings strengthen the need for exploration of the biological and behavioural bases linking dog owner characteristics to the risk of canine infection in prospective cohort studies.
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Affiliation(s)
| | - Debora Marcolino Silva
- Universidade de Brasília, Faculdade de Medicina, Núcleo de Medicina Tropical, Brasília, DF, Brasil
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36
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Gonçalves AFLDS, Lima SSD, Silva APDSC, Barbosa CC. Spatial dynamics and socioeconomic factors correlated with American cutaneous leishmaniasis in Pernambuco, Brazil from 2008 to 2017. Rev Soc Bras Med Trop 2020; 53:e20190373. [PMID: 32348432 PMCID: PMC7198070 DOI: 10.1590/0037-8682-0373-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/12/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION: American cutaneous leishmaniasis (ACL) is a public health problem and has
been associated with country’s territory. We aimed to analyze the spatial
dynamics and socioeconomic factors correlated to the incidence of ACL in
Pernambuco, Brazil from 2008 to 2017. METHODS: A cross-sectional, ecological study was conducted in the Brazilian
municipalities. Patient data were obtained from the Health Hazard
Notification System (SINAN); indicators and incidence for the total period
and for quinquennium were obtained. Socioeconomic factors were analyzed to
evaluate the association between the incidence of ACL and presence of
bathroom and running water, garbage collection availability, inadequate
water supply, sanitation, rural population, per capita income, and
vulnerability to poverty. Spatial analysis considered the gross incidence;
the Bayesian local empirical method and Moran spatial autocorrelation index
were applied using Terra View and QGIS. RESULTS: The incidence of ACL reduced (0.29/100,000 inhabitants per year).
Individuals with ACL were young adults (30.3%), men (60.2%), brown skinned
(62.9%), rural residents (70.6%), and less educated (46.7%); had
autochthonous transmission (78.8%); developed the cutaneous form (97.2%);
had evolution to cure (82.7%); and were diagnosed using the clinical
epidemiological criterion (70.5%). ACL occurred in the large part of the
state and showed heterogeneous distribution, with persistence of two high
priority intervention clusters covering Health Regions I, II, III, IV, and
XII. CONCLUSIONS: Spatial analysis and epidemiological indicators complement each other. The
combination of these methods can improve the understanding on ACL
occurrence, which will help subsidize planning and enhance the quality and
effectiveness of healthcare interventions.
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Affiliation(s)
| | - Suzanne Santos de Lima
- Departamento de Saúde Coletiva, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil
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Hayes CJ, Palframan MJ, Pattenden G. The Impact of Macrocycle Conformation on the Taxadiene-Forming Carbocation Cascade: Insight Gained from Sobralene, a Recently Discovered Verticillene Isomer. J Org Chem 2020; 85:4507-4514. [PMID: 32101002 DOI: 10.1021/acs.joc.0c00369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
DFT calculations on the carbocation intermediates that connect the biosynthetic pathways leading to the sand fly pheromone sobralene and taxadiene have been made. Establishment of the conformation of the macrocyclic carbocation intermediate required to produce the (Z)-C8,C9 alkene bond in sobralene has identified new conformations of the verticillyl carbocation intermediates on the taxadiene biosynthetic pathway. These "sobralene-like" carbocation conformations provide an exothermic pathway to taxadiene and are validated by comparison to closely related structures (X-ray and NMR).
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Affiliation(s)
- Christopher J Hayes
- School of Chemistry, University of Nottingham, University Park, Nottingham NG7 2RD, U.K
| | - Matthew J Palframan
- School of Chemistry, University of Nottingham, University Park, Nottingham NG7 2RD, U.K
| | - Gerald Pattenden
- School of Chemistry, University of Nottingham, University Park, Nottingham NG7 2RD, U.K
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38
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Courtenay O, Dilger E, Calvo-Bado LA, Kravar-Garde L, Carter V, Bell MJ, Alves GB, Goncalves R, Makhdoomi MM, González MA, Nunes CM, Bray DP, Brazil RP, Hamilton JGC. Sand fly synthetic sex-aggregation pheromone co-located with insecticide reduces the incidence of infection in the canine reservoir of visceral leishmaniasis: A stratified cluster randomised trial. PLoS Negl Trop Dis 2019; 13:e0007767. [PMID: 31652261 PMCID: PMC6834291 DOI: 10.1371/journal.pntd.0007767] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/06/2019] [Accepted: 09/09/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of a synthetic sex-aggregation pheromone of the sand fly vector Lu. longipalpis, co-located with residual insecticide, to reduce the infection incidence of Leishmania infantum in the canine reservoir. METHODS A stratified cluster randomised trial was designed to detect a 50% reduction in canine incident infection after 24 months in 42 recruited clusters, randomly assigned to one of three intervention arms (14 cluster each): synthetic pheromone + insecticide, insecticide-impregnated dog collars, or placebo control. Infection incidence was measured by seroconversion to anti-Leishmania serum antibody, Leishmania parasite detection and canine tissue parasite loads. Changes in relative Lu. longipalpis abundance within households were measured by setting three CDC light traps per household. RESULTS A total 1,454 seronegative dogs were followed-up for a median 15.2 (95% C.I.s: 14.6, 16.2) months per cluster. The pheromone + insecticide intervention provided 13% (95% C.I. 0%, 44.0%) protection against anti-Leishmania antibody seroconversion, 52% (95% C.I. 6.2%, 74·9%) against parasite infection, reduced tissue parasite loads by 53% (95% C.I. 5.4%, 76.7%), and reduced household female sand fly abundance by 49% (95% C.I. 8.2%, 71.3%). Variation in the efficacy against seroconversion varied between trial strata. Equivalent protection attributed to the impregnated-collars were 36% (95% C.I. 14.4%, 51.8%), 23% (95% C.I. 0%, 57·5%), 48% (95% C.I. 0%, 73.4%) and 43% (95% C.I. 0%, 67.9%), respectively. Comparison of the two interventions showed no statistically consistent differences in their efficacies; however, the errors were broad for all outcomes. Reductions in sand fly numbers were predominant where insecticide was located (chicken and dog sleeping sites), with no evidence of insecticide-induced repellence onto humans or dogs. CONCLUSION The synthetic pheromone co-located with insecticide provides protection particularly against canine L. infantum parasite transmission and sand fly vector abundance. The effect estimates are not dissimilar to those of the insecticide-impregnated collars, which are documented to reduce canine infection incidence, human infection and clinical VL disease incidence, in different global regions. The trialled novel lure-and-kill approach is a low-cost potential vector control tool against ZVL in the Americas.
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Affiliation(s)
- Orin Courtenay
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
- * E-mail: (OC); (JGCH)
| | - Erin Dilger
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Leo A. Calvo-Bado
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Lidija Kravar-Garde
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Vicky Carter
- School of Life Sciences, Institute of Science & Technology in Medicine, Keele University, Keele, Staffordshire, United Kingdom
| | - Melissa J. Bell
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Graziella B. Alves
- School of Life Sciences, Institute of Science & Technology in Medicine, Keele University, Keele, Staffordshire, United Kingdom
| | - Raquel Goncalves
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Muhammad M. Makhdoomi
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Mikel A. González
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster, Lancashire, United Kingdom
| | - Caris M. Nunes
- Faculdade de Medicina Veterinária, Universidade Estadual Paulista (UNESP), Araçatuba, São Paulo, Brazil
| | - Daniel P. Bray
- School of Life Sciences, Institute of Science & Technology in Medicine, Keele University, Keele, Staffordshire, United Kingdom
| | - Reginaldo P. Brazil
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - James G. C. Hamilton
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster, Lancashire, United Kingdom
- * E-mail: (OC); (JGCH)
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Pires M, Wright B, Kaye PM, da Conceição V, Churchill RC. The impact of leishmaniasis on mental health and psychosocial well-being: A systematic review. PLoS One 2019; 14:e0223313. [PMID: 31622369 PMCID: PMC6797112 DOI: 10.1371/journal.pone.0223313] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 09/18/2019] [Indexed: 12/23/2022] Open
Abstract
Background Leishmaniasis is a neglected tropical parasitic disease endemic in South Asia, East Africa, Latin America and the Middle East. It is associated with low socioeconomic status (SES) and responsible for considerable mortality and morbidity. Reports suggest that patients with leishmaniasis may have a higher risk of mental illness (MI), psychosocial morbidity (PM) and reduced quality of life (QoL), but this is not well characterised. The aim of this study was to conduct a systematic review to assess the reported impact of leishmaniasis on mental health and psychosocial wellbeing. Methods A systematic review of the literature was carried out. Pre-specified criteria were applied to identify publications including observational quantitative studies or systematic reviews. Two reviewers screened all of the titles, abstracts and full-studies and a third reviewer was consulted for disagreements. Data was extracted from papers meeting the criteria and quality appraisal of the methods was performed using the Newcastle-Ottawa Scale or the Risk of Bias in Systematic Review tool. Results A total of 14 studies were identified from 12,517 records. Nine cross-sectional, three case-control, one cohort study and one systematic review were included. Eleven assessed MI outcomes and were measured with tools specifically designed for this; nine measured PM and 12 measured QoL using validated measurement tools. Quality appraisal of the studies showed that six were of good quality. Cutaneous leishmaniasis and post kala-azar dermal leishmaniasis showed evidence of associated MI and PM including depression, anxiety and stigma, while all forms of disease showed decreased QoL. The findings were used to inform a proposed model and conceptual framework to show the possible links between leishmaniasis and mental health outcomes. Conclusion There is evidence that leishmaniasis has an impact on MI, PM or QoL of patients and their families and this occurs in all the main subtypes of the disease. There are however large gaps in the evidence. Further research is required to understand the full extent of this problem and its mechanistic basis.
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Affiliation(s)
- Malini Pires
- Mental Health Research Group, Hull York Medical School and Dept. of Health Sciences, University of York, England, United Kingdom
- * E-mail:
| | - Barry Wright
- Mental Health Research Group, Hull York Medical School and Dept. of Health Sciences, University of York, England, United Kingdom
| | - Paul M. Kaye
- Centre for Reviews and Dissemination, University of York, England, United Kingdom
- Centre for Immunology and Infection, Hull York Medical School and Dept. of Biology, University of York, England, United Kingdom
| | | | - Rachel C. Churchill
- Centre for Reviews and Dissemination, University of York, England, United Kingdom
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Space-time analysis of the incidence of human visceral leishmaniasis (VL) and prevalence of canine VL in a municipality of southeastern Brazil: Identification of priority areas for surveillance and control. Acta Trop 2019; 197:105052. [PMID: 31233726 DOI: 10.1016/j.actatropica.2019.105052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 12/13/2022]
Abstract
Human and canine visceral leishmaniasis (HVL and CVL, respectively) represent serious public health issues in Brazil. The surveillance and control measures currently employed have had limited effect in impeding the territorial expansion of the disease and in reducing the number of cases. We have investigated the space-time distribution of HVL incidence rates and CVL prevalence in the coverage areas of the 148 primary healthcare units in Belo Horizonte (MG, Brazil) during a 6-year period in order to identify those that should be prioritized for disease control actions. Data were smoothed using the empirical Bayes method and analyzed by space-time scanning and application of univariate global Moran's I index and local indicators of spatial association (LISA) statistics to identify spatial autocorrelations. Point data of CVL were analyzed using the Kernel method. Bivariate global Moran's I and LISA techniques were employed to identify spatial correlations between HVL and CVL. Based on our results, we were able to formulate two proposals for establishing the prioritization of coverage areas, namely: (i) classification of maximum priority areas as identified by bivariate LISA for HVL and CVL, and (ii) combination of maximum priority areas with high priority areas as identified by univariate LISA for HVL. According to our proposals, 27 coverage areas in Belo Horizonte were categorized as maximum priority and a further 13 were classified as high priority. Our proposals, which are based on practical, feasible and inexpensive statistical tools, will contribute to a better understanding of VL distribution in urban settings and improving the efficiency of governmental control programs.
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de Carvalho IPSF, Peixoto HM, Romero GAS, de Oliveira MRF. Treatment for human visceral leishmaniasis: a cost-effectiveness analysis for Brazil. Trop Med Int Health 2019; 24:1064-1077. [PMID: 31278808 DOI: 10.1111/tmi.13284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To estimate the cost-effectiveness of strategies for the treatment of VL in Brazil. METHODS Cost-effectiveness study comparing three therapeutic options: meglumine antimoniate (MA), liposomal amphotericin B (LAMB) and a combination of LAMB plus MA (LAMB plus MA), from public health system and societal perspectives. An analytical decision-making model was used to compare strategies for the following outcomes: early therapeutic failure avoided at 30 days, days of hospitalisation avoided and VL cure at 180 days. The efficacy and safety parameters of the drugs came from a randomised, open-label trial and the cost data came from a cost-of-illness study, both carried out in Brazil. RESULTS For all outcomes analysed, the LAMB strategy was more effective. The MA strategy was inferior to the LAMB plus MA strategy for the outcomes early therapeutic failure avoided and cure. When only LAMB and MA were compared from a societal perspective, a cost of US$ 278.56 was estimated for each additional early therapeutic failure avoided, a cost of US$ 26.88 for each additional day of hospitalisation avoided and a cost of US$ 89.88 for each additional case of cured VL, for the LAMB strategy vs. MA. CONCLUSION In Brazil, the LAMB strategy proved to be cost-effective for treating VL, considering a GDP per capita as the willingness-to-pay threshold, for all of the outcomes analysed in comparison to MA.
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Affiliation(s)
| | - Henry Maia Peixoto
- Centre for Tropical Medicine, University of Brasilia, Brasilia, Brazil.,National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, Brazil
| | - Gustavo Adolfo Sierra Romero
- Centre for Tropical Medicine, University of Brasilia, Brasilia, Brazil.,National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, Brazil
| | - Maria Regina Fernandes de Oliveira
- Centre for Tropical Medicine, University of Brasilia, Brasilia, Brazil.,National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, Brazil
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Lamattina D, Berrozpe PE, Casas N, Moya SL, Giuliani MG, Costa SA, Arrabal JP, Martínez MF, Rivero MR, Salas M, Humeres CA, Liotta DJ, Meichtry MB, Salomón OD. Twice upon a time: The progression of canine visceral leishmaniasis in an Argentinean city. PLoS One 2019; 14:e0219395. [PMID: 31276573 PMCID: PMC6611631 DOI: 10.1371/journal.pone.0219395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/21/2019] [Indexed: 11/18/2022] Open
Abstract
Canine Visceral Leishmaniasis (CVL) prevalence, spatial distribution and associated factors were assessed in four locations in Iguazú department in 2014 and in Puerto Iguazú city again in 2018. The city areas were divided into a grid of 400x400m cells. All cells were sampled in 2014 and a random subsampling was developed in 2018. In each cell, five dogs clustered in a 'critical scenario' (prone to have vectors) were sampled. A rapid immunochromatographic dipstick was used to detect antibodies against Leishmania infantum, confirming by lymph node smears observation and PCR. For Puerto Iguazú, Generalized Linear Models (GLMs) were constructed considering environmental, dog and clinical variables. Pearson's Chi square and Fisher's exact tests were employed to evaluate the association between CVL, dog clinical signs and infestation with other parasites. Cartographic outputs were made and Moran's I indices were calculated as spatial autocorrelation indicators. CVL prevalence rates were 26.18% in 2014 and 17.50% in 2018. No associations were established in environmental models, but dog age and repellent use were significant when running 2014 dog models. Clinical models showed significant associations between seropositive dogs and ophthalmological, dermal signs and onychogryphosis in 2014. In 2018, only adenomegaly was associated. The results of global Moran´s I were not significant but regarding local analysis, six sites in 2014 and one in 2018 presented autocorrelation with neighboring sites. The decrease in CVL prevalence may be associated to transmission stabilization, which could explain the lack of associations with dog-related variables. Further, spatial distribution of CVL is a poor evidence for design of transmission control measures but could be important in case of intensive parasite circulation or when the first autochthonous cases appear. For control success, sensitivity of diagnostic methods, political will and adequate material resources remain critical. Modeling of multiple variables will be required to identify factors that drive disease stabilization/destabilization.
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Affiliation(s)
- Daniela Lamattina
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Pablo Eduardo Berrozpe
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Natalia Casas
- Dirección Nacional de Epidemiología y Análisis de la Situación de Salud, Ministerio de Salud y Desarrollo Social de la Nación, Buenos Aires, Argentina
| | - Sofía Lorian Moya
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Magalí Gabriela Giuliani
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Sebastián Andrés Costa
- Instituto de Biología Subtropical, Facultad de Ciencias Forestales, Universidad Nacional de Misiones, Puerto Iguazú, Misiones, Argentina
| | - Juan Pablo Arrabal
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Mariela Florencia Martínez
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - María Romina Rivero
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Martín Salas
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Cristian Alejandro Humeres
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Domingo Javier Liotta
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - María Belén Meichtry
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Oscar Daniel Salomón
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Moreno J. Assessment of Vaccine-Induced Immunity Against Canine Visceral Leishmaniasis. Front Vet Sci 2019; 6:168. [PMID: 31214607 PMCID: PMC6558161 DOI: 10.3389/fvets.2019.00168] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/16/2019] [Indexed: 12/20/2022] Open
Abstract
Canine visceral leishmaniasis is an increasingly important public health problem. Dogs infected by Leishmania infantum are the main domestic reservoir of the parasite and play a key role in its transmission to humans. Recent findings have helped in the development of novel diagnostic methods, and of control measures such as vaccines, some of which are already commercially available. However, quantitative procedures should be followed to confirm whether these vaccines elicit a cell-mediated immune response. The present work describes the need for this evaluation, and the techniques available for confirming this type of immune response.
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Affiliation(s)
- Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, Laboratory for Reference and Research in Parasitology, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
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Courtenay O, Bazmani A, Parvizi P, Ready PD, Cameron MM. Insecticide-impregnated dog collars reduce infantile clinical visceral leishmaniasis under operational conditions in NW Iran: A community-wide cluster randomised trial. PLoS Negl Trop Dis 2019; 13:e0007193. [PMID: 30830929 PMCID: PMC6417739 DOI: 10.1371/journal.pntd.0007193] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 03/14/2019] [Accepted: 01/28/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To assess the effectiveness of community-wide deployment of insecticide-impregnated collars for dogs- the reservoir of Leishmania infantum-to reduce infantile clinical visceral leishmaniasis (VL). METHODS A pair matched-cluster randomised controlled trial involving 40 collared and 40 uncollared control villages (161 [95% C.L.s: 136, 187] children per cluster), was designed to detect a 55% reduction in 48 month confirmed VL case incidence. The intervention study was designed by the authors, but implemented by the Leishmaniasis Control Program in NW Iran, from 2002 to 2006. RESULTS The collars provided 50% (95% C.I. 17·8%-70·0%) protection against infantile VL incidence (0·95/1000/yr compared to 1·75/1000/yr). Reductions in incidence were observed across 76% (22/29) of collared villages compared to pair-matched control villages, with 31 fewer cases by the end of the trial period. In 11 paired villages, no further cases were recorded post-intervention, whereas in 7 collared villages there were 9 new clinical cases relative to controls. Over the trial period, 6,835 collars were fitted at the beginning of the 4 month sand fly season, of which 6.9% (95% C.I. 6.25%, 7.56%) were lost but rapidly replaced. Collar coverage (percent dogs collared) per village varied between 66% and 100%, with a mean annual coverage of 87% (95% C.I. 84·2, 89·0%). The variation in post-intervention clinical VL incidence was not associated with collar coverage, dog population size, implementation logistics, dog owner compliance, or other demographic variables tested. Larger reductions and greater persistence in incident case numbers (indicative of transmission) were observed in villages with higher pre-existing VL case incidence. CONCLUSION Community-wide deployment of collars can provide a significant level of protection against infantile clinical VL, achieved in this study by the local VL Control Program, demonstrating attributes desirable of a sustainable public health program. The effectiveness is not dissimilar to the community-level protection provided against human and canine infection with L. infantum.
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Affiliation(s)
- Orin Courtenay
- Zeeman Institute, and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Ahad Bazmani
- Infectious and Tropical Diseases Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Paul D. Ready
- London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
| | - Mary M. Cameron
- London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
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