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de Moraes L, Santos LA, Arruda LB, da Silva MDPP, Silva MDO, Silva JAG, Ramos A, dos Santos MB, Torres FG, Orge C, Teixeira AMDS, Vieira TS, Ramírez L, Soto M, Grassi MFR, de Siqueira IC, Costa DL, Costa CHN, Andrade BDB, Akrami K, de Oliveira CI, Boaventura VS, Barral-Netto M, Barral A, Vandamme AM, Van Weyenbergh J, Khouri R. High seroprevalence of Leishmania infantum is linked to immune activation in people with HIV: a two-stage cross-sectional study in Bahia, Brazil. Front Microbiol 2023; 14:1221682. [PMID: 37601355 PMCID: PMC10436095 DOI: 10.3389/fmicb.2023.1221682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/28/2023] [Indexed: 08/22/2023] Open
Abstract
Visceral leishmaniasis is an opportunistic disease in HIV-1 infected individuals, unrecognized as a determining factor for AIDS diagnosis. The growing geographical overlap of HIV-1 and Leishmania infections is an emerging challenge worldwide, as co-infection increases morbidity and mortality for both infections. Here, we determined the prevalence of people living with HIV (PWH) with a previous or ongoing infection by Leishmania infantum and investigated the virological and immunological factors associated with co-infection. We adopted a two-stage cross-sectional cohort (CSC) design (CSC-I, n = 5,346 and CSC-II, n = 317) of treatment-naïve HIV-1-infected individuals in Bahia, Brazil. In CSC-I, samples collected between 1998 and 2013 were used for serological screening for leishmaniasis by an in-house Enzyme-Linked Immunosorbent Assay (ELISA) with SLA (Soluble Leishmania infantum Antigen), resulting in a prevalence of previous or ongoing infection of 16.27%. Next, 317 PWH were prospectively recruited from July 2014 to December 2015 with the collection of sociodemographic and clinical data. Serological validation by two different immunoassays confirmed a prevalence of 15.46 and 8.20% by anti-SLA, and anti-HSP70 serology, respectively, whereas 4.73% were double-positive (DP). Stratification of these 317 individuals in DP and double-negative (DN) revealed a significant reduction of CD4+ counts and CD4+/CD8+ ratios and a tendency of increased viral load in the DP group, as compared to DN. No statistical differences in HIV-1 subtype distribution were observed between the two groups. However, we found a significant increase of CXCL10 (p = 0.0076) and a tendency of increased CXCL9 (p = 0.061) in individuals with DP serology, demonstrating intensified immune activation in this group. These findings were corroborated at the transcriptome level in independent Leishmania- and HIV-1-infected cohorts (Swiss HIV Cohort and Piaui Northeast Brazil Cohort), indicating that CXCL10 transcripts are shared by the IFN-dominated immune activation gene signatures of both pathogens and positively correlated to viral load in untreated PWH. This study demonstrated a high prevalence of PWH with L. infantum seropositivity in Bahia, Brazil, linked to IFN-mediated immune activation and a significant decrease in CD4+ levels. Our results highlight the urgent need to increase awareness and define public health strategies for the management and prevention of HIV-1 and L. infantum co-infection.
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Affiliation(s)
- Laise de Moraes
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Luciane Amorim Santos
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Liã Bárbara Arruda
- Centre for Clinical Microbiology, Division of Infection & Immunity, University College London, London, United Kingdom
| | | | - Márcio de Oliveira Silva
- Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil
| | - José Adriano Góes Silva
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil
| | - André Ramos
- Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Secretaria de Saúde do Estado da Bahia, Salvador, Brazil
| | | | | | - Cibele Orge
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | | | - Laura Ramírez
- Departamento de Biología Molecular, Facultad de Ciencias, Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Madrid, Spain
| | - Manuel Soto
- Departamento de Biología Molecular, Facultad de Ciencias, Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, Madrid, Spain
| | - Maria Fernanda Rios Grassi
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | - Dorcas Lamounier Costa
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Carlos Henrique Nery Costa
- Laboratório de Leishmanioses, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Teresina, Brazil
| | - Bruno de Bezerril Andrade
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Kevan Akrami
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Camila Indiani de Oliveira
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Viviane Sampaio Boaventura
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Hospital Santa Izabel, Salvador, Brazil
| | - Manoel Barral-Netto
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Aldina Barral
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Anne-Mieke Vandamme
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
- Center for Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Johan Van Weyenbergh
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
| | - Ricardo Khouri
- Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
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Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area. Microorganisms 2022; 10:microorganisms10112188. [PMID: 36363780 PMCID: PMC9692416 DOI: 10.3390/microorganisms10112188] [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: 09/22/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
This was an open cohort prospective study (2016−2018) that analyzed the prevalence and incidence rates of human Leishmania (L.) infantum chagasi-infection and the evolution of their clinical-immunological profiles in distinct urban and rural scenarios of American visceral leishmaniasis (AVL) in Pará State, in the Brazilian Amazon. These infection profiles were based on species-specific DTH/IFAT-IgG assays and clinical evaluation of infected individuals, comprising five profiles: three asymptomatic, Asymptomatic Infection [AI], Subclinical Resistant Infection [SRI], and Indeterminate Initial Infection [III]; and two symptomatic, Subclinical Oligosymptomatic Infection [SOI] and Symptomatic Infection [SI = AVL]. The two distinct scenarios (900 km away) were the urban area of Conceição do Araguaia municipality and the rural area of Bujaru municipality in the southeast and northeast of Pará State. Human populations were chosen based on a simple convenience sampling design (5−10% in each setting), with 1723 individuals (5.3%) of the population (32,464) in the urban area and 1568 individuals (8.9%) of the population (17,596) in the rural one. A serological survey (IFAT-IgG) of canine infection was also performed in both scenarios: 195 dogs in the urban area and 381 in the rural one. Prevalence and incidence rates of human infection were higher in the urban area (20.3% and 13.6/100 person-years [py]) than in the rural setting (14.1% and 6.8/100-py). The AI profile was the most prevalent and incident in both urban (13.4% and 8.1/100-py) and rural (8.3% and 4.2/100-py) scenarios, but with higher rates in the former. An III profile case evolved to SOI profile after four weeks of incubation and another to SI (=AVL) after six. The prevalence of canine infection in an urban setting (39.2%) was also higher (p < 0.05) than that (32%) in the rural zone. AVL urbanization in Pará State, in the Brazilian Amazon, has led to infection rates significantly higher than those in rural sites, requiring more intense control measures.
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Ferreira JRS, Silva KM, de Almeida MSG, Gomes DCS, Cavalcanti MGS, Ferreira-Júnior GC, Alves LC, Brayner FA, Matos-Rocha TJ. American visceral leishmaniasis in a state of northeastern Brazil: clinical, epidemiological and laboratory aspects. BRAZ J BIOL 2021; 82:e238383. [PMID: 34105676 DOI: 10.1590/1519-6984.238383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022] Open
Abstract
In Brazil, American visceral leishmaniasis (AVL) has become a public health concern due to its high incidence and lethality. This study aimed to analyze the clinical, epidemiological, and laboratory aspects of AVL in a state of Brazil. This descriptive, cross-sectional, retrospective, and quantitative study of notified cases of AVL was carried out in Alagoas between 2008 and 2017 from data obtained from DATASUS/SINAN. Sociodemographic, clinical, and laboratory variables were analyzed. A descriptive analysis was performed using absolute values and valid percentages, using tables and/or graphs. Data processing was performed using Stata 12.0®. Results with P <0.05 were considered statistically significant. During the study period, 352 cases of AVL were reported, of which 6.82% died and 38.92% had met a cure criterion. Male patients were predominant (66.76%). Of the total infected patients, 16.76% had attended only the 1st to the 4th grades, with those most affected aged 1 to 4 years (28.69%). Laboratory diagnostic criteria were most commonly used to confirm the notified cases (76.42%), whereas 51.70% and 8.52% of the cases had positive parasitological and immunofluorescence diagnoses, respectively. Finally, the study showed a higher prevalence of the disease in children, men and in rural residents. Although with low lethality, the expressive frequency of AVL in the State of Alagoas was still verified, since there was an increase in the number of cases during the years of the study.
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Affiliation(s)
- J R S Ferreira
- Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, AL, Brasil
| | - K M Silva
- Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, AL, Brasil
| | - M S G de Almeida
- Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, AL, Brasil
| | - D C S Gomes
- Centro Universitário Cesmac, Maceió, AL, Brasil
| | | | - G C Ferreira-Júnior
- Instituto Federal de Educação, Ciência e Tecnologia do Acre - IFAC, Xapuri, AC, Brasil
| | - L C Alves
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Recife, PE, Brasil
| | - F A Brayner
- Departamento de Parasitologia, Instituto Aggeu Magalhães, Recife, PE, Brasil
| | - T J Matos-Rocha
- Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, AL, Brasil.,Centro Universitário Cesmac, Maceió, AL, Brasil
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Machado CAL, Sevá ADP, Silva AAFAE, Horta MC. Epidemiological profile and lethality of visceral leishmaniasis/human immunodeficiency virus co-infection in an endemic area in Northeast Brazil. Rev Soc Bras Med Trop 2021; 54:e0795. [PMID: 33886819 PMCID: PMC8047714 DOI: 10.1590/0037-8682-0795-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The association of visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) infection is a concern worldwide, and this co-infection is linked to increased lethality. The Northeast is the region that mostly reports cases of VL in Brazil. The knowledge of risk factors associated with VL/HIV co-infection and its impact on lethality is extremely important. METHODS The present study analyzed the epidemiologic features of cases with VL/HIV co-infection in the state of Pernambuco, Northeast of Brazil, from 2014 to 2018. RESULTS There were 858 and 11,514 reported cases of VL and HIV infection, respectively. The average incidences of VL and HIV infection were 1.82 and 24.4/100,000 inhabitants, respectively. Of all reported cases of VL, 4.9% (42/858) also had HIV infection. There was an inverse spatial association between VL and HIV infection incidences. The lethality rates of VL, HIV infection, and co-infection were 9.9%, 26.1%, and 16.6%, respectively. Most of the patients were males and lived in urban areas. The cases of VL mostly occurred in children aged below 10 years, whereas the cases of HIV infection and VL/HIV co-infection were primarily observed in adults between 20 years and 39 years old. CONCLUSIONS We defined the profile and areas with most cases of co-infection and found that the lethality of VL with co-infection increased in the current period. These findings contribute to applying efforts with a greater focus in these identified populations to prevent future deaths.
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Affiliation(s)
| | - Anaiá da Paixão Sevá
- Universidade Estadual de Santa Cruz, Departamento de Ciências Agrárias e Ambientais, Ilhéus, BA, Brasil
| | - Arianna Araujo Falcão Andrade e Silva
- Secretaria de Saúde do Estado de Pernambuco, Diretoria Geral de Vigilância de Doenças Negligenciadas e Sexualmente Transmissíveis, Recife, PE, Brasil
| | - Mauricio Claudio Horta
- Universidade Federal Rural de Pernambuco, Pós-Graduação em Biociência Animal, Recife, PE, Brasil
- Universidade Federal do Vale do São Francisco, Petrolina, PE, Brasil
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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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Aquino SR, Diniz LFB, Queiroz IT, Cunha MA, Justo AM, Silva ED, Pereira VRA, Medeiros ZM, Carmo RF. Case Report: Severe Visceral Leishmaniasis in a Patient with HIV Coinfection Undergoing Treatment for Erythema Nodosum Leprosum. Am J Trop Med Hyg 2020; 103:2253-2256. [PMID: 32901606 DOI: 10.4269/ajtmh.20-0567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We report a case of visceral leishmaniasis (VL)/HIV coinfection in a patient undergoing regular antiretroviral therapy and treatment with thalidomide for erythema nodosum leprosum. He presented at a health service with high fever, chills, asthenia, pale skin, lower limb edema, hepatomegaly, and splenomegaly. Visceral leishmaniasis was confirmed by direct examination, and serological and molecular tests. Serum levels of Th1/Th2 cytokines were measured. The patient began treatment with liposomal amphotericin B, with good clinical response; however, VL recurred 6 months later. Treatment was reinitiated, maintaining secondary prophylaxis with liposomal amphotericin B. The patient showed clinical improvement with important recovery of CD4+ T-lymphocyte count.
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Affiliation(s)
- Samuel R Aquino
- Hospital Universitário da Universidade Federal do Vale do São Francisco, Petrolina, Brazil.,Programa de Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | - Lucyo F B Diniz
- Hospital Universitário da Universidade Federal do Vale do São Francisco, Petrolina, Brazil
| | | | | | - Alda M Justo
- Colegiado de Enfermagem, Universidade de Pernambuco Campus Petrolina, Petrolina, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
| | | | | | - Zulma M Medeiros
- Instituto Aggeu Magalhães, Recife, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, Universidade de Pernambuco, Recife, Brazil
| | - Rodrigo F Carmo
- Programa de Pós-Graduação em Biociências, Universidade Federal do Vale do São Francisco, Petrolina, Brazil.,Programa de Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Petrolina, Brazil
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7
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Carvalho MR, Dias ÁFDLR, Almeida ADBPFD, Alves MR, Paes AS, Sousa VRF. Canine visceral leishmaniasis: perception, prevalence, and spatial distribution in municipality of Nossa Senhora do Livramento, Mato Grosso, Brazil. ACTA ACUST UNITED AC 2020; 29:e021019. [PMID: 32428187 DOI: 10.1590/s1984-29612020017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/19/2020] [Indexed: 11/22/2022]
Abstract
The midwest region of Brazil has witnessed an increase in the number of cases of human (HVL) and canine visceral leishmaniasis (CVL). The aim of the present study was to evaluate the population's perception of these diseases, factors associated with CVL, its spatial distribution, and the prevalence of anti-Leishmania spp. in 385 dogs, determined using a commercially available immunochromatographic rapid test and confirmed using enzyme-linked immunosorbent assay (ELISA). Of the 385 samples, 54 were positive for CVL and confirmed by ELISA, corresponding to a prevalence of 14%. Knowledge of signs of CVL by tutors (p = 0.038); previous occurrence of CVL in the vicinity (p = 0.022); symptomatic dog(s) (p = 0.014), splenomegaly (p = 0.055), and ear ulcer(s) (p = 0.059) were significantly associated with CVL. The results revealed a significant prevalence of CVL spatially distributed in rural and urban contexts. The association between environmentally related variables and perception and the occurrence of CVL underscores the importance of implementing control and prevention strategies primarily focused on environmental management and health education activities.
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Affiliation(s)
- Matheus Roberto Carvalho
- Programa de Pós-graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
| | - Álvaro Felipe de Lima Ruy Dias
- Programa de Pós-graduação em Ciências Veterinárias, Faculdade de Medicina Veterinária, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
| | | | - Mário Ribeiro Alves
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil
| | - Adilson Santos Paes
- Secretaria de Saúde de Nossa Senhora do Livramento, Nossa Senhora do Livramento, MT, Brasil
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Ritter S, Zadik-Weiss L, Almogi-Hazan O, Or R. Cannabis, One Health, and Veterinary Medicine: Cannabinoids' Role in Public Health, Food Safety, and Translational Medicine. Rambam Maimonides Med J 2020; 11:RMMJ.10388. [PMID: 32017686 PMCID: PMC7000163 DOI: 10.5041/rmmj.10388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Public health is connected to cannabis with regard to food, animal feed (feed), and pharmaceuticals. Therefore, the use of phytocannabinoids should be examined from a One Health perspective. Current knowledge on medical cannabis treatment (MCT) does not address sufficiently diseases which are of epidemiological and of zoonotic concern. The use of cannabinoids in veterinary medicine is illegal in most countries, mostly due to lack of evidence-based medicine. To answer the growing need of scientific evidence-based applicable medicine in both human and veterinary medicine, a new approach for the investigation of the therapeutic potential of cannabinoids must be adopted. A model that offers direct study of a specific disease in human and veterinary patients may facilitate development of novel therapies. Therefore, we urge the regulatory authorities-the ministries of health and agriculture (in Israel and worldwide)-to publish guidelines for veterinary use due to its importance to public health, as well as to promote One Health-related preclinical translational medicine studies for the general public health.
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Affiliation(s)
| | | | - Osnat Almogi-Hazan
- Laboratory of Immunotherapy and Bone Marrow Transplantation, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Reuven Or
- Laboratory of Immunotherapy and Bone Marrow Transplantation, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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9
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Nunes BEBR, Leal TC, Paiva JPSD, Silva LFD, Carmo RFD, Machado MF, Araújo MDPD, Santos VS, Souza CDFD. Social determinants of mortality due to visceral leishmaniasis in Brazil (2001-2015): an ecological study. Rev Soc Bras Med Trop 2019; 53:e20190262. [PMID: 31859950 PMCID: PMC7083365 DOI: 10.1590/0037-8682-0262-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/18/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: We aimed to analyze the relationship between visceral leishmaniasis
mortality and social determinants of health (SDH). METHODS: This was an ecological study of all leishmaniasis-related deaths in Brazil,
from 2001 to 2015. We analyzed 49 indicators of human development and social
vulnerability. The association was tested using the classical and spatial
regression model. RESULTS: Mortality was associated with indicators that expressed low human
development and high social vulnerability: lack of garbage collection, low
schooling, unemployment rate, low per capita income, and income inequality
(Gini index). CONCLUSIONS: There was an association between high mortality by leishmaniasis and low
SDH.
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Affiliation(s)
| | | | | | | | - Rodrigo Feliciano do Carmo
- Universidade Federal do Vale do São Francisco, Colegiado de Ciências Farmacêuticas, Petrolina, PE, Brasil
| | | | | | - Victor Santana Santos
- Universidade Federal de Alagoas, Núcleo de Epidemiologia e Saúde Pública. Arapiraca, AL, Brasil
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Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species. J Immunol Res 2019; 2019:4103819. [PMID: 30756088 PMCID: PMC6348913 DOI: 10.1155/2019/4103819] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/22/2018] [Accepted: 12/11/2018] [Indexed: 12/19/2022] Open
Abstract
Worldwide, an estimated 12 million people are infected with Leishmania spp. and an additional 350 million are at risk of infection. Leishmania are intracellular parasites that cause disease by suppressing macrophage microbicidal responses. Infection can remain asymptomatic or lead to a spectrum of diseases including cutaneous, mucocutaneous, and visceral leishmaniasis. Ultimately, the combination of both pathogen and host factors determines the outcome of infection. Leishmaniasis, as well as numerous other infectious diseases, exhibits sex-related differences that cannot be explained solely in terms of environmental exposure or healthcare access. Furthermore, transcriptomic evidence is revealing that biological sex is a variable impacting physiology, immune response, drug metabolism, and consequently, the progression of disease. Herein, we review the distribution, morbidity, and mortality among male and female leishmaniasis patients. Additionally, we discuss experimental findings and new avenues of research concerning sex-specific responses in cutaneous and visceral leishmaniasis. The limitations of current therapies and the emergence of drug-resistant parasites underscore the need for new treatments that could harness the host immune response. As such, understanding the mechanisms driving the differential immune response and disease outcome of males versus females is a necessary step in the development of safer and more effective treatments against leishmaniasis.
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