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Vasconcelos SA, de Sousa RLT, Costa E, Diniz e Souza JP, Cavalcante D, da Silva ACL, de Mendonça IL, Mallet J, Teixeira CR, Werneck GL, Araújo-Pereira T, Pita-Pereira D, Britto C, Vilela ML, Gomes R. Characterisation of an area of coexistent visceral and cutaneous leishmaniasis transmission in the State of Piauí, Brazil. Mem Inst Oswaldo Cruz 2024; 119:e230181. [PMID: 38324880 PMCID: PMC10841424 DOI: 10.1590/0074-02760230181] [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: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND In Brazil, transmission of visceral and cutaneous leishmaniasis has expanded geographically over the last decades, with both clinical forms occurring simultaneously in the same area. OBJECTIVES This study characterised the clinical, spatial, and temporal distribution, and performed entomological surveillance and natural infection analysis of a leishmaniasis-endemic area. METHODS In order to characterise the risk of leishmaniasis transmission in Altos, Piauí, we described the clinical and socio-demographic variables and the spatial and temporal distribution of cases of American visceral leishmaniasis (AVL) and American cutaneous leishmaniasis (ACL) cases and identified potential phlebotomine vectors. FINDINGS The urban area concentrated almost 54% of ACL and 86.8% of AVL cases. The temporal and spatial distribution of AVL and ACL cases in Altos show a reduction in the number of risk areas, but the presence of permanent disease transmission foci is observed especially in the urban area. 3,808 phlebotomine specimens were captured, with Lutzomyia longipalpis as the most frequent species (98.45%). Of the 35 females assessed for natural infection, one specimen of Lu. longipalpis tested positive for the presence of Leishmania infantum and Leishmania braziliensis DNA. MAIN CONCLUSION Our results indicate the presence of risk areas for ACL and AVL in the municipality of Altos and highlight the importance of entomological surveillance to further understand a possible role of Lu. longipalpis in ACL transmission.
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Affiliation(s)
- Silvia Alcântara Vasconcelos
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Medicina Tropical, Rio de Janeiro, RJ, Brasil
| | - Raimundo Leoberto Torres de Sousa
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Enéas Costa
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Medicina Tropical, Rio de Janeiro, RJ, Brasil
| | | | - Diane Cavalcante
- Universidade Federal do Ceará, Departamento de Patologia, Fortaleza, CE, Brasil
| | | | | | - Jacenir Mallet
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar em Vigilância Entomológica em Diptera e Hemiptera, Rio de Janeiro, RJ, Brasil
| | | | | | - Thais Araújo-Pereira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Daniela Pita-Pereira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
- Centro Universitário Lusíada, Santos, SP, Brasil
| | - Constança Britto
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Maurício Luiz Vilela
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar em Vigilância Entomológica em Diptera e Hemiptera, Rio de Janeiro, RJ, Brasil
| | - Regis Gomes
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Eusébio, CE, Brasil
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Castro MDM, Rode J, Machado PRL, Llanos-Cuentas A, Hueb M, Cota G, Rojas IV, Orobio Y, Oviedo Sarmiento O, Rojas E, Quintero J, Pimentel MIF, Soto J, Suprien C, Alvarez F, Ramos AP, Arantes RBDS, da Silva RE, Arenas CM, Vélez ID, Lyra MR, Saravia NG, Arana B, Alexander N. Cutaneous leishmaniasis treatment and therapeutic outcomes in special populations: A collaborative retrospective study. PLoS Negl Trop Dis 2023; 17:e0011029. [PMID: 36689465 PMCID: PMC9894540 DOI: 10.1371/journal.pntd.0011029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 02/02/2023] [Accepted: 12/16/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Treatment guidance for children and older adult patients affected by cutaneous leishmaniasis (CL) is unclear due to limited representation of these groups in clinical trials. METHODS We conducted a collaborative retrospective study to describe the effectiveness and safety of antileishmanial treatments in children ≤ 10 and adults ≥ 60 years of age, treated between 2014 and 2018 in ten CL referral centers in Latin America. RESULTS 2,037 clinical records were assessed for eligibility. Of them, the main reason for non-inclusion was lack of data on treatment follow-up and therapeutic response (182/242, 75% of children and 179/468, 38% of adults). Data on 1,325 eligible CL patients (736 children and 589 older adults) were analyzed. In both age groups, disease presentation was mild, with a median number of lesions of one (IQR: 1-2) and median lesion diameter of less than 3 cm. Less than 50% of the patients had data for two or more follow-up visits post-treatment (being only 28% in pediatric patients). Systemic antimonials were the most common monotherapy regimen in both age groups (590/736, 80.2% of children and 308/589, 52.3% of older adults) with overall cure rates of 54.6% (95% CI: 50.5-58.6%) and 68.2% (95% CI: 62.6-73.4%), respectively. Other treatments used include miltefosine, amphotericin B, intralesional antimonials, and pentamidine. Adverse reactions related to the main treatment were experienced in 11.9% (86/722) of children versus 38.4% (206/537) of older adults. Most adverse reactions were of mild intensity. CONCLUSION Our findings support the need for greater availability and use of alternatives to systemic antimonials, particularly local therapies, and development of strategies to improve patient follow-up across the region, with special attention to pediatric populations.
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Affiliation(s)
- Maria del Mar Castro
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Joelle Rode
- Drugs for Neglected Diseases initiative (DNDi), Rio de Janeiro, Brazil
| | - Paulo R. L. Machado
- Servico de Imunologia, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Alejandro Llanos-Cuentas
- Unidad de Leishmaniasis y Malaria, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, and Hospital Cayetano Heredia, Lima, Perú
| | - Marcia Hueb
- Universidade Federal de Mato Grosso, Hospital Universitário Júlio Müller (HUJM), Cuiabá, Mato Grosso, Brazil
| | - Gláucia Cota
- Instituto René Rachou, Fundação Oswaldo Cruz, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Yenifer Orobio
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Oscar Oviedo Sarmiento
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Ernesto Rojas
- Centro Universitario de Medicina Tropical–Universidad Mayor de San Simón (CUMT), Cochabamba, Bolivia
| | - Juliana Quintero
- PECET—Programa de Estudio y Control de Enfermedades Tropicales, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Jaime Soto
- FUNDERMA (Fundación Nacional de Dermatología), Santa Cruz de la Sierra, Bolivia
| | - Carvel Suprien
- Servico de Imunologia, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Fiorela Alvarez
- Unidad de Leishmaniasis y Malaria, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, and Hospital Cayetano Heredia, Lima, Perú
| | - Ana Pilar Ramos
- Unidad de Leishmaniasis y Malaria, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, and Hospital Cayetano Heredia, Lima, Perú
| | | | | | | | - Ivan Darío Vélez
- PECET—Programa de Estudio y Control de Enfermedades Tropicales, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Marcelo Rosandiski Lyra
- Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Nancy Gore Saravia
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Byron Arana
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
| | - Neal Alexander
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
- * E-mail:
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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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Melo MGND, Morais RCSD, Goes TCD, Silva RPE, Morais RFD, Guerra JADO, Brito MEFD, Brandão Filho SP, Cavalcanti MDP. Clinical and epidemiological profiles of patients with American cutaneous leishmaniasis from the states of Pernambuco and Amazonas, Brazil. Rev Soc Bras Med Trop 2020; 53:e20200083. [PMID: 33263681 PMCID: PMC7723372 DOI: 10.1590/0037-8682-0083-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION: Brazil has a high number of cases of American cutaneous leishmaniasis (ACL)
in the north and northeast regions. Therefore, continuous surveillance of
environmental and socioeconomic factors in endemic areas is needed to
develop strategic control measures. This study aimed to describe the
clinical and epidemiological profiles of patients with ACL. METHODS: All patients were from the states of Amazonas and Pernambuco, and
examinations were carried out between 2015 and 2018. All patients had a
clinical and epidemiological history compatible with ACL after positive
diagnostic tests. Information obtained from medical records included gender,
employment activity, level of education, age, and number and sites of
lesions. RESULTS: A total of 213 patients were included, of whom 30.98% were female and 69.02%
were male. The main employment activity was agriculture (27.56%). The most
common level of education was elementary (62.42%). The average age was
approximately 39 years. The majority of the patients presented only with one
lesion (54.87%), and legs/feet were the most commonly affected area
(48.25%), followed by the arms/hands (44.75%). CONCLUSIONS: These data demonstrated that irrespective of the patients’ places of origin,
interventions need to be focused on men of economically productive age, in
view of the high risk of exposure to the vector in this group. Education
activities need to be directed to farmers about the importance of protection
against ACL vectors during work. Such information must also be directed to
employers as a way of implementing and maintaining appropriate working
conditions and stepping up vector control.
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Amorim RDF, de Lima MAP, da Silva Souza RO, da Silva UM, Dos Santos AP, Tavares AP, Vieira Gadelha MDS, da Silva CGL. Characterization of the sand fly fauna in Barbalha, one of the municipalities with the highest leishmaniasis rates in Brazil. Parasitol Int 2020; 80:102245. [PMID: 33217550 DOI: 10.1016/j.parint.2020.102245] [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] [Received: 06/06/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 10/23/2022]
Abstract
Leishmaniases are a complex of sand fly-borne diseases that are considered a public health issue in several countries. Brazil presents high leishmaniases rates. The South of Ceará State, known as Cariri region, shows worrying statistics mainly on American tegumentary leishmaniasis. In Barbalha, which is one of the municipalities in this region, there is still a lack of studies regarding the local phlebotomine (Diptera: Psychodidae) fauna in order to help clarify the high rates. This study aimed to characterize such fauna by capturing sand flies with light traps during a four-year period. A total of 3730 sand flies were captured, of which 37.8% were females. Fourteen species were found: 13 of the Lutzomyia genus and one of the Brumptomyia genus. Of the Lutzomyia species, four were proven and five had potential involvement in leishmaniasis transmission. Lutzomyia longipalpis was the most common species (66.97%). This predominance, especially in the urban area, indicates its epidemiological importance and adaptation to environmental conditions modified by human activity. In fact, further studies are still required to accurately determine the behavioral features of these vectors in order to guide public health measurements towards its control and prevention.
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Affiliation(s)
- Raimundo Diego Ferreira Amorim
- Laboratory of Microbiology, Immunology and Parasitology (LAMIP), School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil
| | - Marcos Antônio Pereira de Lima
- Laboratory of Microbiology, Immunology and Parasitology (LAMIP), School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil.
| | - Racquel Oliveira da Silva Souza
- Laboratory of Experimental Pathology (LAPEX), School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil
| | - Ulisses Mariano da Silva
- Medical Entomology Laboratory, Superintendence of the Cariri Region (Juazeiro do Norte), State Health Secretariat, Ceará, Brazil
| | - Antônio Pereira Dos Santos
- Medical Entomology Laboratory, Superintendence of the Cariri Region (Juazeiro do Norte), State Health Secretariat, Ceará, Brazil
| | - Ana Paula Tavares
- Laboratory of Experimental Pathology (LAPEX), School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil
| | - Maria do Socorro Vieira Gadelha
- Laboratory of Microbiology, Immunology and Parasitology (LAMIP), School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil
| | - Cláudio Gleidiston Lima da Silva
- Laboratory of Experimental Pathology (LAPEX), School of Medicine, Universidade Federal do Cariri (UFCA), Barbalha, Ceará, Brazil
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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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Jeihooni AK, Harsini PA, Kashfi SM, Rakhshani T. Effect of educational intervention based on the PRECEDE-PROCEED model on preventive behaviors of cutaneous leishmaniasis among housewives. CAD SAUDE PUBLICA 2019; 35:e00158818. [PMID: 31365701 DOI: 10.1590/0102-311x00158818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/06/2019] [Indexed: 11/22/2022] Open
Abstract
Leishmaniasis is an endemic disease in Iran. Since education to prevent the disease is important, this study aimed to determine the effect of educational intervention based on the PRECEDE-PROCEED model on preventive behaviors of cutaneous leishmaniosis among housewives. In this quasi-experimental study, 240 housewives under the coverage of health centers, who lived in the endemic area of Mianshahr, Fasa city, Fars Province, Iran in 2016, were selected (120 people for the experimental group and 120 for the control group). The educational intervention for the experimental group was based on the PRECEDE model, which consists of seven 50-60-minute sessions of lectures, group discussions, role playing, practical displays, and video and PowerPoint displays. These sessions addressed the familiarity with cutaneous leishmaniasis and its different types and carriers, methods of preventing and fighting against it, personal protection, sanitation of the environment and drinking water, spraying of sites, use of mosquito nets, etc. Data were collected before educational intervention and three months after educational intervention. The mean age of the experimental group was 39.24±9.12 years and that of the control group was 38.84±9.28 years. Three months after the intervention, the experimental group showed a significant increase in knowledge, attitudes, reinforcing factors, enabling factors, and performance compared to the control group. The education based on enabling factors, reinforcing factors, and predisposing factors had a significant effect on the preventive behaviors of cutaneous leishmaniasis among housewives.
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Braz LMA. Tegumentary leishmaniasis diagnosis: what happened with MST (Montenegro Skin Test) in Brazil? Rev Inst Med Trop Sao Paulo 2019; 61:e17. [PMID: 30864622 PMCID: PMC6413772 DOI: 10.1590/s1678-9946201961017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/12/2019] [Indexed: 12/27/2022] Open
Affiliation(s)
- Lucia Maria Almeida Braz
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Soroepidemiologia, São Paulo, São Paulo, Brazil
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