Ecoepidemiologia da leishmaniose tegumentar no Município de Buriticupu, Amazônia do Maranhão, Brasil, 1996 a 1998

Trichophoromyia auraensis: evidence for cryptic species and first record in the state of Maranhão, Brazil

Trichophoromyia auraensis (Mangabeira, 1942) (Diptera, Psychodidae, Phlebotominae) has a wide geographic distribution in the western region of the Amazon biome, where it is a putative Leishmania vector. Here, we reported for the first time a population of this species in the Brazilian state of Maranhão, in the eastern Amazon, from which we DNA-barcoded and compared with previously processed specimens from Acre State, in the western Amazon. For this, we analyzed the DNA barcoding fragment (658 bp) of the mitochondrial cytochrome c oxidase subunit I (COI) gene and the nuclear internal transcribed spacer 2 (ITS2) of Trichophoromyia species using phylogenetic gene trees, and species delimitation algorithms. The analyses of COI barcodes showed high values of genetic distance (mean K2P = 5.17) and well-supported clades/MOTUs for the eastern and western populations of T. auraensis, which may indicate a possible complex of cryptic species. The western population of this taxon merged with the close-related sand fly Trichophoromyia velezbernali Posada-López, Galvis and Galati, 2018 from Colombia, which may be associated with the recent speciation history and introgression between these populations. These evidences should be evaluated with a more comprehensive sampling in terms of analyzed populations and molecular markers.

Epidemiology, Biodiversity, and Technological Trajectories in the Brazilian Amazon: From Malaria to COVID-19

The Amazon biome is under severe threat due to increasing deforestation rates and loss of biodiversity and ecosystem services while sustaining a high burden of neglected tropical diseases. Approximately two thirds of this biome are located within Brazilian territory. There, socio-economic and environmental landscape transformations are linked to the regional agrarian economy dynamics, which has developed into six techno-productive trajectories (TTs). These TTs are the product of the historical interaction between Peasant and Farmer and Rancher practices, technologies and rationalities. This article investigates the distribution of the dominant Brazilian Amazon TTs and their association with environmental degradation and vulnerability to neglected tropical diseases. The goal is to provide a framework for the joint debate of the local economic, environmental and health dimensions. We calculated the dominant TT for each municipality in 2017. Peasant trajectories (TT1, TT2, and TT3) are dominant in ca. fifty percent of the Amazon territory, mostly concentrated in areas covered by continuous forest where malaria is an important morbidity and mortality cause. Cattle raising trajectories are associated with higher deforestation rates. Meanwhile, Farmer and Rancher economies are becoming dominant trajectories, comprising large scale cattle and grain production. These trajectories are associated with rapid biodiversity loss and a high prevalence of neglected tropical diseases, such as leishmaniasis, Aedes-borne diseases and Chagas disease. Overall, these results defy simplistic views that the dominant development trajectory for the Amazon will optimize economic, health and environmental indicators. This approach lays the groundwork for a more integrated narrative consistent with the economic history of the Brazilian Amazon.

Effects of forest degradation on the sand fly communities of northeast Brazil

The richness and abundance of sand fly species were studied in northeastern Brazil in areas of leishmaniasis transmission. The study was carried out in two forest areas with different deforestation times for agricultural and livestock activities: one modified by long-term settlement (more than 50 years of occupation) and another less impacted by short-term settlement (10 years). The sand flies were captured with CDC light traps from 18:00 to 06:00 for three consecutive nights, once a month, from May, 2012 to April, 2014. The study captured 21,708 specimens and also 33 species of Lutzomyia and two of Brumptomyia. Species richness and abundance were higher in the more conserved area of short-term occupation (31 species; 61.7%) than in the more degraded area with long-term occupation (17 species; 38.3%). In the most conserved area, the species richness was higher in the forest fragment than in the rural settlement, whereas in the degraded area the richness was higher in the peri-domicile than in the forest. The diversity was higher in the degraded area forest. There were significant statistical differences when comparing the means of total abundance with the intra-domicile, peri-domicile, and forest environments. The average abundance was statistically higher in the peri-domicile compared to the forest (p = 0.009), but there were no statistically significant differences between intra-domicile-peri-domicile (p = 0.11) and forest-intra-domicile (p = 0.87). In conclusion, a change in vegetation cover negatively affects the richness and abundance of sand flies in the natural environment.

DNA Barcoding Reveals Hidden Diversity of Sand Flies (Diptera: Psychodidae) at Fine and Broad Spatial Scales in Brazilian Endemic Regions for Leishmaniasis

Sand fly (Diptera: Psychodidae) taxonomy is complex and time-consuming, which hampers epidemiological efforts directed toward controlling leishmaniasis in endemic regions such as northeastern Brazil. Here, we used a fragment of the mitochondrial cytochrome c oxidase I (COI) gene to identify sand fly species in Maranhão State (northeastern Brazil) and to assess cryptic diversity occurring at different spatial scales. For this, we obtained 148 COI sequences of 15 sand fly species (10 genera) from Maranhão (fine spatial scale), and joined them to COI sequences from other Brazilian localities (distant about 2,000 km from Maranhão, broad spatial scale) available in GenBank. We revealed cases of cryptic diversity in sand flies both at fine (Lutzomyia longipalpis (Lutz and Neiva) and Evandromyia termitophila (Martins, Falcão and Silva)) and broad spatial scales (Migonemyia migonei (França), Pressatia choti (Floch and Abonnenc), Psychodopygus davisi (Root), Sciopemyia sordellii (Shannon and Del Ponte), and Bichromomyia flaviscutellata (Mangabeira)). We argue that in the case of Bi. flaviscutellata, the cryptic diversity is associated with a putative new species. Cases in which DNA taxonomy was not as effective as morphological identification possibly involved recent speciation and/or introgressive hybridization, highlighting the need for integrative approaches to identify some sand fly species. Finally, we provide the first barcode sequences for four species (Brumptomyia avellari (Costa Lima), Evandromyia infraspinosa (Mangabeira), Evandromyia evandroi (Costa Lima and Antunes), and Psychodopygus complexus (Mangabeira)), which will be useful for further molecular identification of neotropical species.

Risk factors for cutaneous leishmaniasis in the rainforest of Bolivia: a cross-sectional study

Background

Cutaneous leishmaniasis (CL) is an endemic disease in Bolivia, particularly in the rainforest of Cochabamba, in the municipality of Villa Tunari. The precarious, dispersed, and poorly accessible settlements in these farming communities make it difficult to study them, and there are no epidemiological studies in the area. The aim of the present study was to identify the risk factors associated with cutaneous leishmaniasis.

Methods

A cross-sectional study was conducted in August 2015 and August 2016 in two communities of Villa Tunari, Cochabamba. The cases were diagnosed through clinical examinations, identification of the parasite by microscopic examination, and the Montenegro skin test. Risk factors were identified through logistic regression.

Results

A total of 274 participants (40.9% female and 59.1% male) were surveyed, of which 43% were CL positive. Sex was the only factor associated with CL with three times more risk for men than for women; this finding suggests a sylvatic mechanism of transmission in the area.

Conclusions

It is advisable to focus on education and prevention policies at an early age for activities related to either leisure or work. Further research is needed to assess the influence of gender-associated behavior for the risk of cutaneous leishmaniasis.

Epidemiological surveillance of tegumentary leishmaniasis: local territorial analysis

OBJECTIVE

To propose a new operational unit in the locality scale capable of subsidizing the construction of an information system to control the transmission of tegumentary leishmaniasis at this scale, in a region of high endemicity of the Atlantic Forest.

METHODS

We examined the adequacy of data and instruments in an area of high endemicity in the Atlantic Forest located in the South of the State of Rio de Janeiro from 1990 to 2012. The study proposed an operational unit called Local Surveillance Unit to make all used databases compatible by adjusting census sectors. This enabled the overlap and comparison of information in different periods.

RESULTS

The spreading process of the transmission of tegumentary leishmaniasis in the Baía da Ilha Grande region does not depend on great population movements, and can occur in areas with population growth or decrease. The data information system allowed the adequate identification and characterization of the place of residence. We identified relevant characteristics of the place of transmission, such as self-limited in time and not associated with recent deforestation. The results also highlight the lack of synchronicity in the case production in territorial units involved in the endemic-epidemic process, noting that this process is in constant motion.

CONCLUSIONS

The transmission process seems more connected to the presence and movement of rodents that move continuously in the region than to the local density of vectors or the permanence of infected dogs at home. New control strategies targeted at the foci of transmission must be considered. The construction of a new operational unit, called Local Surveillance Unit, was instrumental in the endemic-epidemic process analysis.

Epidemiological aspects of American cutaneous leishmaniasis (ACL) in an endemic area of forest extractivist culture in western Brazilian Amazonia

The study sought to analyze clinical and epidemiological aspects of cutaneous leishmaniasis (CL) in Xapuri, Acre, Brazil. Data from 2008 to 2014 registered in the notification records of the disease of the Information System of the Complaints of Notification (SINAN), and the data of the Information Department of the Unified Health System (DATASUS) available from 2007 to 2013 were used and analyzed in the light of the statistics of the temporal series by the Prais-Winsten method and chi-squared test. A total of 906 cases were registered with 60.2% occurring in men and 39.7% in women. The groups from 0 to 4 years of age (48.0%) and from 5 to 19 years of age (23.3%) were the most affected. Regarding the clinical forms, 77.7% presented CL and 22.3% mucocutaneous leishmaniasis (MCL). Among the 896 cases with information on the diagnostic methods used, Montenegro's skin test predominated (66.4%), with a positive result of 95.8% for CL and 99.3% for MCL. Treatment with N-methylglucamine antimony was performed in 99.4% of the cases, but discontinuously used in the majority of patients. This study presents information which may be used as a tool for the epidemiological surveillance and control of the disease in Xapuri, a region which depends essentially on forest resources and ecological tourism.

Evaluating the Adaptation Process of Sandfly Fauna to Anthropized Environments in a Leishmaniasis Transmission Area in the Brazilian Amazon

Phlebotomines (Diptera: Psychodidae) are vectors of several etiological agents of human and animal diseases, including protozoans of the gender Leishmania. Precarious socioeconomic conditions and uncontrolled population growth directly influence the transmission risk of parasites and the urbanization of vector species, previously restricted to wild environments. The Marajó Archipelago is considered a high incidence area of leishmaniasis in the Brazilian Amazon. However, it is poorly studied. The aim of this study was to assess the adaptation processes of phlebotomine species to anthropized environments in this region. For this purpose, the phlebotomine fauna was compared between three municipalities of the Marajó Archipelago: Anajás, Portel, and São Sebastião da Boa Vista. To survey the phlebotomine fauna, CDC (Center for Disease Control) light traps were installed in the wild areas and in the intra and peridomiciliary areas of rural and urban environments. The environments studied presented a diversified phlebotomine fauna, with higher richness in the wild environment (15 species), followed by the rural (seven species), and finally, the urban environment (three species). A migration of wild fauna to the adjacent anthropized areas (rural environment) and to urban areas was observed, evidencing the adaptation process of this vector to anthropized environments in the studied region. Thus, our study evidenced that the disorganized human occupation and utilization of the landscape might cause the invasion of urban areas by wild populations of phlebotomines, in this way enabling the settlement of urban leishmaniasis transmission cycles.

STATUS OF THE AMERICAN TEGUMENTARY LEISHMANIASIS IN THE STATE OF RIO DE JANEIRO , BRAZIL, FROM 2004 TO 2013

The aim of the present study was to analyze the status of the American Tegumentary Leishmaniasis (ATL) in the state of Rio de Janeiro, from 2004 to 2013, through its spatiotemporal distribution. We also described variables considered relevant to the epidemiology of the disease, such as the clinical form, gender, ethnic group, age group, and progression of disease. This is a descriptive study, which used notified secondary data from the Brazilian Information System of Notifiable Diseases (SINAN), Ministry of Health, Brazil, regarding confirmed diagnoses. To help the calculation of coefficients of detection and mortality, we used population data from the Brazilian Institute of Geography and Statistics (IBGE). We analyzed 1,470 cases of ATL with the predominance of the cutaneous clinical form (1,292/87.89%). The data has also revealed seven deaths, a predominance of males (922/62.72%), and a higher incidence of ATL in the white ethnic group (731/49.72%). We observed a high incidence of ATL in the group of 20 - 39 years old (477/32.44%). We concluded that there was a decrease in the number of ATL cases in the state of Rio de Janeiro, based on a coefficient of detection of 1.44/100.000 inhabitants in 2004 decreasing to 0.20/100.000 inhabitants in 2013. The localities with the highest occurrences of ATL were the metropolitan region (843 cases) and the municipality of Rio de Janeiro (740 cases). In 2005, the highest incidence of the disease was observed (351 cases) in the study. Among the variables selected to describe the epidemiology of the disease, the following categories: cutaneous clinical form, male patients, white ethnic group, and the age group of 20 - 39 years old were more affected than the others.

Seventeen years of American cutaneous leishmaniasis in a Southern Brazilian municipality

We reviewed the records of 151 patients diagnosed with American cutaneous leishmaniasis (ACL) from 1993 to 2009 in the municipality of Japura, Paraná, Brazil. Gender, age, occupation, place of residence, location of lesions, type and number of lesions were analyzed. The prevalence rate of ACL was 11.5/10,000 hab, of which 84.7% were male, 58.3% lived in rural area and 49.0% were farmers. The most frequent age group was between 30 to 39 years (26.6%). Skin lesions occurred in 92.7% of the patients with predominance in the lower limbs (23.9%) and 49.1% of the records did not include the number of lesions location due to incomplete filling. A single ulceration was present in 44.4%. Japurá is an endemic area for ACL, requiring public actions and preventive education.

Phlebotomine sandflies fauna (Diptera: Psychodidae) at rural settlements in the municipality of Cáceres, State of Mato Grosso, Brazil

INTRODUCTION: Leishmaniasis is expanding across Brazil, including the State of Mato Grosso (MT). The aim of this study was to characterize the phlebotomine sandfly fauna at threerural settlements located in the municipality of Cáceres, MT, from August 2010 to July 2011. METHODS: Sandfly captures were conducted at the forest border and in intra and peridomicile areas with automatic light traps, biweekly, from 5pm to 6am. RESULTS: Of the 630 sandflies collected, 348 were female, and 282 were male. Captured specimens were distributed across 11 genera - Brumptomyia, Evandromyia, Expapillata, Lutzomyia, Martinsmyia, Micropygomyia, Nyssomyia, Pintomyia, Psathyromyia, Psychodopygus, and Sciopemyia - and 28 species. Among these, six species had not been marked yet in MT (Brumptomyia avellari, Br. mangabeirai, Evandromyia aldafalcaoae, Micropygomyia echinatopharynx, Micropygomyia peresi, and Pa. campograndensis). Nyssomyia whitmani was the most abundant species across ecotopes at all settlements. Interestingly, Lutzomyia longipalpis and Lutzomyia cruzi were found in sympatry. CONCLUSIONS: The disorganized occupation of the environment that is happening at the rural settlements of Mata Comprida, Laranjeira I and II could provide opportunities for the domiciliation of wild populations of phlebotomine, including vectors of leishmaniasis. Therefore, more studies are needed to understand the epidemiology of the disease in these areas and its impact on the human population.

[Production of transmission foci for cutaneous leishmaniasis: the case of Pau da Fome, Rio de Janeiro, Brazil]

This study analyzes the characteristics of one of the main foci for cutaneous leishmaniasis transmission in the city of Rio de Janeiro, Brazil, examining its territorial configuration and the relations with spatial organization processes. An analytical model was applied to the process of occupation and organization of urban space on a local scale, considering the new functions acquired by the spatial elements expressed by different work relations, land use, and land value. The study employed geoprocessing techniques and classification of images obtained by remote sensing, localization of households, and cases of cutaneous leishmaniasis, associated with qualitative data on the historical process of land occupation and use. The analysis detected areas with distinct conditions of vulnerability and showed that changes in these conditions allowed production of the epidemic in a given time period and its subsequent reduction. The study contributes to monitoring of the disease at the local level and application of effective measures for cutaneous leishmaniasis surveillance and control.

Estrutura da comunidade de Phlebotominae (Diptera, Psychodidae) em mata ciliar do município de Urbano Santos, Maranhão, Brasil

A diversidade, abundância relativa e a distribuição de Phlebotominae foram estudadas em três setores (bordas e centro) de um fragmento de mata ciliar no município de Urbano Santos, Maranhão, Brasil. Os espécimes foram capturados em junho e novembro/2003 e em janeiro e março/2004 das 18 às 6 horas. Em cada noite de coleta foram instaladas 18 armadilhas, seis em cada setor da mata, totalizando um esforço de 864 horas. Foram encontradas 17 espécies. O centro do fragmento obteve a maior riqueza de espécies (14), seguido da borda B (13) e da borda A (12). As espécies Lutzomyia infraspinosa (Mangabeira, 1941), L. flaviscutellata (Mangabeira, 1942) e L. evandroi (Costa Lima & Antunes, 1936) foram as únicas que apareceram como dominantes nos três setores da mata. Quatorze espécies ocorreram em ambas estações, sendo que L. fluviatilis (Floch & Abonnenc, 1944) foi encontrada apenas na estação chuvosa (janeiro e março) e L. migonei (França, 1920) e L. pinottii (Damasceno & Arouck, 1956) apenas na estação seca (junho e novembro). As diferenças registradas na abundância de indivíduos entre as estações não foram estatisticamente significativas. A presença frequente de L. flaviscutellata pode explicar um caso de leishmaniose cutânea difusa em uma paciente deste município.

[Bacterial infection in cutaneous leishmaniasis: bacterial pattern and sensitivity to antibiotics]

The bacterial flora from leishmanial ulcers was studied. The aerobic species Staphylococcus aureus and Pseudomonas aeruginosa were found most frequently. Evaluation of the sensitivity of these species to antibiotics showed that 100% of these isolates of Staphylococcus aureus were sensitive to vancomycin, amikacin and chloramphenicol, while 100% of the isolates of Pseudomonas aeruginosa were sensitive to amikacin, gentamicin and tobramycin. These species were generally resistant to penicillins and tetracycline.

Epidemiologia da leishmaniose tegumentar americana no Estado do Acre, Amazônia brasileira

Efetuou-se estudo estatístico descritivo em 8.516 casos de leishmaniose tegumentar americana no Estado do Acre, Brasil, no período de 2001 a 2006 (segundo período), comparando-se com os resultados de publicação anterior com dados no mesmo estado entre 1992 e 1997 (primeiro período). A prevalência no estado mais que dobrou entre os dois momentos (55,7/10 mil habitantes de 1992 a 1997 e 128,5/10 mil habitantes entre 2001 e 2006. O sexo masculino foi o mais acometido (68,8%, n = 5.860) no segundo período. A média das idades foi de 26,3 anos, valor discretamente menor do que o do primeiro período. Pacientes com baixa escolaridade foram os mais acometidos pela doença. As demais variáveis avaliadas foram zona de residência, ocupação, critério de diagnóstico, forma clínica, tratamento, recidiva, tempo para procurar tratamento e evolução da doença. Conclui-se que houve piora nos indicadores epidemiológicos da leishmaniose tegumentar americana avaliados no estado entre os períodos estudados.

Epidemiologia da Leishmaniose Tegumentar e descrição das populações de flebotomíneos no município de Acrelândia, Acre, Brasil

São apresentadas neste artigo a distribuição da leishmaniose tegumentar (LT) e descrição das populações de flebotomíneos em Acrelândia, Acre. Os dados epidemiológicos foram obtidos a partir de fichas de notificação de casos ocorridos entre 2001 e 2004, e os dados entomológicos são provenientes de capturas com armadilhas luminosas efetuadas entre 2004 e 2005 na zona rural de Acrelândia. Ocorreram 82 novos casos de LT, com idade entre 2 e 69 anos, sendo 75,6% em homens e 83,9% na zona rural. Predominou a LT com lesões únicas (78%). A microscopia direta da lesão, intradermorreação de Montenegro e biópsia apresentaram positividade de 100%, 98% e 79,5%, respectivamente. A resposta ao tratamento farmacológico foi bem sucedida em 71,6% dos casos; a falência terapêutica foi maior em pacientes com diagnóstico exclusivamente clínico (41,2%) e nos que receberam dose diária inadequada de antimonial pentavalente (64,3%). Foram coletados 40 espécimes de flebotomíneos em propriedades rurais com casos de LT (3 gêneros, 14 espécies), sendo 3 espécies conhecidas como vetoras ou possíveis vetoras de Leishmania: Nyssomyia antunesi predominou no peridomicílio (59,1%) e em margens de matas; Nyssomyia whitmani foi freqüente no peridomicílio (15%) e a única espécie encontrada no intradomicílio, e Trichophoromyia ubiquitalis foi capturada no peridomicílio. O uso de dados epidemiológicos existentes no serviço de saúde de Acrelândia, embora com várias limitações, permitiu avaliar a eficácia do diagnóstico e o tratamento empregados no município, enquanto os dados entomológicos coletados podem orientar estudos mais amplos visando identificar os vetores e espécies circulantes na região.

Leishmaniose tegumentar americana em crianças: aspectos epidemiológicos de casos atendidos em Manaus, Amazonas, Brasil

No período entre janeiro a dezembro de 2005, foram avaliadas crianças de zero a 14 anos de idade com leishmaniose tegumentar americana, atendidas na Fundação de Medicina Tropical do Amazonas; registraram-se 147 casos; 55,78% do sexo masculino; 48,3% procediam do Município de Rio Preto da Eva; 76% procediam de duas estradas. Entre 90 (67,67%) pacientes, entrevistaram-se os responsáveis sobre a moradia na área de transmissão e os hábitos da criança. Desses, 58,89% residiam no local da provável infecção; 60% das crianças penetravam na mata acompanhando os pais; em 91,11% dos casos havia animais domésticos na moradia; 77,78% das residências localizavam-se até 100m de distância da mata; 76,67% pacientes tinham pelo menos um parente com história de leishmaniose tegumentar americana. O padrão de transmissão foi relacionado especialmente a atividades de manejo florestal ocorrendo próximas ao domicílio, habitações próximas à floresta primária, com a ocorrência de leishmaniose tegumentar americana em crianças pequenas, sugerindo transmissão no intra e no peridomicílio, em alguns casos, crianças penetrando na floresta.

Diagnóstico molecular da taxa de infecção natural de flebotomíneos (Psychodidae, Lutzomyia) por Leishmania sp na Amazônia maranhense

A taxa de infecção natural de três diferentes espécies de flebotomíneos por Leishmania foi estudada usando a técnica de reação em cadeia da polimerase. Primers específicos para Leishmania foram designados para examinar se os pools de flebotomíneos estavam infectadas. Um total de 1.100 fêmeas separadas em pools de 10 indivíduos foram examinados, consistindo de 50 Lutzomyia whitmani, 43 Lutzomyia triacantha e 17 Lutzomyia choti. De todos os pools analisados, 4 de Lutzomyia whitmani estavam positivos, mas nenhum pool das duas espécies restantes estava infectado. Deste modo, uma taxa de infecção de 0,4% foi verificada neste estudo. Esta taxa de infecção associada a estudos anteriores sugere que Lutzomyia whitmani transmite Leishmania aos mamíferos em Buriticupu, Maranhão.

Dinâmica espaço-temporal de flebotomíneos (Diptera, Psychodidae) do município de Santa Quitéria, área de cerrado do Estado do Maranhão, Brasil

A flutuação sazonal, a freqüência horária e a ocorrência dos flebotomíneos nos ambientes intradomiciliar, peridomiciliar e extradomiciliar (cerrado), no município de Santa Quitéria, Estado do Maranhão foram estudados. Os espécimes foram capturados entre 18 e 6 horas, de maio de 1999 a abril de 2000, com armadilhas luminosas tipo CDC. Foram coletados 4.880 espécimes de 11 espécies. A riqueza e abundância foram maiores no peridomicílio (11 espécies; 50,1% dos espécimes), seguido pelo intradomicílio (9 espécies, 34%) e cerrado (7 espécies, 15,8%). Duas espécies foram encontradas na estação chuvosa, uma na estiagem e oito em ambas estações. Na estiagem foram registradas elevadas freqüências de Lutzomyia longipalpis Lutz & Neiva, 1912 (88,4%), L. evandroi Costa Lima & Antunes, 1936 (83,6%), L. lenti Mangabeira, 1938 (86%) e L. shannoni Dyar, 1929 (100%), enquanto as freqüências de L. quinquefer Dyar, 1929 (100%) e L. whitmani Antunes & Coutinho, 1939 (75%) foram maiores no período chuvoso. Os flebotomíneos foram encontrados a noite inteira, mas os horários de maior freqüência variaram de acordo com a espécie, observando-se picos no crepúsculo vespertino e primeiras horas da noite: L. quinquefer (18 h - 19 h); L. goiana Martins, Falcão & Silva, 1962 (18 h - 21 h); L. whitmani (19 h - 21 h) e L. longipalpis (20 h - 21 h) e ao longo da noite e no crepúsculo matutino: L. evandroi (21 h - 23 h e 3 h - 5 h), L. longipalpis (1 h - 3 h), L. lenti (22 h - 23 h e 4 h - 5 h). A ocorrência dos flebotomíneos nos diferentes ambientes, horários e estações vem sendo acompanhada por notificações de vários casos de leishmanioses cutânea e visceral.