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Bastidas GA. [Contributions of epidemiology to the control of leishmaniasis]. Rev Salud Publica (Bogota) 2023; 21:472-475. [PMID: 36753272 DOI: 10.15446/rsap.v21n4.74866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 06/11/2019] [Indexed: 11/09/2022] Open
Abstract
Leishmaniasis despite government efforts, groups and individuals continues to be a major public health problem, it is estimated that globally occur between 50 000 and 90 000 new cases of visceral leishmaniasis and between 0.5 and 1 million tegumentary leishmaniasis, plus in some regions, this parasitism has an endemo-epidemic nature, and in recent years its frequency and distribution have increased. The purpose of this paper is to show some contributions of epidemiology to the control of leishmaniasis, as a result of the description and analysis of the distribution and determinants of this parasitism, extremely complex in terms of transmitter, etiological agent, reservoir and susceptible. Based on the review of the scientific literature in the context of a descriptive, documentary and retrospective study, the objective of this paper was achieved. It is concluded that the usefulness of epidemiology in the control of leishmaniasis is clear or in any case reaffirms the validity and practicality of epidemiology in the programmatic and operational task of health intervention in the case of leishmaniasis.
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Affiliation(s)
- Gilberto A Bastidas
- GB: MD. M. Sc. Internacional Salud Pública y Gestión Sanitaria. Ph.D. Parasitología. Departamento de Salud Pública. Facultad de Ciencias de la Salud, Universidad de Carabobo. Campus Bárbula, municipio Naguanagua. Carabobo, Venezuela.
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Dires A, Gedamu S, Kumar P, Yimam W, Ademe S, Dires T. Determinants of cutaneous leishmaniasis among students in Delanta district, Northeast Ethiopia: A case-control study. Health Sci Rep 2022; 5:e917. [PMID: 36324427 PMCID: PMC9621467 DOI: 10.1002/hsr2.917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/18/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Aims Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis that causes skin lesions on exposed parts of the body. It is endemic in over 170 districts and highly prevalent in the northern and southern parts of Ethiopia. Thus, the aim of this study was to assess the determinants of CL among students of Wegeltena secondary school in Delanta district, Northeast Ethiopia. Methods This unmatched case-control study was conducted from January 4 to 20, 2021 at Wegeltena secondary school. Cases were students who had an active lesion of CL and controls were students who had never been infected with CL (no active lesions). A simple random sampling technique was utilized to select participants in the control group. Data were collected by using a pretested, interviewer-administered structured questionnaire. Bivariable and multivariable logistic regression analyses were performed and variables were declared determinants of CL at a p value of <0.05. Results A total of 225 students (58 cases and 167 controls) participated in the study. The mean age of cases and controls was 18.6 (SD ± 0.99 years) and 18.5 years (SD ± 1.17 years), respectively. In this study, 74.1% of cases and 51.5% of controls have been living in rural areas. Furthermore, being male (adjusted odds ratio [AOR] = 4.11; 95% confidence interval [CI]: 1.94-8.69), rural residents (AOR = 2.95; 95% CI: 1.33-6.52), living in areas where caves (AOR = 3.63; 95% CI: 1.24-10.59), nearby forest (AOR = 4.04; 95% CI: 1.42-11.51), and hyrax available (AOR = 2.43; 95% CI: 1.16-5.08) were significantly associated with CL. Conclusion In our study, sociodemographic and environmental factors were found to be determinants of CL. Therefore, reducing outdoor activities, wearing protective clothes, use of insecticide-treated nets, and destruction of sand fly breeding sites shall be implemented targeting the rural population that resides in areas where forests, caves, and hyraxes are prominent.
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Affiliation(s)
- Abebe Dires
- Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences Wollo University Dessie Ethiopia
| | - Sisay Gedamu
- Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences Wollo University Dessie Ethiopia
| | - Prem Kumar
- Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences Wollo University Dessie Ethiopia
| | - Wondosen Yimam
- Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences Wollo University Dessie Ethiopia
| | - Sewunet Ademe
- Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences Wollo University Dessie Ethiopia
| | - Tadila Dires
- Department of Nursing Debre Tabor University Debre Tabor Ethiopia
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Amane M, Echchakery M, Daoudi M, Hafidi M, Boussaa S. Determinants of anthroponotic cutaneous leishmaniasis by case-control study in Morocco. PLoS One 2022; 17:e0266291. [PMID: 36240203 PMCID: PMC9565455 DOI: 10.1371/journal.pone.0266291] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022] Open
Abstract
Leishmaniasis is endemic in Morocco where both cutaneous and visceral forms coexist. To date, anthroponotic cutaneous leishmaniasis (ACL) determinants remain poorly investigated in Morocco. However, the disease risk factors identification is vital to determine the specific preventive process. In this aim, a case-control study was conducted in the main active ACL foci in central Morocco. Epidemiological data were extracted from bulletins, registers and annual reports of the regional direction of Health offices. The socioeconomic and environmental data were collected from epidemiological surveys, completed by a questionnaire intended for accessible positive population and control people selected from the cases' entourage. The study included 258 cases and 395 controls. Our results showed that many socioeconomic factors were associated with ACL in Morocco such as the rural habitation (OR = 4.163; 95% CI: 2.91-5.96), movement to endemic area (OR = 4.53; 95% CI: 3.03-6.77), provenance from leishmaniasis foci (in Essaouira focus OR = 5.34; 95% CI: 1.19-24.03) and poverty. In addition, environmental factors like proximity of vegetation (OR = 2.45; 95% CI: 1.14-5.25), poor domestic hygiene, particularly the absence of sewage system/waste management (OR = 1.63; 95% CI: 1.35-1.96), and presence of animals (OR = 2.67; 95% CI: 1.14-5.25) increase the risk of ACL in Morocco. Except for Matrimonial status (married people, OR = 4.11; 95% CI: 1.80-9.41), there is however no significant association of the disease with the other socio-demographic factors in the study area (p>0.05). These several risk factors must be taken in consideration to prevent this disease through multidisciplinary collaboration and community participation.
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Affiliation(s)
- Mounia Amane
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - Mohamed Echchakery
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University, Settat, Morocco
| | - Mohamed Daoudi
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - Mohamed Hafidi
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - Samia Boussaa
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
- ISPITS-Higher Institute of Nursing and Technical Health Occupations, Ministry of Health and Social Protection, Rabat, Morocco
- * E-mail:
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Chastonay AHM, Chastonay OJ. Housing Risk Factors of Four Tropical Neglected Diseases: A Brief Review of the Recent Literature. Trop Med Infect Dis 2022; 7:tropicalmed7070143. [PMID: 35878154 PMCID: PMC9319438 DOI: 10.3390/tropicalmed7070143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023] Open
Abstract
Alongside peace, education, food, income, a stable ecosystem, sustainable resources and social justice, shelter is a prerequisite for health. According to international human rights law, everyone is entitled to an adequate standard of living, which includes adequate housing. Adequate housing, including access to water and sanitation, plays a critical role in the prevention and management of neglected tropical diseases, which affect over 1 billion people worldwide. Inadequate housing conditions represent a risk factor for many of them, e.g., Chagas disease that affects 6–8 million people worldwide, visceral leishmaniasis that kills 20,000–30,000 people/year, lymphatic filariasis which threatens 859 million people worldwide or dengue that has increased 8–10 fold over the last two decades. Vector control strategies for the above-mentioned diseases have shown their effectiveness and should include systematic and repetitive in-house spraying and individual protection (e.g., impregnated nets), as well as better-quality construction material and techniques and better sanitation infrastructures and practices. Access to adequate housing is a basic human right. The violation of the right to adequate housing may affect the enjoyment of other human rights. Access to adequate housing can strengthen (and facilitate access to) other basic human rights, such as the rights to work, health, security, and education.
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Affiliation(s)
| | - Oriane J. Chastonay
- Réseau Fribourgeois de Santé Mentale, 1700 Fribourg, Switzerland
- Correspondence:
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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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Sanei-Dehkordi A, Soleimani-Ahmadi M, Zare M, Mirzaei H. Epidemiological features of cutaneous leishmaniasis and distribution of sand flies in an endemic area in southeast of Iran. Parasite Epidemiol Control 2021; 14:e00220. [PMID: 34430724 PMCID: PMC8365509 DOI: 10.1016/j.parepi.2021.e00220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/30/2021] [Accepted: 07/11/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Cutaneous leishmaniasis (CL) is a widespread tropical infectious disease in the world. It is one of the most important health problem in Iran which is endemic in different parts of country. This study was conducted to determine epidemiological features of CL and distribution of sand flies in Hajiabad County, one of the important CL foci in southeast of Iran. Methods This descriptive cross-sectional study was conducted from March 2019 to March 2020. All of the suspected CL cases with skin lesions who referred to Hajiabad County health centers and all actively detected patients were clinically and parasitologically examined for CL. Demographic and clinical data of all patients were recorded. Moreover, in this study, sand flies were collected monthly from four typical plain and foothill villages during their active season (May–November) using sticky trap. Sand flies were mounted as permanent microscopic slides, using Puri's medium, and identified by taxonomic keys. Data were analyzed using SPSS.21 software and descriptive statistics. Results and discussion A total of 70 confirmed cases of CL were recorded; the incidence rate of the disease was 101 per 100,000 people. The most infected age group was 0–10 years, with a rate of 64.3%. Males were infected more than females and the majority of cases (85.7%) were recorded from rural areas. Most of the cases had 1 lesion (51.4%) and the most lesions (55.8%) were in upper extremities. During the study period, 832 sand fly specimens comprised of ten species of Sergentomyia and seven of Phlebotomus were collected and identified. The most prevalent species was P. papatasi (47.12%), followed by P. alexandri (8.41%) and P. salehi (6.25%). Among the collected Phlebotomus species, P. papatasi and P. sergenti are known as the primary vectors of CL and P. alexandri, P. salehi, and P. caucasicus, play the main role as the secondary vectors of CL in Iran. Conclusion This study has revealed that CL is endemic in Hajiabad County and there are five CL vectors that are distributed in this County and some of them are more prevalent in plain areas. These findings can be used as a basis for implementation of interventions toward vector control, which may help in suppression of vector density, and consequently, control of CL in the study area.
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Affiliation(s)
- Alireza Sanei-Dehkordi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, P.O. Box: 79145-3838, Iran
| | - Moussa Soleimani-Ahmadi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, P.O. Box: 79145-3838, Iran.,Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Zare
- Department of Occupational Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Mirzaei
- Hajiabad Health Center, Hormozgan University of Medical Sciences, Hajiabad, Iran
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Lehlewa AM, Khaleel HA, Lami F, Hasan SAF, Malick HA, Mohammed RH, Abdulmottaleb QA. Impact of Modifiable Risk Factors on the Occurrence of Cutaneous Leishmaniasis in Diyala, Iraq: Case-Control Study. JMIRX MED 2021; 2:e28255. [PMID: 37725543 PMCID: PMC10414455 DOI: 10.2196/28255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/25/2021] [Accepted: 05/16/2021] [Indexed: 09/21/2023]
Abstract
BACKGROUND In 2018, an outbreak of cutaneous leishmaniasis (CL) occurred in Diyala Province in Iraq. Several risk factors of CL were identified in a prior study; however, the impact of removing modifiable risk factors on the occurrence of the disease was not measured. OBJECTIVE The aim of this study is to measure the impact of removing modifiable risk factors of CL on the occurrence of the disease. METHODS We conducted a population-based unmatched case-control study in two conveniently selected districts in Diyala Province. All cases of CL were included. Controls were chosen preferentially according to the site where the cases occurred. A structured questionnaire was used to collect data. The unadjusted odds ratios (ORs) and 95% confidence intervals for each risk factor were calculated using binary logistic regression. We also calculated the attributable fractions and 95% confidence intervals of the modifiable risk factors. A P value <.05 was considered statistically significant. RESULTS Data from 844 persons (432 cases, 51.2%) were analyzed. Cases were more likely than controls to report a history of previous displacement (OR 5.18, 95% CI 3.84-6.98), electricity supply for less than 12 hours per day (OR 1.94, 95% CI 1.47-2.55), living in a rural area (OR 1.91, 95% CI 1.45-2.51), living in a clay house (OR 2.41, 95% CI 1.59-3.66), having an unpainted indoor living space (OR 2.14, 95% CI 1.51-3.02), having rodents inside the house (OR 5.15, 95% CI 3.56-7.47), having chickens, sheep, or both (OR 3.44, 95% CI 2.48-4.75), having a mixture of dogs and sheep or of dogs and chickens within a distance of less than 100 meters (OR 3.92, 95% CI 2.59-5.94), fogging (OR 2.11, 95% CI 1.40-3.19), bed net use (OR 1.72, 95% CI 1.08-2.72), and sleeping outside or a mixture of inside and outside (OR 4.01, 95% CI 1.32-12.19). The data show that the exposure of approximately 70% to 80% of cases was associated with displacement, the presence of rodents inside the house, the presence of animals within 100 meters of the house, the presence of animals (chickens/sheep/both or a mixture of dogs and sheep or of dogs and chickens), and sleeping outside. Approximately 40%-50% of the cases reported living in a clay house, living in a rural area, having an unpainted indoor space, having an electricity supply for less than 12 hours, and using a bed net. CONCLUSIONS Prevention and control of CL requires a multifaceted approach that relies on changing environmental conditions, housing conditions, and human behavior. Fogging and bed net use were not effective because the underlying housing characteristics and human behavior provided a good culture for the disease. We recommend conducting a study to identify the species, reservoirs, and vectors of CL in Iraq; studying vector behaviors before applying environmental control measures; and educating the public on how and when to use bed nets as well as how to accompany their use with behavioral changes.
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Affiliation(s)
| | - Hanan Abdulghafoor Khaleel
- Communicable Diseases Control Center, Public Health Directorate, Ministry of Health of Iraq, Baghdad, Iraq
| | - Faris Lami
- Department of Community and Family Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Saif Aldeen Falah Hasan
- Communicable Diseases Control Center, Public Health Directorate, Ministry of Health of Iraq, Baghdad, Iraq
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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: 6] [Impact Index Per Article: 2.0] [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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Salgueiro MM, Pimentel MIF, Miranda LFC, Cunha E Silva RR, Oliveira LFA, Lyra MR, Saheki MN, Valete-Rosalino CM, Martins ACC, Schubach AO, Marzochi MCA, Bedoya-Pacheco SJ. Parasite species variation and impact of spatial displacement of the population on cutaneous leishmaniasis in Rio de Janeiro, Brazil. Trans R Soc Trop Med Hyg 2021; 116:70-79. [PMID: 34125907 DOI: 10.1093/trstmh/trab088] [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: 03/11/2020] [Revised: 03/05/2021] [Accepted: 06/03/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis results from complex interactions between human beings, vectors and the environment. Parasitic species differ in epidemiological and geographical contexts. METHODS We studied a retrospective cohort of 696 patients with cutaneous leishmaniasis treated at a reference centre in the state of Rio de Janeiro, Brazil, between 2000 and 2015. We analysed displacements due to work, leisure and migrations with identification of Leishmania species. RESULTS The geographic distribution of autochthonous cases showed that >95% of infections occurred in urban areas. In the state of Rio de Janeiro, most cases were concentrated in the cities surrounding forest parks and nature conservation areas. The same applies to the city of Rio de Janeiro, where these infections occurred in the neighbourhoods surrounding some mountain and forest areas. The non-displacement group included 575 (82.6%) patients and the displacement group included 121 (17.4%) patients. Leishmania (Viannia) braziliensis predominated in both groups. Other species were found in the displacement group. CONCLUSIONS The disordered urbanization of the state of Rio de Janeiro in recent decades has created conditions for the emergence of urban foci of transmission close to forest areas. Changes in the environment, movement of infected individuals and adaptation of sandflies may have contributed to this.
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Affiliation(s)
- Mariza M Salgueiro
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Maria Inês F Pimentel
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Luciana F C Miranda
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Rafael R Cunha E Silva
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, CEP: 21041-210, RJ, Brazil
| | - Liliane F A Oliveira
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Marcelo R Lyra
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Mauricio N Saheki
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Claudia M Valete-Rosalino
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil.,Productivity grant (PQ) of the "Programa de Produtividade em Pesquisa", Conselho Nacional de Desenvolvimento Científico e Tecnológico, SHIS QI 01, Conjunto B, Blocos A, B, C e D, Edifício Santos Dumont, Lago Sul, Brasília, CEP: 71.605-001, DF, Brazil.,Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho, 373 - Bloco K, 2º andar, Sala 49 - Cidade Universitária da Universidade Federal do Rio de Janeiro, Rio de Janeiro, CEP: 21044-020, RJ, Brazil
| | - Ana Cristina C Martins
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Armando O Schubach
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil.,Productivity grant (PQ) of the "Programa de Produtividade em Pesquisa", Conselho Nacional de Desenvolvimento Científico e Tecnológico, SHIS QI 01, Conjunto B, Blocos A, B, C e D, Edifício Santos Dumont, Lago Sul, Brasília, CEP: 71.605-001, DF, Brazil
| | - Mauro C A Marzochi
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil.,Productivity grant (PQ) of the "Programa de Produtividade em Pesquisa", Conselho Nacional de Desenvolvimento Científico e Tecnológico, SHIS QI 01, Conjunto B, Blocos A, B, C e D, Edifício Santos Dumont, Lago Sul, Brasília, CEP: 71.605-001, DF, Brazil
| | - Sandro J Bedoya-Pacheco
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, CEP: 21041-210, RJ, Brazil
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10
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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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11
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Pinto MOKM, de Oliveira TM, de Assis Aguiar AN, Pinto PEM, Barbosa DS, de Araújo Diniz S, Silva MX. Profile of American tegumentary leishmaniasis in transmission areas in the state of Minas Gerais, Brazil, from 2007 to 2017. BMC Infect Dis 2020; 20:163. [PMID: 32087701 PMCID: PMC7036229 DOI: 10.1186/s12879-020-4860-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND American tegumentary leishmaniasis (ATL) is a widespread anthropozoonosis caused by protozoa of the genus Leishmania and is considered a serious public health problem. The aim of this study was to provide a descriptive analysis of confirmed ATL cases and evaluate the spatial distribution of ATL in high-risk transmission areas from the state of Minas Gerais, Brazil. METHODS An ecological, analytical, and retrospective study of the confirmed cases of ATL in Minas Gerais from 2007 to 2017 was conducted. To characterize these cases, multiple correspondence analysis and georeferencing of the ATL prevalence rates in the municipalities were conducted based on variables obtained at Sistema Nacional de Agravos de Notificação and Instituto Brasileiro de Geografia e Estatística databases. RESULTS There were 13,025 confirmed cases of ATL from 74.4% (635) municipalities of Minas Gerais, corresponding to a prevalence rate of 66.5 cases for every 100,000 inhabitants. Males aged 20 to 59 years and individuals who attended elementary school were most affected with ATL. Multiple correspondence analysis presented an accumulated qui-squared value of 44.74%, proving that there was a relationship between the variables, including ethnicity, age, pregnancy status, zone of infection, and number of cases. CONCLUSION We confirmed that ATL is endemic to Minas Gerais, and there is high risk of infection within the municipalities due to a high rate of parasite transmission. The occurrence of infection in children, pregnant women, and the indigenous population demonstrates the need for the government to expand social policies aimed at vulnerable groups.
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Affiliation(s)
| | - Tiago Mendonça de Oliveira
- Preventive Veterinary Medicine Department, School of Veterinary, Federal University of Minas Gerais, Belo Horizonte, 31270-901, Brazil.
| | | | | | - David Soeiro Barbosa
- Parasitology Department, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | - Soraia de Araújo Diniz
- Centro Universitário UniDoctum de Teófilo Otoni, Veterinary Medicine Course, Teófilo Otoni, Brazil
| | - Marcos Xavier Silva
- Preventive Veterinary Medicine Department, School of Veterinary, Federal University of Minas Gerais, Belo Horizonte, 31270-901, Brazil.
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12
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Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review. Parasitol Res 2020; 119:365-384. [PMID: 31897789 DOI: 10.1007/s00436-019-06575-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
Abstract
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were "leishmaniasis" AND "risk factors" using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
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13
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"Cheaper and better": Societal cost savings and budget impact of changing from systemic to intralesional pentavalent antimonials as the first-line treatment for cutaneous leishmaniasis in Bolivia. PLoS Negl Trop Dis 2019; 13:e0007788. [PMID: 31693661 PMCID: PMC6834242 DOI: 10.1371/journal.pntd.0007788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 09/16/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction Cutaneous leishmaniasis (CL), endemic in Bolivia, mostly affects poor people in rainforest areas. The current first-line treatment consists of systemic pentavalent antimonials (SPA) for 20 days and is paid for by the Ministry of Health (MoH). Long periods of drug shortages and a lack of safe conditions to deliver treatment are challenges to implementation. Intralesional pentavalent antimonials (ILPA) are an alternative to SPA. This study aims to compare the cost of ILPA and SPA, and to estimate the health and economic impacts of changing the first-line treatment for CL in a Bolivian endemic area. Methods The cost-per-patient treated was estimated for SPA and ILPA from the perspectives of the MoH and society. The quantity and unit costs of medications, staff time, transportation and loss of production were obtained through a health facility survey (N = 12), official documents and key informants. A one-way sensitivity analysis was conducted on key parameters to evaluate the robustness of the results. The annual number of patients treated and the budget impact of switching to ILPA as the first-line treatment were estimated under different scenarios of increasing treatment utilization. Costs were reported in 2017 international dollars (1 INT$ = 3.10 BOB). Results Treating CL using ILPA was associated with a cost-saving of $248 per-patient-treated from the MoH perspective, and $688 per-patient-treated from the societal perspective. Switching first-line treatment to ILPA while maintaining the current budget would allow two-and-a-half times the current number of patients to be treated. ILPA remained cost-saving compared to SPA in the sensitivity analysis. Conclusions The results of this study support a shift to ILPA as the first-line treatment for CL in Bolivia and possibly in other South American countries. Cutaneous leishmaniasis is a neglected tropical disease which causes chronic skin ulcers and disproportionally affects the poorest of the poor. The current first-line treatment, based on systemic pentavalent antimonials, is quite toxic for patients but also expensive for governments and patients. Given limited budgets, national decision-makers need to know not only the efficacy of alternative treatments, but also how to maximise the population health impact of available resources. To strengthen the evidence base for the scale-up of effective NTD interventions in the era of universal health coverage, we conducted cost-effectiveness analyses and estimations of population-level impact of the implementation of intralesional pentavalent antimonials as first-line treatment for cutaneous leishmaniasis using realistic scenarios. Our results demonstrate that changing first-line treatment would have considerable economic advantages for patients due to the shorter treatment duration (savings in terms of food, accommodation, transport, productivity loss); and for the national control program due to the reduced use of drugs and staff time. In addition, this change would offer better value for money given that two-and-a-half times the current number of patients could be treated with the current expenditure level if intralesional pentavalent antimonials were offered to eligible patients.
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14
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Teles GDC, Fonseca FR, Gonçalves MJF. American Tegumentary Leishmaniasis in the Brazilian Amazon from 2010 to 2014. Rev Inst Med Trop Sao Paulo 2019; 61:e22. [PMID: 30970050 PMCID: PMC6466847 DOI: 10.1590/s1678-9946201961022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/12/2019] [Indexed: 11/23/2022] Open
Abstract
American tegumentary leishmaniasis (ATL) is one of the most important but
neglected infectious diseases, and can cause severe deformities. ATL incidence
remains high in forest regions, such as in the Amazonas State, Brazil. However,
differences within the State and over time have been observed, since infection
patterns are not homogeneous, and these aspects need to be clarified. This study
aimed to identify the epidemiological profile of ATL and its spatial and
temporal distribution in the Brazilian Amazon, from 2010 to 2014. Data were
extracted from the Information System for Notifiable Diseases, which
descriptively evaluates the incidence rate, as well as the temporal and spatial
distribution of the disease. The highest prevalence of ATL was found in men and
in the age group of 20-40 years. Approximately 95% of the cases were of
cutaneous ATL and they were identified through direct examination. The spatial
analysis has shown that ATL was widely distributed, both in rural and urban
areas, and more concentrated in the Southern part of the State. Moreover,
although there was an expansion in the spatial distribution and an increasing
incidence of ATL in Amazonas, the epidemiological profile remained unchanged,
suggesting that other factors must be responsible for its widespread
distribution and increasing incidence.
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Affiliation(s)
- Giovana da Costa Teles
- Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Manaus, Amazonas, Brazil
| | | | - Maria Jacirema Ferreira Gonçalves
- Universidade Federal do Amazonas, Escola de Enfermagem de Manaus, Manaus, Amazonas, Brazil.,Fundação Oswaldo Cruz, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
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15
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Sales KGDS, de Oliveira Miranda DE, Costa PL, da Silva FJ, Figueredo LA, Brandão-Filho SP, Dantas-Torres F. Home sweet home: sand flies find a refuge in remote indigenous villages in north-eastern Brazil, where leishmaniasis is endemic. Parasit Vectors 2019; 12:118. [PMID: 30909958 PMCID: PMC6434633 DOI: 10.1186/s13071-019-3383-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/07/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND From 2012 to 2013, an outbreak of cutaneous leishmaniasis by Leishmania braziliensis was detected in indigenous villages located in a remote rural area of Pernambuco state, north-eastern Brazil. Considering that the principal activities of this indigenous community are farming and crop plantation, and also that the outbreak involved many children, we investigated the presence of sand fly vectors inside human houses and also the exposure of dogs to leishmanial parasites. Our general objective was to gather epidemiological data that could indicate the occurrence of a peri-domestic/domestic transmission cycle of L. braziliensis in these indigenous villages. METHODS From March 2015 to March 2016, sand flies were collected using light traps in the indoor and immediate outdoor environments in the three indigenous villages that reported the most cutaneous leishmaniasis cases during the 2012-2013 outbreak. Moreover, samples obtained from 300 dogs living in the outbreak villages and two nearby villages were tested by a rapid immunochromatographic test and by a real-time PCR for detecting anti-Leishmania antibodies and Leishmania DNA, respectively. RESULTS In total, 5640 sand flies belonging to 11 species were identified. Males (n = 3540) predominated over females (n = 2100). Migonemyia migonei (84.3%) was the most abundant species, followed by Evandromyia lenti (5.5%), Lutzomyia longipalpis (4.1%), Nyssomyia intermedia (1.6%) and Micropygomyia capixaba (1.4%), representing together ~97% of the sand flies collected. Nine out of the 11 species identified in this study were found indoors, including M. migonei, L. longipalpis and N. intermedia, which are proven vectors of Leishmania spp. Out of 300 dogs tested, 26 (8.7%) presented anti-Leishmania antibodies and six (2%) were Leishmania DNA-positive. The level of exposure in dogs living in the indigenous villages where the 2012-2013 outbreak of human CL was detected was almost 2-fold higher than in the two nearby villages (11.0 vs 6.2% for serology and 2.6 vs 1.4% for real-time PCR). CONCLUSIONS The results suggest that different sand fly vectors may be adapted to human dwellings, thus increasing the risk of transmission in the indoor and immediate outdoor environments. The adaptation of sand flies to the indoor environment in the studied indigenous villages may be partly explained by the poor housing conditions and the proximity of the houses to crop plantations and forest fragments.
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Affiliation(s)
| | | | | | - Fernando José da Silva
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
| | - Luciana Aguiar Figueredo
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
| | | | - Filipe Dantas-Torres
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil.
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16
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Hamzavi Y, Nazari N, Khademi N, Hassani K, Bozorgomid A. Cutaneous leishmaniasis in Qasr-e Shirin, a border area in the west of Iran. Vet World 2018; 11:1692-1697. [PMID: 30774260 PMCID: PMC6362329 DOI: 10.14202/vetworld.2018.1692-1697] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/31/2018] [Indexed: 12/20/2022] Open
Abstract
Aim: The prevalence of cutaneous leishmaniasis (CL) is growing in Iran, and new sources of the disease have been found in the country. The purpose of this study was to describe the epidemiology of CL in Qasr-e Shirin County, Kermanshah Province, West of Iran. Qasr-e Shirin is located near the Iran-Iraq border, and several million pilgrims pass through this area to Iraq every year. Materials and Methods: A descriptive cross-sectional study was carried out for active case detection from April 1, 2014, to March 31, 2015. All individuals with suspicious lesions were identified through house-to-house visits in the aforementioned area. A questionnaire was filled out for everyone with clinical suspicion of CL. A diagnosis was made based on parasitological examination of the lesion exudate. The annual incidence and prevalence of CL were estimated. Results: In total, 5277 individuals were randomly screened for the presence of active lesions or scars suspected of CL. The overall prevalence of CL in the County was 4.8% (60 cases had active lesions and 194 cases had scars). All age groups were affected, but the highest incidence of CL was seen in the age group 20-29 years (1.9%). The incidence and prevalence were higher in women than men (5.5% vs. 4%). Most cases (45.6%) had a single lesion or scar and 44 (17.4%) patients had five or more lesions or scars. Conclusion: The incidence of CL in Qasr-e Shirin County is high. There is a need for further studies on reservoirs and vectors of leishmaniasis in this area. The results of such studies help to perform more efficient and timely spraying against phlebotomine sandfly or detect and decrease the animal reservoir population.
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Affiliation(s)
- Yazdan Hamzavi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Naser Nazari
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nahid Khademi
- Department of Disease, Kermanshah Health Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Keivan Hassani
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arezoo Bozorgomid
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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17
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Abstract
Leishmaniasis is a poverty-related disease with two main clinical forms: visceral leishmaniasis and cutaneous leishmaniasis. An estimated 0·7-1 million new cases of leishmaniasis per year are reported from nearly 100 endemic countries. The number of reported visceral leishmaniasis cases has decreased substantially in the past decade as a result of better access to diagnosis and treatment and more intense vector control within an elimination initiative in Asia, although natural cycles in transmission intensity might play a role. In east Africa however, the case numbers of this fatal disease continue to be sustained. Increased conflict in endemic areas of cutaneous leishmaniasis and forced displacement has resulted in a surge in these endemic areas as well as clinics across the world. WHO lists leishmaniasis as one of the neglected tropical diseases for which the development of new treatments is a priority. Major evidence gaps remain, and new tools are needed before leishmaniasis can be definitively controlled.
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Affiliation(s)
- Sakib Burza
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Médecins Sans Frontières, Delhi, India
| | - Simon L Croft
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
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18
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Eid D, Guzman-Rivero M, Rojas E, Goicolea I, Hurtig AK, Illanes D, San Sebastian M. Risk factors for cutaneous leishmaniasis in the rainforest of Bolivia: a cross-sectional study. Trop Med Health 2018; 46:9. [PMID: 29692654 PMCID: PMC5902850 DOI: 10.1186/s41182-018-0089-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/01/2018] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Daniel Eid
- Institute of Biomedical Research, Faculty of Medicine, San Simon University, Aniceto Arce Avenue 371, Cochabamba, Bolivia.,2Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Miguel Guzman-Rivero
- Institute of Biomedical Research, Faculty of Medicine, San Simon University, Aniceto Arce Avenue 371, Cochabamba, Bolivia
| | - Ernesto Rojas
- Institute of Biomedical Research, Faculty of Medicine, San Simon University, Aniceto Arce Avenue 371, Cochabamba, Bolivia
| | - Isabel Goicolea
- 2Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Anna-Karin Hurtig
- 2Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Daniel Illanes
- Institute of Biomedical Research, Faculty of Medicine, San Simon University, Aniceto Arce Avenue 371, Cochabamba, Bolivia
| | - Miguel San Sebastian
- 2Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden
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19
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Mercadante LM, dos Santos MAS, Pegas ES, Kadunc BV. Leprosy and American cutaneous leishmaniasis coinfection. An Bras Dermatol 2018; 93:123-125. [PMID: 29641713 PMCID: PMC5871378 DOI: 10.1590/abd1806-4841.20186698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/14/2017] [Indexed: 11/22/2022] Open
Abstract
Brazil is a country with a high prevalence of infectious diseases such as leprosy and leishmaniasis. However, coinfection of these diseases is still poorly understood. We report a case of a patient who presented with lepromatous leprosy and cutaneous-mucosal leishmaniasis at the same period. After clinical, laboratory, and histopathological diagnosis, the treatment was introduced and the patient showed important clinical improvement. He was followed in our outpatient clinic. Both pathologies play an important role in the immune system. Depending on the immune response profile of the host, diseases may present themselves in different ways. In this case, the patient showed a divergent immune response for each disease. We hypothesized that this response is specific for each pathogen.
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Affiliation(s)
| | | | - Elisangela Samartin Pegas
- Leprosy Outpatient Service at Pontifícia
Universidade Católica de Campinas (PUC - Campinas) - Campinas (SP),
Brazil
| | - Bogdana Victória Kadunc
- Dermatology Service at Pontifícia Universidade
Católica de Campinas (PUC - Campinas) - Campinas (SP), Brazil
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