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de Sousa Oliveira R, Andrade Pimentel KB, Ribeiro da Silva RC, Suely Guimarães-E-Silva A, Soares Moura ME, Soares Pinheiro VC. Spatial-temporal risk clusters, social vulnerability, and identification of priority areas for surveillance and control of cutaneous leishmaniasis in Maranhão, Brazil: an ecological study. J Med Entomol 2024; 61:481-490. [PMID: 38157319 DOI: 10.1093/jme/tjad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/08/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
Cutaneous leishmaniasis (CL) is a neglected disease widely distributed in Maranhão, Brazil and presents a significant public health problem. However, its transmission dynamics and determining factors are not clearly understood. In this context, geospatial technologies help interpret the process. This study, then, characterized the space-time dynamics and the influence of social vulnerability on CL in an endemic area in Northeast Brazil. This is an ecological study about new cases of CL in Maranhão, from 2007 to 2020, obtained directly from the Notifiable Diseases Information System. The incidence rate was smoothed using a spatial empirical Bayesian method. Subsequently, global and local Moran statistics and their association with social vulnerability indicators were determined. Disease distribution was not random but grouped in space and time. All Social Vulnerability Index domains were positively correlated with the CL incidence. A likely cluster was detected in western Maranhão (P < 0.001), which encompassed 18 municipalities, from January 2007 to December 2013, with a high relative risk (5.06). The research findings suggest that planning public health actions and allocating resources should be prioritized in these areas to help effectively reduce the incidence of the disease.
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Affiliation(s)
- Romário de Sousa Oliveira
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
| | - Karen Brayner Andrade Pimentel
- Universidade Federal do Maranhão, Programa de Pós-graduação em Biodiversidade e Biotecnologia - Rede BIONORTE, Avenida dos Portugueses, 1966, Bacanga, São Luís, Maranhão, 65080-805, Brazil|
| | - Rosa Cristina Ribeiro da Silva
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
| | - Antonia Suely Guimarães-E-Silva
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
| | - Maria Edileuza Soares Moura
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
| | - Valéria Cristina Soares Pinheiro
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
- Universidade Federal do Maranhão, Programa de Pós-graduação em Biodiversidade e Biotecnologia - Rede BIONORTE, Avenida dos Portugueses, 1966, Bacanga, São Luís, Maranhão, 65080-805, Brazil
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Guimarães-E-Silva AS, de Sousa Oliveira R, Pimentel KBA, Ribeiro da Silva RC, Rodrigues BL, Rebêlo JMM, Pinheiro VCS. Spatiotemporal Distribution of Leishmaniasis in an Endemic Area of Northeast Brazil: Implications for Intervention Actions. J Med Entomol 2023; 60:165-172. [PMID: 36287635 DOI: 10.1093/jme/tjac123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to analyze the spatiotemporal distribution of leishmaniases, and contribute to the knowledge of their epidemiological dynamics from 2007 to 2017 in the municipality of Caxias, Maranhão, Northeast Brazil. Data on American tegumentary leishmaniasis (ATL) and human visceral leishmaniasis (HVL) were obtained in the Epidemiological Surveillance Sector of Caxias, while data on canine visceral leishmaniasis (CVL) were obtained in the Zoonoses Surveillance Unit. For data analysis and spatial representation of leishmaniasis cases, the geoprocessing of the data was performed, and the geometric features of the state of Maranhão, Caxias, and the disease registration sites were obtained from the shapefile database of the Brazilian Institute of Geography and Statistics. Geostatistics was used to create maps based on the Kernel density method, starting from the points, producing a raster file for each case with several data frames, allowing the instantaneous comparison of the phenomena. During the study period, ATL, HVL, and CVL were reported in Caxias, accounting for 114,304 and 8,498 cases, respectively. The geoprocessing analysis showed that leishmaniasis is widely distributed in the urban area of Caxias. However, there are risk areas for the transmission of these diseases to humans and dogs, associated with deforestation and urban expansion, and may vary over time. Preventive measures must focus on risk areas, including conservation efforts and urban planning, in order to reduce the transmission of leishmaniases.
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Affiliation(s)
- Antonia Suely Guimarães-E-Silva
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Laboratório de Entomologia Médica (LABEM), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
| | - Romário de Sousa Oliveira
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Laboratório de Entomologia Médica (LABEM), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
| | | | - Rosa Cristina Ribeiro da Silva
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Laboratório de Entomologia Médica (LABEM), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
| | - Bruno Leite Rodrigues
- Faculdade de Saúde Pública da Universidade de São Paulo - (FSP/USP), Pós-graduação em Saúde Pública, Avenida Doutor Arnaldo, 715, São Paulo, 01246-904, Brazil
| | - José Manuel Macário Rebêlo
- Universidade Federal do Maranhão, Laboratório de Entomologia e Vetores, Avenida dos Portugueses, 1966, Bacanga, São Luís, Maranhão, 65080-805, Brazil
| | - Valéria Cristina Soares Pinheiro
- Universidade Estadual do Maranhão, Programa de Biodiversidade, Ambiente e Saúde (PPGBAS), Laboratório de Entomologia Médica (LABEM), Praça Duque de Caxias, s/n, Morro do Alecrim, Caxias, Maranhão, 65604-380, Brazil
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Silva RCRD, Cruz LNPD, Coutinho JMDS, Fonseca-Alves CE, Rebêlo JMM, Pereira SRF. Experimental transmission of Leishmania (Leishmania) amazonensis to immunosuppressed mice through the bite of Lutzomyia longipalpis (Diptera: Psychodidae) results in cutaneous leishmaniasis. Rev Inst Med Trop Sao Paulo 2021; 63:e81. [PMID: 34878039 PMCID: PMC8670602 DOI: 10.1590/s1678-9946202163081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/21/2021] [Indexed: 12/04/2022] Open
Abstract
Lutzomyia longipalpis is the natural vector of
Leishmania (Leishmania) infantum, but it is also permissive
for several Leishmania species that are related to cutaneous
leishmaniasis (CL). Maranhao State (Northeast of Brazil) is endemic for CL and
has the highest number of cases of diffuse cutaneous leishmaniasis (DCL) in the
country. It is a rare disease associated with a defective immune response mainly
caused by L. (L.) amazonensis. Additionally, the number of
immunosuppressed patients infected with the etiologic agents of CL has
increased, including regions in which the main vectors of CL are rare.
Therefore, we investigated whether Lu. longipalpis is able to
transmit L. (L.) amazonensis to uninfected and immunosuppressed
mice, resulting in CL. For that, 291 sand flies took an initial blood meal in
mice infected with L. (L.) amazonensis. Of these, 17 underwent
a second feeding on uninfected and immunosuppressed mice (of which 58.8% were
also positive for Leishmania according to data on the
dissection of the intestine). After 27 days of infection, these mice exhibited
leishmaniotic lesions. The occurrence of parasites on the animal’s skin was
confirmed by limiting dilution and immunohistopathological analyses. Parasite
DNA was also detected in paw lesions and inguinal lymph nodes. DNA sequencing
confirmed the Leishmania species in insects and mice. The
results confirmed the ability of Lu. longipalpis to become
infected and experimentally transmit L. (L.) amazonensis to
immunosuppressed rodents, resulting in leishmaniotic lesions. Our data open
perspectives for the potential role of Lu. longipalpis in the
epidemiology of urban cutaneous leishmaniasis, especially in immunosuppressed
patients.
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Affiliation(s)
- Rosa Cristina Ribeiro da Silva
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Ciências da Saúde, São Luís, Maranhão, Brazil.,Universidade Federal do Maranhão, Departamento de Biologia, Laboratório de Genética e Biologia Molecular, São Luís, Maranhão, Brazil.,Universidade Federal do Maranhão Departamento de Biologia, Laboratório de Entomologia e Vetores, São Luís, Maranhão, Brazil
| | - Léo Nava Piorsky Dominici Cruz
- Universidade Federal do Maranhão, Departamento de Biologia, Laboratório de Genética e Biologia Molecular, São Luís, Maranhão, Brazil.,Universidade Federal do Maranhão Departamento de Biologia, Laboratório de Entomologia e Vetores, São Luís, Maranhão, Brazil
| | - João Manoel da Silva Coutinho
- Universidade Federal do Maranhão, Programa de Pós-Graduação em Ciências da Saúde, São Luís, Maranhão, Brazil.,Universidade Federal do Maranhão Departamento de Biologia, Laboratório de Entomologia e Vetores, São Luís, Maranhão, Brazil
| | | | - José Manuel Macário Rebêlo
- Universidade Federal do Maranhão Departamento de Biologia, Laboratório de Entomologia e Vetores, São Luís, Maranhão, Brazil
| | - Silma Regina Ferreira Pereira
- Universidade Federal do Maranhão, Departamento de Biologia, Laboratório de Genética e Biologia Molecular, São Luís, Maranhão, Brazil
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Ribeiro da Silva RC, Nava Piorsky Dominici Cruz L, da Silva Coutinho JM, Correia Santana NC, Macário Rebêlo JM. Maintenance and Productivity of a Lutzomyia longipalpis (Diptera: Psychodidae) Colony from an Area Endemic for Visceral and Cutaneous Leishmaniasis in Northeastern Brazil. J Med Entomol 2021; 58:1917-1925. [PMID: 33822113 DOI: 10.1093/jme/tjab053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Indexed: 06/12/2023]
Abstract
Studies on experimental sand fly infection require the availability of colonies and laboratory conditions. In Brazil, Lutzomyia longipalpis (Diptera: Psychodidae) (Lutz and Neiva 1912) is responsible for the highest infection rates by Leishmania spp. and this species is one of the most suitable species for laboratory colonization. In this study, we describe a method for growing Lu. longipalpis in laboratory conditions (10 generations) from natural populations sampled from a region of high endemicity for visceral leishmaniasis in the state of Maranhão, Northeastern Brazil. Using two methods (individualized or grouped females), the colony's highest productivity occurred in the first four generations, where all stages presented with high frequency. Nonviable eggs represented more than 50% of the total eggs produced by engorged females, while pupae were more resistant to fungal contamination, with a mortality rate of only 2%. In both methods, there was a predominance of female emergence; however, the ratio between males and females did not show significant differences, IF (P = 0.8023) and GF (P = 0.1831). Using the method of individualized females, the F4 generation took the longest to appear (234 d; 64 ± 57 d); by grouped females, F3 took the longest to appear (102 d; 47 ± 20 d). This method provides sufficient numbers of insects to perform vector competence tests for Leishmania spp. that cause the cutaneous form of leishmaniasis, usually found in Lu. longipalpis sampled from the study location.
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Affiliation(s)
- Rosa Cristina Ribeiro da Silva
- Laboratory of Entomology and Vectors, Department of Biologia, Universidade Federal do Maranhão - UFMA, Cidade Universitária do Bacanga, São Luís, Maranhão, Brazil
- Programa de Pós-Graduação em Ciências da Saúde da UFMA, Department of Ciências Fisiológicas, São Luís, Maranhão, Brazil
- Laboratório de Genética e Biologia Molecular, Department of Biologia (UFMA), São Luís, Maranhão, Brazil
| | - Léo Nava Piorsky Dominici Cruz
- Laboratory of Entomology and Vectors, Department of Biologia, Universidade Federal do Maranhão - UFMA, Cidade Universitária do Bacanga, São Luís, Maranhão, Brazil
- Laboratório de Biologia Molecular de Insetos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Department of Biologia Parasitária, Rio de Janeiro, Brazil
| | - João Manoel da Silva Coutinho
- Laboratory of Entomology and Vectors, Department of Biologia, Universidade Federal do Maranhão - UFMA, Cidade Universitária do Bacanga, São Luís, Maranhão, Brazil
- Programa de Pós-Graduação em Ciências da Saúde da UFMA, Department of Ciências Fisiológicas, São Luís, Maranhão, Brazil
| | - Núrzia Cristina Correia Santana
- Laboratory of Entomology and Vectors, Department of Biologia, Universidade Federal do Maranhão - UFMA, Cidade Universitária do Bacanga, São Luís, Maranhão, Brazil
| | - José Manuel Macário Rebêlo
- Laboratory of Entomology and Vectors, Department of Biologia, Universidade Federal do Maranhão - UFMA, Cidade Universitária do Bacanga, São Luís, Maranhão, Brazil
- Programa de Pós-Graduação em Ciências da Saúde da UFMA, Department of Ciências Fisiológicas, São Luís, Maranhão, Brazil
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Ribeiro da Silva RC, Guimarães E Silva AS, da Silva Sousa SS, Bezerra JMT, Macário Rebêlo JM, Pinheiro VCS. Occurrence of Phlebotominae (Diptera: Psychodidae) in Urban Leishmaniasis Transmission Foci in North-Eastern Brazil. J Med Entomol 2019; 56:247-253. [PMID: 30380076 DOI: 10.1093/jme/tjy182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Indexed: 06/08/2023]
Abstract
In this study, we analyzed species composition, richness, and monthly and seasonal abundance of sand flies in an urban area, municipality Caxias, state Maranhão, endemic for American visceral and tegumentary leishmaniasis. Sand flies were caught using Center for Disease Control (CDC) light traps in peridomicile (animal shelter) and extradomicile (forest) environments twice a month for 1 yr. A total of 16,332 specimens belonging to 20 species were captured. The predominant species identified in this study were Lutzomyia longipalpis (Diptera: Psychodidae) (Lutz and Neiva 1912) (43.08%) and Lutzomyia whitmani (Diptera: Psychodidae) (Antunes and Coutinho 1939) (43.02%), which occurred throughout the year (every month). The highest abundance of phlebotomine was recorded during the dry season (53.75%) and in the urban peridomicile environment (59.1%), wherein 17 species were found. In the study area, L. longipalpis and L. whitmani are reported to be effective visceral or tegumentary leishmaniasis vectors, respectively, due to their abundance throughout the year.
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Affiliation(s)
- Rosa Cristina Ribeiro da Silva
- Laboratório de Entomologia Médica da Universidade Estadual do Maranhão (LABEM-UEMA), Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
- Programa de Pós-Graduação em Biodiversidade, Ambiente e Saúde da Universidade Estadual do Maranhão, Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
- Laboratório de Entomologia e Vetores da Universidade Federal do Maranhão (LEV-UFMA), Avenida dos Portugueses, Bacanga, São Luís, Maranhão, Brazil
| | - Antonia Suely Guimarães E Silva
- Laboratório de Entomologia Médica da Universidade Estadual do Maranhão (LABEM-UEMA), Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
- Programa de Pós-Graduação em Biodiversidade, Ambiente e Saúde da Universidade Estadual do Maranhão, Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
| | - Sêmilly Suélen da Silva Sousa
- Laboratório de Entomologia Médica da Universidade Estadual do Maranhão (LABEM-UEMA), Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
- Programa de Pós-Graduação em Biodiversidade, Ambiente e Saúde da Universidade Estadual do Maranhão, Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
| | - Juliana Maria Trindade Bezerra
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias da Universidade Federal de Minas Gerais (UFMG), Avenida Presidente Antônio Carlos, Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - José Manuel Macário Rebêlo
- Laboratório de Entomologia e Vetores da Universidade Federal do Maranhão (LEV-UFMA), Avenida dos Portugueses, Bacanga, São Luís, Maranhão, Brazil
| | - Valéria Cristina Soares Pinheiro
- Laboratório de Entomologia Médica da Universidade Estadual do Maranhão (LABEM-UEMA), Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
- Programa de Pós-Graduação em Biodiversidade, Ambiente e Saúde da Universidade Estadual do Maranhão, Centro de Estudos Superiores de Caxias, Morro do Alecrim, s/n, Caxias, Maranhão, Brazil
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Guimarães-e-Silva AS, Silva SDO, Ribeiro da Silva RC, Pinheiro VCS, Rebêlo JMM, Melo MN. Leishmania infection and blood food sources of phlebotomines in an area of Brazil endemic for visceral and tegumentary leishmaniasis. PLoS One 2017; 12:e0179052. [PMID: 28837565 PMCID: PMC5570267 DOI: 10.1371/journal.pone.0179052] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 05/23/2017] [Indexed: 11/29/2022] Open
Abstract
The aims of the study were to determine the blood feeding preferences of sandflies and to identify species of Leishmania that infected phlebotomines in Caxias, Maranhão, Brazil, an area that is highly endemic for leishmaniasis. Sandflies were captured in light traps located in the peridomiciliary environments of randomly selected houses in urban and rural settings between 1800 and 0600 hours on new moon days between March 2013 and February 2015. DNA extracts from 982 engorged female sandflies were submitted to fragment length polymorphism analysis to identify infecting species of Leishmania, and blood sources were identified for 778 of these specimens. Infection by Leishmania infantum was detected in Lutzomyia longipalpis, Lu. whitmani and Lu. termitophila; L. infantum/L. braziliensis in Lu. longipalpis, Lu. whitmani and Lu. trinidadensis; L. shawi in Lu. longipalpis; L. mexicana in Lu. longipalpis; L. braziliensis in Lu. longipalpis and Lu. whitmani; L. guyanensis in Lu. longipalpis and Lu. termitophila; L. amazonensis in Lu. longipalpis and L. lainsoni or L. naiffi in Lu. longipalpis, while Lu. longipalpis and Lu. trinidadensis were infected with unidentified Leishmania sp. Blood sources were identified in 573 individual phlebotomines and the preferred hosts were, in decreasing order, chicken, dog, rodent and human with lower preferences for pig, horse, opossum and cattle. Lu. longipalpis and Lu. whitmani performed mixed feeding on man, dog and rodent, while Lu. longipalpis was the most opportunistic species, feeding on the blood of all hosts surveyed, but preferably on dog/chicken, dog/rodent and rodent/chicken. Our findings reveal the concomitant circulation of Leishmania species that cause visceral leishmaniasis and tegumentary leishmaniasis in the study area, and explain the occurrence of autochthonous human cases of both clinical forms of leishmaniasis in Caxias, Maranhão. The results support our hypothesis that, in the municipality of Caxias, transmission of Leishmania occurs in close proximity to humans.
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Affiliation(s)
- Antônia Suely Guimarães-e-Silva
- Centro de Estudos Superiores de Caxias, Laboratório de Entomologia Médica (LABEM), Universidade Estadual do Maranhão, Caxias, Maranhão, Brazil
| | - Soraia de Oliveira Silva
- Departamento de Parasitologia, Laboratório de Biologia de Leishmania, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosa Cristina Ribeiro da Silva
- Centro de Estudos Superiores de Caxias, Laboratório de Entomologia Médica (LABEM), Universidade Estadual do Maranhão, Caxias, Maranhão, Brazil
| | - Valéria Cristina Soares Pinheiro
- Centro de Estudos Superiores de Caxias, Laboratório de Entomologia Médica (LABEM), Universidade Estadual do Maranhão, Caxias, Maranhão, Brazil
| | - José Manuel Macário Rebêlo
- Departamento de Biologia, Laboratório de Entomologia e Vetores, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | - Maria Norma Melo
- Departamento de Parasitologia, Laboratório de Biologia de Leishmania, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail: ,
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