Historical analysis of leishmaniasis cases in the transamazonian region: from 2009 to 2019

Objective: To determine the total number of notified cases, new cases and recurrence of American Tegumentary Leishmaniasis (ATL), to investigate the association between HIV coinfection and the presence of cutaneous lesion, as well to assess the concordance of two different laboratorial procedures: parasitological and histopathological in this region. Methods: This is a cross-sectional study. The research used data from the Information System for Notifiable Diseases, hence forth designated as SINAN (Sistema de Informação de Agravos de Notificação) that contained 6,183 cases of leishmaniasis in 9 municipalities. Results: As results, 5795 were of new cases and 351 recurrence cases. Among the cases 1,146 patients were tested for HIV, 16 presented coinfection from these 15 developed cutaneous lesion. In the overall studied population 5,690 subjects manifested cutaneous lesion. There was no agreement of the results regarding the quality of the parasitological and histopathological exams, demonstrating that they are poorly replicable (p <0.005). Conclusion: The ATL is endemic in the transamazonian region posing as a major public health problem. All patients with leishmaniasis must be tested for HIV and health professionals must register on the notification form. The tests to diagnose leishmaniasis need to be more specific and sensitive.

American Tegumentary Leishmaniasis in Montes Claros: an epidemiological study

Introduction: American Tegumentary Leishmaniasis (ATL), or kala azar, is a serious chronic disease caused by Leishmania spp. It is an infectious and non-contagious disease that affects both humans and several species of wild and domestic animals, presenting the clinical forms of cutaneous, mucocutaneous and diffuse cutaneous. ATL is classified as a generalized zoonotic disease that has a global impact. It is caused by protozoa of the genus Leishmania and is considered a serious public health problem. Objective: To describe the epidemiological profile of cases found in Montes Claros-MG. Methodology: An epidemiological assessment was performed based on secondary data from SINAN/MS from January 2010 to December 2015. Results: From 2010 to 2015, 286 cases of ATL were registered, with the majority of cases occurring in children under 19 years of age (31.81%) and patients over 59 years (17.83%) had a lower percentage of disease involvement. The first choice drug used by patients was Glucantime (87.06%). The most affected gender was male (52.44%) and most patients had no comorbidities (76.96%). Conclusion: In Montes Claros, Minas Gerais, ATL presented high cases during the research period. In this sense, this study guides the development of new researches that address and monitor the spread of the disease by monitoring urban areas concomitantly with the capture of animals for the presence of the parasite, thus assisting in public health decision-making in controlling the disease.

Anthropogenic Dispersal of Leishmania (Viannia) braziliensis in the Americas: A Plausible Hypothesis

There are several gaps in our knowledge on the origin and spread of Leishmania (Viannia) braziliensis, an etiological agent of cutaneous and mucocutaneous or American tegumentary leishmaniasis, to different biomes, hosts, and vectors, with important epidemiological implications, including the possible existence of an anthroponotic component. Historical, biological, and epidemiological evidence suggests that Leishmania (V.) braziliensis and its variants were preexistent in Amazonia with great genetic variability, where they dispersed with less variability to other regions (clonal expansion). During pre-Columbian times the parasite may have been transported by migrating humans and probably also their dogs, from western Amazonia to the high inter-Andean valleys and from there to other regions of South America. The same thing could have happened later, in the same way, when it spread to non-Amazonian regions of Brazil and other countries of South and Central America, between the late 19th and early 20th centuries, during the so-called Rubber Boom and construction of the Madeira-Mamoré Railway in the Brazilian Amazon, by migrant workers who later returned to their places of origin, transporting the agent. The parasite’s dispersal in genetic correlated clusters, involving unexpectedly distinct ecosystems in Brazil (Amazonian, Cerrado, Caatinga and Atlantic Forest biomes), has continued until the present through human displacement. The infection of certain species of domestic, synanthropic and even wild animals, could be secondary to anthropogenic introduction of L. (V.) braziliensis in new environments. We admit the same phenomena happening in the probable transference of Leishmania infantum (visceral leishmaniasis), and of Yersinia pestis (plague) from the Old world to the New world, generating domestic and wild enzotic cycles from these agents. These assumptions associated with human infections, chronicity and parasite persistence with possibility of recovery of Leishmania in peripheral blood, skin and scars of cured or asymptomatic patients, (that may provide an alternative blood meal), along with the sand flies’ adaptation to the peri-domicile and the high susceptibility of domestic dogs, horses, mules and cats to the parasite, can reinforce the evidence of anthropogenic spread of L. (V.) braziliensis.

Serological study of American Tegumentary Leishmaniasis in working horses and contact dogs in the city of Bandeirantes, Parana

The American Tegumentary Leishmaniasis (ATL) occurs in several parts of the world, in Brazil and also in the State of Parana, it is a disease of great importance in public health, since it affects animals and humans, with a zoonotic character. Leishmaniasis is found in two forms, tegumentary and visceral, and has sandflies as vectors and wild animals and domestic dogs as reservoirs. ATL is considered an endemic disease in the city of Bandeirantes, with human cases occurring in several urban and rural locations, mainly in areas close to forest remnants, peri-urban and peripheral areas, where vulnerable populations live in general, and with precarious basic sanitation conditions. In these regions also live the participants of the wagon driver project, who own several working horses. The project provides guidance on management, good practices, disease prevention, and animal welfare. Since the role of horses as reservoirs and in the chain of transmission of ATL is not well known, the aim of this study was to carry out a serological study of ATL in horses and in the contact dogs of the participants of the " wagon driver" project, at UENP-CLM, to evaluate seropositivity in these species. Blood samples were collected from 20 horses and 12 contact dogs. A serological study, using the ELISAi test for ATL diagnosis, was carried out on the horses and dogs in relation to this study population, to assess seropositivity. In the serological survey, eight horses out of 20 animals (40%) and four dogs out of 12 animals (33.33%) were seropositive, a result considered significant, indicating the presence of the disease and the risk of transmission where they live. The occurrence of human cases and the presence of ATL vectors have already been identified in several locations in the city. Due to the lack of knowledge about the disease and the difficulty in controlling the vectors, health education is necessary in order to provide the population with orientation on how to prevent the disease, as well as entomological surveillance and new serological studies in areas at risk for ATL transmission. The results indicate that there may be importance in the role of horses as reservoirs and in the transmission of Tegumentary Leishmaniasis, which still needs to be clarified.