1
|
Courtenay O, Marinho-Júnior JF, Brito MEF, Monteiro JFCLS, Shaw JJ, Brandão-Filho SP. Incidence of Human and Free-Ranging Wild Rodent Infections with Leishmania ( Viannia) braziliensis, Aetiological Agent of Cutaneous Leishmaniasis. Pathogens 2023; 12:1395. [PMID: 38133280 PMCID: PMC10746019 DOI: 10.3390/pathogens12121395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/06/2023] [Accepted: 11/19/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Human and wild rodent infection rates with Leishmania (Viannia) braziliensis are needed to differentiate transmission pathways in anthropogenically altered habitats. METHODS Human participants in northeast Brazil were tested by the leishmanin skin test (LST) and inspected for lesions/scars characteristic of American clinical leishmaniasis (ACL). Molecular (PCR/qPCR) test records of free-ranging rodents were available from a concurrent capture-mark-recapture study. Force of Infection (λ) and recovery (ρ) rates were estimated from cross-sectional and longitudinal datasets. RESULTS Cumulative prevalences of human LST+ves and ACL scar+ves were 0.343-0.563 (n = 503 participants) and 0.122-0.475 (n = 503), respectively. Active ACL lesions were not detected. Annual rates of LST conversions were λ = 0.03-0.15 and ρ = 0.02-0.07. The probability of infection was independent of sex and associated with increasing age in addition to the period of exposure. Rodents (n = 596 individuals of 6 species) showed high rates of exclusively asymptomatic infection (λ = 0.222/month) and potential infectiousness to the sand fly vector. Spatially concurrent rodent and household human infection prevalences were correlated. CONCLUSIONS Human exposure to L. (V.) braziliensis continues to be high despite the substantial drop in reported ACL cases in recent years. Spill-over transmission risk to humans from rodents in peridomestic habitats is likely supported by a rodent infection/transmission corridor linking houses, plantations, and the Atlantic Forest.
Collapse
Affiliation(s)
- Orin Courtenay
- Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, and School of Life Sciences, University of Warwick, Coventry CV8 2PB, UK
| | - José F. Marinho-Júnior
- Departament of Immunology, Instituto Aggeu Magalhães/FIOCRUZ, Cidade Universitária, Recife 50740-465, PE, Brazil; (J.F.M.-J.); (M.E.F.B.); (J.F.C.L.S.M.); (S.P.B.-F.)
| | - Maria Edileuza F. Brito
- Departament of Immunology, Instituto Aggeu Magalhães/FIOCRUZ, Cidade Universitária, Recife 50740-465, PE, Brazil; (J.F.M.-J.); (M.E.F.B.); (J.F.C.L.S.M.); (S.P.B.-F.)
| | - Juliana F. C. L. S. Monteiro
- Departament of Immunology, Instituto Aggeu Magalhães/FIOCRUZ, Cidade Universitária, Recife 50740-465, PE, Brazil; (J.F.M.-J.); (M.E.F.B.); (J.F.C.L.S.M.); (S.P.B.-F.)
| | - Jeffrey J. Shaw
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 03001-000, SP, Brazil;
| | - Sinval P. Brandão-Filho
- Departament of Immunology, Instituto Aggeu Magalhães/FIOCRUZ, Cidade Universitária, Recife 50740-465, PE, Brazil; (J.F.M.-J.); (M.E.F.B.); (J.F.C.L.S.M.); (S.P.B.-F.)
| |
Collapse
|
2
|
Silva CJD, Lima KPB, Monteiro JFDCLS, Silva AKSFD, Silva FJD, Pereira AMDS, Hernandes VP, Silva EDD, Silva CSDAGE, Brandão Filho SP, Brito MEFD. Leishmania V. braziliensis infection in asymptomatic domestic animals within an endemic region in the Northeast of Brazil. Rev Soc Bras Med Trop 2022; 55:e0600. [PMID: 35976338 PMCID: PMC9405948 DOI: 10.1590/0037-8682-0600-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background: American cutaneous leishmaniasis is a commonly neglected, vector-borne tropical parasitic disease that is a major public health concern in Brazil. Leishmania (Viannia) braziliensis is the main species associated with the disease. Accurate diagnosis is based on epidemiological surveillance, clinical assessment, and laboratory testing. Leishmania (V.) braziliensis has been detected in several wild and synanthropic mammals. Their epidemiological role has not been entirely elucidated. This study aimed to assess potential L. braziliensis infections in asymptomatic domestic animals, by molecular and serological testing in endemic areas, in the metropolitan region of Recife. Methods: Blood samples and conjunctival fluids were collected from 232 animals (canids, felids, equines, and caprines) for the detection of L. braziliensis using molecular tests (conventional and real-time polymerase chain reaction [PCR and qPCR]). For immunological detection, blood samples from 115 dogs were assessed using enzyme-linked immunosorbent assay. Results: Real-time quantitative PCR showed positive results for blood and conjunctival samples in all investigated species. The results of the blood and conjunctival samples were 68.2% and 26.9% in Canis familiaris, 100% and 41.7% in Felis catus, 77.3% and 30.8% in Equus caballus/Equus asinus, and 50% and 33.3% in Capra hircus samples, respectively. Conclusions: Results from this study adds valuable information to our understanding of the role of asymptomatic domestic animals, L. braziliensis life cycle, and American cutaneous leishmaniasis in Northeast Brazil.
Collapse
Affiliation(s)
- Claudio Júlio da Silva
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil.,Núcleo de Vigilância em Saúde de Moreno, Moreno, PE, Brasil.,Universidade Fernando Pessoa, Faculdade de Ciência e Tecnologia, Porto, Portugal
| | - Karina Patricia Baracho Lima
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil
| | | | | | - Fernando José da Silva
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil
| | - Allana Maria de Souza Pereira
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil
| | - Valéria Pereira Hernandes
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil
| | - Elis Dionísio da Silva
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil
| | - Cláudia Sofia de Assunção Gonçalves E Silva
- Universidade Fernando Pessoa, Faculdade de Ciência e Tecnologia, Porto, Portugal.,Universidade Fernando Pessoa, Centro de Investigação em Biomedicina, Unidade de Investigação em Energia, Ambiente e Saúde, Porto, Portugal
| | - Sinval Pinto Brandão Filho
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil
| | - Maria Edileuza Felinto de Brito
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Laboratório de Imunoparasitologia, Recife, PE, Brasil
| |
Collapse
|
3
|
Peralta MF, Usseglio NA, Bracamonte ME, Guzmán ML, Olivera ME, Marco JD, Barroso PA, Carrer DC. Efficacy of topical Miltefosine formulations in an experimental model of cutaneous leishmaniasis. Drug Deliv Transl Res 2022; 12:180-196. [PMID: 33502733 DOI: 10.1007/s13346-021-00896-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
Cutaneous leishmaniasis (CL) is a neglected tropical disease endemic in ~ 90 countries, with an increasing incidence. Presently available pharmacotherapy implies the systemic administration of moderately/very toxic drugs. Miltefosine (Milt) is the only FDA-approved drug to treat CL via the oral route (Impavido®). It produces side effects; in particular, teratogenic effects are of concern. A topical treatment would have the great advantage of minimising the systemic circulation of the drug, preventing side effects. We prepared dispersions containing Milt and liposomes of different compositions to enhance/modulate trans-epidermal penetration and evaluated in vitro and in vivo efficacy and toxicity, in vitro release rate of the drug and particles size stability with time. Treatments were topically administered to BALB/c mice infected with Leishmania (Leishmania) amazonensis. The dispersions containing 0.5% Milt eliminated 99% of the parasites and cured the lesions with a complete re-epithelisation, no visible scar and re-growth of hair. Fluid liposomes decreased the time to heal the lesion and the time needed to eliminate viable amastigotes from the lesion site. Relapse of the infection was not found 1 month after treatment in any case. Ultraflexible liposomes on the other hand had no significant in vitro effect but decreased in vivo efficacy. A topical Milt formulation including fluid liposomes seems a promising treatment against CL.
Collapse
Affiliation(s)
- Ma Florencia Peralta
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC- CONICET- UNC, 5016, Córdoba, Argentina
| | - Nadina A Usseglio
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC- CONICET- UNC, 5016, Córdoba, Argentina
- Departamento de Ciencias Farmacéuticas, UNITEFA - CONICET - Universidad Nacional de Córdoba, 5016, Córdoba, Argentina
| | - Ma Estefanía Bracamonte
- Instituto de Patología Experimental - CONICET - , Universidad Nacional de Salta, 4400, Salta, Argentina
| | - Ma Laura Guzmán
- Departamento de Ciencias Farmacéuticas, UNITEFA - CONICET - Universidad Nacional de Córdoba, 5016, Córdoba, Argentina
| | - Ma Eugenia Olivera
- Departamento de Ciencias Farmacéuticas, UNITEFA - CONICET - Universidad Nacional de Córdoba, 5016, Córdoba, Argentina
| | - J Diego Marco
- Instituto de Patología Experimental - CONICET - , Universidad Nacional de Salta, 4400, Salta, Argentina
| | - Paola A Barroso
- Instituto de Patología Experimental - CONICET - , Universidad Nacional de Salta, 4400, Salta, Argentina
| | - Dolores C Carrer
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC- CONICET- UNC, 5016, Córdoba, Argentina.
| |
Collapse
|
4
|
Risk and protective factors of Leishmaniasis in the rural area of the western border region of Rio Grande do Sul, Brazil. BMC Vet Res 2021; 17:330. [PMID: 34649576 PMCID: PMC8515718 DOI: 10.1186/s12917-021-03021-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 09/13/2021] [Indexed: 12/01/2022] Open
Abstract
Background The Leishmaniases are on the top of the global list of tropical neglected diseases. The number of infected dogs in South America is estimated in millions and correlated to disease cases in humans, especially in Brazil. Equines may get infected too and can play a role in the epidemiological chain. Thus, the aim of the present study was to evaluate risk and protective factors of leishmaniasis in rural areas of the western border region of Rio Grande do Sul state, Brazil by Leishmania spp. protozoa molecular detection and serological evaluation (ELISA) in equine and canine blood samples. This work included nine farms around the city of Uruguaiana. Epidemiologic information regarding farm characteristics and biologic material collection of canine (22) and equine (91), totalizing 113 samples was collected. The polymerase chain reaction (PCR) technique was used to detect Leishmania spp. in biological samples. Variables related to the farm were collected and evaluated through descriptive analysis followed by chi-square test and a logistic regression analysis. Results Nineteen positive samples (19/113 – 16,81%) were detected, being 18 equines and 1 canine, in six of the nine farms included in the study. No animal showed clinical signs of the disease. According to the variables analyzed, when compared each characteristic separately, the presence of abundant vegetation and poor hygiene demonstrated to be risk factors to Leishmania infection in rural areas. The logistic regression showed that excellent general hygiene, proximity to the weir and trimmed grass were protective factors (p=0.038, p=0.001 and p=0.014, respectively). Having excellent hygiene represents a 70% lower chance of getting infected, keeping the grass cut protects the animal by more than 90% and the proximity of the weir represents a protective factor of 96%. Conclusions The presence of Leishmania infection in the western border region of Rio Grande do Sul was 16,81% and it was influenced by farm characteristics. The role of the excellent general hygiene as a protective factor is extremely relevant in the leishmaniases prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-03021-6.
Collapse
|
5
|
Lana JT, Mallipudi A, Ortiz EJ, Arevalo JH, Llanos-Cuentas A, Pan WK. Risk factors for cutaneous leishmaniasis in a high-altitude forest region of Peru. Trop Med Health 2021; 49:40. [PMID: 34001266 PMCID: PMC8130303 DOI: 10.1186/s41182-021-00332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND American cutaneous leishmaniasis (CL) is a neglected tropical disease typically associated with men working in remote, sylvatic environments. We sought to identify CL risk factors in a highly deforested region where anecdotal reports suggested an atypical proportion of women and children were infected with CL raising concern among authorities that transmission was shifting towards domestic spaces and population centers. METHODS We describe the characteristics of CL patients from four participating clinics after digitizing up to 10 years of patient data from each clinic's CL registries. We assessed risk factors of CL associated with intradomestic, peridomestic, or non-domestic transmission through a matched case-control study with 63 patients who had visited these same clinics for CL (cases) or other medical reasons (controls) between January 2014 and August 2016. The study consisted of an in-home interview of participants by a trained field worker using a standard questionnaire. Risk factors were identified using bivariable and multivariable conditional logistic regression. RESULTS Between 2007 and 2016, a total of 529 confirmed CL positives were recorded in the available CL registries. Children and working aged women made up 58.6% of the cases. Our final model suggests that the odds of sleeping in or very near an agricultural field were five times greater in cases than controls (p = 0.025). Survey data indicate that women, children, and men have similar propensities to both visit and sleep in or near agricultural fields. CONCLUSIONS Women and children may be underappreciated as CL risk groups in agriculturally dependent regions. Despite the age-sex breakdown of clinical CL patients and high rates of deforestation occurring in the study area, transmission is mostly occurring outside of the largest population centers. Curbing transmission in non-domestic spaces may be limited to decreasing exposure to sandflies during the evening, nighttime, and early morning hours. Our paper serves as a cautionary tale for those relying solely on the demographic information obtained from clinic-based data to understand basic epidemiological trends of vector-borne infections.
Collapse
Affiliation(s)
- Justin T Lana
- Nicholas School of the Environment, Duke University, Durham, NC, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Andrés Mallipudi
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ernesto J Ortiz
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jairo H Arevalo
- Facultad de Medicina San Fernando, Universidad Nacional de San Martin Tarapoto, Tarapoto, San Martin, Perú
- Laboratorio Referencial de Salud Publica San Martin, Tarapoto, San Martin, Peru
| | - Alejandro Llanos-Cuentas
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Lima, Peru
| | - William K Pan
- Nicholas School of the Environment, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| |
Collapse
|
6
|
Melo MGND, Morais RCSD, Goes TCD, Silva RPE, Morais RFD, Guerra JADO, Brito MEFD, Brandão Filho SP, Cavalcanti MDP. Clinical and epidemiological profiles of patients with American cutaneous leishmaniasis from the states of Pernambuco and Amazonas, Brazil. Rev Soc Bras Med Trop 2020; 53:e20200083. [PMID: 33263681 PMCID: PMC7723372 DOI: 10.1590/0037-8682-0083-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION: Brazil has a high number of cases of American cutaneous leishmaniasis (ACL)
in the north and northeast regions. Therefore, continuous surveillance of
environmental and socioeconomic factors in endemic areas is needed to
develop strategic control measures. This study aimed to describe the
clinical and epidemiological profiles of patients with ACL. METHODS: All patients were from the states of Amazonas and Pernambuco, and
examinations were carried out between 2015 and 2018. All patients had a
clinical and epidemiological history compatible with ACL after positive
diagnostic tests. Information obtained from medical records included gender,
employment activity, level of education, age, and number and sites of
lesions. RESULTS: A total of 213 patients were included, of whom 30.98% were female and 69.02%
were male. The main employment activity was agriculture (27.56%). The most
common level of education was elementary (62.42%). The average age was
approximately 39 years. The majority of the patients presented only with one
lesion (54.87%), and legs/feet were the most commonly affected area
(48.25%), followed by the arms/hands (44.75%). CONCLUSIONS: These data demonstrated that irrespective of the patients’ places of origin,
interventions need to be focused on men of economically productive age, in
view of the high risk of exposure to the vector in this group. Education
activities need to be directed to farmers about the importance of protection
against ACL vectors during work. Such information must also be directed to
employers as a way of implementing and maintaining appropriate working
conditions and stepping up vector control.
Collapse
|
7
|
Gonçalves AFLDS, Lima SSD, Silva APDSC, Barbosa CC. Spatial dynamics and socioeconomic factors correlated with American cutaneous leishmaniasis in Pernambuco, Brazil from 2008 to 2017. Rev Soc Bras Med Trop 2020; 53:e20190373. [PMID: 32348432 PMCID: PMC7198070 DOI: 10.1590/0037-8682-0373-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/12/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION: American cutaneous leishmaniasis (ACL) is a public health problem and has
been associated with country’s territory. We aimed to analyze the spatial
dynamics and socioeconomic factors correlated to the incidence of ACL in
Pernambuco, Brazil from 2008 to 2017. METHODS: A cross-sectional, ecological study was conducted in the Brazilian
municipalities. Patient data were obtained from the Health Hazard
Notification System (SINAN); indicators and incidence for the total period
and for quinquennium were obtained. Socioeconomic factors were analyzed to
evaluate the association between the incidence of ACL and presence of
bathroom and running water, garbage collection availability, inadequate
water supply, sanitation, rural population, per capita income, and
vulnerability to poverty. Spatial analysis considered the gross incidence;
the Bayesian local empirical method and Moran spatial autocorrelation index
were applied using Terra View and QGIS. RESULTS: The incidence of ACL reduced (0.29/100,000 inhabitants per year).
Individuals with ACL were young adults (30.3%), men (60.2%), brown skinned
(62.9%), rural residents (70.6%), and less educated (46.7%); had
autochthonous transmission (78.8%); developed the cutaneous form (97.2%);
had evolution to cure (82.7%); and were diagnosed using the clinical
epidemiological criterion (70.5%). ACL occurred in the large part of the
state and showed heterogeneous distribution, with persistence of two high
priority intervention clusters covering Health Regions I, II, III, IV, and
XII. CONCLUSIONS: Spatial analysis and epidemiological indicators complement each other. The
combination of these methods can improve the understanding on ACL
occurrence, which will help subsidize planning and enhance the quality and
effectiveness of healthcare interventions.
Collapse
Affiliation(s)
| | - Suzanne Santos de Lima
- Departamento de Saúde Coletiva, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil
| | | | | |
Collapse
|
8
|
Mendes APO, Oliveira BC, Pereira AMS, Castro MCAB, Souza MA, Brito MEF, Araújo FF, Teixeira-Carvalho A, Martins-Filho OA, Pereira VRA. American tegumentary leishmaniasis diagnosis using L. (V.) braziliensis fixed promastigotes: a comparative performance of serological tests and spontaneous cure identification. BMC Infect Dis 2019; 19:1015. [PMID: 31783798 PMCID: PMC6884772 DOI: 10.1186/s12879-019-4642-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/20/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The present study aimed to demonstrate the applicability of a flow cytometry-based serology approach to identify spontaneous cure by the detection of immunoglobulin G, and also, the diagnosis and cure criterion by the IgG1 isotype in American Tegumentary Leishmaniasis - ATL caused by L. (V.) braziliensis. Also, a comparison between flow cytometry with the serological conventional technique was performed. METHODS Forty five individuals were included in study. They were assessed in two moments: First, 8 subjects spontaneously cured of ATL, 8 healthy individuals and 15 patients who had a positive diagnosis for ATL were selected before treatment to identify spontaneous cure by immunoglobulin G detection. Secondly, 14 patients who were positive for ATL were selected and had their blood collected before and 1, 2 and 5 years after treatment, respectively, for the diagnostic tests (ELISA and flow cytometry) and cure criterion evaluation using the IgG1 isotype. RESULTS The analysis of the mean percentage of positive fluorescent parasites (PPFP) along with the titration curves of IgG anti-fixed promastigotes of L.(V.)braziliensis, confirmed the applicability of this method for monitoring spontaneous cure in ATL with outstanding co-positivity (100%) and co-negativity (100%) performance indexes. Regarding the results of the comparison between flow cytometry and ELISA it was seen that there was a better accuracy of the first one in relation to the other. When IgG1 applicability was evaluated, it was observed that before treatment, 36.8% of the patients were negative; in patients 1 year post-treatment, 82.3%; 2 years post-treatment, 27.2% and in patients 5 years post-treatment, 87.5%. The overall analysis of the results suggests that flow cytometry can be applied to ATL detection, and that the use of IgG1 isotype has possibilities to contribute as a more specific diagnostic method. CONCLUSIONS Therefore, this area has great perspectives use for the diagnosis and cure criterion, and also it can be scaled up with the possibility to characterize the different clinical stages of the disease. Together, these findings demonstrate the applicability of a flow cytometry-based serology approach and opens up new avenues of research with this technique, such as the understanding the humoral response in ATL patients.
Collapse
Affiliation(s)
- Andresa Pereira Oliveira Mendes
- Departamento de Imunologia, Instituto Aggeu Magalhães, FIOCRUZ, Av. Moraes Rego s/n, Cidade Universitária, Recife, Pernambuco CEP: 50670-420 Brazil
- Universidade Federal de Pernambuco, Programa de Pós-graduação em Inovação Terapêutica, Recife, Pernambuco Brazil
| | - Beatriz Coutinho Oliveira
- Departamento de Imunologia, Instituto Aggeu Magalhães, FIOCRUZ, Av. Moraes Rego s/n, Cidade Universitária, Recife, Pernambuco CEP: 50670-420 Brazil
- Universidade Federal de Pernambuco, Programa de Pós-graduação em Inovação Terapêutica, Recife, Pernambuco Brazil
| | - Allana Maria S. Pereira
- Departamento de Imunologia, Instituto Aggeu Magalhães, FIOCRUZ, Av. Moraes Rego s/n, Cidade Universitária, Recife, Pernambuco CEP: 50670-420 Brazil
| | | | - Marina Assis Souza
- Departamento de Imunologia, Instituto Aggeu Magalhães, FIOCRUZ, Av. Moraes Rego s/n, Cidade Universitária, Recife, Pernambuco CEP: 50670-420 Brazil
| | - Maria Edileuza Felinto Brito
- Departamento de Imunologia, Instituto Aggeu Magalhães, FIOCRUZ, Av. Moraes Rego s/n, Cidade Universitária, Recife, Pernambuco CEP: 50670-420 Brazil
| | | | | | | | - Valeria Rêgo Alves Pereira
- Departamento de Imunologia, Instituto Aggeu Magalhães, FIOCRUZ, Av. Moraes Rego s/n, Cidade Universitária, Recife, Pernambuco CEP: 50670-420 Brazil
| |
Collapse
|
9
|
Bueno MG, Catão-Dias JL, de Oliveira Laroque P, Arruda Vasconcellos S, Ferreira Neto JS, Gennari SM, Ferreira F, Laurenti MD, Umezawa ES, Kesper N, Kirchgatter K, Oliveira Guimarães L, Pavanato HJ, Valença-Montenegro MM. Infectious Diseases in Free-Ranging Blonde Capuchins, Sapajus flavius, in Brazil. INT J PRIMATOL 2017. [DOI: 10.1007/s10764-017-9994-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
10
|
Dynamics of American tegumentary leishmaniasis in a highly endemic region for Leishmania (Viannia) braziliensis infection in northeast Brazil. PLoS Negl Trop Dis 2017; 11:e0006015. [PMID: 29095818 PMCID: PMC5685640 DOI: 10.1371/journal.pntd.0006015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/14/2017] [Accepted: 10/05/2017] [Indexed: 11/19/2022] Open
Abstract
Background American Tegumentary Leishmaniasis (ATL) caused by Leishmania braziliensis is endemic in Corte de Pedra, Northeast Brazil. Most L. braziliensis infections manifest as localized cutaneous leishmaniasis (CL). Disseminated manifestations include mucosal leishmaniasis (ML), present at a low constant level for several decades, and newly emerging disseminated leishmaniasis (DL). Surprisingly, DL has recently surpassed ML in its spatial distribution. This led us to hypothesize that distinct forms of ATL might spread in different patterns through affected regions. Methodology/Principal findings We explored the incidence and geographic dispersion of the three clinical types of ATL over a span of nearly two decades in Corte de Pedra. We obtained the geographic coordinates of the homes of patients with ATL during 1992–1996, 1999–2003 and 2008–2011. The progressive dispersion of ML or DL in each time period was compared to that of CL in 2008–2011 with the Cusick and Edward’s geostatistical test. To evaluate whether ATL occurred as clusters, we compared each new case in 2008–2011 with the frequency of and distance from cases in the previous 3 to 12 months. The study revealed that DL, ML and CL actively spread within that region, but in distinct patterns. Whereas CL and DL propagated in clusters, ML occurred as sporadic cases. DL had a wider distribution than ML until 2003, but by 2011 both forms were distributed equally in Corte de Pedra. The incidence of ML fluctuated over time at a rate that was distinct from those of CL and DL. Conclusions/Significance These findings suggest that CL and DL maintain endemic levels through successive outbreaks of cases. The sporadic pattern of ML cases may reflect the long and variable latency before infected patients develop clinically detectable mucosal involvement. Intimate knowledge of the geographic distribution of leishmaniasis and how it propagates within foci of active transmission may guide approaches to disease control. American tegumentary leishmaniasis (ATL) caused by Leishmania braziliensis is characterized by lesions to the skin and/or mucosal surfaces of the oropharynx. It is widely distributed in endemic regions of northeast Brazil and has been difficult to control. Three common clinical forms of L. braziliensis infections are localized skin ulcers called cutaneous leishmaniasis (CL), mucosal leishmaniasis (ML) affecting mucosal surfaces, and disseminated leishmaniasis (DL), a recently described form with widespread skin lesions. Using GPS and epidemiologic data we explored the incidence and pattern of spread of ATL in the highly endemic region of Corte de Pedra, Brazil between 1992 and 2011. Geographic clusters of CL and DL cases were observed. In contrast, there was a sporadic non-clustered pattern of ML cases in the study area. The numbers of new cases of CL and DL presented similar fluctuation during the study period, but ML incidences were never correlated to those of CL and DL. We conclude that all forms of ATL actively spread within affected foci, but in different patterns. CL and DL cases occur in clusters suggesting active spread of causative parasite strains, whereas ML cases occurred in a sporadic pattern suggesting it may emerge due to factors such as host immunity or environmental conditions.
Collapse
|
11
|
Karimkhani C, Wanga V, Coffeng LE, Naghavi P, Dellavalle RP, Naghavi M. Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013. THE LANCET. INFECTIOUS DISEASES 2016; 16:584-591. [PMID: 26879176 DOI: 10.1016/s1473-3099(16)00003-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 12/17/2015] [Accepted: 12/22/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND High-quality epidemiological studies evaluating the burden of cutaneous leishmaniasis worldwide are lacking. We compared the burden of cutaneous leishmaniasis in each country to the overall global burden and assessed the equality of cutaneous leishmaniasis burden across different countries and regions. METHODS Data were extracted from scientific literature, hospital sources, country reports, and WHO sources on the prevalence of sequalae of both acute and chronic cutaneous leishmaniasis. Prevalence data were combined with a disability weight to yield years lived with disability. Disability-adjusted life-years (DALYs) are a sum of the years lived with disability and years of life lost (or mortality, assumed to be zero). We compared DALYs due to cutaneous leishmaniasis for 152 countries using standard Z score analysis with Bonferroni correction (p<0·003) and generation of Lorenz curves with a Gini coefficient. FINDINGS In 2013, the global mean age-standardised DALYs for cutaneous leishmaniasis was 0·58 per 100 000 people. Nine countries had significantly greater DALYs from cutaneous leishmaniasis than the mean: Afghanistan (87·0), Sudan (20·2), Syria (9·2), Yemen (6·2), Iraq (6·0), Burkina Faso (4·8), Bolivia (4·6), Haiti (4·1), and Peru (4·0). The Gini coefficient was 0·89. Andean Latin America, North Africa and Middle East, western sub-Saharan Africa, and south Asia had the highest DALYs from cutaneous leishmaniasis. Among males, Palestine had the highest incidence rates (616·2 cases per 100 000 people) followed by Afghanistan (566·4), Syria (357·1), and Nicaragua (354·8). Among females, Afghanistan had the highest incidence rates (623·9) followed by Syria (406·3), Palestine (222·1), and Nicaragua (180·8). Similar proportions of males and females had cutaneous leishmaniasis in most countries with a high incidence. INTERPRETATION The burden from cutaneous leishmaniasis mainly falls on countries in Africa and the Middle East. Global and national data on the burden of cutaneous leishmaniasis disease are pivotal to promote field studies and initiate behavioural change. FUNDING Bill & Melinda Gates Foundation.
Collapse
Affiliation(s)
- Chante Karimkhani
- University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
| | - Valentine Wanga
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Luc E Coffeng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Public Health, Erasmus MC University Medical Center Rotterdam, CA Rotterdam, Netherlands
| | - Paria Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Dermatology Service, United States Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA; Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| |
Collapse
|
12
|
Andrade MS, Courtenay O, F. Brito ME, Carvalho FG, Carvalho AWS, Soares F, Carvalho SM, Costa PL, Zampieri R, Floeter-Winter LM, Shaw JJ, Brandão-Filho SP. Infectiousness of Sylvatic and Synanthropic Small Rodents Implicates a Multi-host Reservoir of Leishmania (Viannia) braziliensis. PLoS Negl Trop Dis 2015; 9:e0004137. [PMID: 26448187 PMCID: PMC4598029 DOI: 10.1371/journal.pntd.0004137] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/10/2015] [Indexed: 11/28/2022] Open
Abstract
Background The possibility that a multi-host wildlife reservoir is responsible for maintaining transmission of Leishmania (Viannia) braziliensis causing human cutaneous and mucocutaneous leishmaniasis is tested by comparative analysis of infection progression and infectiousness to sandflies in rodent host species previously shown to have high natural infection prevalences in both sylvatic or/and peridomestic habitats in close proximity to humans in northeast Brazil. Methods The clinical and parasitological outcomes, and infectiousness to sandflies, were observed in 54 colonized animals of three species (18 Necromys lasiurus, 18 Nectomys squamipes and 18 Rattus rattus) experimentally infected with high (5.5×106/ml) or low (2.8×105/ml) dose L. (V.) braziliensis (MBOL/BR/2000/CPqAM95) inoculum. Clinical signs of infection were monitored daily. Whole animal xenodiagnoses were performed 6 months post inoculation using Lutzomyia longipalpis originating from flies caught in Passira, Pernambuco, after this parasite evaluation was performed at necropsy. Heterogeneities in Leishmania parasite loads were measured by quantitative PCR in ear skin, liver and spleen tissues. Results All three rodent species proved to establish infection characterized by short-term self-resolving skin lesions, located on ears and tail but not on footpads (one site of inoculation), and variable parasite loads detected in all three tissues with maximum burdens of 8.1×103 (skin), 2.8×103 (spleen), and 8.9×102 (liver). All three host species, 18/18 N. lasiurus, 10/18 N. squamipes and 6/18 R. rattus, also proved infectious to sandflies in cross-sectional study. R. rattus supported significantly lower tissue parasite loads compared to those in N. lasiurus and N. squamipes, and N. lasiurus appeared to be more infectious, on average, than either N. squamipes or R. rattus. Conclusions A multi-host reservoir of cutaneous leishmaniasis is indicated in this region of Brazil, though with apparent differences in the competence between the rodent species. The results provide preliminary insights into links between sylvatic and peri-domestic transmission cycles associated with overlaps in the rodent species’ ecological niches. Across the Americas, Leishmania (V.) braziliensis is the predominant Leishmania species causing cutaneous and mucocutaneous leishmaniasis in humans. Transmitted by Phlebotomine sandflies, questions remain about the epidemiological contributions of the numerous zoonotic and more domestic host species. Domestication of the principal vector and human infection patterns suggest that human infection risk is predominantly peridomestic, whereas control strategies will be more complex if there is a link to a wildlife transmission cycle. Almost no studies have been conducted on the transmission potential of natural hosts of L. (V.) braziliensis. This study evaluates the infectiousness of experimentally infected natural rodent host species, that in different ecological habitats are proposed to act as a single or a multi-host reservoir. Clinical and parasitological development, and the ability to transmit Leishmania to sandflies, was observed under experimental conditions using a single strain of L. (V.) braziliensis isolated from the wild rat, Necromys lasiurus. Xenodiagnoses were performed with laboratory bred sand fly females established from a local population of Lutzomyia longipalpis. All three rodent species developed disseminated subclinical parasitological infections, but clinical signs (lesions) were transient and self-resolving. N. squamipes, N. lasiurus and R. rattus were all infectious when asymptomatic, though their competence in transmission potential appears to differ with R. rattus showing signs of lower susceptibility. These results provide further evidence that a multi-host reservoir is responsible for maintaining transmission with a bridge between infectious sylvatic and peridomestic rodent populations.
Collapse
Affiliation(s)
- Maria S. Andrade
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
- University of Pernambuco, Recife, Pernambuco, Brazil
| | - Orin Courtenay
- Warwick Infectious Disease Epidemiology Research (WIDER) and School of Life Sciences, University Warwick, Coventry, United Kingdom
| | - Maria E. F. Brito
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Francisco G. Carvalho
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Ana Waléria S. Carvalho
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Fábia Soares
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Silvia M. Carvalho
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Pietra L. Costa
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
| | - Ricardo Zampieri
- Biosiences Institute, São Paulo University, São Paulo, São Paulo, Brazil
| | | | - Jeffrey J. Shaw
- Biomedical Institute, São Paulo University, São Paulo, São Paulo, Brazil
- * E-mail: (JJS); SPBF
| | - Sinval P. Brandão-Filho
- Department of Immunology, Aggeu Magalhães Research Center-Oswaldo Cruz Foundation (FIOCRUZ), Recife, Pernambuco, Brazil
- * E-mail: (JJS); SPBF
| |
Collapse
|
13
|
Lewnard JA, Jirmanus L, Júnior NN, Machado PR, Glesby MJ, Ko AI, Carvalho EM, Schriefer A, Weinberger DM. Forecasting temporal dynamics of cutaneous leishmaniasis in Northeast Brazil. PLoS Negl Trop Dis 2014; 8:e3283. [PMID: 25356734 PMCID: PMC4214672 DOI: 10.1371/journal.pntd.0003283] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 09/22/2014] [Indexed: 11/19/2022] Open
Abstract
Introduction Cutaneous leishmaniasis (CL) is a vector-borne disease of increasing importance in northeastern Brazil. It is known that sandflies, which spread the causative parasites, have weather-dependent population dynamics. Routinely-gathered weather data may be useful for anticipating disease risk and planning interventions. Methodology/Principal Findings We fit time series models using meteorological covariates to predict CL cases in a rural region of Bahía, Brazil from 1994 to 2004. We used the models to forecast CL cases for the period 2005 to 2008. Models accounting for meteorological predictors reduced mean squared error in one, two, and three month-ahead forecasts by up to 16% relative to forecasts from a null model accounting only for temporal autocorrelation. Significance These outcomes suggest CL risk in northeastern Brazil might be partially dependent on weather. Responses to forecasted CL epidemics may include bolstering clinical capacity and disease surveillance in at-risk areas. Ecological mechanisms by which weather influences CL risk merit future research attention as public health intervention targets. Cutaneous leishmaniasis (CL) is a disease resulting from infection by the Leishmania parasites, which humans may acquire when bitten by an infected sandfly. From a public health standpoint, it is important to identify cases early and monitor patients' clinical outcomes because unsuccessfully-treated patients are at risk for severe complications. Since weather conditions affect survival and reproduction of sandflies that transmit Leishmania, routinely-gathered weather and climate data may be useful for anticipating CL outbreaks, bolstering clinical capacity for high-risk periods, and initiating interventions such as active case-finding during these periods to limit disease burden. Here we assessed whether the number of CL cases occurring per month in a rural region of Bahía, Brazil was associated temperature, humidity, precipitation, and El Niño sea surface temperature oscillation patterns observed during preceding seasons. We formulated models that improved accuracy of one, two, and three month-ahead CL predictions by accounting for weather. Forecasts of this nature can contribute to reducing CL burden by informing resource allocation and intervention planning in preparation for epidemics.
Collapse
Affiliation(s)
- Joseph A. Lewnard
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- * E-mail:
| | - Lara Jirmanus
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahía, Salvador, Brazil
- Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Nivison Nery Júnior
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Paulo R. Machado
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahía, Salvador, Brazil
| | - Marshall J. Glesby
- Division of Infectious Diseases, Weill Cornell Medical College, New York, New York, United States of America
| | - Albert I. Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Edgar M. Carvalho
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahía, Salvador, Brazil
| | - Albert Schriefer
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahía, Salvador, Brazil
| | - Daniel M. Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| |
Collapse
|
14
|
Costa DL, Cardoso TM, Queiroz A, Milanezi CM, Bacellar O, Carvalho EM, Silva JS. Tr-1-like CD4+CD25-CD127-/lowFOXP3- cells are the main source of interleukin 10 in patients with cutaneous leishmaniasis due to Leishmania braziliensis. J Infect Dis 2014; 211:708-18. [PMID: 25139022 DOI: 10.1093/infdis/jiu406] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
CD4(+)CD25(+)FOXP3(+) regulatory T cells have long been shown to mediate susceptibility to Leishmania infection, mainly via interleukin 10 production. In this work, we showed that the main sources of interleukin 10 in peripheral blood mononuclear cells (PBMCs) from patients with cutaneous leishmaniasis due to Leishmania braziliensis are CD4(+)CD25(-)CD127(-/low)FOXP3(-) cells. Compared with uninfected controls, patients with CL had increased frequencies of circulating interleukin 10-producing CD4(+)CD25(-)CD127(-/low) cells, which efficiently suppressed tumor necrosis factor α production by the total PBMC population. Also, in CL lesions, interleukin 10 was mainly produced by CD4(+)CD25(-) cells, and interleukin 10 messenger RNA expression was associated with interleukin 27, interleukin 21, and interferon γ expression, rather than with FOXP3 or transforming growth factor β expressions. Active production of both interleukin 27 and interleukin 21, together with production of interferon γ and interleukin 10, was also detected in the lesions. Since these cytokines are associated with the differentiation and activity of Tr-1 cells, our results suggest that this cell population may play an important role in the immunomodulation of CL. Therefore, development of treatments that interfere with this pathway may lead to faster parasite elimination.
Collapse
Affiliation(s)
- Diego L Costa
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto
| | - Tiago M Cardoso
- Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia National Institute of Science and Technology in Tropical Diseases (INCT-DT), Salvador, Brazil
| | - Adriano Queiroz
- Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia National Institute of Science and Technology in Tropical Diseases (INCT-DT), Salvador, Brazil
| | - Cristiane M Milanezi
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto
| | - Olívia Bacellar
- Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia National Institute of Science and Technology in Tropical Diseases (INCT-DT), Salvador, Brazil
| | - Edgar M Carvalho
- Immunology Service, University Hospital Professor Edgar Santos, Federal University of Bahia National Institute of Science and Technology in Tropical Diseases (INCT-DT), Salvador, Brazil
| | - João S Silva
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto
| |
Collapse
|
15
|
Balbino VQ, Coutinho-Abreu IV, Sonoda IV, Marques da Silva W, Marcondes CB. Phlebotomine sandflies (Diptera: Psychodidae) of the Atlantic forest in Recife, Pernambuco state, Brazil: the species coming to human bait, and their seasonal and monthly variations over a 2-year period. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 99:683-93. [PMID: 16212802 DOI: 10.1179/136485905x65116] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In a study of the phlebotomine sandflies (Diptera: Psychodidae) in a forest reserve in Recife, Pernambuco state, north-eastern Brazil, the sandflies landing on human bait between 1.00 and 1.42 h after sunset were collected weekly for 2 years. Although 10,287 sandflies of 10 Lutzomyia species were collected, almost all (96.5%) of the sandflies caught were Lu. umbratilis. This species and several others caught are potential vectors of some of the Leishmania parasites that cause human disease. The recorded landing rate for Lu. umbratilis peaked, at the high level of 333.3 flies/person-hour, during the collections made in May 2003.The relative rarity in the collections of males of some of the species caught probably indicates that these species do not lek on their bloodmeal sources. It is likely that the sizes of the local populations of species that are not very anthrophilic, such as Lu. flaviscutellata, are much larger than indicated by the collections made on human bait.
Collapse
Affiliation(s)
- V Q Balbino
- Department of Genetics, Federal University of Pernambuco, 50732-970 Recife, Pernambuco, Brazil
| | | | | | | | | |
Collapse
|
16
|
Karagiannis-Voules DA, Scholte RGC, Guimarães LH, Utzinger J, Vounatsou P. Bayesian geostatistical modeling of leishmaniasis incidence in Brazil. PLoS Negl Trop Dis 2013; 7:e2213. [PMID: 23675545 PMCID: PMC3649962 DOI: 10.1371/journal.pntd.0002213] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 04/02/2013] [Indexed: 11/18/2022] Open
Abstract
Background Leishmaniasis is endemic in 98 countries with an estimated 350 million people at risk and approximately 2 million cases annually. Brazil is one of the most severely affected countries. Methodology We applied Bayesian geostatistical negative binomial models to analyze reported incidence data of cutaneous and visceral leishmaniasis in Brazil covering a 10-year period (2001–2010). Particular emphasis was placed on spatial and temporal patterns. The models were fitted using integrated nested Laplace approximations to perform fast approximate Bayesian inference. Bayesian variable selection was employed to determine the most important climatic, environmental, and socioeconomic predictors of cutaneous and visceral leishmaniasis. Principal Findings For both types of leishmaniasis, precipitation and socioeconomic proxies were identified as important risk factors. The predicted number of cases in 2010 were 30,189 (standard deviation [SD]: 7,676) for cutaneous leishmaniasis and 4,889 (SD: 288) for visceral leishmaniasis. Our risk maps predicted the highest numbers of infected people in the states of Minas Gerais and Pará for visceral and cutaneous leishmaniasis, respectively. Conclusions/Significance Our spatially explicit, high-resolution incidence maps identified priority areas where leishmaniasis control efforts should be targeted with the ultimate goal to reduce disease incidence. Leishmaniasis is a neglected tropical disease that causes approximately 20 to 40 thousand deaths every year. In Brazil, more than 600,000 clinical cases of leishmaniasis have been reported since 1990. Almost 90% of these cases are due to cutaneous leishmaniasis, whereas the remaining 10% are due to visceral leishmaniasis. Understanding of disease transmission, together with model-based incidence maps, will assist in designing and optimizing control efforts. We used reported leishmaniasis incidence data in Brazil covering the period between 2001 and 2010 to explore the association of the disease with climatic, environmental, and socioeconomic variables, and to predict its spatial distribution using Bayesian geostatistical models. We produced countrywide high spatial resolution maps for both forms of leishmaniasis and estimated the number of infected people, stratified by state. We believe that our incidence maps are useful to prioritize the spatial targeting of prevention and control.
Collapse
Affiliation(s)
- Dimitrios-Alexios Karagiannis-Voules
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ronaldo G. C. Scholte
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, Brazil
| | - Luiz H. Guimarães
- Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| |
Collapse
|
17
|
Guerra-Silveira F, Abad-Franch F. Sex bias in infectious disease epidemiology: patterns and processes. PLoS One 2013; 8:e62390. [PMID: 23638062 PMCID: PMC3634762 DOI: 10.1371/journal.pone.0062390] [Citation(s) in RCA: 190] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 03/25/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Infectious disease incidence is often male-biased. Two main hypotheses have been proposed to explain this observation. The physiological hypothesis (PH) emphasizes differences in sex hormones and genetic architecture, while the behavioral hypothesis (BH) stresses gender-related differences in exposure. Surprisingly, the population-level predictions of these hypotheses are yet to be thoroughly tested in humans. METHODS AND FINDINGS For ten major pathogens, we tested PH and BH predictions about incidence and exposure-prevalence patterns. Compulsory-notification records (Brazil, 2006-2009) were used to estimate age-stratified ♂:♀ incidence rate ratios for the general population and across selected sociological contrasts. Exposure-prevalence odds ratios were derived from 82 published surveys. We estimated summary effect-size measures using random-effects models; our analyses encompass ∼0.5 million cases of disease or exposure. We found that, after puberty, disease incidence is male-biased in cutaneous and visceral leishmaniasis, schistosomiasis, pulmonary tuberculosis, leptospirosis, meningococcal meningitis, and hepatitis A. Severe dengue is female-biased, and no clear pattern is evident for typhoid fever. In leprosy, milder tuberculoid forms are female-biased, whereas more severe lepromatous forms are male-biased. For most diseases, male bias emerges also during infancy, when behavior is unbiased but sex steroid levels transiently rise. Behavioral factors likely modulate male-female differences in some diseases (the leishmaniases, tuberculosis, leptospirosis, or schistosomiasis) and age classes; however, average exposure-prevalence is significantly sex-biased only for Schistosoma and Leptospira. CONCLUSIONS Our results closely match some key PH predictions and contradict some crucial BH predictions, suggesting that gender-specific behavior plays an overall secondary role in generating sex bias. Physiological differences, including the crosstalk between sex hormones and immune effectors, thus emerge as the main candidate drivers of gender differences in infectious disease susceptibility.
Collapse
Affiliation(s)
- Felipe Guerra-Silveira
- Instituto Leônidas e Maria Deane – Fiocruz Amazônia, Manaus, Amazonas, Brazil
- School of Medicine, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | |
Collapse
|
18
|
de Morais RCS, Gonçalves-de-Albuquerque SDC, Pessoa e Silva R, Costa PL, da Silva KG, da Silva FJ, Brandão-Filho SP, Dantas-Torres F, de Paiva-Cavalcanti M. Detection and quantification of Leishmania braziliensis in ectoparasites from dogs. Vet Parasitol 2013; 196:506-8. [PMID: 23601843 DOI: 10.1016/j.vetpar.2013.03.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/18/2013] [Accepted: 03/21/2013] [Indexed: 10/27/2022]
Abstract
American cutaneous leishmaniasis (ACL) is a disease caused by different species of Leishmania protozoa, Leishmania braziliensis being the main species found in Brazil. In this study, two rural areas in Pernambuco, northeastern Brazil, where ACL is endemic, were selected. Genomic DNA was extracted from canine ectoparasites (ticks, fleas, and lice) and tested using a conventional PCR and a quantitative real time PCR. A total of 117 ectoparasites were collected, being 50 (42.74%) of them positive for L. braziliensis (in at least one PCR protocol), with a mean parasite load of 14.14 fg/μL. Furthermore, 46 (92.00%) positive ectoparasites were collected from positive dogs and 4 (8.00%) from negative ones. This study reports the detection of L. braziliensis DNA in ectoparasites, but does not prove their vector competence. Certainly, experimental transmission studies are necessary to assess their role, if any, in the transmission of Leishmania parasites to dogs.
Collapse
Affiliation(s)
- Rayana Carla Silva de Morais
- Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego s/n, 50670-420 Recife, Pernambuco, Brazil
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
de Oliveira AP, de Castro MCAB, de Almeida AF, Souza MDA, de Oliveira BC, Reis LC, Goto H, de Brito MEF, Celeste BJ, Martins-Filho OA, Pereira VRA. Comparison of flow cytometry and indirect immunofluorescence assay in the diagnosis and cure criterion after therapy of American tegumentary leishmaniasis by anti-live Leishmania (Viannia) braziliensis immunoglobulin G. J Immunol Methods 2012; 387:245-53. [PMID: 23142460 DOI: 10.1016/j.jim.2012.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 10/12/2012] [Accepted: 11/01/2012] [Indexed: 10/27/2022]
Abstract
The aim of this study was to compare the techniques of indirect immunofluorescence assay (IFA) and flow cytometry to clinical and laboratorial evaluation of patients before and after clinical cure and to evaluate the applicability of flow cytometry in post-therapeutic monitoring of patients with American tegumentary leishmaniasis (ATL). Sera from 14 patients before treatment (BT), 13 patients 1 year after treatment (AT), 10 patients 2 and 5 years AT were evaluated. The results from flow cytometry were expressed as levels of IgG reactivity, based on the percentage of positive fluorescent parasites (PPFP). The 1:256 sample dilution allowed us to differentiate individuals BT and AT. Comparative analysis of IFA and flow cytometry by ROC (receiver operating characteristic curve) showed, respectively, AUC (area under curve)=0.8 (95% CI=0.64-0.89) and AUC=0.90 (95% CI=0.75-0.95), demonstrating that the flow cytometry had equivalent accuracy. Our data demonstrated that 20% was the best cut-off point identified by the ROC curve for the flow cytometry assay. This test showed a sensitivity of 86% and specificity of 77% while the IFA had a sensitivity of 78% and specificity of 85%. The after-treatment screening, through comparative analysis of the technique performance indexes, 1, 2 and 5 years AT, showed an equal performance of the flow cytometry compared with the IFA. However, flow cytometry shows to be a better diagnostic alternative when applied to the study of ATL in the cure criterion. The information obtained in this work opens perspectives to monitor cure after treatment of ATL.
Collapse
|
20
|
Brito MEFD, Andrade MS, Dantas-Torres F, Rodrigues EHG, Cavalcanti MDP, Almeida AMPD, Brandão-Filho SP. Cutaneous leishmaniasis in northeastern Brazil: a critical appraisal of studies conducted in State of Pernambuco. Rev Soc Bras Med Trop 2012; 45:425-9. [DOI: 10.1590/s0037-86822012005000006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 06/20/2012] [Indexed: 11/21/2022] Open
Abstract
American cutaneous leishmaniasis (ACL) is a complex disease with clinical and epidemiological features that may vary from region to region. In fact, at least seven different Leishmania species, including Leishmania (Viannia) braziliensis, Leishmania (Viannia) guyanensis, Leishmania (Viannia) lainsoni, Leishmania (Viannia) naiffi, Leishmania (Viannia) shawi, Leishmania (Viannia) lindenbergi, and Leishmania (Leishmania) amazonensis, have been implicated in the etiology of ACL in Brazil, and numerous phlebotomine sandfly species of the genus Lutzomyia have been regarded as putative or proven vectors. Because ACL is a focal disease, understanding the disease dynamics at the local level is essential for the implementation of more effective control measures. The present paper is a narrative review about the ACL epidemiology in Pernambuco, northeastern Brazil. Furthermore, the need for more effective diagnosis, treatment, control and prevention strategies for the affected populations is highlighted. This paper will provide researchers with a critical appraisal of ACL in Pernambuco. Hopefully, it will also be helpful for public health authorities to improve current control strategies against ACL at the state and country levels.
Collapse
|
21
|
Microspatial distributional patterns of vectors of cutaneous leishmaniasis in pernambuco, northeastern Brazil. J Trop Med 2012; 2012:642910. [PMID: 22315619 PMCID: PMC3270472 DOI: 10.1155/2012/642910] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 10/09/2011] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study is to analyze the spatial distribution and population trends through time of Lutzomyia species in a long-term focus of cutaneous leishmaniasis transmission in an Atlantic Forest area, northeastern Brazil. Sand fly populations of different ecological niches were monitored spatiotemporally in 2009. To summarize vegetation characteristics and phenology, we calculated the Normalized Difference Vegetation Index from Landsat images. Using niche modeling approaches, we assessed suites of environmental factors to identify areas of transmission risk. Although 12 species were detected, L. whitmani was the most abundant and broadly distributed across the area, particularly in peridomiciliary locations, and associated negatively with denser vegetation areas. On the other hand, L. complexa, L. sordelli, and L. tupynambai were found almost exclusively in forested areas (P < 0.05), and associated positively with denser vegetation. Lutzomyia species' occurrences are related to specific environmental combinations (with contrast among species) in the region.
Collapse
|
22
|
Costa DL, Carregaro V, Lima-Júnior DS, Silva NM, Milanezi CM, Cardoso CR, Giudice Â, de Jesus AR, Carvalho EM, Almeida RP, Silva JS. BALB/c mice infected with antimony treatment refractory isolate of Leishmania braziliensis present severe lesions due to IL-4 production. PLoS Negl Trop Dis 2011; 5:e965. [PMID: 21390155 PMCID: PMC3046967 DOI: 10.1371/journal.pntd.0000965] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 01/13/2011] [Indexed: 11/18/2022] Open
Abstract
Background Leishmania braziliensis is the main causative agent of cutaneous leishmaniasis in Brazil. Protection against infection is related to development of Th1 responses, but the mechanisms that mediate susceptibility are still poorly understood. Murine models have been the most important tools in understanding the immunopathogenesis of L. major infection and have shown that Th2 responses favor parasite survival. In contrast, L. braziliensis–infected mice develop strong Th1 responses and easily resolve the infection, thus making the study of factors affecting susceptibility to this parasite difficult. Methodology/Principal Findings Here, we describe an experimental model for the evaluation of the mechanisms mediating susceptibility to L. braziliensis infection. BALB/c mice were inoculated with stationary phase promastigotes of L. braziliensis, isolates LTCP393(R) and LTCP15171(S), which are resistant and susceptible to antimony and nitric oxide (NO), respectively. Mice inoculated with LTCP393(R) presented larger lesions that healed more slowly and contained higher parasite loads than lesions caused by LTCP15171(S). Inflammatory infiltrates in the lesions and production of IFN-γ, TNF-α, IL-10 and TGF-β were similar in mice inoculated with either isolate, indicating that these factors did not contribute to the different disease manifestations observed. In contrast, IL-4 production was strongly increased in LTCP393(R)-inoculated animals and also arginase I (Arg I) expression. Moreover, anti-IL-4 monoclonal antibody (mAb) treatment resulted in decreased lesion thickness and parasite burden in animals inoculated with LTCP393(R), but not in those inoculated with LTCP15171(S). Conclusion/Significance We conclude that the ability of L. braziliensis isolates to induce Th2 responses affects the susceptibility to infection with these isolates and contributes to the increased virulence and severity of disease associated with them. Since these data reflect what happens in human infection, this model could be useful to study the pathogenesis of the L. braziliensis infection, as well as to design new strategies of therapeutic intervention. Leishmaniasis is a neglected disease that affects more than 12 million people worldwide. In Brazil, the cutaneous disease is more prevalent with about 28,000 new cases reported each year, and L. braziliensis is the main causative agent. The interesting data about the infection with this parasite is the wide variety of clinical manifestations that ranges from single ulcerated lesions to mucocutaneous and disseminated disease. However, experimental models to study the infection with this parasite are difficult to develop due to high resistance of most mouse strains to the infection, and the mechanisms underlying the distinct manifestations remain poorly understood. Here, the authors use a mouse experimental model of infection with different L. braziliensis isolates, known to induce diseases with distinct severity in the human hosts, to elucidate immune mechanisms that may be involved in the different manifestations. They showed that distinct parasite isolates may modulate host response, and increased IL-4 production and Arg I expression was related to more severe disease, resulting in longer length of disease with larger lesions and reduced parasite clearance. These findings may be useful in the identification of immunological targets to control L. braziliensis infection and potential clinical markers of disease progression.
Collapse
Affiliation(s)
- Diego L. Costa
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Vanessa Carregaro
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Djalma S. Lima-Júnior
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Neide M. Silva
- Biomedical Sciences Institute, Federal University of Uberlândia, Uberlândia, Brazil
| | - Cristiane M. Milanezi
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Cristina R. Cardoso
- Department of Biological Sciences, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Ângela Giudice
- Immunology Service, Professor Edgar Santos Universitary Hospital, Federal University of Bahia, Salvador, Brazil
| | - Amélia R. de Jesus
- Department of Internal Medicine and Pathology, Federal University of Sergipe, Aracajú, Brazil
| | - Edgar M. Carvalho
- Immunology Service, Professor Edgar Santos Universitary Hospital, Federal University of Bahia, Salvador, Brazil
| | - Roque P. Almeida
- Department of Internal Medicine and Pathology, Federal University of Sergipe, Aracajú, Brazil
| | - João S. Silva
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- * E-mail:
| |
Collapse
|
23
|
Brandão-Filho SP, Donalisio MR, da Silva FJ, Valença HF, Costa PL, Shaw JJ, Peterson AT. Spatial and temporal patterns of occurrence of Lutzomyia sand fly species in an endemic area for cutaneous leishmaniasis in the Atlantic Forest region of northeast Brazil. JOURNAL OF VECTOR ECOLOGY : JOURNAL OF THE SOCIETY FOR VECTOR ECOLOGY 2011; 36 Suppl 1:S71-S76. [PMID: 21366783 DOI: 10.1111/j.1948-7134.2011.00114.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Sand fly populations of different ecological niches in the Amaraji endemic American Cutaneous Leishmaniasis (ACL) focus of the Pernambuco Atlantic Forest region of northeastern Brazil were monitored spatiotemporally. Lutzomyia whitmani was dominant in all niches but occurred in smaller numbers in forested locations. L. whitmani was significantly less seasonal than the other species, being present throughout the year while other species were more abundant between February and April. These results suggest that L. whitmani may potentially be the principal vector of ACL in the region, even though the sand fly fauna was diverse: 88% were L.whitmani and 12% belonged to 11 other species. Two other species, L. complexa (1.3%) and L. migonei (0.8%), considered to be ACL vectors in other regions, were also present. This detailed picture of the sand fly population's abundance and spatiotemporal distribution provides a basis for future modeling studies of forecasting sand fly activity patterns and ACL occurrence.
Collapse
Affiliation(s)
- Sinval P Brandão-Filho
- Centro de Pesquisas Aggeu Magalhães/Fundação Oswaldo Cruz, Av. Moraes Rego S/N, Recife-PE, Brazil
| | | | | | | | | | | | | |
Collapse
|
24
|
Characterization of Leishmania spp. causing cutaneous leishmaniasis in Manaus, Amazonas, Brazil. Parasitol Res 2010; 108:671-7. [PMID: 21072540 PMCID: PMC3040821 DOI: 10.1007/s00436-010-2139-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 09/30/2010] [Indexed: 11/06/2022]
Abstract
In the State of Amazonas, American tegumentary leishmaniasis is endemic and presents a wide spectrum of clinical variability due to the large diversity of circulating species in the region. Isolates from patients in Manaus and its metropolitan region were characterized using monoclonal antibodies and isoenzymes belonging to four species of the parasite: Leishmania (Viannia) guyanensis, 73% (153/209); Leishmania (Viannia) braziliensis, 14% (30/209); Leishmania (Leishmania) amazonensis, 8% (17/209); and Leishmania (Viannia) naiffii, 4% (9/209). The most prevalent species was L. (V.) guyanensis. The principal finding of this study was the important quantity of infections involving more than one parasite species, representing 14% (29/209) of the total. The findings obtained in this work regarding the parasite are further highlighted by the fact that these isolates were obtained from clinical samples collected from single lesions.
Collapse
|
25
|
de Carvalho MR, Valença HF, da Silva FJ, de Pita-Pereira D, de Araújo Pereira T, Britto C, Brazil RP, Brandão Filho SP. Natural Leishmania infantum infection in Migonemyia migonei (França, 1920) (Diptera:Psychodidae:Phlebotominae) the putative vector of visceral leishmaniasis in Pernambuco State, Brazil. Acta Trop 2010; 116:108-10. [PMID: 20457120 DOI: 10.1016/j.actatropica.2010.03.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 03/13/2010] [Accepted: 03/23/2010] [Indexed: 11/30/2022]
Abstract
A study of the natural infection of phlebotomine sand flies by Leishmania (Leishmania) infantum was conducted in an area of visceral leishmaniasis in São Vicente Férrer, located in the northern part of the Atlantic rain forest region in the State of Pernambuco, Brazil. In a previous study, Migonemyia migonei have been found predominantly in peridomiciles and houses in this endemic area. The analysis of M. migonei, collected by CDC light trap, by multiplex PCR assay coupled to non-isotopic hybridization showed that 2 females out of 50 were infected by L. infantum. This is the first finding of natural infection of M. migonei by L. infantum suggesting that M. migonei may be the vector of L. infantum in areas of visceral leishmaniasis where Lutzomyia longipalpis, the usual vector, is absent.
Collapse
|
26
|
Andrade MS, Brito MEF, Silva STD, Ishikawa E, Carvalho SMS, Brandão-Filho SP. Novo surto de leishmaniose tegumentar americana em área de treinamento militar na Zona da Mata norte do Estado de Pernambuco. Rev Soc Bras Med Trop 2009; 42:594-6. [DOI: 10.1590/s0037-86822009000500022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2009] [Accepted: 09/15/2009] [Indexed: 11/22/2022] Open
Abstract
Relata-se novo surto de LTA em militares com 71 casos confirmados pelos critérios clínico, epidemiológico e laboratorial. Obteve-se o isolamento de sete amostras, identificadas como Leishmania (Viannia) braziliensis. A ocorrência de surtos nesta região confirma o caráter endêmico, cuja magnitude parece estar relacionada a não adoção de medidas de proteção individual.
Collapse
|
27
|
Brito MEF, Andrade MS, Mendonça MG, Silva CJ, Almeida EL, Lima BS, Félix SM, Abath FGC, da Graça GC, Porrozzi R, Ishikawa EA, Shaw JJ, Cupolillo E, Brandão-Filho SP. Species diversity of Leishmania (Viannia) parasites circulating in an endemic area for cutaneous leishmaniasis located in the Atlantic rainforest region of northeastern Brazil. Trop Med Int Health 2009; 14:1278-86. [PMID: 19708899 DOI: 10.1111/j.1365-3156.2009.02361.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To identify the aetiological agents of cutaneous leishmaniasis and to investigate the genetic polymorphism of Leishmania (Viannia) parasites circulating in an area with endemic cutaneous leishmaniasis (CL) in the Atlantic rainforest region of northeastern Brazil. METHODS Leishmania spp. isolates came from three sources: (i) patients diagnosed clinically and parasitologically with CL based on primary lesions, secondary lesions, clinical recidiva, mucocutaneous leishmaniasis and scars; (ii) sentinel hamsters, sylvatic or synanthropic small rodents; and (iii) the sand fly species Lutzomyia whitmani. Isolates were characterised using monoclonal antibodies, multilocus enzyme electrophoresis (MLEE) and polymerase chain reaction-restriction fragment length polymorphism of the internal transcribed spacer region rDNA locus. RESULTS Seventy-seven isolates were obtained and characterised. All isolates were identified as Leishmania (Viannia) braziliensis serodeme 1 based on reactivity to monoclonal antibodies. MLEE identified 10 zymodemes circulating in the study region. Most isolates were classified as zymodemes closely related to L. (V.) braziliensis, but five isolates were classified as Leishmania (Viannia) shawi. All but three of the identified zymodemes have so far been observed only in the study region. Enzootic transmission and multiclonal infection were observed. CONCLUSIONS Our results confirm that transmission cycle complexity and the co-existence of two or more species in the same area can affect the level of genetic polymorphism in a natural Leishmania population. Although it is not possible to make inferences as to the modes of genetic exchange, one can speculate that some of the zymodemes specific to the region are hybrids of L. (V.) braziliensis and L. (V.) shawi.
Collapse
Affiliation(s)
- Maria Edileuza F Brito
- Departamento de Imunologia, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife-PE CEP 50670-420, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Rocha A, Barbosa CS, Brandão Filho SP, Oliveira CMFD, Almeida AMPD, Gomes YDM. [First internal workshop of the reference services at Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz]. Rev Soc Bras Med Trop 2009; 42:228-34. [PMID: 19448951 DOI: 10.1590/s0037-86822009000200030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Abraham Rocha
- Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE.
| | | | | | | | | | | |
Collapse
|
29
|
González U, Pinart M, Rengifo-Pardo M, Macaya A, Alvar J, Tweed JA. Interventions for American cutaneous and mucocutaneous leishmaniasis. Cochrane Database Syst Rev 2009:CD004834. [PMID: 19370612 DOI: 10.1002/14651858.cd004834.pub2] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pentavalent antimonial drugs are the most prescribed treatment for American cutaneous and mucocutaneous leishmaniasis. Other drugs have been used with varying success. OBJECTIVES To assess the effects of therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis. SEARCH STRATEGY We searched the Cochrane Skin Group Specialised Register (January 2009), the Register of Controlled Clinical Trials in The Cochrane Library (Issue 1,2009), MEDLINE (2003 to January 2009), EMBASE (2005 to January 2009), LILACS (from inception to January 2009), CINAHL (1982-May 2007) and other databases. SELECTION CRITERIA Randomised controlled trials (RCTs) assessing treatments for American cutaneous and mucocutaneous leishmaniasis. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. MAIN RESULTS We included 38 trials involving 2728 participants. Results are based on individual studies or limited pooled analyses. There was good evidence in:Leishmania braziliensis and L. panamensis infections:Intramuscular (IM) meglumine antimoniate (MA) was better than oral allopurinol for 28 days (1RCT n=127, RR 0.39; 95% CI 0.26, 0.58). Intravenous (IV)MA for 20-days was better than 3-day and 7-day IVMA plus 15% paromomycin plus 12% methylbenzethonium chloride (PR-MBCL) or 7-day IVMA (1RCT n= 150, RR 0.24; 95% CI 0.11, 0.50; RR 0.69; 95% CI 0.53, 0.90; RR 0.64; 95% CI 0.44, 0.92 respectively). Oral allopurinol plus antimonials was better than IV antimonials (2RCT n= 168, RR 1.90; 95% CI 1.40, 2.59; I(2)=0%).L. braziliensis infections:Oral pentoxifylline plus IV sodium stibogluconate (SSG) was better than IVSSG (1RCT n= 23, RR 1.66; 95% CI 1.03, 2.69); IVMA was better than IM aminosidine sulphate (1RCT n= 38, RR 0.05; 95% CI 0.00, 0.78) and better than IV pentamidine isethionate (1RCT n= 80, RR 0.45; 95% CI 0.29, 0.71). Intramuscular MA was better than Bacillus Calmette-Guérin (1RCT n= 93, RR 0.46; 95% CI 0.32, 0.65).L .panamensis infections:Oral allopurinol was better than IVMA (1RCT n= 58, RR 2.20; 95% CI 1.34, 3.60). Aminosidine sulphate at doses of 12 mg/kg/day and 18 mg/kg/day for 14 days were better than aminosidine sulphate 12 mg/kg/day for 7 days (1RCT n= 60, RR 0.23; 95% CI 0.07, 0.73; RR 0.23; 95% CI 0.07, 0.73 respectively). Oral ketoconazole for 28 days, oral miltefosine and topical PR-MBCL were better than placebo. AUTHORS' CONCLUSIONS Most trials have been designed and reported so poorly that they are inconclusive. There is a need for large well conducted studies that evaluate long-term effects of current therapies to improve quality and standardization of methods.
Collapse
Affiliation(s)
- Urbà González
- Department of Dermatology, Research Unit for Evidence-based Dermatology, Hospital Plató, c/ Plato 21, Barcelona, Catalunya, Spain, 08006.
| | | | | | | | | | | |
Collapse
|
30
|
Brito MEFD, Silva CJ, Silva CM, Salazar PR, Coutinho JS, Reis LDC, Pereira VRA, Brandão-Filho SP, Medeiros ÂCR. Clinical epidemiological profile of American tegumentary leishmaniasis at the Pinto Sugar Mill in Moreno Municipality, Greater Metropolitan Recife, Pernambuco State, Brazil. CAD SAUDE PUBLICA 2008; 24:2445-8. [DOI: 10.1590/s0102-311x2008001000025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 04/24/2008] [Indexed: 11/21/2022] Open
Abstract
American tegumentary leishmaniasis (ATL) is present in all regions of Pernambuco State, Brazil, where it is spreading, with the emergence of foci in new areas like the Municipality (County) of Moreno in Greater Metropolitan Recife. The objective of the current study was to assess the prevalence of infection and identify autochthonous cases of ATL. In April 2006 a population survey was performed using a questionnaire and the Montenegro skin test (MST) in 481 individuals from the Pinto Sugar Mill, of whom 47% were males and 74% were younger than 30 years. One hundred forty-four individuals (30%) showed a positive MST. Of these, five presented active lesions, 41 were cured after meglumine antimoniate treatment, and one showed a spontaneous cure. Indirect immunofluorescence (IIF) was performed on sera from 89 individuals and showed a 36% positive rate. The high ATL prevalence demonstrates the epidemiological spread of the disease in Greater Metropolitan Recife, a worrisome development since there are no effective measures for ATL control except ecological awareness raising to minimize the risk of infection.
Collapse
|
31
|
Reis LDC, Brito MEFD, Almeida ÉLD, Félix SM, Medeiros ÂCR, Silva CJ, Pereira VRA. Clinical, epidemiological and laboratory aspects of patients with American cutaneous leishmaniasis in the State of Pernambuco. Rev Soc Bras Med Trop 2008; 41:439-43. [DOI: 10.1590/s0037-86822008000500001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Accepted: 08/27/2008] [Indexed: 11/21/2022] Open
Abstract
The diagnosis for American cutaneous leishmaniasis is based on an association of clinical, epidemiological and laboratory characteristics. The present study identified the circulating species of Leishmania in the State of Pernambuco, described its clinical-epidemiological characteristics and diagnosed the disease. Nineteen patients presenting active lesions who had been diagnosed through clinical evaluation and laboratory tests were selected. The tests included direct investigation, in vitro culturing, Montenegro skin test, indirect immunofluorescence and polymerase chain reaction. The Montenegro Skin Test showed positive results in 89% of the patients; indirect immunofluorescence, in 79%; direct investigation, in 58%; and polymerase chain reaction in 75%. Seven Leishmania (Viannia) braziliensis samples were isolated from these patients and were characterized by means of specific monoclonal antibodies. These data confirm that a combination of different diagnosis techniques is needed in order to obtain efficient results and that, so far, Leishmania (Viannia) braziliensis is the only species responsible for American cutaneous leishmaniasis infection in Pernambuco. Thus, it is essential to identify the parasite species involved in cases of human disease in an endemic area in order to determine the clinical and epidemiological characteristics, especially with regard to diagnosis, therapy development and disease prognosis.
Collapse
|
32
|
Shaw JJ, De Faria DL, Basano SA, Corbett CE, Rodrigues CJ, Ishikawa EA, Camargo LM. The aetiological agents of American cutaneous leishmaniasis in the municipality of Monte Negro, Rondônia state, western Amazonia, Brazil. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2008; 101:681-8. [PMID: 18028729 DOI: 10.1179/136485907x229103] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Although American cutaneous leishmaniasis (ACL) is one of the most important endemic diseases in the Brazilian state of Rondônia, there is very little information on the species of parasite involved. The objective of the present study was to identify the Leishmania species causing ACL in the Monte Negro municipality of the state. Over a 6-year period (1997-2002), the skin lesions of 233 patients were examined while the patients were attending an outpatients' clinic at the University of São Paulo's Advanced Research Unit in Monte Negro. ACL was diagnosed in 137 (58.8%) of the patients and leishmanial parasites were successfully isolated from 14 of the ACL cases. Using a panel of 24 monoclonal antibodies, 12 of the 14 isolates were identified, as L. (Viannia) braziliensis (seven), L. (V.) lainsoni (one), a L. (V.) lainsoni-like species (two), a L. (V.) guyanensis-like species (one), or a L. (Viannia) species that was different from all named species (one). These are the first records of human infection with L. (V.) braziliensis and L. (V.) lainsoni in Rondônia.
Collapse
Affiliation(s)
- J J Shaw
- Parasitology Department, Biomedical Sciences Institute, São Paulo University, Avenida Prof Lineu Prestes 1374, 05508-000, São Paulo, SP, Brazil.
| | | | | | | | | | | | | |
Collapse
|
33
|
Garcia AL, Tellez T, Parrado R, Rojas E, Bermudez H, Dujardin JC. Epidemiological monitoring of American tegumentary leishmaniasis: molecular characterization of a peridomestic transmission cycle in the Amazonian lowlands of Bolivia. Trans R Soc Trop Med Hyg 2007; 101:1208-13. [DOI: 10.1016/j.trstmh.2007.09.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2006] [Revised: 09/04/2007] [Accepted: 09/04/2007] [Indexed: 10/22/2022] Open
|
34
|
Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S. Cutaneous leishmaniasis. THE LANCET. INFECTIOUS DISEASES 2007; 7:581-96. [PMID: 17714672 DOI: 10.1016/s1473-3099(07)70209-8] [Citation(s) in RCA: 912] [Impact Index Per Article: 53.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cutaneous leishmaniasis is endemic in the tropics and neotropics. It is often referred to as a group of diseases because of the varied spectrum of clinical manifestations, which range from small cutaneous nodules to gross mucosal tissue destruction. Cutaneous leishmaniasis can be caused by several Leishmania spp and is transmitted to human beings and animals by sandflies. Despite its increasing worldwide incidence, but because it is rarely fatal, cutaneous leishmaniasis has become one of the so-called neglected diseases, with little interest by financial donors, public-health authorities, and professionals to implement activities to research, prevent, or control the disease. In endemic countries, diagnosis is often made clinically and, if possible, by microscopic examination of lesion biopsy smears to visually confirm leishmania parasites as the cause. The use of more sophisticated diagnostic techniques that allow for species identification is usually restricted to research or clinical settings in non-endemic countries. The mainstays of cutaneous leishmaniasis treatment are pentavalent antimonials, with new oral and topical treatment alternatives only becoming available within the past few years; a vaccine currently does not exist. Disease prevention and control are difficult because of the complexity of cutaneous leishmaniasis epizoology, and the few options available for effective vector control.
Collapse
|
35
|
Guerra JADO, Barbosa MDGV, Loureiro ACDSP, Coelho CP, Rosa GG, Coelho LIDADCR. Leishmaniose tegumentar americana em crianças: aspectos epidemiológicos de casos atendidos em Manaus, Amazonas, Brasil. CAD SAUDE PUBLICA 2007; 23:2215-23. [PMID: 17700956 DOI: 10.1590/s0102-311x2007000900029] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Accepted: 03/30/2007] [Indexed: 11/21/2022] Open
Abstract
No período entre janeiro a dezembro de 2005, foram avaliadas crianças de zero a 14 anos de idade com leishmaniose tegumentar americana, atendidas na Fundação de Medicina Tropical do Amazonas; registraram-se 147 casos; 55,78% do sexo masculino; 48,3% procediam do Município de Rio Preto da Eva; 76% procediam de duas estradas. Entre 90 (67,67%) pacientes, entrevistaram-se os responsáveis sobre a moradia na área de transmissão e os hábitos da criança. Desses, 58,89% residiam no local da provável infecção; 60% das crianças penetravam na mata acompanhando os pais; em 91,11% dos casos havia animais domésticos na moradia; 77,78% das residências localizavam-se até 100m de distância da mata; 76,67% pacientes tinham pelo menos um parente com história de leishmaniose tegumentar americana. O padrão de transmissão foi relacionado especialmente a atividades de manejo florestal ocorrendo próximas ao domicílio, habitações próximas à floresta primária, com a ocorrência de leishmaniose tegumentar americana em crianças pequenas, sugerindo transmissão no intra e no peridomicílio, em alguns casos, crianças penetrando na floresta.
Collapse
|
36
|
Dantas-Torres F. The role of dogs as reservoirs of Leishmania parasites, with emphasis on Leishmania (Leishmania) infantum and Leishmania (Viannia) braziliensis. Vet Parasitol 2007; 149:139-46. [PMID: 17703890 DOI: 10.1016/j.vetpar.2007.07.007] [Citation(s) in RCA: 187] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2007] [Revised: 05/08/2007] [Accepted: 07/05/2007] [Indexed: 11/15/2022]
Abstract
Leishmania parasites cause a group of diseases collectively known as leishmaniases. The primary hosts of Leishmania are sylvatic mammals of several orders (Rodentia, Marsupialia, Carnivora, etc.). Under certain circumstances, particularly in peridomestic and domestic transmission foci, synanthropic and domestic animals can act as source of infection for phlebotomine sand fly vectors. Dogs have long been implicated as the main domestic reservoirs of Leishmania (Leishmania) infantum, the aetiological agent of zoonotic visceral leishmaniasis, and there exists an increasing trend to regard dogs as the main domestic reservoirs of Leishmania (Viannia) braziliensis, the most widespread aetiological agent of American tegumentary leishmaniasis. However, insights derived from recent research indicate that not dogs but humans are probably the most important domestic reservoirs of L. (V.) braziliensis. In the present article, the role of dogs as reservoirs of Leishmania parasites, with emphasis on L. (L.) infantum and L. (V.) braziliensis, is reviewed.
Collapse
Affiliation(s)
- Filipe Dantas-Torres
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, CP 7472, Recife 50670-420, Pernambuco, Brazil.
| |
Collapse
|
37
|
de Carvalho MR, Lima BS, Marinho-Júnior JF, da Silva FJ, Valença HF, Almeida FDA, da Silva AL, Brandão-Filho SP. Phlebotomine sandfly species from an American visceral leishmaniasis area in the Northern Rainforest region of Pernambuco State, Brazil. CAD SAUDE PUBLICA 2007; 23:1227-32. [PMID: 17486244 DOI: 10.1590/s0102-311x2007000500024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2006] [Accepted: 08/11/2006] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to identify the fauna of phlebotomine sandflies in an area with incidence of American visceral leishmaniasis (AVL) in São Vicente Férrer, a municipality (county) located in the northern Zona da Mata in Pernambuco State, Brazil. Sandfly captures were conducted monthly for four nights/month from December 2002 to November 2003, by means of manual captures (with a Shannon trap) and by CDC light traps. A total of 23,156 specimens of phlebotomines sandflies were collected in a remnant of the Atlantic rainforest, houses, and animal shelters. Lutzomyia complexa was the most prevalent species, with a frequency of 62.5% (14,445/23,156), followed by Lutzomyia migonei, with 33.2% (7,677/23,156). No Lutzomyia longipalpis (the main vector of Leishmania chagasi in Brazil and the Americas) was found in the target area. Some specimens were dissected, but no Leishmania parasites were found.
Collapse
|
38
|
Guerra JADO, Ribeiro JAS, Coelho LIDARDC, Barbosa MDGV, Paes MG. [Epidemiology of tegumentary leishmaniasis in São João, Manaus, Amazonas, Brazil]. CAD SAUDE PUBLICA 2007; 22:2319-27. [PMID: 17091169 DOI: 10.1590/s0102-311x2006001100006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2005] [Accepted: 01/17/2006] [Indexed: 11/21/2022] Open
Abstract
In Manaus, Amazonas State, Brazil, the degree of individual exposure to leishmaniasis is related to disorganized land occupation. In order to evaluate predisposing factors for an outbreak, confirm the parasitological diagnosis, treat patients, and assess etiological agents, reservoirs, and vectors, a 12-month study was conducted in Manaus in a community located along the BR-174 federal highway. Some 451 individuals were studied, among whom 17 cases of American tegumentary leishmaniasis (ATL) were diagnosed (six women and 11 men). Age varied from one to 64 years. Eleven patients had from one to three lesions. As for reservoirs, three opossums were captured. No hemoflagellates were found in the blood tests. Lutzomyia umbratilis was the predominant vector species captured. Many ATL patients were engaged in activities that exposed them to Leishmania vectors. Some patients may have been infected in the household and peridomiciliary environments. The epidemiological profile of ATL in this community is similar that of other foci in the region. This case series characterizes ATL as an endemic local public health problem.
Collapse
|
39
|
Dantas-Torres F, de Brito MEF, Brandão-Filho SP. Seroepidemiological survey on canine leishmaniasis among dogs from an urban area of Brazil. Vet Parasitol 2006; 140:54-60. [PMID: 16621286 DOI: 10.1016/j.vetpar.2006.03.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2005] [Revised: 03/08/2006] [Accepted: 03/10/2006] [Indexed: 10/24/2022]
Abstract
A cross-sectional seroepidemiological survey on canine leishmaniasis among pet dogs was carried out in an urban area in the State of Pernambuco (Brazil) where human cases of visceral leishmaniasis have sporadically been reported. Using an indirect fluorescent antibody test, anti-Leishmania antibodies were detected in 130 out of 322 dogs, confirming previous exposure to Leishmania parasites. The overall seroprevalence found was 40.3% (95% confidence interval: 34.9-45.9). Data analysis revealed that serological positivity was statistically associated with male (chi2=20.60, P-value=0.000) and juvenile dogs (chi2=4.24, P-value=0.039). Furthermore, it was observed that 85.3% of all seropositive dogs showed no clinical signs of leishmaniasis. The results showed a high seroprevalence of anti-Leishmania antibodies among dogs from an urban area of Pernambuco - with a large proportion of asymptomatic seropositive dogs - indicating that the prevalence of Leishmania infection in this area has been underestimated.
Collapse
Affiliation(s)
- Filipe Dantas-Torres
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Caixa Postal 7472, Avenida Professor Moraes Rego s/n, Campus UFPE, Recife, Pernambuco CEP 50670-420, Brazil.
| | | | | |
Collapse
|
40
|
Chagas AC, Pessoa FAC, Medeiros JFD, Py-Daniel V, Mesquita ÉC, Balestrassi DA. Leishmaniose Tegumentar Americana (LTA) em uma vila de exploração de minérios - Pitinga, município de Presidente Figueiredo, Amazonas, Brasil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2006. [DOI: 10.1590/s1415-790x2006000200005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A Vila de Pitinga, Presidente Figueiredo/AM, é uma área de exploração de minérios e endêmica para leishmaniose tegumentar americana (LTA). A vila é a sede administrativa e local de moradia de seus funcionários. O comportamento epidemiológico da endemia, avaliado para o período de 2000 a 2004, foi relacionado com as medidas de controle adotadas para reduzir a incidência da doença na área e comparado com o registrado para o município e o Estado do Amazonas. A maior proporção dos casos detectados no período ocorreu no gênero masculino, com atividades laborais de contato com a floresta. O declínio na incidência de casos de LTA na área do estudo, não foi observado como ocorrido no Município e Estado e foi considerado resultante das medidas de controle para a doença, aplicadas na área.
Collapse
|
41
|
Gramiccia M, Gradoni L. The current status of zoonotic leishmaniases and approaches to disease control. Int J Parasitol 2006; 35:1169-80. [PMID: 16162348 DOI: 10.1016/j.ijpara.2005.07.001] [Citation(s) in RCA: 320] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2005] [Revised: 07/05/2005] [Accepted: 07/20/2005] [Indexed: 02/06/2023]
Abstract
Leishmaniases are a complex of world-wide diseases with a range of clinical and epidemiological features caused by Leishmania spp. of protozoan parasites. Among 15 well-recognised Leishmania species known to infect humans, 13 have zoonotic nature, which include agents of visceral, cutaneous and mucocutaneous forms of the disease in both the Old and New Worlds. Currently, leishmaniases show a wider geographic distribution and increased global incidence of human disease than previously known. Environmental, demographic and human behavioural factors contribute to the changing landscape of leishmaniasis, which includes increasing risk factors for zoonotic cutaneous leishmaniases and new scenarios associated with the zoonotic visceral leishmaniases. The latter consist of the northward spread of Leishmania infantum transmission in Europe and America, the identification of unusual mammal hosts, and the decline of HIV-Leishmania co-infections in southern Europe following the introduction of the highly active antiretroviral therapy. Few advances have been made in the surveillance and control of the zoonotic leishmaniasis, however a number of tools have been developed for the control of the canine reservoir of L. infantum. These include: (i) several canine vaccine candidates, in particular an FML Leishmania enriched fraction showing good clinical protection, has been registered in Brazil for veterinary use; (ii) a number of insecticide-based preparations have been specifically registered for dog protection against sand fly bites. Laboratory and field studies have shown improved efficacy of these preparations for both individual and mass protection.
Collapse
Affiliation(s)
- Marina Gramiccia
- Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy.
| | | |
Collapse
|
42
|
Andrade MS, Valença HF, da Silva AL, Almeida FDA, Almeida EL, de Brito MEF, Brandão Filho SP. Sandfly fauna in a military training area endemic for American tegumentary leishmaniasis in the Atlantic Rain Forest region of Pernambuco, Brazil. CAD SAUDE PUBLICA 2006; 21:1761-7. [PMID: 16410860 DOI: 10.1590/s0102-311x2005000600023] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to characterize the sandfly fauna in a military training area situated in the "Zona da Mata" region of Pernambuco State, Brazil, where human cases of American tegumentary leishmaniasis (ATL) had been observed, caused by Leishmania (Viannia) braziliensis. The occurrence of 16 sandfly species in the Marshall Newton Cavalcanti Military Training Camp (CIMNC) indicates an important diversity of sandfly species in this study area. Lutzomyia complexa was the most common species (51.36%) followed by L. choti (43.54%). All the captures were made in areas where training activities were conducted and where clinical cases had been detected in individuals performing training, following this period. The data relating the sandfly behavior to previous data in the same area provides strong evidence for the occurrence of an enzootic cycle of the parasite, and outbreaks followed the period of training activities in the remaining Atlantic Rain Forest and secondary forest areas.
Collapse
|
43
|
Andrade MS, Brito MEF, Silva STD, Lima BS, Almeida EL, Albuquerque EL, Marinho Júnior JF, Ishikawa E, Cupolillo E, Brandão-Filho SP. [American tegumentary leishmaniasis caused by Leishmania (Viannia) braziliensis in military training area of Zona da Mata in Pernambuco]. Rev Soc Bras Med Trop 2005; 38:229-33. [PMID: 15895173 DOI: 10.1590/s0037-86822005000300004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of work was to study the epidemiology of American tegumentary leishmaniasis in a military training unit situated in Zona da Mata region of Pernambuco State. Between 2002 and 2003 twenty-three cases were notified by clinical exam, detection and/or isolation of parasite and Montenegro skin test. Seven stocks of Leishmania (Viannia) braziliensis were obtained from patients, identified by a panel of specific monoclonal antibodies and isoenzymatic electrophoresis profiles. An epidemiologic survey on prevalence of infection was carried out by Montenegro skin test in the population that underwent training activities during the same period, out of which 25.3% were identified as positive. These results in association with previous data from this area, shows the maintenance of a primary transmission cycle and the occurrence of periodical outbreaks after training activities in local areas of remnant Atlantic rain forest.
Collapse
Affiliation(s)
- Maria S Andrade
- Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
Leishmaniasis remains a major world health problem that continues to increase in incidence. This review considers epidemiology, clinical features, diagnosis and current treatment options. Recent developments in the treatment of simple cutaneous leishmaniasis are discussed followed by speculation about future therapies.
Collapse
|
45
|
Basano SDA, Camargo LMA. Leishmaniose tegumentar americana: histórico, epidemiologia e perspectivas de controle. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2004. [DOI: 10.1590/s1415-790x2004000300010] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A Leishmaniose Tegumentar Americana (LTA) é uma doença causada por protozoários do gênero Leishmania, transmitida ao homem pela picada de mosquitos flebotomíneos (Ordem Diptera; Família Psychodidae; Sub-Família Phlebotominae). No Brasil existem atualmente 6 espécies de Leishmania responsáveis pela doença humana, e mais de 200 espécies de flebotomíneos implicados em sua transmissão. Trata-se de uma doença que acompanha o homem desde tempos remotos e que tem apresentado, nos últimos 20 anos, um aumento do número de casos e ampliação de sua ocorrência geográfica, sendo encontrada atualmente em todos os Estados brasileiros, sob diferentes perfis epidemiológicos. Estima-se que, entre 1985 e 2003, ocorreram 523.975 casos autóctones, a sua maior parte nas regiões Nordeste e Norte do Brasil. Neste estudo, são discutidos aspectos relacionados ao tratamento e ao controle dessa doença, assim como também as dificuldades para a implementação dessas medidas. São apontadas alternativas que passam pela estruturação dos serviços de saúde, com respeito ao diagnóstico, no desenvolvimento de drogas de aplicação tópica ou por via oral, no desenvolvimento de vacinas, no controle diferenciado de vetores e no aprofundamento de estudos relacionados à biologia celular do parasita.
Collapse
|
46
|
González U, Pinart M, Rengifo-Pardo M, Macaya A, Alvar J. Interventions for mucocutaneous leishmaniasis. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2004. [DOI: 10.1002/14651858.cd004834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
47
|
King RJ, Campbell-Lendrum DH, Davies CR. Predicting geographic variation in cutaneous leishmaniasis, Colombia. Emerg Infect Dis 2004; 10:598-607. [PMID: 15200848 PMCID: PMC3323104 DOI: 10.3201/eid1004.030241] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Predicting Geographic Variation in ACL, Colombia Approximately 6,000 cases of cutaneous leishmaniasis are reported annually in Colombia, a greater than twofold increase since the 1980s. Such reports certainly underestimate true incidence, and their geographic distribution is likely biased by local health service effectiveness. We investigated how well freely available environmental data explain the distribution of cases among 1,079 municipalities. For each municipality, a unique predictive logistic regression model was derived from the association among remaining municipalities between elevation, land cover (preclassified maps derived from satellite images), or both, and the odds of at least one case being reported. Land cover had greater predictive power than elevation; using both datasets improved accuracy. Fitting separate models to different ecologic zones, reflecting transmission cycle diversity, enhanced the accuracy of predictions. We derived measures that can be directly related to disease control decisions and show how results can vary, depending on the threshold selected for predicting a disease-positive municipality. The results identify areas where disease is most likely to be underreported.
Collapse
Affiliation(s)
- Raymond J King
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
| | | | | |
Collapse
|
48
|
Oliveira CCG, Lacerda HG, Martins DRM, Barbosa JDA, Monteiro GR, Queiroz JW, Sousa JMA, Ximenes MFFM, Jeronimo SMB. Changing epidemiology of American cutaneous leishmaniasis (ACL) in Brazil: a disease of the urban-rural interface. Acta Trop 2004; 90:155-62. [PMID: 15177141 DOI: 10.1016/j.actatropica.2003.11.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2003] [Revised: 11/07/2003] [Accepted: 11/21/2003] [Indexed: 10/26/2022]
Abstract
American cutaneous leishmaniasis (ACL) was first reported from the south-western region of the state of Rio Grande do Norte in 1987. São Miguel municipality and adjacent areas have accounted for 90% of the American cutaneous leishmaniasis cases in the region since then. A population survey conducted in São Miguel and adjacent areas was undertaken to identify individuals with a history of ACL. The incidence of ACL, distribution by age and gender, clinical characteristics, family clustering, relationship to animals, association with skin test responses, and development of mucosal lesions were determined. Males and females were equally likely to be infected by Leishmania. Thirty-eight percent of the individuals tested were found to be Montenegro skin test positive. No difference in the Montenegro skin test was observed with gender, but the response increased with age. Among the 140 ACL cases treated in a 4-year period in São Miguel, five (3.6%) developed mucosal involvement. Sandflies capable of transmitting Leishmania were captured inside households and in the areas surrounding them. The high density of sandfly species potentially able to transmit Leishmania species and the age distribution of cases of cutaneous leishmaniasis suggest that transmission of the parasite occurred inside or in close proximity to houses.
Collapse
Affiliation(s)
- Carlos C G Oliveira
- Department of Microbiology and Parasitoloty, Universidade Federal do Rio Grande do Norte, RN, CP 1624, 59.072-970 Natal, Brazil
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Peterson AT, Shaw J. Lutzomyia vectors for cutaneous leishmaniasis in Southern Brazil: ecological niche models, predicted geographic distributions, and climate change effects. Int J Parasitol 2003; 33:919-31. [PMID: 12906876 DOI: 10.1016/s0020-7519(03)00094-8] [Citation(s) in RCA: 169] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Geographic and ecological distributions of three Lutzomyia sand flies that are cutaneous leishmaniasis vectors in South America were analysed using ecological niche modelling. This new tool provides a large-scale perspective on species' geographic distributions, ecological and historical factors determining them, and their potential for change with expected environmental changes. As a first step, the ability of this technique to predict geographic distributions of the three species was tested statistically using two subsampling techniques: a random-selection technique that simulates 50% data density, and a quadrant-based technique that challenges the method to predict into broad unsampled regions. Predictivity under both test schemes was highly statistically significant. Visualisation of ecological niches provided insights into the ecological basis for distributional differences among species. Projections of potential geographic distributions across scenarios of global climate change suggested that only Lutzomyia whitmani is likely to be experiencing dramatic improvements in conditions in south-eastern Brazil, where cutaneous leishmaniasis appears to be re-emerging; Lutzomyia intermedia and Lutzomyia migonei may be seeing more subtle improvements in climatic conditions, but the implications are not straightforward. More generally, this technique offers the possibility of new views into the distributional ecology of disease, vector, and reservoir species.
Collapse
|
50
|
Cupolillo E, Brahim LR, Toaldo CB, de Oliveira-Neto MP, de Brito MEF, Falqueto A, de Farias Naiff M, Grimaldi G. Genetic polymorphism and molecular epidemiology of Leishmania (Viannia) braziliensis from different hosts and geographic areas in Brazil. J Clin Microbiol 2003; 41:3126-32. [PMID: 12843052 PMCID: PMC165365 DOI: 10.1128/jcm.41.7.3126-3132.2003] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Numerical zymotaxonomy and variability of the internal transcribed spacers (ITS) between the small and large subunits of the rRNA genes were used to examine strain variation and relationships in natural populations of Leishmania (Viannia) braziliensis. A total of 101 strains from distinct hosts and Brazilian geographic regions were assigned to 15 zymodemes clustered in two major genetic groups. The great number of isolates (48.5%) placed in zymodeme IOC/Z-27 were collected on the Atlantic coast. The high molecular diversity found in populations in the Amazon Basin was related to the great number of sandfly vector(s) in that region. The results of the restriction fragment length polymorphism analysis of the ITS depicted considerable intraspecific variation. Genotypic groups A, B, and C contained 39, 40, and 22 isolates, which were divided into 16, 10, and 15 genotypes, respectively. The genetic polymorphism observed demonstrates the degree of diversity of L. (V.) braziliensis strains from different regions where they are endemic. The results reinforce the clonal theory for Leishmania parasites showing the genetic diversity of this pathogen and an association of L. (V.) braziliensis genotypes with specific transmission cycles, probably reflecting an adaptation of different clones to the vector species involved.
Collapse
Affiliation(s)
- Elisa Cupolillo
- Laboratório de Pesquisas em Leishmaniose-Instituto Oswaldo Cruz, Rio de Janeiro, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|