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da Silva AS, de Medeiros Silva MM, de Oliveira Mendes Aguiar C, Nascimento PRP, da Costa EG, Jeronimo SMB, de Melo Ximenes MDFF. Challenges of animals shelters in caring for dogs infected with Leishmania and other pathogens. Vet Parasitol Reg Stud Reports 2024; 49:100988. [PMID: 38462297 DOI: 10.1016/j.vprsr.2024.100988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/30/2023] [Accepted: 01/12/2024] [Indexed: 03/12/2024]
Abstract
The incidence of human Visceral Leishmaniasis (VL) has decreased in Brazil; however, the number of areas reporting human and canine cases has increased, with Leishmania infantum usually preceding human infection. This study aimed to analyze the profile of infectious diseases that are endemic for both human and canine VL, in dogs housed in a shelter located in the state of Rio Grande do Norte, Northeast Brazil. Data was obtained between November/2021 to April/2022. All dogs residing at the shelter (98 dogs) were examined and blood was collected for testing for L. infantum, Ehrlichia canis, and Babesia sp. Statistical analyses considered the clinical and laboratory findings. Of the 98 animals, approximately 43% were positive for L. infantum antibodies, 19% were positive for L. infantum kDNA, and 18% were L. infantum positive by culture. Greater levels of anti-leishmania antibodies were observed in dogs with symptoms suggestive of VL. The dogs tested positive for E. canis (19/98) and B. canis (18/98). Lutzomyia longipalpis was captured inside the shelter, representing 74.25% (n = 225) of whole sandflies in the dog shelter. Concomitant infection by L. infantum and E. canis increased the odds of death. Treatment of VL included the use of allopurinol (n = 48) and miltefosine (n = 8). Treated animals showed more signs of Leishmania infection. Tickborn parasites and Leishmania were prevalent in sheltered dogs in a VL-endemic area, which increases the odds of death and poses an additional challenge for caring for abandoned dogs and at the same time setting protocols to manage reservoirs of L. infantum.
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Affiliation(s)
- Alessandra Salles da Silva
- Postgraduate Program in Development and Environment, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Marcel Miranda de Medeiros Silva
- Postgraduate Program in Development and Environment, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Carolina de Oliveira Mendes Aguiar
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Paulo Ricardo Petrucio Nascimento
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Eliardo Guimarães da Costa
- Department of Statistics, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Selma M B Jeronimo
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil; Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil
| | - Maria de Fátima Freire de Melo Ximenes
- Postgraduate Program in Development and Environment, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil; Department of Microbiology and Parasitology, Biosciences Center, Federal University of Rio Grande do Norte, Natal 59078-900, Rio Grande do Norte, Brazil.
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Vasconcelos SA, de Sousa RLT, Costa E, Diniz e Souza JP, Cavalcante D, da Silva ACL, de Mendonça IL, Mallet J, Teixeira CR, Werneck GL, Araújo-Pereira T, Pita-Pereira D, Britto C, Vilela ML, Gomes R. Characterisation of an area of coexistent visceral and cutaneous leishmaniasis transmission in the State of Piauí, Brazil. Mem Inst Oswaldo Cruz 2024; 119:e230181. [PMID: 38324880 PMCID: PMC10841424 DOI: 10.1590/0074-02760230181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND In Brazil, transmission of visceral and cutaneous leishmaniasis has expanded geographically over the last decades, with both clinical forms occurring simultaneously in the same area. OBJECTIVES This study characterised the clinical, spatial, and temporal distribution, and performed entomological surveillance and natural infection analysis of a leishmaniasis-endemic area. METHODS In order to characterise the risk of leishmaniasis transmission in Altos, Piauí, we described the clinical and socio-demographic variables and the spatial and temporal distribution of cases of American visceral leishmaniasis (AVL) and American cutaneous leishmaniasis (ACL) cases and identified potential phlebotomine vectors. FINDINGS The urban area concentrated almost 54% of ACL and 86.8% of AVL cases. The temporal and spatial distribution of AVL and ACL cases in Altos show a reduction in the number of risk areas, but the presence of permanent disease transmission foci is observed especially in the urban area. 3,808 phlebotomine specimens were captured, with Lutzomyia longipalpis as the most frequent species (98.45%). Of the 35 females assessed for natural infection, one specimen of Lu. longipalpis tested positive for the presence of Leishmania infantum and Leishmania braziliensis DNA. MAIN CONCLUSION Our results indicate the presence of risk areas for ACL and AVL in the municipality of Altos and highlight the importance of entomological surveillance to further understand a possible role of Lu. longipalpis in ACL transmission.
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Affiliation(s)
- Silvia Alcântara Vasconcelos
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Medicina Tropical, Rio de Janeiro, RJ, Brasil
| | - Raimundo Leoberto Torres de Sousa
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Enéas Costa
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Teresina, PI, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Medicina Tropical, Rio de Janeiro, RJ, Brasil
| | | | - Diane Cavalcante
- Universidade Federal do Ceará, Departamento de Patologia, Fortaleza, CE, Brasil
| | | | | | - Jacenir Mallet
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar em Vigilância Entomológica em Diptera e Hemiptera, Rio de Janeiro, RJ, Brasil
| | | | | | - Thais Araújo-Pereira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Daniela Pita-Pereira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
- Centro Universitário Lusíada, Santos, SP, Brasil
| | - Constança Britto
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular e Doenças Endêmicas, Rio de Janeiro, RJ, Brasil
| | - Maurício Luiz Vilela
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Interdisciplinar em Vigilância Entomológica em Diptera e Hemiptera, Rio de Janeiro, RJ, Brasil
| | - Regis Gomes
- Fundação Oswaldo Cruz-Fiocruz, Escritório Técnico Regional, Eusébio, CE, Brasil
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Costa CHN, Chang KP, Costa DL, Cunha FVM. From Infection to Death: An Overview of the Pathogenesis of Visceral Leishmaniasis. Pathogens 2023; 12:969. [PMID: 37513817 PMCID: PMC10384967 DOI: 10.3390/pathogens12070969] [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: 05/13/2023] [Revised: 07/02/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Kala-azar, also known as visceral leishmaniasis (VL), is a disease caused by Leishmania infantum and L. donovani. Patients experience symptoms such as fever, weight loss, paleness, and enlarged liver and spleen. The disease also affects immunosuppressed individuals and has an overall mortality rate of up to 10%. This overview explores the literature on the pathogenesis of preclinical and clinical stages, including studies in vitro and in animal models, as well as complications and death. Asymptomatic infection can result in long-lasting immunity. VL develops in a minority of infected individuals when parasites overcome host defenses and multiply in tissues such as the spleen, liver, and bone marrow. Hepatosplenomegaly occurs due to hyperplasia, resulting from parasite proliferation. A systemic inflammation mediated by cytokines develops, triggering acute phase reactants from the liver. These cytokines can reach the brain, causing fever, cachexia and vomiting. Similar to sepsis, disseminated intravascular coagulation (DIC) occurs due to tissue factor overexpression. Anemia, hypergammaglobulinemia, and edema result from the acute phase response. A regulatory response and lymphocyte depletion increase the risk of bacterial superinfections, which, combined with DIC, are thought to cause death. Our understanding of VL's pathogenesis is limited, and further research is needed to elucidate the preclinical events and clinical manifestations in humans.
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Affiliation(s)
- Carlos H N Costa
- Centro de Investigações em Agravos Tropicais Emergentes e Negligenciados, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Rua Artur de Vasconcelos 151-Sul, Teresina 64002-510, PI, Brazil
| | - Kwang-Poo Chang
- Department of Microbiology/Immunology, Center for Cancer Cell Biology, Immunology & Infection, Chicago Medical School, Rosalind Franklin University, North Chicago, IL 60064, USA
| | - Dorcas L Costa
- Centro de Investigações em Agravos Tropicais Emergentes e Negligenciados, Instituto de Doenças Tropicais Natan Portella, Universidade Federal do Piauí, Rua Artur de Vasconcelos 151-Sul, Teresina 64002-510, PI, Brazil
| | - Francisco Valmor M Cunha
- Departament of Physiotherapy, Centro Universitário Uninovafapi, Rua Vitorino Orthiges Fernandes, 6123-Uruguai, Teresina 64073-505, PI, Brazil
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de Sousa RLT, Araujo-Pereira TD, Leal ARDS, Freire SM, Silva CLM, Mallet JRDS, Vilela ML, Vasconcelos SA, Gomes R, Teixeira C, Britto C, Pita Pereira DD, Carvalho BMD. Association between the potential distribution of Lutzomyia longipalpis and Nyssomyia whitmani and leishmaniasis incidence in Piauí State, Brazil. PLoS Negl Trop Dis 2023; 17:e0011388. [PMID: 37276231 DOI: 10.1371/journal.pntd.0011388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Leishmaniases are vector borne diseases caused by Leishmania spp. parasites transmitted by female sandflies (Diptera: Psychodidae) whose geographic distribution is influenced by environmental factors. Among the main tools for studying the distribution of vector species, modeling techniques are used to analyze the influence of climatic and environmental factors on the distribution of these insects and their association with human cases of the disease. METHODOLOGY/PRINCIPAL FINDINGS Here, we used a multiscale ecological niche modeling approach to assess the environmental suitability of sandfly vectors of the etiological agents of Visceral (VL) and American Cutaneous Leishmaniasis (ACL) in Piauí state, northeastern Brazil, and then evaluated their relationship with human disease incidence. For this, we obtained the geographic coordinates of the vector species Lutzomyia longipalpis and Nyssomyia whitmani through literature review, online databases and unpublished records. These data were used for the development of predictive models of the distribution of both sandflies species based on climatic and environmental variables. Finally, the environmental suitability for the presence of these vectors was compared with the incidence of both the diseases at the municipality level. The final models for each sandfly species showed good predictive powers with performance metric values of 0.889 for Lu. longipalpis and 0.776 for Ny. whitmani. The areas with greater environmental suitability for the presence of these species were concentrated in the central-north region of Piauí and coincide with the location of those municipalities presenting higher incidences of VL and ACL, situated in the central-north and extreme north of the state, respectively. The south and southeast regions of Piauí state have low incidence of these diseases and presented low environmental suitability for the presence of both vectors. CONCLUSIONS/SIGNIFICANCE We discuss how predictive modeling can guide entomological and epidemiological surveillances and recommend an increased supervision and control activities in Teresina (capital of the state of Piaui), Altos and Pedro II, in addition to other municipalities with similar social and environmental characteristics.
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Affiliation(s)
| | - Thais de Araujo-Pereira
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | | | - Simone Mousinho Freire
- Laboratório de Zoologia e Biologia Parasitária, Universidade Estadual do Piauí, Teresina, Piauí, Brasil
| | - Cleanto Luiz Maia Silva
- Laboratório de Zoologia e Biologia Parasitária, Universidade Estadual do Piauí, Teresina, Piauí, Brasil
| | - Jacenir Reis Dos Santos Mallet
- Laboratório Interdisciplinar de Vigilância Entomológica em Díptera e Hemíptera, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
- Escritório Regional Fiocruz-Piauí, Teresina, Piauí, Brasil
- Laboratório de Vigilância e Biodiversidade em Saúde, Universidade Iguaçu, Nova Iguaçu, Rio de Janeiro, Brasil
| | - Mauricio Luiz Vilela
- Laboratório Interdisciplinar de Vigilância Entomológica em Díptera e Hemíptera, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | | | - Régis Gomes
- Departamento de Biotecnologia Fiocruz-Ceará, Eusébio, Ceará, Brasil
| | | | - Constança Britto
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | - Daniela de Pita Pereira
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro, Brasil
| | - Bruno Moreira de Carvalho
- Climate and Health Program, Earth Sciences Department, Barcelona Institute for Global Health, Barcelona, Spain
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5
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Hernandez HG, Brown GD, Lima ID, Coutinho JF, Wilson ME, Nascimento ELT, Jeronimo SMB, Petersen CA, Oleson JJ. Hierarchical spatiotemporal modeling of human visceral leishmaniasis in Rio Grande do Norte, Brazil. PLoS Negl Trop Dis 2023; 17:e0011206. [PMID: 37011128 PMCID: PMC10101641 DOI: 10.1371/journal.pntd.0011206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/13/2023] [Accepted: 03/01/2023] [Indexed: 04/05/2023] Open
Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease that is globally distributed and has the potential to cause very serious illness. Prior literature highlights the emergence and spread of VL is influenced by multiple factors, such as socioeconomic status, sanitation levels or animal and human reservoirs. The study aimed to retrospectively investigate the presence and infectiousness of VL in Rio Grande do Norte (RN), Brazil between 2007 and 2020. We applied a hierarchical Bayesian approach to estimate municipality-specific relative risk of VL across space and time. The results show evidence that lower socioeconomic status is connected to higher municipality-specific VL risk. Overall, estimates reveal spatially heterogeneous VL risks in RN, with a high probability that VL risk for municipalities within the West Potiguar mesoregion are more than double the expected VL risk. Additionally, given the data available, results indicate there is a high probability of increasing VL risk in the municipalities of Natal, Patu and Pau dos Ferros. These findings demonstrate opportunities for municipality-specific public health policy interventions and warrant future research on identifying epidemiological drivers in at-risk regions.
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Affiliation(s)
- Helin G Hernandez
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, United States of America
| | - Grant D Brown
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, United States of America
| | - Iraci D Lima
- State Health Secretariat, State Government of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José F Coutinho
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Mary E Wilson
- Departments of Internal Medicine and Microbiology & Immunology, University of Iowa, Iowa City, Iowa, United States of America
- Iowa City VA Medical Center, Iowa City, Iowa, United States of America
| | - Eliana L T Nascimento
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Selma M B Jeronimo
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil
- National Institute of Sciences and Technology of Tropical Disease, Natal, Rio Grande do Norte, Brazil
| | - Christine A Petersen
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, United States of America
| | - Jacob J Oleson
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, United States of America
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Cavalcante KKDS, Almeida CP, Boigny RN, Cavalcante FRA, Correia FGS, Florêncio CMGD, Alencar CH. Epidemiological and clinical factors associated with lethality from Human Visceral Leishmaniasis in Northeastern Brazil, 2007 to 2018. Rev Inst Med Trop Sao Paulo 2022; 64:e52. [PMID: 36074447 PMCID: PMC9448254 DOI: 10.1590/s1678-9946202264052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/04/2022] [Indexed: 11/25/2022] Open
Abstract
Human Visceral Leishmaniasis (HVL) presents a subacute clinical evolution with systemic involvement, which can result in high case fatality, especially among untreated individuals or those with low socioeconomic status. This study aimed to identify epidemiological and clinical factors associated with HVL case fatality in the Ceara State, from 2007 to 2018. This is an analytical cross-sectional study. The bivariate analysis was performed by Stata 15.1 using Pearson’s Chi-square or Fisher’s exact test; and Poisson regression for age-controlled multivariate analysis. From 2007 to 2018, there were 4,863 new confirmed cases and 343 deaths from HVL (case fatality rate=7.05%). The risk factors associated with case fatalities were: age group (RR=8.69; 95%CI:3.56-21.20); black population (RR=2.21; 95%CI:1.45-3.35); jaundice symptoms (RR=1.72; 95%CI:1.38-2.14); edema (RR=2.62; 95%CI:2.10-3.26) and hemorrhagic phenomena (RR=1.63; 95%CI:1.26-2.10); and no prescription drug intake (RR=4.03; 95%CI:2.98-5.46). Treatment with pentavalent antimonial was a protective factor (RR=0.35; 95%CI:0.27-0.45). The number of deaths increased among the elderly, illiterate, urban residents, and black skin color individuals. The drugs pentavalent antimonial and amphotericin B showed an association with death, but were not considered causal factors. Treatment failure led to a high risk of death. In multivariate analysis, the risk factors for fatal cases were age group, black skin, symptoms of jaundice, edema and hemorrhagic phenomena; and failure to take the prescription drugs. Treatment with pentavalent antimonial was shown to be a protective factor. Knowing the factors associated with the fatality of VL-HIV cases may help to improve public policies, in order to refine the epidemiological surveillance program and, consequently, prevent deaths related to the disease in Ceara.
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Affiliation(s)
| | - Clarice Pessoa Almeida
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, Ceará, Brazil
| | - Reagan Nzundu Boigny
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, Ceará, Brazil
| | | | | | | | - Carlos Henrique Alencar
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, Ceará, Brazil
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Borges MS, Niero LB, da Rosa LDS, Citadini-Zanette V, Elias GA, Amaral PDA. Factors associated with the expansion of leishmaniasis in urban areas: a systematic and bibliometric review (1959–2021). J Public Health Res 2022; 11:22799036221115775. [PMID: 36062236 PMCID: PMC9434684 DOI: 10.1177/22799036221115775] [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: 07/09/2022] [Accepted: 07/09/2022] [Indexed: 11/15/2022] Open
Abstract
This work describes a systematic and bibliometric review of the factors that contribute to the expansion of leishmaniasis in urban areas. Three scientific databases were used: Scientific Electronic Library (Sci ELO), Scopus and Web of Science, encompassing all original and review articles between 1959 and 2021. Three descriptors were used: “leishmaniasis” AND “urban” AND “rural.” Planning, execution, summarization, and selection processes were performed using StArt ( State of the Art through Systematic Review) software. We obtained a total of 304 articles, 60 of which concerned canine leishmaniasis. The factors associated with the expansion of leishmaniasis in urban areas are interrelated, including socioenvironmental and economic complexity, the type of leishmaniasis, the reservoirs, vectors, deforestation, disorderly occupation of space, poor sanitary conditions, and human migration trends. A lack of diagnosis and underreporting of cases in some regions may reflect the increase of cases seen in urban areas. A majority ( n = 121) of studies were conducted in Brazil, followed by Iran ( n = 43). In relation to publications; in general, output has increased over the years, particularly in 2021. The majority of published studies were in the area of epidemiology ( n = 158).
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Affiliation(s)
- Marília Schutz Borges
- Mestra em Ciências Ambientais, Programa
de Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul Catarinense
(UNESC), Criciúma, Santa Catarina, Brasil
- Marília Schutz Borges, Programa de
Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul Catarinense
(UNESC), Av. Universitária, 1105 - Bairro Universitário CEP: 88806-000 Criciúma,
Santa Catarina, Brasil.
| | - Luana Budny Niero
- Farmacêutica e mestranda do Programa de
Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul Catarinense
(UNESC), Criciúma, Santa Catarina, Brasil
| | - Laíse Dimer Sant’ana da Rosa
- Acadêmica do curso de farmácia da
Universidade do Extremo Sul Catarinense (UNESC), Criciúma, Santa Catarina,
Brasil
| | - Vanilde Citadini-Zanette
- Doutora em Ecologia e Recursos
Naturais, Programa de Pós-Graduação em Ciências Ambientais, Universidade do Extremo
Sul Catarinense (UNESC), Criciúma, Santa Catarina, Brasil
| | - Guilherme Alves Elias
- Doutor em Ciências Ambientais, Programa
de Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul Catarinense
(UNESC), Criciúma, Santa Catarina, Brasil
| | - Patrícia de Aguiar Amaral
- Doutora em Ciências Farmacêuticas,
Programa de Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul
Catarinense (UNESC), Criciúma, Santa Catarina, Brasil
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Cruz CDSS, Cardoso DT, Ferreira CL, Barbosa DS, Carneiro M. Spatial and spatiotemporal patterns of human visceral leishmaniasis in an endemic southeastern area in countryside Brazil. Rev Soc Bras Med Trop 2022; 55:e07022021. [PMID: 35522814 PMCID: PMC9070065 DOI: 10.1590/0037-8682-0702-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/18/2022] [Indexed: 11/21/2022] Open
Abstract
Visceral leishmaniasis (VL) has shown endemic pattern and epidemic episodes in urban and rural areas, however, there are still gaps in knowledge with regards to disease transmission. This study aimed to analyze the spatiotemporal dispersion of VL cases in the municipality of Araçuaí, Minas Gerais. A study of confirmed VL cases was conducted considering the endemic and epidemic periods between 2012 and 2017. The incidence rate was calculated, and for spatial analysis, the kernel map, directional distribution ellipse, and space-time scanning techniques were used. The correlations between VL cases and exposure variables (precipitation, humidity, and temperature) were calculated. The mean incidence of VL in the endemic period was 18.5 (95% confidence interval (CI) 5.9-32.5) and 44.4 in the epidemic period (95%CI, 12.0-28.6) by 100,000 inhabitants. The relative risk for the epidemic period was 2.4 (95% CI 1.4-4.1) when compared to the endemic period. A higher incidence of the disease was observed in rural areas of the municipality. Kernel mapping analysis revealed hotspots in the urban area of the municipality. The directional distribution ellipse encompasses the urban perimeter and part of the rural area of the municipality, expanding eastward during the epidemic period. Spatial analysis revealed a high-risk cluster for VL in rural areas. A positive correlation was observed between VL cases and temperature during the endemic period. Spatial analysis allowed us to outline the epidemiological scenario of human VL cases. These findings may be useful in case surveillance and in the work of health professionals and managers in Brazil.
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Affiliation(s)
- Cleya da Silva Santana Cruz
- Universidade Federal de Minas Gerais, Faculdade de Medicina,
Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG,
Brasil
- Secretaria de Estado da Saúde de Minas Gerais, Diamantina, MG,
Brasil
| | - Diogo Tavares Cardoso
- Universidade Federal de Minas Gerais, Instituto de Ciências
Biológicas, Programa de Pós-Graduação em Parasitologia, Belo Horizonte, MG, Brasil
| | - Claudio Luiz Ferreira
- Universidade Federal de Minas Gerais, Faculdade de Medicina,
Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG,
Brasil
- Secretaria de Estado da Saúde de Minas Gerais, Diamantina, MG,
Brasil
| | - David Soeiro Barbosa
- Universidade Federal de Minas Gerais, Instituto de Ciências
Biológicas, Programa de Pós-Graduação em Parasitologia, Belo Horizonte, MG, Brasil
| | - Mariângela Carneiro
- Universidade Federal de Minas Gerais, Faculdade de Medicina,
Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG,
Brasil
- Universidade Federal de Minas Gerais, Instituto de Ciências
Biológicas, Programa de Pós-Graduação em Parasitologia, Belo Horizonte, MG, Brasil
- Universidade Federal de Ouro Preto, Núcleo de Pesquisas em Ciências
Biológicas, Programa de Pós-Graduação e Doenças Parasitárias, Ouro Preto, MG,
Brasil
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Batista FMDA, Sousa RAD, Aguiar BGA, Ibiapina AB, Albuquerque LPDA, Mendonça VJ, Costa CHN. [Epidemiological profile and time trend in visceral leishmaniasis: Piauí, Brazil, 2008-2018]. CAD SAUDE PUBLICA 2021; 37:e00340320. [PMID: 34877994 DOI: 10.1590/0102-311x00340320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/28/2021] [Indexed: 11/22/2022] Open
Abstract
Visceral leishmaniasis (VL) or kala azar is one of the main neglected tropical diseases, of major importance due to the lethal nature of this zoonosis caused by protozoa of genus Leishmania. The study aimed to analyze the time trend in VL cases in the state of Piauí, Brazil, from 2008 to 2018, within the total period from 1971 to 2018. Data were obtained from the Brazilian Information System for Notificable Diseases (SINAN) and the Brazilian Mortality Information System (SIM). For burden of disease analysis, data were collected from the Institute for Health Metrics and Evaluation through the Global Burden of Diseases, Injuries, and Risk Factors (GBD Compare). Prais-Winsten regression analysis was used. A total of 2,374 cases were recorded with probable infection in the state of Piauí and 2,492 cases in residents of the state. The historical series analyzed, from 1971 to 2018, reaffirms the cyclical nature of the disease, based on the identification of epidemic peaks in 1983-1984, 1993-1994, 2003-2004, and 2013-2014. No significant alterations were identified in the trends in incidence, mortality, and case-fatality coefficients in the state. However, there was a significant increase in the incidence coefficient in the Chapada das Mangabeiras Development Territory, with an annual percent change of 17.5%, and a decrease in the Vale do Sambito Development Territory (-18.3%) and Vale do Rio Guaribas Development Territory (-8,1%). VL has a high burden of disease, measured by disability-adjusted life years, and is among the leading neglected tropical diseases in the state of Piauí. The study concludes by recommending the improvement of surveillance and control measures for this disease.
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Affiliation(s)
| | | | - Bruno Guedes Alcoforado Aguiar
- Universidade Federal do Piauí, Teresina, Brasil.,Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciado, Teresina, Brasil
| | - Andressa Barros Ibiapina
- Universidade Federal do Piauí, Teresina, Brasil.,Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciado, Teresina, Brasil
| | | | | | - Carlos Henrique Nery Costa
- Universidade Federal do Piauí, Teresina, Brasil.,Instituto de Doenças Tropicais Natan Portella, Teresina, Brasil
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10
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Ferreira GR, Santos-Oliveira JR, Silva-Freitas ML, Honda M, Costa DL, Da-Cruz AM, Costa CHN. Biomarkers of disease severity in patients with visceral leishmaniasis co-infected with HIV. Cytokine 2021; 149:155747. [PMID: 34715475 DOI: 10.1016/j.cyto.2021.155747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 12/30/2022]
Abstract
Visceral leishmaniasis (VL) is caused by the protozoan Leishmania spp, transmitted by sand fly bites. VL is one of the deadliest tropical infection diseases, yet the coinfection with HIV virus drastically increases relapses, treatment failure and mortality. The concomitant action of these two pathogens leads to high cellular activation independently of the progression to AIDS. In addition, microbial translocation and bacterial infections are thought to contribute worsening the clinical picture. Identifying biomarkers associated with disease severity is of interest for clinical management of patients with VL-HIV/AIDS. Thus, we analyzed in the sera several markers including interleukins (IL-1β, IL-6, IL-8, and IL-17), interferon-γ (IFN- γ), tumor necrosis factor (TNF), lipopolysaccharide (LPS), soluble CD14 (sCD14), macrophage migration inhibitory factor (MIF) and intestinal fatty acid-binding protein (IFABP). These markers were compared with disease severity in 24 patients with VL/HIV presenting different clinical outcomes. Disease severity was defined by the probability of death calculated using a score set system derived by the Kala-Cal® software. Probability of death ranged from 3.7% to 97.9%, with median of 28.8%. Five patients died (20%). At the univariate analysis, disease severity was correlated with TNF, IFN-γ and sCD14. LPS was positively correlated with sCD14 specifically in patients with low CD4+ count (CD4+ T-cell <200 cells/mL). Most importantly, the multivariate analysis including LPS, CD4+count and sCD14 showed that sCD14 was the only independent predictor for disease severity and death. Altogether, our results indicated that sCD14 is a powerful marker of pathogenicity and death for patients with VL-HIV/AIDS.
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Affiliation(s)
- Gabriel Reis Ferreira
- Department of Microbiology-Infectious Disease and Immunology, Faculty of Medicine, University Laval, Quebec, Canada; Leishmaniasis Research Laboratory at Natan Portella Tropical Diseases Institute, Teresina, Brazil.
| | | | | | | | - Dorcas Lamounier Costa
- Leishmaniasis Research Laboratory at Natan Portella Tropical Diseases Institute, Teresina, Brazil; Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciados, Teresina, Brazil; Universidade Federal do Piauí, Teresina, Brazil
| | | | - Carlos Henrique Nery Costa
- Leishmaniasis Research Laboratory at Natan Portella Tropical Diseases Institute, Teresina, Brazil; Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciados, Teresina, Brazil; Universidade Federal do Piauí, Teresina, Brazil
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11
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Monteiro MJDSD, da Silva MNP, Paiva ADA, Marreiro DDN, Luzia LA, Henriques GS, Rondó PHDC, Sene IDS, de Almeida ATA, Costa CHN, Costa DL. Nutritional status and vitamin A and zinc levels in patients with kala-azar in Piauí, Brazil. Rev Soc Bras Med Trop 2021; 54:e08002020. [PMID: 34495261 PMCID: PMC8437443 DOI: 10.1590/0037-8682-0800-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 07/26/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Malnutrition and kala-azar (or visceral leishmaniasis) are significant public health problems in different parts of the world. Immunity and susceptibility to infectious and parasitic diseases are directly linked to the host's nutritional state, but little is known about the interaction between nutrition and kala-azar. This study aimed to evaluate nutritional status with kala-azar and correlate these findings with the clinical and laboratory manifestations of the disease, and zinc and retinol levels. METHODS This was a cross-sectional study of 139 patients with kala-azar. Nutritional status classification was performed according to international recommendations. Parametric or nonparametric tests were applied whenever indicated in a two-sided test with a 5% significance level. RESULTS Weight loss and malnutrition were more frequent in adults. Body mass index-for-age, fat area of the arm, and upper arm muscle area were significantly associated with probability of death. The presence of human immunodeficiency virus, hepatomegaly, and splenomegaly was correlated with nutritional assessment. Blood leukocyte and lymphocyte, serum creatine, and vitamin A levels were significantly higher in adult men. Vitamin A levels were highly associated with the level of hemoglobin and C-reactive protein (CRP) in multivariate analysis. All patients had reduced plasma zinc levels, but this finding had no association with the outcome variables. CONCLUSIONS Malnutrition was correlated with severe disease and was more prevalent in older people with kala-azar. Vitamin A deficiency was associated with hemoglobin and CRP. Zinc levels were reduced in patients with kala-azar.
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Affiliation(s)
| | - Maria Nauside Pessoa da Silva
- Universidade Federal do Piauí, Programa de Pós-Graduação em Biotecnologia, Rede Nordeste de Biotecnologia, Teresina, PI, Brasil
| | | | | | - Liania Alves Luzia
- Universidade de São Paulo, Laboratório de Micronutrientes, São Paulo, SP, Brasil
| | - Gilberto Simeone Henriques
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Laboratório Experimental de Nutrição, Belo Horizonte, MG, Brasil
| | | | - Ingridi de Souza Sene
- Universidade Federal do Piauí, Laboratório de Pesquisas em Leishmanioses, Teresina, PI, Brasil
- Laboratório de Anatomia Patológica e Biologia Molecular, Teresina, PI, Brasil
| | | | - Carlos Henrique Nery Costa
- Universidade Federal do Piauí, Laboratório de Pesquisas em Leishmanioses, Teresina, PI, Brasil
- Centro de Inteligência para Agravos Tropicais Emergentes e Negligenciados, Teresina, PI, Brasil
- Universidade Federal do Piauí, Departamento de Medicina Comunitária, Teresina, PI, Brasil
| | - Dorcas Lamounier Costa
- Universidade Federal do Piauí, Laboratório de Pesquisas em Leishmanioses, Teresina, PI, Brasil
- Centro de Inteligência para Agravos Tropicais Emergentes e Negligenciados, Teresina, PI, Brasil
- Universidade Federal do Piauí, Departamento Materno-Infantil, Teresina, PI, Brasil
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12
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Berenguer LKAR, Gomes CFCDA, Nascimento JDO, Bernardi JCM, Lima VFS, de Oliveira JB, Ramos CADN, Ramos RAN, Alves LC. Leishmania infantum Infection in a Domestic Cat: A Real Threat or an Occasional Finding? Acta Parasitol 2021; 66:673-676. [PMID: 33044603 DOI: 10.1007/s11686-020-00294-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Visceral Leishmaniasis (VL) has been considered one of the most important neglected zoonosis in the world. In Brazil, this disease passed for an urbanization process and currently pets (dogs and cats) animals have acquired a great importance on its epidemiology. Studies on dogs have been extensively performed throughout the country, but information about infection in cats has been concentrated in few areas. Therefore, the aim of this study was to investigate the occurrence of infection by Leishmania infantum in domestic cats living in endemic areas for Canine Visceral Leishmaniasis (CVL) in the state of Pernambuco, Northeastern Brazil. METHODS Domiciled cats (n = 128) were sampled for different biological samples (i.e., blood, conjunctival swab and fine needle aspiration of lymph nodes) that were microscopically and molecularly analyzed through PCR and sequencing. RESULTS Amastigote forms of Leishmania sp. were detected in a single animal (fine needle aspiration of lymph node). This same animal scored positive at molecular examination (blood and lymph node) and the sequence analysis revealed an identity higher than 99% with L. infantum sequences DNA available in Genbank database. CONCLUSION This is the first molecular characterization of L. infantum infecting domestic cats in Pernambuco. Therefore, veterinary practitioners should consider this putative infection in cats living in areas where canine and human Leishmaniasis has been reported.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Leucio Câmara Alves
- Department of Veterinary Medicine, Federal Rural University of Pernambuco, Recife, Pernambuco, CEP: 52171-900, Brazil
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13
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Socio-economic and environmental factors associated with the occurrence of canine infection by Leishmania infantum in Teresina, Brazil. Vet Parasitol Reg Stud Reports 2021; 24:100561. [PMID: 34024377 DOI: 10.1016/j.vprsr.2021.100561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/28/2021] [Accepted: 03/25/2021] [Indexed: 11/21/2022]
Abstract
American visceral leishmaniasis (AVL) is a zoonosis caused by protozoan parasites of the genus Leishmania. In Brazil, the disease is caused by Leishmania infantum and the main vector is the phlebotomine sandfly Lutzomyia longipalpis, found both in natural ecotopes and in the rural and urban environments, being very well adapted to the peridomestic environment. The domestic dog has been incriminated as the main reservoir of the parasite in the urban environment, but the control measures based on culling seropositive dogs have not shown to be effective to contain the spread of the disease throughout the country. Many studies evaluated risk factors for human visceral leishmaniasis but few focused on the socioeconomic and environmental factors associated with infection among dogs. Knowledge of these factors might help identify the conditions that contribute to the maintenance of transmission cycles in the urban environment and identify new targets for intervention. The objective of this study was to assess the association between socioeconomic and environmental factors and the occurrence of canine leishmaniasis at Teresina city, Brazil. This cross-sectional study was developed in ten districts of Teresina, involving 532 houses and 810 dogs. Peripheral blood samples were collected by vein punction using vacutainer tubes without anticoagulant for performing serological test (indirect immunofluorescence - IFI). Serum samples with IFI titers ≥1: 80 were considered positive. Owners of the selected dwellings were interviewed using a semi-structured questionnaire addressing socioeconomic and environment aspects. The association between variables and seropositivity was assessed through multilevel logistic regression models. Global seropositivity was 39%. There was no statistically significant difference between seropositivity and age and sex of animals, literacy of the household head, presence of other domestic animals or with household characteristic like water supply, inadequate sewage disposal system, type of floor and roof. Mixed-breed dogs and those living for a long time in houses with absence of masonry walls and presence of a kennel showed higher odds of seropositivity. These results suggest that some peridomestic characteristics, especially the absence of barriers that allow dogs to have free access to the street, in association with the presence of a kennel, might contribute to maintaining the infection cycle in urban areas. Intervention measures oriented to the management of the peridomestic environment and responsible dog possession could be useful tools for reducing disease burden in endemic area.
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14
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da Silva Santana Cruz C, Soeiro Barbosa D, Oliveira VC, Cardoso DT, Guimarães NS, Carneiro M. Factors associated with human visceral leishmaniasis cases during urban epidemics in Brazil: a systematic review. Parasitology 2021; 148:639-647. [PMID: 33431094 PMCID: PMC11010180 DOI: 10.1017/s0031182021000019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 11/06/2022]
Abstract
Visceral leishmaniasis (VL) is endemic in 70 countries and has been reported in 12 countries of Latin America, with over 90% of the cases reported in Brazil, where epidemics have occurred since 1980. The objective of this review is to describe the factors associated with the occurrence of VL epidemics in humans in urban areas. A systematic review was conducted according to the PRISMA-P guidelines. The databases PubMed (by Medline), Cochrane Library, Embase, Amed, LILACS and grey literature [Google Scholar and handsearch of the database of the Information System for Notifiable Diseases (SINAN) of Brazil's Unified Health System] were used. The protocol was registered under PROSPERO (CRD42019128998). Climatic, environmental factors and indicators of urban social structure were described as influencing the outbreaks in the North and Northeast regions. Gender and age characteristics were related to a greater chance of developing VL in the Central-West, Northeast and Southeast regions. Vector indicators showed a positive correlation with the incidence of VL in studies in the Northeast region. In the Southeast and Northeast regions, studies revealed the presence of dogs with positive correlation with VL. Knowledge gaps remain regarding the contribution to the increase in the risk factors described in ecological approaches, as no analysis was performed at the individual level, and it is still necessary to discuss the influence of other associated elements in epidemic episodes in the spread of VL.
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Affiliation(s)
- Cleya da Silva Santana Cruz
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
| | - Vinícius Cunha Oliveira
- Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, MG, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
| | - Nathália Sernizon Guimarães
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
| | - Mariângela Carneiro
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
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15
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Abuzaid AA, Aldahan MA, Helal MAA, Assiri AM, Alzahrani MH. Visceral leishmaniasis in Saudi Arabia: From hundreds of cases to zero. Acta Trop 2020; 212:105707. [PMID: 32950481 DOI: 10.1016/j.actatropica.2020.105707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
Abstract
The kingdom of Saudi Arabia (KSA) has succeeded in bringing the reported numbers of Visceral leishmaniasis (VL) cases from hundreds during the 1980s and 1990s to zero case in 2019. The endemicity of VL has been confined mainly to the Southwest regions, namely Jazan and Aseer regions. Leishmania donovani species have been identified as the causative species of VL, while L. infantum have been isolated only from dogs in the endemic areas. Many species of sand flies were caught in Southwest, but P. orientalis is the probable transmitter of the disease. The black rat (Rattus ratus) was found to be contributing to maintenance of the parasite life cycle. VL is primarily a disease of children, and 80% of cases were Saudi's, while cases from Yeminis nationality represent the majority of non- Saudi patients. The common clinical presentation consist of chronic fever, abdominal distention, weight loss, anemia and hepatosplenomegaly. Laboratory findings include: anemia, leukopenia, thrombocytopenia, hypoalbuminemia, hyperproteinaemia and hypergammaglobulinemia, low serum iron, and abnormal liver enzymes. Occurrence of jaundice has been identified as a bad prognostic sign. Diagnosis relying on direct smears from bone marrow aspirates was the commonest tool used, and also is advocated by the National Leishmaniasis Control Program (NLCP). Sodium stibogluconate (SSG) is the main drug used to treat VL cases, while Ambisome is preserved for complicated cases. Chemical control of sand flies using indoor residual spraying (IRS) with synthetic pyrethroids has been the most effective measure applied to prevent vector-human contact and disease transmission. The geographical overlap of VL and Malaria has facilitated the adoption and implementation of integrated vector control strategies. After reaching a zero case in 2019, the Ministry of Health (MoH) has a new commitment and facing a great challenge which are maintenance of current situation and elimination of VL. Through the support of stakeholders, encouragement of community participation, preparedness and readiness of leishmaniasis personnel, the new mission of the NLCP now is elimination of the scourge of VL from the country.
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16
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Rancan EA, Chagas EFB, Sperança MA, Carvalho VCDL, Martins LPA, Suzuki RB. Spatio-temporal distribution of human American visceral leishmaniasis in the Western region of Sao Paulo State, from 2004 to 2018. Rev Inst Med Trop Sao Paulo 2020; 62:e80. [PMID: 33146309 PMCID: PMC7608071 DOI: 10.1590/s1678-9946202062080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/15/2020] [Indexed: 11/21/2022] Open
Abstract
Leishmaniasis comprises a group of zoonotic diseases caused by protozoa belonging to the Leishmania genus, noting that the visceral form is the most severe and lethal, if untreated. Nowadays visceral leishmaniasis is widespread in Brazil and the Adamantina microregion, located in the west of Sao Paulo State, has been affected by Human American Visceral Leishmaniasis (HAVL) since 2004. We evaluated the epidemiological profile of HAVL in the Adamantina microregion through a Geographic Information Systems (GIS) and established its incidence rate by location and time. Notified cases were provided by the Sao Paulo State Epidemiological Surveillance Center. Home addresses of patients who tested positive to HAVL were converted into geographic coordinates through the Google Geocoding Application Programming Interface submitted to ArcMap 10.5 System for georeferencing. Kernel spatial analyses were performed to obtain the incidence distribution and the total area involvement rate. From 2004 to 2018, 325 cases of HAVL were diagnosed in 11 of the 12 municipalities belonging to the of Adamantina microregion. The disease has disseminated to the Northwest and East-Southeast directions, taking place along the Comandante Joao Ribeiro de Barros highway, with higher incidences rates in the municipalities where the highway passes. HAVL incidence was higher in children aged between 0 to 9 years and in the elderly; there was no difference in relation to sex and the majority of cases were located in urban areas. The determination of the epidemiological profile and the the spread of disease patterns can indicate possible areas of vulnerability, in order to contribute to the management and prevention of the disease through a strategic resources optimization.
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Affiliation(s)
| | | | - Márcia Aparecida Sperança
- Universidade Federal do ABC , Centro de Ciências Naturais e Humanas , São Bernardo do Campo , São Paulo , Brazil
| | | | | | - Rodrigo Buzinaro Suzuki
- Faculdade de Medicina de Marília , Departamento de Parasitologia , Marília , São Paulo , Brazil.,Universidade de Marília , Faculdade de Medicina , Marília , São Paulo , Brazil
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17
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Falcão de Oliveira E, de Oliveira AG, de Arruda CCP, Fernandes WDS, de Medeiros MJ. Spatio-temporal modeling of visceral leishmaniasis in Midwest Brazil: An ecological study of 18-years data (2001-2018). PLoS One 2020; 15:e0240218. [PMID: 33007033 PMCID: PMC7531797 DOI: 10.1371/journal.pone.0240218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/23/2020] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis (VL) is a neglected vector-borne disease associated with socioeconomic and environmental issues. In Brazil, epidemics of VL have occurred in major cities since 1980. Applied models for medical and epidemiological research have been used to assess the distribution and characteristics of disease endpoints and identify and characterize potential risk factors. This study described the demographic features of VL and modeled the spatio-temporal distribution of human VL cases and their relationship with underlying predicitve factors using generalized additive models. We conducted an ecological study covering an 18-year period from the first report of an autochthonous case of VL in Campo Grande, state of Mato Grosso do Sul, in 2001 to 2018. The urban area of the city has 74 neighborhoods, and they were the units of analysis of our work. Socioeconomic and demographic data available from Brazilian public databases were considered as covariables. A total of 1,855 VL cases were reported during the study period, with an annual mean incidence rate of 13.23 cases per 100,000 population and a cumulative crude incidence of 235.77 per 100,000 population. The results showed the rapid transition from epidemic to endemic and the centrifugal dispersal pattern of the disease. Moreover, the model highlighted that the urban quality of life index, which is calculated based on income, education, housing conditions, and environmental sanitation data, plays a role in VL occurrence. Our findings highlighted the potential for improving spatio-temporal segmentation of control measures and the cost-effectiveness of integrated disease management programs as soon as VL is difficult to control and prevent and has rapid geographical dispersion and increased incidence rates.
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Affiliation(s)
- Everton Falcão de Oliveira
- Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- * E-mail: (EFO); (MJM)
| | - Alessandra Gutierrez de Oliveira
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- Instituto de Biociências, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | | | - Wagner de Souza Fernandes
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Márcio José de Medeiros
- Campus Macaé, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
- * E-mail: (EFO); (MJM)
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Application of next generation sequencing (NGS) for descriptive analysis of 30 genomes of Leishmania infantum isolates in Middle-North Brazil. Sci Rep 2020; 10:12321. [PMID: 32704096 PMCID: PMC7378178 DOI: 10.1038/s41598-020-68953-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
Visceral leishmaniasis (VL) is a life-threatening disease caused by the protozoa Leishmania donovani and L. infantum. Likely, L. infantum was introduced in the New World by the Iberic colonizers. Due to recent introduction, the genetic diversity is low. Access to genomic information through the sequencing of Leishmania isolates allows the characterization of populations through the identification and analysis of variations. Population structure information may reveal important data on disease dynamics. Aiming to describe the genetic diversity of L. infantum from the Middle-North, Brazil, next generation sequencing of 30 Leishmania isolates obtained in the city of Teresina, from where the disease dispersed, was performed. The variations were categorized accordingly to the genome region and impact and provided the basis for chromosomal ploidy and population structure analysis. The results showed low diversity between the isolates and the Iberic reference genome JPCM5. Most variations were seen in non-coding regions, with modifying impact. The ploidy number analysis showed aneuploid profile. The population structure analysis revealed the presence of two L. infantum populations identified in Teresina. Further population genetics studies with a larger number of isolates should be performed in order to identify the genetic background associated with virulence and parasite ecology.
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19
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Boité MC, Späth GF, Bussotti G, Porrozzi R, Morgado FN, Llewellyn M, Schwabl P, Cupolillo E. Trans-Atlantic Spill Over: Deconstructing the Ecological Adaptation of Leishmania infantum in the Americas. Genes (Basel) 2019; 11:E4. [PMID: 31861501 PMCID: PMC7017240 DOI: 10.3390/genes11010004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 12/13/2022] Open
Abstract
Pathogen fitness landscapes change when transmission cycles establish in non-native environments or spill over into new vectors and hosts. The introduction of Leishmania infantum in the Americas into the Neotropics during European colonization represents a unique case study to investigate the mechanisms of ecological adaptation of this important parasite. Defining the evolutionary trajectories that drive L. infantum fitness in this new environment are of great public health importance as they will allow unique insight into pathways of host/pathogen co-evolution and their consequences for region-specific changes in disease manifestation. This review summarizes current knowledge on L. infantum genetic and phenotypic diversity in the Americas and its possible role in the unique epidemiology of visceral leishmaniasis (VL) in the New World. We highlight the importance of appreciating adaptive molecular mechanisms in L. infantum to understand the parasites' successful establishment on the continent.
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Affiliation(s)
- Mariana C. Boité
- Laboratory of Research on Leishmaniasis, Oswaldo Cruz Institute, FIOCRUZ, 21040-360 Rio de Janeiro, Brazil; (R.P.); (F.N.M.); (E.C.)
| | - Gerald F. Späth
- Department of Parasites and Insect Vectors, Laboratory of Molecular Parasitology and Signaling, Institut Pasteur, INSERN U1201, 75015 Paris, France; (G.F.S.); (G.B.)
| | - Giovanni Bussotti
- Department of Parasites and Insect Vectors, Laboratory of Molecular Parasitology and Signaling, Institut Pasteur, INSERN U1201, 75015 Paris, France; (G.F.S.); (G.B.)
- Institut Pasteur-Bioinformatics and Biostatistics Hub-C3BI, USR 3756 IP CNRS, 75015 Paris, France
| | - Renato Porrozzi
- Laboratory of Research on Leishmaniasis, Oswaldo Cruz Institute, FIOCRUZ, 21040-360 Rio de Janeiro, Brazil; (R.P.); (F.N.M.); (E.C.)
| | - Fernanda N. Morgado
- Laboratory of Research on Leishmaniasis, Oswaldo Cruz Institute, FIOCRUZ, 21040-360 Rio de Janeiro, Brazil; (R.P.); (F.N.M.); (E.C.)
| | - Martin Llewellyn
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, G128QQ Glasgow, UK; (M.L.); (P.S.)
| | - Philipp Schwabl
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, G128QQ Glasgow, UK; (M.L.); (P.S.)
| | - Elisa Cupolillo
- Laboratory of Research on Leishmaniasis, Oswaldo Cruz Institute, FIOCRUZ, 21040-360 Rio de Janeiro, Brazil; (R.P.); (F.N.M.); (E.C.)
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Azevedo TSD, Lorenz C, Chiaravalloti-Neto F. Risk mapping of visceral leishmaniasis in Brazil. Rev Soc Bras Med Trop 2019; 52:e20190240. [PMID: 31778399 DOI: 10.1590/0037-8682-0240-2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 09/13/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Brazil experiences a large number of visceral leishmaniasis (VL) cases. Our objective was to examine both spatial patterns of dispersion and space-time trends for this disease. METHODS We used all autochthonous confirmed cases of VL in Brazil from 2001 to 2017. RESULTS Throughout Brazil, 53,715 human cases of VL were recorded. The Northeast, Southeast, and Midwest regions of Brazil were the most affected areas and presented a higher risk of transmission. Regarding spatiotemporal variation, significant differences were observed each year, with a peak in 2005. CONCLUSIONS The dynamics of VL showed a clear non-random pattern of spread in Brazil.
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Affiliation(s)
| | - Camila Lorenz
- Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Epidemiologia, São Paulo, SP, Brasil
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21
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Dispersion of Leishmania (Leishmania) infantum in central-southern Brazil: Evidence from an integrative approach. PLoS Negl Trop Dis 2019; 13:e0007639. [PMID: 31465422 PMCID: PMC6715157 DOI: 10.1371/journal.pntd.0007639] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 07/17/2019] [Indexed: 11/19/2022] Open
Abstract
Leishmania (Leishmania) infantum is the zoonotic agent of visceral leishmaniasis (VL), a disease with a global distribution. The transmission scenario of VL has been undergoing changes worldwide, with the biologic cycle invading urbanized areas and dispersing the parasites into other previously free areas. The epidemiological cycle in Brazil has dispersed from the Northeast to other regions of the country. In this study, an integrative approach, including genotyping Brazilian strains of L. (L.) infantum for 14 microsatellite markers and reviewing historical records of the disease, was used to assess dispersion routes throughout central-southern Brazil. Our results support three L. (L.) infantum dispersion routes: A) dispersion from Bolivia to the states of Mato Grosso, Mato Grosso do Sul and São Paulo via the Bolivia-Brazil gas pipeline from 1998 to 2005; B) VL dispersion from Paraguay to the Brazilian side of the triple border (Foz do Iguaçu and Santa Terezinha de Itaipu) during after 2012; and C) emergence of a new L. (L.) infantum cluster in western Santa Catarina State and its dispersion to southern Paraná State (municipality of Pato Branco), after 2013. Hypotheses regarding possible entries of Leishmania (L.) infantum into the area of the triple border are presented and discussed. Understanding how VL has dispersed is vital to the development of control measures for this disease and to avoid future dispersion events. The dispersion of visceral leishmaniasis is an enigma. The State of Paraná, in southern Brazil, borders the states of São Paulo and Mato Grosso, which have experienced LV epidemics over the past 20 years. Therefore, we expected that the disease would enter this state through the contiguity of epidemics from other regions following by "ghost shadows". However, in 2012, the vectors of the parasite were reported in the western region (Foz do Iguaçu) of Paraná state, far from the epidemic regions. In the cross-sectional study, 23.8% of the dogs were infected, which is more than the eyes can see, showing an unexpected scenario where the disease was already widespread in the city. Now the question was: where does the life cycle element came from? In this study, we used genetic markers to understand the dispersion of Leishmania infantum throughout central-southern Brazil. Our results showed two possible agent inputs in the Paraná state, one coming from Paraguay and, another from Santa Catarina state. When we verify our results we perceived the monitoring importance of the distribution of these agents by diverse hypotheses, not only those that the scientific literature presents. Another relevant factor is always to be attentive to the environmental and socioeconomic events that can provide this dispersion.
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22
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Lima ÁLM, de Lima ID, Coutinho JFV, de Sousa ÚPST, Rodrigues MAG, Wilson ME, Pearson RD, Queiroz JW, Jerônimo SMB. Changing epidemiology of visceral leishmaniasis in northeastern Brazil: a 25-year follow-up of an urban outbreak. Trans R Soc Trop Med Hyg 2018; 111:440-447. [PMID: 29394411 DOI: 10.1093/trstmh/trx080] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 12/19/2017] [Indexed: 12/30/2022] Open
Abstract
Background Visceral leishmaniasis (VL) continues to be a deadly parasitic disease in Brazil but the epidemiology has changed. The objective of this study was to assess the evolution of urban VL in the city of Natal, Brazil, over the past 25 y. Methods A retrospective study of human VL was performed, considering reported cases over the past 25 y in Natal. Analyses considered the spatial distribution of VL cases, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) co-infection, Leishmania infantum infection in dogs, density of the insect vector (Lutzomyia longipalpis) and socio-economic factors. Results Paralleling migration of the population, VL cases changed from mostly rural to predominantly urban regions. The incidence of human VL was highest during the initial years (1990-1994) of our study. Human VL was positively associated with a high density of L. longipalpis, a high prevalence of canine L. infantum infection and HIV/AIDS co-infection. The average age at diagnosis increased over prior years and males were more frequently affected. The overall fatality rate was 6%. Socio-economic variables indicative of poverty were associated with a greater incidence of VL and clusters of VL. Conclusion VL has become endemic in Natal. The disease is associated with poverty and male gender. Surprisingly, there has been an increase in the age at diagnosis.
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Affiliation(s)
- Ádila L M Lima
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil
| | - Iraci D de Lima
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José F V Coutinho
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil.,Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Úrsula P S T de Sousa
- Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil
| | - Marcos A G Rodrigues
- Center for Zoonotic Control, Health Secretariat of Natal, Rio Grande do Norte, Brazil
| | - Mary E Wilson
- Departments of Internal Medicine and Microbiology, University of Iowa and the Iowa City Veterans' Affairs Medical Center, Iowa City, IA, USA
| | - Richard D Pearson
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - José W Queiroz
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Selma M B Jerônimo
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,National Institute of Science and Technology of Tropical Diseases, Salvador, Brazil
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23
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Ozanne MV, Brown GD, Oleson JJ, Lima ID, Queiroz JW, Jeronimo SMB, Petersen CA, Wilson ME. Bayesian compartmental model for an infectious disease with dynamic states of infection. J Appl Stat 2018; 46:1043-1065. [PMID: 31537954 PMCID: PMC6752225 DOI: 10.1080/02664763.2018.1531979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/30/2018] [Indexed: 12/21/2022]
Abstract
Population-level proportions of individuals that fall at different points in the spectrum [of disease severity], from asymptomatic infection to severe disease, are often difficult to observe, but estimating these quantities can provide information about the nature and severity of the disease in a particular population. Logistic and multinomial regression techniques are often applied to infectious disease modeling of large populations and are suited to identifying variables associated with a particular disease or disease state. However, they are less appropriate for estimating infection state prevalence over time because they do not naturally accommodate known disease dynamics like duration of time an individual is infectious, heterogeneity in the risk of acquiring infection, and patterns of seasonality. We propose a Bayesian compartmental model to estimate latent infection state prevalence over time that easily incorporates known disease dynamics. We demonstrate how and why a stochastic compartmental model is a better approach for determining infection state proportions than multinomial regression is by using a novel method for estimating Bayes factors for models with high-dimensional parameter spaces. We provide an example using visceral leishmaniasis in Brazil and present an empirically-adjusted reproductive number for the infection.
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Affiliation(s)
- Marie V Ozanne
- Department of Biostatistics, University of Iowa College of Public Health, USA
| | - Grant D Brown
- Department of Biostatistics, University of Iowa College of Public Health, USA
| | - Jacob J Oleson
- Department of Biostatistics, University of Iowa College of Public Health, USA
| | - Iraci D Lima
- Department of Infectious Diseases, Universidade Federal do Rio Grande do Norte, Brazil
| | - Jose W Queiroz
- Department of Infectious Diseases, Universidade Federal do Rio Grande do Norte, Brazil
| | - Selma M B Jeronimo
- Institute of Tropical Medicine, Universidade Federal do Rio Grande do Norte, Brazil
- Department of Biochemistry, Universidade Federal do Rio Grande do Norte, Brazil
- National Institute of Science and Technology in Tropical Diseases, Bahia, Brazil
| | - Christine A Petersen
- Department of Epidemiology, University of Iowa College of Public Health, USA
- Center for Emerging Infectious Diseases, University of Iowa College of Public Health, USA
| | - Mary E Wilson
- Department of Epidemiology, University of Iowa College of Public Health, USA
- Department of Internal Medicine, University of Iowa Roy J and Lucille A Carver College of Medicine, USA
- Department of Microbiology, University of Iowa Roy J and Lucille A Carver College of Medicine, USA
- Iowa City VA Medical Center, Iowa City, IA, USA
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24
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Carbone DCB, Zanoni LZG, Cônsolo FZ, Sanches SC, Reis VQD, Muller KDTC, Carvalho CME, Silva MC. Potential role of zinc in the visceromegaly regression and recovery of hematological parameters during treatment of visceral leishmaniasis in children from an endemic area. Rev Inst Med Trop Sao Paulo 2018; 60:e50. [PMID: 30231161 PMCID: PMC6169088 DOI: 10.1590/s1678-9946201860050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/09/2018] [Indexed: 11/24/2022] Open
Abstract
Leishmaniasis is a disease complex with various clinical symptoms caused by different species of parasites of the genus Leishmania. The visceral form of the disease, characterized by severe symptoms is fatal, if not treated. The high toxicity of current antileishmanial drugs and the need for long-term treatment make the therapy complicated, especially in a large number of infected children. Hence, the search for new therapies must be intensified. Oral administration of the trace element zinc has been considered in alternative treatments against different clinical forms of leishmaniasis. This study revealed that the administration of zinc in children with visceral leishmaniasis, during treatment with amphotericin B or glucantime, accelerates the regression of the spleen enlargement without interfering with the recovery of hematological parameters.
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Affiliation(s)
- Débora Cardozo Bonfim Carbone
- Programa de Pós-Graduação em Saúde e Desenvolvimento, Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Lourdes Zélia Garcia Zanoni
- Programa de Pós-Graduação em Saúde e Desenvolvimento, Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Fernanda Zanoni Cônsolo
- Programa de Pós-Graduação em Saúde e Desenvolvimento, Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Simone Camargo Sanches
- Rede Centro-Oeste de Pós-Graduação, Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Vanessa Quadros Dos Reis
- Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | - Maria Cláudia Silva
- Programa de Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, Mato Grosso do Sul, Brazil
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Bezerra JMT, de Araújo VEM, Barbosa DS, Martins-Melo FR, Werneck GL, Carneiro M. Burden of leishmaniasis in Brazil and federated units, 1990-2016: Findings from Global Burden of Disease Study 2016. PLoS Negl Trop Dis 2018; 12:e0006697. [PMID: 30188898 PMCID: PMC6126835 DOI: 10.1371/journal.pntd.0006697] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/17/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The study presents estimates for the burden of visceral leishmaniasis (VL) and cutaneous and mucocutaneous leishmaniasis (CML) in Brazil and its 27 federated units using data from the Global Burden of Disease Study (GBD) 2016. METHODOLOGY We report the incidence, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) for leishmaniasis in Brazil from 1990 to 2016. The metrics are presented as age-standardized rates per 100,000 inhabitants with their respective uncertainty intervals (95%UI) and relative percentages of change. PRINCIPAL FINDINGS The age-standardized incidence rate of leishmaniasis decreased 48.5% from 1990 (71.0, 95%UI 24.3-150.7) to 2016 (36.5, 95%UI 24.7-50.9), whereas the age-standardized DALY increased 83.6% over the studied period from 12.2 (95%UI 7.9-18.8) to 22.4 (95%UI 13.3-36.2). The age-standardized incidence rate and YLL for VL increased by 52.9% and 108% from 1990 to 2016, respectively. Considering CML, the age-standardized incidence rate and YLD decreased by 51% and 31.8% respectively for the same period. For VL, similar profiles for male and female were observed, with YLL and DALY increasing over time; with males presenting slightly higher values. The highest YLL rates were among "under 1-year old" children, which increased 131.2% from 1990 to 2016. Regarding CML, the highest values of YLD and DALY were verified among males, and YLD values showed a similar profile, with rates increasing with age. The VL burden increased in some states in the Northeast and Southeast regions and decreased for CML in some Northern states. CONCLUSION The increase of VL burden over the study period might be associated with the difficulties in controlling the disease spread. Information regarding the weight of VL and CML, including the death and disability tolls that they cause, highlights the impact of these neglected diseases on public health and the importance of effective prevention and treatment.
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Affiliation(s)
- Juliana Maria Trindade Bezerra
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | | | - David Soeiro Barbosa
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Francisco Rogerlândio Martins-Melo
- Federal Institute of Education, Science and Technology of Ceará, Caucaia, Ceará, Brazil
- Institute for Public Health Studies, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Loureiro Werneck
- Institute for Public Health Studies, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariângela Carneiro
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Post-Graduation Program in Health Sciences, Infectology and Tropical Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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26
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de Freitas Rocha AT, Mira de Espindola G, Araujo Soares MR, de Ribamar de Sousa Rocha J, Nery Costa CH. Visceral leishmaniasis and vulnerability conditions in an endemic urban area of Northeastern Brazil. Trans R Soc Trop Med Hyg 2018; 112:5057683. [PMID: 30053165 DOI: 10.1093/trstmh/try058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/02/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is considered an urban endemic that may be related to sociodemographic factors and urban infrastructure. The objective of this study was to analyze the conditions of vulnerability and the incidence of VL, and to identify the spatiotemporal pattern of the disease. METHODS Data on reported cases of VL were collected from 2007 to 2016. Thematic maps on the spatiotemporal distribution were produced using values normalized by the area of the neighborhoods. The primary indicators of vulnerability were normalized for later construction of the synthetic indicators of vulnerability of social structure, household structure, and urban infrastructure, and from these, a vulnerability index was developed. The bivariate global Moran index was used to verify the existence of spatial autocorrelation between the incidence of VL and the conditions of vulnerability, while the bivariate local Moran index was used to identify the existence of spatial clusters. RESULTS The 695 cases reported presented a diffuse distribution when the spatial pattern was evaluated. The incidence of the disease was correlated with worsened living conditions. Statistically significant clusters were revealed between the incidence of the disease and the vulnerability indicators of social structure, household structure, urban infrastructure and composite vulnerability index. CONCLUSION Addressing the local vulnerability conditions is important to the understanding of the distribution of visceral leishmaniasis, identifying the most susceptible areas, and planning control strategies.
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Affiliation(s)
| | - Giovana Mira de Espindola
- Graduate Program in Development and Environment, Federal University of Piauí, Teresina, PI
- Technology Center, Department of Transportation, Minister Petrônio Portella Campus, Federal University of Piauí, Teresina, PI
| | | | - José de Ribamar de Sousa Rocha
- Graduate Program in Development and Environment, Federal University of Piauí, Teresina, PI
- Center for Natural Sciences, Department of Biology, Minister Petrônio Portella Campus, Federal University of Piauí, Teresina, PI
| | - Carlos Henrique Nery Costa
- Department of Community Medicine, Minister Petrônio Portella Campus, Federal University of Piauí, Teresina, PI
- Natan Portella Institute for Tropical Diseases, Teresina, PI, Brazil
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27
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Lima ID, Lima ALM, Mendes-Aguiar CDO, Coutinho JFV, Wilson ME, Pearson RD, Queiroz JW, Jeronimo SMB. Changing demographics of visceral leishmaniasis in northeast Brazil: Lessons for the future. PLoS Negl Trop Dis 2018; 12:e0006164. [PMID: 29509765 PMCID: PMC5839541 DOI: 10.1371/journal.pntd.0006164] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 12/12/2017] [Indexed: 01/08/2023] Open
Abstract
Background Visceral leishmaniasis (VL) caused by Leishmania infantum became a disease of urban areas in Brazil in the last 30 years and there has been an increase in asymptomatic L. infantum infection with these areas. Methodology/Principal findings A retrospective study of human VL was performed in the state of Rio Grande do Norte, Brazil, for the period of 1990–2014. The data were divided into five-time periods. For all VL cases, data on sex, age, nutritional status and childhood vaccination were collected. Geographic information system tools and statistical models were used to analyze the dispersion of human VL. The mean annual incidence of VL was 4.6 cases/100,000 inhabitants, with total 3,252 cases reported. The lethality rate was 6.4%. Over time the annual incidence of VL decreased in the 0–4 years (p<0.0001) and 5–9 (p <0.0001) age groups, but increased in ages 20–39 (p<0.001) and >40 years (p<0.0001). VL occurred more often in males (β2 = 2.5; p<0.0001). The decreased incidence of VL in children was associated with improved nutritional status and childhood immunizations including measles, poliomyelitis, BCG, and hepatitis B. Human VL correlated temporally and geographically with canine L. infantum infection (p = 0.002, R2 = 0.438), with rainfall and with Lutzomyia longipalpis density (r = 0.762). Overall, the incidence of VL decreased, while VL-AIDS increased, especially between 2010–2014. VL was more frequently found in areas that lacked urban infrastructure, detected by lack of garbage collection and sewers, whereas HIV infection was associated with higher levels of schooling and evidence of higher socioeconomic status. Conclusion/Significance The demographics of VL in northeastern Brazil have changed. Disease incidence has decreased in children and increased in adults. They were associated with improvements in nutrition, socioeconomic status and immunization rates. Concurrent VL-AIDS poses a serious challenge for the future. We studied factors associated with the changing demographics of visceral leishmaniasis (VL) in Northeast Brazil, including environmental and socioeconomic determinants of disease, during the period 1990 to 2014. The incidence of VL was higher in urban areas, and regions with higher levels of canine L. infantum infection. Human males were more commonly affected than females. The incidence of VL in children under age 10 decreased during the period of study, simultaneous with increased incidence in adults. Reduction in the VL incidence among children was associated with improved socioeconomic status, administration of childhood vaccines and better nutritional status. Geographic areas with higher rainfall had higher densities of Lu. longipalpis, the primary vector of L. infantum in Brazil. VL was more frequently found in areas with indicators of poverty including sparse garbage collection and lack of urban infrastructure. During the past 25 years, HIV/AIDS has spread to areas where VL is endemic and has contributed to an increased incidence of VL-AIDS co-infection in adults.
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Affiliation(s)
- Iraci Duarte Lima
- Health Graduate Program, Health Science Center; Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte; Natal, RN, Brazil
- State of Rio Grande do Norte Health Secretariat; Natal, RN, Brazil
| | - Adila L. M. Lima
- Health Graduate Program, Health Science Center; Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte; Natal, RN, Brazil
- State of Rio Grande do Norte Health Secretariat; Natal, RN, Brazil
- Center for Zoonosis Control, Natal Health Secretariat, Natal, RN, Brazil
| | | | - José F. V. Coutinho
- Health Graduate Program, Health Science Center; Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte; Natal, RN, Brazil
- Center for Zoonosis Control, Natal Health Secretariat, Natal, RN, Brazil
| | - Mary E. Wilson
- Departments of Internal Medicine, Microbiology and Epidemiology, University of Iowa, and the Veterans’ Affairs Medical Center, Iowa City, IA, United States of America
| | - Richard D. Pearson
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, United States of America
| | - José Wilton Queiroz
- Health Graduate Program, Health Science Center; Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte; Natal, RN, Brazil
- Institute of Science and Technology of Tropical Diseases, INCT-DT, Salvador, Brazil
| | - Selma M. B. Jeronimo
- Health Graduate Program, Health Science Center; Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte; Natal, RN, Brazil
- Institute of Science and Technology of Tropical Diseases, INCT-DT, Salvador, Brazil
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- * E-mail:
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Performance of two immunochromatographic tests for diagnosis of visceral leishmaniasis in patients coinfected with HIV. Parasitol Res 2017; 117:419-427. [PMID: 29270768 DOI: 10.1007/s00436-017-5716-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/11/2017] [Indexed: 01/11/2023]
Abstract
Because of visceral leishmaniasis (VL) urbanization and spreading of the human immunodeficiency virus (HIV) infection to rural areas, coinfection has become more common. Here, we compared the accuracy of Kalazar Detect® (KD), an rK39-based immunochromatographic (IC) test, and OrangeLife® (OL), an rK39 + rK28 IC test, for diagnosing VL in patients coinfected with HIV in an endemic area in Brazil. Seventy-six VL patients and 40 patients with other diseases, of which 31 and 21 patients, respectively, were infected with HIV, were examined. The sensitivity of OL and KD tests was 88.89 and 95.45%, respectively, in patients without HIV. The sensitivity dropped to 67.74 and 61.29%, respectively, in coinfected patients. The decrease in sensitivity was not related to a decrease in the production of Leishmania-specific IgG. Because of the low sensitivity of rk39 test in HIV-infected patients, we suggest that patients with negative rK39 results should undergo further investigation with additional serological tests that are not based only on the rK39 antigen and examination of bone marrow aspirates.
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Reis LLD, Balieiro AADS, Fonseca FR, Gonçalves MJF. Changes in the epidemiology of visceral leishmaniasis in Brazil from 2001 to 2014. Rev Soc Bras Med Trop 2017; 50:638-645. [PMID: 29160510 DOI: 10.1590/0037-8682-0243-2017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/05/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Visceral leishmaniasis (VL) is a neglected disease, with territorial expansion and regional differences in Brazil that require explanation. This study aimed to describe changes in the epidemiology of VL in Brazil from 2001 to 2014. METHODS The incidence rates, sociodemographic and clinical data, and case evolution were subgrouped from 2001 to 2006 and from 2007 to 2014 and presented descriptively. Spatial distribution of disease incidence rates and changes in the spatial and temporal pattern were examined. RESULTS In total, 47,859 VL cases were reported in Brazil between 2001 and 2014, with predominance in the Northeast macroregion (55%), though the incidence rate in this region declined between the two study periods. The State of Tocantins had the highest crude rate (26.2/100,000 inhabitants), which was responsible for VL increasing in the North macroregion. VL predominated in the urban zone (70%), in children under 4 years (34%); however, an increase in the incidence of VL in adults older than 40 years was identified, with 12.3% and 31% in the first and second period, respectively. The mapping of crude rates and autochthonous canine cases showed territorial expansion. The temporal distribution of VL was consistent in Brazil in general, with no pattern observed, but regional differences were found. CONCLUSIONS The incidence of VL is increasing in Brazil. In addition to the State of Tocantins, which had the highest rate, new outbreaks of VL have occurred in the South macroregion of Brazil with small decreases identified in the incidence rate in the Northeast.
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Affiliation(s)
| | | | | | - Maria Jacirema Ferreira Gonçalves
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, AM, Brasil.,Escola de Enfermagem de Manaus, Universidade Federal do Amazonas, Manaus, AM, Brasil
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Teixeira DG, Monteiro GRG, Martins DRA, Fernandes MZ, Macedo-Silva V, Ansaldi M, Nascimento PRP, Kurtz MA, Streit JA, Ximenes MFFM, Pearson RD, Miles A, Blackwell JM, Wilson ME, Kitchen A, Donelson JE, Lima JPMS, Jeronimo SMB. Comparative analyses of whole genome sequences of Leishmania infantum isolates from humans and dogs in northeastern Brazil. Int J Parasitol 2017; 47:655-665. [PMID: 28606698 PMCID: PMC5641220 DOI: 10.1016/j.ijpara.2017.04.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 04/01/2017] [Accepted: 04/06/2017] [Indexed: 12/30/2022]
Abstract
The genomic sequences of 20 Leishmania infantum isolates collected in northeastern Brazil were compared with each other and with the available genomic sequences of 29 L. infantum/donovani isolates from Nepal and Turkey. The Brazilian isolates were obtained in the early 1990s or since 2009 from patients with visceral or non-ulcerating cutaneous leishmaniasis, asymptomatic humans, or dogs with visceral leishmaniasis. Two isolates were from the blood and bone marrow of the same visceral leishmaniasis patient. All 20 genomic sequences display 99.95% identity with each other and slightly less identity with a reference L. infantum genome from a Spanish isolate. Despite the high identity, analysis of individual differences among the 32 million base pair genomes showed sufficient variation to allow the isolates to be clustered based on the primary sequence. A major source of variation detected was in chromosome somy, with only four of the 36 chromosomes being predominantly disomic in all 49 isolates examined. In contrast, chromosome 31 was predominantly tetrasomic/pentasomic, consistent with its regions of synteny on two different disomic chromosomes of Trypanosoma brucei. In the Brazilian isolates, evidence for recombination was detected in 27 of the 36 chromosomes. Clustering analyses suggested two populations, in which two of the five older isolates from the 1990s clustered with a majority of recent isolates. Overall the analyses do not suggest individual sequence variants account for differences in clinical outcome or adaptation to different hosts. For the first known time, DNA of isolates from asymptomatic subjects were sequenced. Of interest, these displayed lower diversity than isolates from symptomatic subjects, an observation that deserves further investigation with additional isolates from asymptomatic subjects.
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Affiliation(s)
- D G Teixeira
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, RN, Rio Grande do Norte, Brazil; Institute of Tropical Medicine of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - G R G Monteiro
- Institute of Tropical Medicine of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - D R A Martins
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, RN, Rio Grande do Norte, Brazil; Department of Cellular Biology and Genetics, Bioscience Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - M Z Fernandes
- Department of Internal Medicine, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - V Macedo-Silva
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, RN, Rio Grande do Norte, Brazil
| | - M Ansaldi
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - P R P Nascimento
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, RN, Rio Grande do Norte, Brazil
| | - M A Kurtz
- Veterans' Affairs Medical Center, Iowa City, IA, USA
| | - J A Streit
- Veterans' Affairs Medical Center, Iowa City, IA, USA; Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - M F F M Ximenes
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - R D Pearson
- Division of Infectious Disease, Department of Internal Medicine, University of Virginia, Charlottesville, VA, USA
| | - A Miles
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - J M Blackwell
- Telethon Institute for Child Health, University of Western Australia, Perth, WA, Australia
| | - M E Wilson
- Veterans' Affairs Medical Center, Iowa City, IA, USA; Department of Internal Medicine, University of Iowa, Iowa City, IA, USA; Departments of Microbiology and Epidemiology, University of Iowa, Iowa City, IA, USA
| | - A Kitchen
- Department of Anthropology, University of Iowa, Iowa City, IA, USA
| | - J E Donelson
- Institute of Tropical Medicine of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Department of Biochemistry, University of Iowa, Iowa City, IA, USA
| | - J P M S Lima
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, RN, Rio Grande do Norte, Brazil; Institute of Tropical Medicine of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - S M B Jeronimo
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, RN, Rio Grande do Norte, Brazil; Institute of Tropical Medicine of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; National Institute of Science and Technology of Tropical Diseases, Natal, Rio Grande do Norte, Brazil.
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Donalisio MR, Paiz LM, da Silva VG, Richini-Pereira VB, von Zuben APB, Castagna CL, Motoie G, Hiramoto RM, Tolezano JE. Visceral leishmaniasis in an environmentally protected area in southeastern Brazil: Epidemiological and laboratory cross-sectional investigation of phlebotomine fauna, wild hosts and canine cases. PLoS Negl Trop Dis 2017; 11:e0005666. [PMID: 28704391 PMCID: PMC5509102 DOI: 10.1371/journal.pntd.0005666] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 05/26/2017] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Leishmaniasis is a rapidly expanding zoonosis that shows increasing urbanization. Concern exists regarding the role of wildlife in visceral leishmaniasis (VL) transmission, due to frequent natural or anthropogenic environmental changes that facilitate contact between wildlife, humans and their pets. The municipality of Campinas, in southeastern Brazil, initially recorded VL in 2009, when the first autochthonous case was confirmed in a dog living in an upscale residential condominium, located inside an environmentally protected area (EPA). Since then, disease transmission remains restricted to dogs inhabiting two geographically contiguous condominiums within the EPA. METHODOLOGY/PRINCIPAL FINDINGS We conducted a cross-sectional study of the VL focus to investigate Leishmania spp. infection in domestic dogs, wild mammals and sand flies using molecular tools and recommended serological techniques. Canine seroprevalences of 1.5% and 1.2% were observed in 2013 and 2015, respectively. Six insect species, confirmed or suspected vectors or potential transmitters of Leishmania, were identified. Two specimens of the main L. (L.) infantum vector in Brazil, Lutzomyia longipalpis, were captured in the EPA. Natural infection by L. (L.) infantum was recorded in one Expapillata firmatoi specimen and two Pintomyia monticola. Natural infection by L. (L.) infantum and Leishmania subgenus Viannia was also detected in two white-eared opossums (Didelphis albiventris), a known reservoir of VL. Geographical coordinates of each sampling of infected animals were plotted on a map of the EPA, demonstrating proximity between these animals, human residences, including the dogs positive for VL, and forest areas. CONCLUSIONS/SIGNIFICANCE The EPA, which is inhabited by humans, has an active VL focus. The risk of establishing and maintaining disease transmission foci in similar scenarios, i.e. wild areas that undergo environmental modifications, is evident. Moreover, different epidemiological profiles of VL must be included to elaborate prevention and control measures that consider the particularities of each transmission area.
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Affiliation(s)
- Maria Rita Donalisio
- Department of Public Health, State University of Campinas, Campinas, São Paulo, Brazil
| | - Laís Moraes Paiz
- Department of Public Health, State University of Campinas, Campinas, São Paulo, Brazil
| | | | | | | | | | - Gabriela Motoie
- Center for Systemic Parasitic Diseases, Adolfo Lutz Institute, São Paulo, São Paulo, Brazil
| | | | - José Eduardo Tolezano
- Center for Systemic Parasitic Diseases, Adolfo Lutz Institute, São Paulo, São Paulo, Brazil
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Leishmania infantum in domestic cats from the municipality of Teresina, state of Piauí, Brazil. ACTA ACUST UNITED AC 2017. [DOI: 10.1017/pao.2017.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYFeline leishmaniasis has been reported in various parts of the world in recent years, occurring mainly in areas where zoonotic visceral leishmaniasis (VL) is endemic. The purpose of this study was to assess the occurrence of natural infection byLeishmaniaspp. in domestic cats (Felis catus) in the municipality of Teresina, Piauí state, Brazil, an endemic area of VL in Brazil. The prevalence of infection byLeishmaniaspp. in the population under study was 4% (3/83) in the enzyme-linked immunosorbent assay (ELISA) and 4% (3/83) by smear observation and isolation in a culture medium, using popliteal lymphnode sample. Only one of the three infected cats was positive for ELISA, also being positive for feline immunodeficiency virus. In the haematologic parameters, normocytic normochromic anaemia was the most common change, being present in the three infected animals. In the biochemical measurements also were observed alterations in infected animals. TheLeishmaniaspp. strains isolated from the culture medium were characterized asL. infantum. The presence ofL. infantuminfection in cats in the city of Teresina, an area endemic for VL, suggests the possible involvement of these animals in the epidemiological chain ofL. infantumin high-transmission areas.
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Waldman EA, Sato APS. Path of infectious diseases in Brazil in the last 50 years: an ongoing challenge. Rev Saude Publica 2016; 50:68. [PMID: 28099652 PMCID: PMC5152805 DOI: 10.1590/s1518-8787.2016050000232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 09/05/2016] [Indexed: 12/14/2022] Open
Abstract
In this article, we comment on the main features of infectious diseases in Brazil in the last 50 years, highlighting how much of this path Revista de Saúde Pública could portray. From 1967 to 2016, 1,335 articles focusing on infectious diseases were published in Revista de Saúde Pública. Although the proportion of articles on the topic have decreased from about 50.0% to 15.0%, its notability remained and reflected the growing complexity of the research required for its control. It is noteworthy that studies design and analysis strategies progressively became more sophisticated, following the great development of epidemiology in Brazil in the recent decades. Thus, the journal has followed the success of public health interventions that permitted to control or eliminate numerous infectious diseases - which were responsible, in the past, for high rates of morbidity and mortality -, and also followed the reemergence of diseases already controlled and the emergence of until then unknown diseases, with a strong impact on the Brazilian population, establishing a little predictable and very challenging path. RESUMO Neste artigo, comentamos as principais características das doenças infecciosas no Brasil, nos últimos 50 anos, destacando o quanto a Revista de Saúde Pública conseguiu capturar essa trajetória. De 1967 a 2016, foram publicados 1.335 artigos na Revista de Saúde Pública com foco em doenças infecciosas. Ainda que a proporção de artigos sobre esse tema tenha declinado de cerca de 50,0% para 15,0%, seu destaque se manteve e refletiu a crescente complexidade das pesquisas necessárias para o seu controle. Nota-se que os desenhos dos estudos e as estratégias de análise ganharam progressivamente maior sofisticação, acompanhando o grande desenvolvimento da epidemiologia no Brasil, nas últimas décadas. Assim, foi registrado não apenas o sucesso de intervenções de saúde pública que permitiram o controle ou a eliminação de inúmeras doenças infecciosas responsáveis, no passado, por elevadas taxas de morbimortalidade, como também a reemergência de males já controlados e o surgimento de doenças até então desconhecidas, com forte impacto na população brasileira, desenhando uma trajetória pouco previsível e muito desafiadora.
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Affiliation(s)
- Eliseu Alves Waldman
- Departamento de Epidemiologia. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Ana Paula Sayuri Sato
- Departamento de Epidemiologia. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
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Leishmania infantum: illness, transmission profile and risk factors for asymptomatic infection in an endemic metropolis in Brazil. Parasitology 2016; 144:546-556. [PMID: 27894365 DOI: 10.1017/s0031182016002134] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
To evaluate the distribution of asymptomatic infection by Leishmania infantum in a metropolis in Brazil with different relative risks (RRs) for disease and risk factors associated with the infection, an ecological study was conducted using a Bayesian approach to estimate the RR of human visceral leishmaniasis (HVL) based on cases between 2008 and 2011. The areas were categorized and selected according to disease incidence: low (area-1), medium (area-2) and high (area-3). Cross-sectional study enrolling 935 children was used to estimate the prevalence of infection by L. infantum. Volunteers from these three areas were tested for L. infantum infection by ELISA (rK39 and soluble antigens). Infection prevalence rates were estimated and compared with the RR of disease. Multilevel logistic regression model evaluated the relationship between infection and the analysed variables. The RR of HVL was distributed heterogeneously in the municipality. The infection prevalence rates were: 34·9% in area-1; 29·3% in area-2; and 33·6% in area-3, with no significant differences between these areas. The variables 'Presence of backyards in the neighbourhood' and 'Younger children' were associated with L. infantum infection. We conclude that infection by L. infantum affects a significant proportion of the infant population regardless of the RR of disease.
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DNA barcode for the identification of the sand fly Lutzomyia longipalpis plant feeding preferences in a tropical urban environment. Sci Rep 2016; 6:29742. [PMID: 27435430 PMCID: PMC4951712 DOI: 10.1038/srep29742] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/22/2016] [Indexed: 11/09/2022] Open
Abstract
Little is known about the feeding behavior of hematophagous insects that require plant sugar to complete their life cycles. We studied plant feeding of Lutzomyia longipalpis sand flies, known vectors of Leishmania infantum/chagasi parasites, in a Brazilian city endemic with visceral leishmaniasis. The DNA barcode technique was applied to identify plant food source of wild-caught L. longipalpis using specific primers for a locus from the chloroplast genome, ribulose diphosphate carboxylase. DNA from all trees or shrubs within a 100-meter radius from the trap were collected to build a barcode reference library. While plants from the Anacardiaceae and Meliaceae families were the most abundant at the sampling site (25.4% and 12.7% of the local plant population, respectively), DNA from these plant families was found in few flies; in contrast, despite its low abundance (2.9%), DNA from the Fabaceae family was detected in 94.7% of the sand flies. The proportion of sand flies testing positive for DNA from a given plant family was not significantly associated with abundance, distance from the trap, or average crown expansion of plants from that family. The data suggest that there may indeed be a feeding preference of L. longipalpis for plants in the Fabaceae family.
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Alves EB, Costa CHN, de Carvalho FAA, Pires E Cruz MDS, Werneck GL. Risk Profiles for Leishmania infantum Infection in Brazil. Am J Trop Med Hyg 2016; 94:1276-81. [PMID: 27114290 DOI: 10.4269/ajtmh.15-0513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 03/07/2016] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to characterize risk profiles for Leishmania infantum infection in a population living in an area endemic for visceral leishmaniasis. A cohort study was conducted between January 2004 and December 2006 with the participation of 430 individuals living in the city of Teresina, northeast Brazil, who were initially negative for the Montenegro test. Data analysis was performed using the classification and regression tree method. The cumulative incidence (CI) of Montenegro's test conversion was 35% at 18-month follow-up. Eight different risk profiles for L. infantum infection were identified. The profile with the highest risk (CI = 75%) comprised individuals with less than 4 years of education who had never lived outside Teresina. The profile with the lowest risk (CI = 5%) included highly educated subjects who had owned a dog for 5 years or more and lived in areas that received some type of intervention. These results show that there is a high degree of complexity involved in the risk for L. infantum infection and point out the need of developing new studies to perform a comprehensive analysis focused on investigating the interrelation between risk factors rather than their isolated roles on the determination of infection levels in urban areas.
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Affiliation(s)
- Erika Barretto Alves
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Carlos Henrique Nery Costa
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Fernando Aécio Amorim de Carvalho
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Maria do Socorro Pires E Cruz
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
| | - Guilherme Loureiro Werneck
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Doenças Tropicais Natan Portela, Teresina, Piauí, Brazil; Universidade Federal do Piauí, Teresina, Piauí, Brazil; Departamento de Bioquímica e Farmacologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, Piauí, Brazil; Programa de Pós-graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brazil
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Menon SS, Rossi R, Nshimyumukiza L, Zinszer K. Decentralized control of human visceral leishmaniasis in endemic urban areas of Brazil: a literature review. Trop Med Health 2016; 44:9. [PMID: 27433128 PMCID: PMC4940922 DOI: 10.1186/s41182-016-0011-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/17/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of some parasitic infections in Brazil. Human visceral leishmaniasis (HVL) control is particularly fraught with intricacies. It is against a backdrop of decentralized health care that the complex HVL control initiatives are brought to bear. This comprehensive review aims to explore the obstacles facing decentralized HVL control in urban endemic areas in Brazil. METHOD A literature search was carried out in December 2015 by means of three databases: MEDLINE, Google Scholar, and Web of Science. RESULTS Although there have been many strides that have been made in elucidating the eco-epidemiology of Leishmania infantum, which forms the underpinnings of the national control program, transmission risk factors for HVL are still insufficiently elucidated in urban settings. Decentralized HVL epidemiological surveillance and control for animal reservoirs and vectors may compromise sustainability. In addition, it may hamper timely human HVL case management. With the burgeoning of the HIV-HVL co-infection, the potential human transmission may be underestimated. CONCLUSION HVL is a disease with focal transmission at a critical juncture, which warrants that the bottlenecks facing the control program within contexts of decentralized healthcare systems be taken into account. In addition, HIV-driven HVL epidemics may substantially increase the transmission potential of the human reservoir. Calculating the basic reproductive number to fine-tune interventions will have to take into consideration the specific socio-economic development context.
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Affiliation(s)
- Sonia S. Menon
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- />Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | | | - Leon Nshimyumukiza
- />Department of Social and Preventive Medicine, Laval University, Boston, USA
| | - Kate Zinszer
- />Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
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Silva DAD, Madeira MDF, Figueiredo FB. GEOGRAPHICAL EXPANSION OF CANINE VISCERAL LEISHMANIASIS IN RIO DE JANEIRO STATE, BRAZIL. Rev Inst Med Trop Sao Paulo 2016; 57:435-8. [PMID: 26603233 PMCID: PMC4660455 DOI: 10.1590/s0036-46652015000500012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/22/2015] [Indexed: 11/27/2022] Open
Abstract
Visceral Leishmaniasis (VL) is a vector-borne disease that affects humans, and domestic and wild animals. It is caused by the protozoan Leishmania (Leishmania) infantum (syn = Leishmania chagasi). The domestic dog (Canis familiaris) is considered the main reservoir of the etiologic agent of VL in domestic and peridomestic environments. In the past three years, although control actions involving domestic dogs are routinely performed in endemic areas of the Rio de Janeiro State, new cases of canine visceral leishmaniasis (CVL) have been reported in several municipalities. The objective of this short communication was to describe the geographical expansion of CVL in the Rio de Janeiro State, Brazil, through its reports in the scientific literature and studies performed by our group. From 2010 to 2013, autochthonous and allochthonous cases of CVL were reported in the municipalities of Mangaratiba, Marica, Niteroi, Barra Mansa, Cachoeiras de Macacu, Volta Redonda, Resende and Rio de Janeiro. These reports demonstrate that CVL is in intense geographical expansion around the state; therefore, a joint effort by public agencies, veterinarians and researchers is needed in order to minimize and/or even prevent the dispersion of this disease.
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Affiliation(s)
- Denise Amaro da Silva
- Instituto Nacional de Doenças Infecciosas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Maria de Fátima Madeira
- Instituto Nacional de Doenças Infecciosas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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dos Santos PL, de Oliveira FA, Santos MLB, Cunha LCS, Lino MTB, de Oliveira MFS, Bomfim MOM, Silva AM, de Moura TR, de Jesus AR, Duthie MS, Reed SG, de Almeida RP. The Severity of Visceral Leishmaniasis Correlates with Elevated Levels of Serum IL-6, IL-27 and sCD14. PLoS Negl Trop Dis 2016; 10:e0004375. [PMID: 26814478 PMCID: PMC4729473 DOI: 10.1371/journal.pntd.0004375] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 12/18/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a severe disease caused by infection with protozoa of the genus Leishmania. Classic VL is characterized by a systemic infection of phagocytic cells and an intense activation of the inflammatory response. It is unclear why 90% of infected individuals do not develop the disease while a minority develop the classical form. Furthermore, among those that develop disease, a small group progresses to more severe form that is unresponsive to treatment. The presence of inflammatory mediators in serum could theoretically help to control the infection. However, there is also a release of anti-inflammatory mediators that could interfere with the control of parasite multiplication. In this study, we took advantage of the spectrum of outcomes to test the hypothesis that the immune profile of individuals infected with Leishmania (L.) infantum is associated with the development and severity of disease. METHODOLOGY/PRINCIPAL FINDINGS Sera from patients with confirmed diagnosis of VL were evaluated for the presence of numerous molecules, and levels compared with healthy control and asymptomatic infected individuals. CONCLUSIONS/PRINCIPAL FINDINGS Although differences were not observed in LPS levels, higher levels of sCD14 were detected in VL patients. Our data suggest that L. infantum may activate the inflammatory response via CD14, stimulating a generalized inflammatory response with production of several cytokines and soluble molecules, including IFN-γ, IL-27, IL-10, IL-6 and sCD14. These molecules were strongly associated with hepatosplenomegaly, neutropenia and thrombocytopenia. We also observed that IL-6 levels greater than 200 pg/ml were strongly associated with death. Together our data reinforce the close relationship of IFN-γ, IL-10, IL-6, TNF-α and IL-27 in the immune dynamics of VL and suggest the direct participation of sCD14 in the activation of the immune response against L. infantum.
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Affiliation(s)
- Priscila L. dos Santos
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Fabrícia A. de Oliveira
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Micheli Luize B. Santos
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Luana Celina S. Cunha
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Michelle T. B. Lino
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Michelle F. S. de Oliveira
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Manuela O. M. Bomfim
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Angela Maria Silva
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Tatiana R. de Moura
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Amélia R. de Jesus
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
| | - Malcolm S. Duthie
- Infectious Diseases Research Institute (IDRI), Seattle, Washington, United States of America
| | - Steven G. Reed
- Infectious Diseases Research Institute (IDRI), Seattle, Washington, United States of America
| | - Roque P. de Almeida
- Laboratório de Biologia Molecular, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia, São Paulo, Brazil
- * E-mail:
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Werneck GL. Visceral leishmaniasis in Brazil: rationale and concerns related to reservoir control. Rev Saude Publica 2015; 48:851-6. [PMID: 25372177 PMCID: PMC4211574 DOI: 10.1590/s0034-8910.2014048005615] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 06/16/2014] [Indexed: 11/21/2022] Open
Abstract
The control of zoonotic visceral leishmaniasis is a challenge, particularly in Brazil, where the disease has been gradually spreading across the country over the past 30 years. Strategies employed for decreasing the transmission risk are based on the control of vector populations and reservoirs; since humans are considered unnecessary for the maintenance of transmission. Among the adopted strategies in Brazil, the sacrifice of infected dogs is commonly performed and has been the most controversial measure. In the present study, we provide the rationale for the implementation of different control strategies targeted at reservoir populations and highlight the limitations and concerns associated with each of these strategies.
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Almeida ASD, Werneck GL, Resendes APDC. [Object-oriented remote sensing image classification in epidemiological studies of visceral leishmaniasis in urban areas]. CAD SAUDE PUBLICA 2015; 30:1639-53. [PMID: 25210905 DOI: 10.1590/0102-311x00059414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 01/30/2014] [Indexed: 11/22/2022] Open
Abstract
This study explored the use of object-oriented classification of remote sensing imagery in epidemiological studies of visceral leishmaniasis (VL) in urban areas. To obtain temperature and environmental information, an object-oriented classification approach was applied to Landsat 5 TM scenes from the city of Teresina, Piauí State, Brazil. For 1993-1996, VL incidence rates correlated positively with census tracts covered by dense vegetation, grass/pasture, and bare soil and negatively with areas covered by water and densely populated areas. In 2001-2006, positive correlations were found with dense vegetation, grass/pasture, bare soil, and densely populated areas and negative correlations with occupied urban areas with some vegetation. Land surface temperature correlated negatively with VL incidence in both periods. Object-oriented classification can be useful to characterize landscape features associated with VL in urban areas and to help identify risk areas in order to prioritize interventions.
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Werneck GL, Costa CHN, de Carvalho FAA, Pires e Cruz MDS, Maguire JH, Castro MC. Effectiveness of insecticide spraying and culling of dogs on the incidence of Leishmania infantum infection in humans: a cluster randomized trial in Teresina, Brazil. PLoS Negl Trop Dis 2014; 8:e3172. [PMID: 25357122 PMCID: PMC4214628 DOI: 10.1371/journal.pntd.0003172] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 08/06/2014] [Indexed: 11/23/2022] Open
Abstract
Background To evaluate the effect of insecticide spraying for vector control and elimination of infected dogs on the incidence of human infection with L. infantum, a randomized community intervention trial was carried out in the city of Teresina, Brazil. Methods/Principal Findings Within each of ten localities in the city, four blocks were selected and randomized to 4 interventions: 1) spraying houses and animal pens with insecticide; 2) eliminating infected dogs; 3) combination of spraying and eliminating dogs, and 4) nothing. The main outcome is the incidence of infection assessed by the conversion of the Montenegro skin test (MST) after 18 months of follow-up in residents aged ≥1 year with no previous history of visceral leishmaniasis (VL). Reactions were measured at 48–72 h, induration of ≥5 mm considered positive. Interventions were executed after the baseline interview and repeated 6 and 12 months later. The effects of each type of intervention scheme on the incidence of infection were assessed by calculating relative risks and 95% confidence intervals using Poisson population-averaged regression models with robust variance. Among the 1105 participants, 408 (37%) were MST positive at baseline. Of the 697 negatives, only 423 (61%) were reexamined at the end of the follow-up; 151 (36%) of them converted to a positive MST. Only dog culling had some statistically significant effect on reducing the incidence of infection, with estimates of effectiveness varying between 27% and 52%, depending on the type of analysis performed. Conclusions/Significance In light of the continuous spread of VL in Brazil despite the large scale deployment of insecticide spraying and dog culling, the relatively low to moderate effectiveness of dog culling and the non-significant effect of insecticide spraying on the incidence of human infection, we conclude that there is an urgent need for revision of the Brazilian VL control program. Zoonotic visceral leishmaniasis (VL) constitutes a serious public health problem in the Americas, particularly in Brazil. The disease is caused by the protozoan parasite Leishmania infantum, which is transmitted by the bite of female sand flies, and dogs are the main source of infection. To decrease the risk of transmission, the Brazilian VL control program recommends residual insecticide spraying and environmental management for vector control, and culling of seropositive dogs in areas with moderate to high levels of transmission. Because there is a lack of scientific evidence supporting such interventions, we designed a study to assess the effectiveness of dog culling and residual insecticide spraying in the reduction of incidence of human VL infection. The results show that only dog culling had some statistically significant effect on reducing the incidence of infection, with estimates of effectiveness varying between 27% and 52%. In light of the continuous spread of VL in Brazil despite the large scale deployment of insecticide spraying and dog culling, the relatively low to moderate effectiveness of dog culling and the non-significant effect of insecticide spraying on the incidence of human infection, we conclude that there is an urgent need for revision of the Brazilian VL control program.
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Affiliation(s)
- Guilherme L. Werneck
- Instituto de Estudos em Saúde Coletiva (UFRJ) e Departamento de Epidemiologia, Instituto de Medicina Social/IMS, Universidade do Estado do Rio de Janeiro (UERJ), Maracanã, Rio de Janeiro, Rio de Janeiro, Brasil
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Carlos H. N. Costa
- Instituto de Doenças Tropicais Nathan Portella and Universidade Federal do Piauí, Teresina, Piauí, Brasil
| | | | - Maria do Socorro Pires e Cruz
- Programa de Pós-Graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Federal do Piauí, Teresina, Piauí, Brasil
| | - James H. Maguire
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, United States of America
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Teixeira-Neto RG, da Silva ES, Nascimento RA, Belo VS, de Oliveira CDL, Pinheiro LC, Gontijo CMF. Canine visceral leishmaniasis in an urban setting of Southeastern Brazil: an ecological study involving spatial analysis. Parasit Vectors 2014; 7:485. [PMID: 25326767 PMCID: PMC4209036 DOI: 10.1186/s13071-014-0485-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/08/2014] [Indexed: 11/14/2022] Open
Abstract
Background The physical characteristics of the environment influence the composition, distribution and behavior of the vectors and mammalian hosts involved in the transmission of visceral leishmaniasis (VL), thereby affecting the epidemiology of the disease. In Brazil, urbanization of human VL is a recent phenomenon and represents an issue of particular concern to local health authorities. The present study aimed to establish the degree of spatial dependency between canine and human VL in the municipality of Divinópolis, Minas Gerais, Brazil, and to identify priority risk areas in which stricter control measures should be implemented. Methods The selected canine population comprised 3,652 dogs distributed within 11 strata and 1,247 urban blocks. Serum samples were collected between March 2013 and February 2014. Serodiagnosis of dogs was performed using the enzyme-linked immunosorbent assay and the indirect fluorescent-antibody test. The blocks sampled for canine VL and the addresses of the 16 confirmed cases of human VL notified in Divinópolis during the period 2007–2013 were georeferenced. Spatial analysis of the data was performed using Kernel density estimation, Ripley’s bivariate K-function and directional distribution methods. Results The overall prevalence of seropositive animals was 4.63% (range 3.95 - 5.31) (n =169) and varied in different strata between 0.9 (range 0.0 - 1.91) and 8.73% (range 5.65 - 11.81). A positive spatial dependency was detected between human and canine VL in which the occurrence of human cases of the disease tended to concentrate in locations that were close to areas with a higher incidence of canine VL. The priority risk area could be clearly distinguished from Kernel density estimation and standard deviational ellipse plots in which the human VL ellipse was totally enclosed within the canine VL ellipse. Conclusions The results presented herein will enable the Municipal Health Office of Divinópolis to devise a more effective management plan for human VL in which specific strategies would be applied to areas presenting different levels of risk. This spatial evaluation of leishmaniasis model could be applied in other urban areas of Brazil.
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Affiliation(s)
- Rafael Gonçalves Teixeira-Neto
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil. .,Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Eduardo Sérgio da Silva
- Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Renata Aparecida Nascimento
- Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Vinícius Silva Belo
- Escola Nacional de Saúde Pública, FIOCRUZ, Rua Leopoldo Bulhões 1480, Manguinhos, 21041-210, Rio de Janeiro, RJ, Brazil. .,Universidade Federal de Juiz de Fora, Campus Governador Valadares, Rua Israel Pinheiro 2000, 35020-220, Governador Valadares, MG, Brazil.
| | - Cláudia di Lorenzo de Oliveira
- Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil.
| | - Letícia Cavalari Pinheiro
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil.
| | - Célia Maria Ferreira Gontijo
- Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil.
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Murto C, Ariza L, Alencar CH, Chichava OA, Oliveira AR, Kaplan C, Silva LFMD, Heukelbach J. Migration among individuals with leprosy: a population-based study in central Brazil. CAD SAUDE PUBLICA 2014; 30:487-501. [PMID: 24714939 DOI: 10.1590/0102-311x00005913] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 08/26/2013] [Indexed: 12/25/2023] Open
Abstract
This study investigates social and clinical factors associated with migration among individuals affected by leprosy. A cross-sectional study was conducted among those newly diagnosed with leprosy (2006-2008), in 79 endemic municipalities in the state of Tocantins, Brazil (N = 1,074). In total, 76.2% were born in a municipality different from their current residence. In the five years before diagnosis 16.7% migrated, and 3.6% migrated after leprosy diagnosis. Findings reflect aspects associated with historical rural-urban population movement in Brazil. Indicators of poverty were prominent among before-diagnosis migrants but not after-diagnosis migrants. Migration after diagnosis was associated with prior migration. The association of multibacillary leprosy with migration indicates healthcare access may be an obstacle to early diagnosis among before-diagnosis migrants, which may also be related to the high mobility of this group.
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Evaluation of PCR in the diagnosis of canine leishmaniasis in two different epidemiological regions: Campinas (SP) and Teresina (PI), Brazil. Epidemiol Infect 2014; 143:1088-95. [DOI: 10.1017/s0950268814001721] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
SUMMARYUsing the polymerase chain reaction (PCR) test for diagnosis of canine leishmaniasis has greater sensitivity and specificity than culture and visualization of the parasite. This study compares PCR for the diagnosis of the genus and species ofLeishmaniawith serological techniques used for the control of canine visceral leishmaniasis (CVL) in Brazil, considering two regions. We analysed peripheral blood samples collected from 195 dogs in the Campinas (SP) and Teresina (PI) regions. ELISA was performed as a serological method and PCR was performed using specific primers for the genusLeishmaniaspp. and the speciesLeishmania chagasi. In Campinas, a greater sensitivity of PCR (88·24%) (P = 0·0455) compared to Teresina (14·71%) (P < 0·0001) was observed, and an agreement was observed for Cohen's kappa index (0·9096). Both PCR and ELISA showed discordance for sensitivity (Campinas 100%, Teresina 21·74%), specificity (Campinas 30·77%, Teresina 100%), positive predictive value (Campinas 68·97%, Teresina 100%), negative predictive value (Campinas 100%, Teresina 37·94%) and Cohen's kappa index (0·1238). This study confirms the importance of PCR in analysis of the canine reservoir, and as an effective method for the detection of active and recent infection.
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Macedo-Silva VP, Martins DRA, De Queiroz PVS, Pinheiro MPG, Freire CCM, Queiroz JW, Dupnik KM, Pearson RD, Wilson ME, Jeronimo SMB, Ximenes MDFF. Feeding preferences of Lutzomyia longipalpis (Diptera: Psychodidae), the sand fly vector, for Leishmania infantum (Kinetoplastida: Trypanosomatidae). JOURNAL OF MEDICAL ENTOMOLOGY 2014; 51:237-244. [PMID: 24605474 PMCID: PMC4277188 DOI: 10.1603/me12131] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Leishmania infantum, the causative agent of visceral leishmaniasis (VL) in Brazil, is spread mostly by the bite of the sand fly Lutzomyia longipalpis (Lutz & Neiva). We trapped sand flies in endemic neighborhoods near Natal, Brazil, where cases of human and dog VL were documented. Amplification of species-specific cytochrome b (Cyt b) genes by polymerase chain reaction revealed that sand flies from rural and periurban areas harbored blood from different sources. The most common source ofbloodmeal was human, but blood from dog, chicken, and armadillo was also present. We tested the preference for a source of bloodmeal experimentally by feeding L. longipalpis F1 with blood from different animals. There were significant differences between the proportion of flies engorged and number of eggs laid among flies fed on different sources, varying from 8.4 to 19 (P < 0.0001). Blood from guinea pig or horse was best to support sand fly oviposition, but human blood also supported sand fly oviposition well. No sand flies fed on cats, and sand flies feeding on the opossum Monodelphis domestica Wagner produced no eggs. These data support the hypothesis that L. longipalpis is an eclectic feeder, and humans are an important source of blood for this sand fly species in periurban areas of Brazil.
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Affiliation(s)
- Virgínia P. Macedo-Silva
- Department of Biochemistry, Biosciences Center, Universidade Federal do Rio Grande do Norte, Av. Sen. Salgado Filho, 3000, Natal, RN, Brazil, 59078
| | - Daniella R. A. Martins
- Department of Biology and Genetics, Biosciences Center, Universidade Federal do Rio Grande do Norte, Av. Sen. Salgado Filho, 3000, Natal, RN, Brazil, 59078
| | | | - Marcos Paulo G. Pinheiro
- Department of Microbiology and Parasitology, Biosciences Center, Universidade Federal do Rio Grande do Norte, Av. Sen. Salgado Filho, 3000, Natal, RN, Brazil, 59078
| | - Caio C. M. Freire
- Department of Microbiology and Parasitology, Biosciences Center, Universidade Federal do Rio Grande do Norte, Av. Sen. Salgado Filho, 3000, Natal, RN, Brazil, 59078
| | - José W. Queiroz
- Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Av. Sen. Salgado Filho, 3000, Natal, RN, Brazil, 59078
| | - Kathryn M. Dupnik
- Division of Infectious Diseases, Center for Global Health, Weill Cornell Medical College, 402 East 67th Street, New York, NY 10065
| | - Richard D. Pearson
- Division of Infectious Diseases, Center for Global Health, Department of Medicine, University of Virginia, Charlottesville, VA 22908
| | - Mary E. Wilson
- Departments of Internal Medicine and Microbiology, University of Iowa and the Veterans’ Affairs Medical Center, Iowa City, IA 52242
| | - Selma M. B. Jeronimo
- Department of Biochemistry, Biosciences Center, Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Av. Sen. Salgado Filho, 3000, Natal, RN, Brazil, 59078
| | - Maria De Fátima F.M. Ximenes
- Department of Microbiology and Parasitology, Biosciences Center, Universidade Federal do Rio Grande do Norte, Av. Sen. Salgado Filho, 3000, Natal, RN, Brazil, 59078
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M Nail A, M Imam A. Visceral leishmaniasis: Clinical and demographic features in an African population. Pak J Med Sci 2013; 29:485-9. [PMID: 24353561 PMCID: PMC3809264 DOI: 10.12669/pjms.292.3151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 03/13/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the clinical and demographic features of patients with visceral leishmaniasis (VL), from Sudan, Africa. METHODOLOGY A descriptive study was conducted during 5 years period on confirmed VL patients. These patients are, originally, from White Nile Province (WNP) region, a previously non-endemic VL focus which is located in southern part of Sudan. They were referred during the period 2006-2010 for management at Tropical Diseases Hospital (TDH) in the capital Khartoum. The patients data were retrieved from the hospital electronic software system, and were studied. RESULTS A total of 71 patients with VL were reviewed. The main clinical features were: fever 68 (95.8%), splenomegaly 66 (93%), weight loss 61 (85.9%), pallor 59 (83.1%), hepatomegaly 52 (73.2%). The most notable haematology finding was the mean Hb value (7.6 g/dL) on admission to hospital. Gender showed males at higher risk for VL as compared to females with a ratio of 3:1 (53 vs 18). VL was largely a disease of children with 42 (59.1%) aged < 15 year, and around quarter (23.9%) under 5 years. CONCLUSION The clinical features of Sudanese VL in WNP region is, generally, similar to the pattern seen globally in endemic foci. The majority of the study population are paediatric indigenous VL patients, suggesting that adults were immune, and indicating change of disease pattern from previous sporadic to present endemic. This finding emphasizes the need for research to better understand VL in non-endemic areas with the objective of developing effective and sustainable control strategies.
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Affiliation(s)
- Abdelsalam M Nail
- Abdelsalam M. Nail, MBBS, MD, MSc (Tropical Medicine), Department of Medicine, College of Medicine
| | - Abdelmageed M Imam
- Jouf University, Jouf, Kingdom of Saudi Arabia. Abdelmageed M. Imam, MBBS, PhD, DTM&H, Parasitology Unit, College of Medicine, Qassim University, Qassim, Kingdom of Saudi Arabia
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de Oliveira EF, dos Santos Fernandes CE, Araújo e Silva E, Brazil RP, de Oliveira AG. Climatic factors and population density of Lutzomyia longipalpis (Lutz & Neiva, 1912) in an urban endemic area of visceral leishmaniasis in midwest Brazil. JOURNAL OF VECTOR ECOLOGY : JOURNAL OF THE SOCIETY FOR VECTOR ECOLOGY 2013; 38:224-228. [PMID: 24581349 DOI: 10.1111/j.1948-7134.2013.12034.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 11/03/2011] [Indexed: 06/03/2023]
Abstract
The life cycle of vectors and the reservoirs that participate in the chain of infectious diseases have a strong relationship with the environmental dynamics of the ecosystems in which they live. Oscillations in population abundance and seasonality of insects can be explained by factors inherent in each region and time period. Therefore, knowledge of the relationship and influence of environmental factors on the population of Lutzomyia longipalpis is necessary because of the high incidence of visceral leishmaniasis (VL) in Brazil. This study evaluates the influence of abiotic variables on the population density and seasonal behavior of L. longipalpis in an urban endemic area of VL in Brazil. The sand fly captures were performed every two months between November, 2009 and November, 2010 in the peridomicile of 13 randomly selected residences. We captured 1,367 specimens of L. longipalpis, and the ratio of male/female flies was 2.86:1. The comparison of the total male specimens in the two seasons showed a statistical difference in the wet season, but there was no significant difference when considering the total females. With respect to climatic variables, a significant negative association was observed only with wind speed. During periods of high wind speeds, the population density of this vector decreased. The presence of L. longipalpis was found in all months of the study with bimodal behavior and population peaks during the wet season.
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Affiliation(s)
- Everton Falcão de Oliveira
- Postgraduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, MS 79070900, Brazil.
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do Nascimento PRP, Martins DRA, Monteiro GRG, Queiroz PV, Freire-Neto FP, Queiroz JW, Morais Lima ÁL, Jeronimo SMB. Association of pro-inflammatory cytokines and iron regulatory protein 2 (IRP2) with Leishmania burden in canine visceral leishmaniasis. PLoS One 2013; 8:e73873. [PMID: 24146743 PMCID: PMC3795717 DOI: 10.1371/journal.pone.0073873] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 07/30/2013] [Indexed: 12/03/2022] Open
Abstract
Leishmania infantum infection in humans and dogs can evolve with a wide range of clinical presentations, varying from asymptomatic infections to visceral leishmaniasis. We hypothesized that the immune response elicited by L. infantum infection could modulate whether the host will remain asymptomatic or progress to disease. A total of 44 dogs naturally infected with L. infantum were studied. Leishmania burden was estimated in the blood and spleen by qPCR. The expression of IFN-γ, TNF-α, IL-10 and Iron Regulatory Protein 2 (IRP2) were determined in the spleen by quantitative PCR. Sera cytokines were evaluated by ELISA. Dogs were grouped in quartiles according parasite burden. Increased expression of IFN-γ and TNF-α was associated with reduced Leishmania burden, whereas increased IL-10 and IRP2 expressions were associated with higher Leishmania load. Increased plasma albumin and IFN-γ expression explained 22.8% of the decrease in parasite burden in the spleen. These data confirm that lower IFN-γ response and higher IL-10 correlated with increased parasite load and severity of the visceral leishmaniasis in dogs. The balance between the branches of immune response and the intracellular iron availability could determine, in part, the course of Leishmania infection.
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Affiliation(s)
- Paulo Ricardo Porfírio do Nascimento
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Daniella Regina Arantes Martins
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Biology and Genetics, Bioscience Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Glória Regina Góis Monteiro
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Paula Vivianne Queiroz
- College of Medicine, State University of Rio Grande do Norte, Mossoró, Rio Grande do Norte, Brazil
| | - Francisco Paulo Freire-Neto
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José Wilton Queiroz
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Institute of Science and Technology of Tropical Diseases (INCT-DT), Salvador, Bahia, Brazil
| | - Ádila Lorena Morais Lima
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Selma Maria Bezerra Jeronimo
- Department of Biochemistry, Bioscience Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Health Graduate Program, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Institute of Science and Technology of Tropical Diseases (INCT-DT), Salvador, Bahia, Brazil
- * E-mail:
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Epidemiology of visceral leishmaniasis in a reemerging focus of intense transmission in Minas Gerais State, Brazil. BIOMED RESEARCH INTERNATIONAL 2013; 2013:405083. [PMID: 24000322 PMCID: PMC3755404 DOI: 10.1155/2013/405083] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/17/2013] [Accepted: 07/15/2013] [Indexed: 11/27/2022]
Abstract
This study was developed in the urban area of Governador Valadares, a reemerging focus of intense transmission of visceral leishmaniasis (VL) in Brazil, presenting 86 human cases of VL from 2008 to 2011. The disease prevailed in males (73.2%) with most patients between 0 and 9 years (44.1%) and a lethality rate of 16.2%. A canine survey was carried out on 16,529 domestic dogs in 35 districts in the area and it showed that 30.2% of them (4,992 dogs) were positive for VL by serum assays. Prevalence ratios for canine VL varied between 13.6% and 53.4%. The clinical exam of 343 seropositive dogs showed that 49.9% of them were considered symptomatic, with larger prevalence of canine VL being in short-furred animals (90%). The entomological survey was performed in eight districts, where 2,539 phlebotomines were captured, preferentially in the peridomicile (84.5%). Lutzomyia longipalpis was the predominant species (90%) suggesting its participation in the VL transmission in the area. The correlation between canine prevalence and L. longipalpis density was evaluated.
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