Between 1986 and 1997 a total of 1418 patients were examined at the Clinical Analysis Teaching and Research Laboratory of Maringá State University (LEPAC/UEM) for cutaneous leishmaniasis by direct examination of stained smears made from the lesions, the Montenegro skin test and the indirect immunofluorescent antibody test. Nine hundred and fifty five patients (67.3%) were positive for at least one of the three tests and of these 804 (84.2%) were considered to have contracted the disease in Paraná State; 665 (69.6%) were between 15 and 49 years old; 658 (68.9%) were males; 523 (54.8%) sought medical advice during the first three months of their infections and 74 (7.7%) had mucosal lesions. Of the 83 counties of Paraná State, where the patients had most probably acquired their infections, 44.7% were from the counties of São Jorge do Ivaí (10.2%), Doutor Camargo (9.8%), Terra Boa (7.3%), Maringá (7.3%), Jussara (6.0%) and Cianorte (4.5%). Seventy seven strains of Leishmania (Viannia) braziliensis were isolated and 63.6% of these strains belong to serodema 1.

A leishmaniose tegumentar americana ocorre em ambientes florestais primitivos e tem sido classicamente descrita como uma zoonose 6 . Nesses ambientes, o ciclo do parasita processa-se sem a participação humana, caracterizando o foco silvestre, onde a manifestação da doença existe concomitantemente com a atividade humana 4 . Contudo, a parasitose humana vem sendo relatada em áreas que sofreram notáveis modificações ambientais 2,3,5 .No Estado do Paraná, a leishmaniose cutânea vem sendo* notificada com freqüência, ocorrendo diversos casos entre mulheres e crianças 8,9 . No Município de Jussara, Paraná, já foram assinalados inúmeros casos, inclusive entre membros de uma mesma família 8 .A infecção de animais domésticos (cavalos, muares e cães) em áreas endêmicas 1,3,6 sugere a participação desses animais na cadeia de transmissão de Leishmania nos ambientes domiciliar e peridomiciliar.Alguns pacientes atendidos no laboratório da Universidade Estadual de Maringá relataram que seus cães também apresentavam úlceras de difícil cicatrização, lembrando a leishmaniose tegumentar. A investi- Agradecimentos

No abstract

An epidemiological investigation of cutaneous leishmaniasis (CL) was performed in 1992 and 1993 in an endemic area of Jussara and Terra Boa counties, in the Northern Paraná State. The study covered 684 individuals from a population of approximately 1,400 from six agricultural areas (Fazenda Palmital, Cerâmica Andirá, Fazenda Jussara, Fazenda Lagoa, Destilaria Melhoramentos, and Fazenda Mururê) in Northern Paraná, Brazil. The mean frequency of CL history was 19.9%. The highest frequency was at Fazenda Jussara (40.5%). Based on the indirect immunofluorescence test, 58 (8.5%) presented significant titers of anti-Leishmania antibody, 17 (29.3%) of whom had no history of CL. The Montenegro skin test was applied to 97 individuals with a history of CL and was positive in 80 (82.5%). During the survey, seven individuals presented lesions, four of which were positive for Leishmania sp. The strain isolated was identified as Leishmania (Viannia) braziliensis.

No abstract

RESUMOInvestigou-se casos subclínicos de leishmaniose tegumentar em um bairro de Maringá-Paraná, pelas reações de imunofluorescência indireta e enzimaimunoensaio. Das 130 amostras analisadas, uma amostra apresentou título 40 e três apresentaram título 20 pela imunofluorescência indireta, enquanto 11 amostras apresentaram-se positivas pela reação de enzimaimunoensaio. Estes dados sugerem a existência de casos subclínicos nesta localidade.Palavras-chaves: Leishmaniose tegumentar. Imunofluorescência indireta. Enzimaimunoensaio. Casos subclínicos. ABSTRACTSubclinical cases of cutaneous leishmaniasis were investigated in a district of Maringá, State of Paraná, by means of the indirect immunofluorescence reaction and enzyme immunoassay. Among the 130 samples analyzed, one presented titer 40 and three presented titer 20 in the indirect immunofluorescence reaction, while 11 samples were positive in the enzyme immunoassay reaction. These data suggest that subclinical cases exist at this locality.

RESUMO

Findings suggest that for the adequate identification of ACL cases a combination of laboratory tests that involves the association of MST with at least another test should be used.