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.

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Studies of topical treatments for leishmaniasis were systematically reviewed, to evaluate the therapeutic efficacy, safety and any adverse effects of these treatments. The papers identified in the databases PubMed and Web of Knowledge involved eight studies with a total of 1744 patients. The majority of trials was from Iran (4/8), covered a period of 8 years (2003-2011), and included patients 4-85 years of age. The most frequent Leishmania species in the studies were L. tropica (4/8) and L. major (2/8). The treatments administered were thermotherapy, paromomycin and combinations, CO2 laser, 5-aminolevulinic acid hydrochloride (10%) plus visible red light (633 nm) and cryotherapy. Six articles reported cure rates over 80·0%. Six studies reported on failure rates, three of them reporting rates lower than 10%. Four studies did not report relapses or recurrences, while the other studies reported low rates (1·8-6·3%). The most common adverse effects of the topical treatments were redness/erythema, pain, pruritus burning, oedema, vesicles and hyper- or hypopigmentation. The results provide strong evidence that the treatments topical evaluated showed high cure rates, safety and effectiveness, with low side-effects, relapse and recurrence rates, except for cryotherapy, which showed a moderate cure rate.

Comparam-se os resultados de coletas de flebotomíneos, feitas com armadilhas de Falcão, no domicílio e em abrigos de animais domésticos no peridomicílio, antes e após a reorganização, a limpeza e a desinsetização destes ambientes. As coletas foram realizadas de outubro de 1998 a abril de 2000, no Recanto Marista, Município de Doutor Camargo, Estado do Paraná. Os resultados foram comparados com outros obtidos no período de outubro de 1996 a setembro de 1997. Nesta investigação foram coletados 122.616 flebotomíneos, com dez armadilhas, contra 157.983 coletados anteriormente, com seis armadilhas. Lutzomyia neivai predominou nos dois períodos de coletas. No primeiro foram coletados em média por hora (MH) 1.641,9 flebotomíneos contra 806,7 no segundo. Os resultados das coletas com quatro armadilhas, instaladas nos mesmos ecótopos, mostram que a MH no primeiro período foi 1.318,8 e no segundo 156,0. Os dados sugerem que a redução expressiva no número de flebotomíneos coletados foi devido ao impacto das alterações introduzidas no ambiente e pela desinsetização das edificações, realizadas após o primeiro período de coleta.

Sandflies of municipalities in North of Paraná State, South of Brazil-This work reports the results of sandfly collections in several places, during 2001 and 2002, in Bom Sucesso, Jardim Alegre, Kaloré, Londrina and Sabáudia municipalities, North of the State. The sandflies catches were performed with Shannon and Falcão traps in domiciliary areas, domestic animal shelters, barns and in the forest. A total of 4,019 specimens of 8 species were captured. Nyssomyia whitmani predominates in all of the municipalities. The species Migonemyia migonei, Nyssomyia neivai and N. whitmani may be involved in the epidemiology of American Tegumentary Leishmaniasis in this state.

Tetradenia riparia plant is used as a traditional medicine in Africa for the treatment of inflammatory and infectious diseases as like parasitic. Therapy for leishmaniasis caused by Leishmania (Leishmania) amazonensis specie often fails, and the conventional drugs are toxic, expensive, require a long period of treatment, and adverse effects are common. The alternative therapies using natural products are inexpensive and have few or any adverse reaction. These reasons are sufficient to investigate the new natural therapeutic for leishmaniasis. We evaluated the potential of the essential oil (TrEO) and 6,7-dehydroroyleanone (TrROY) isolated from T. riparia on L. (L.) amazonensis promastigote and amastigote forms, cytotoxicity on human erythrocytes and murine macrophages, nitric production and inducible nitric oxide synthase (iNOS) mRNA expression. TrEO was the most effective to promote the Leishmania promastigote death. After 72 h incubation, the lethal dose of TrEO and TrROY that promoted 50% Leishmania death (LD50) were 0.8 μg/mL and 3 μg/mL, respectively. TrEO and TrROY were not cytotoxic to human erythrocytes, but TrROY was toxic to murine macrophages resulting in a low selectivity index. The transmission electronic microscopy showed that TrEO (0.03 μg/mL) was able to modify the promastigote ultrastructures suggesting autophagy as chromatin condensation, blebbing, membranous profiles and nuclear fragmentation. Infected-macrophages treated with TrEO (0.03 μg/mL) or TrROY (10 μg/mL) had an infection index decreased in 65 and 48%. TrEO did not induce iNOS mRNA expression or nitrite production in macrophages infected with Leishmania. TrROY and mainly TrEO promoted the Leishmania death, and TrROY showed loss toxicity to erythrocytes cells. Other compounds derived from T. riparia and the essential oil could be explored to develop a new alternative treatment for leishmaniasis.

The aim of this study was to investigate the effectiveness of Photodynamic Therapy (PDT) using Methylene Blue (MB) as the photosensitizing compound and a Light-Emitting Diode (LED) in American cutaneous leishmaniasis (ACL). Hamsters were experimentally infected with Leishmania (Leishmania) amazonensis. After the development of the lesions in the footpad, the animals were treated with MB three times a week for 3 months. Ten minutes after each application of MB, the lesions were irradiated with LED for 1 h. The lesions were evaluated weekly by the measurement of the hamster footpad thickness. At the end of the treatment the parasitic load was quantified in the regional lymph node of the hamsters. The treatment promoted a decrease in the thickness of infected footpad (P=0.0001) and reduction in the parasitic load in the regional lymph node (P=0.0007) of the animals from group treated with MB+LED. PDT using MB+LED in ACL caused by L. amazonensis shows a strong photodynamic effect. This therapy is very promising, once it is an inexpensive system and the own patient can apply it in their wound and in their house without the need of technical assistance.

No Estado do Paraná, a leishmaniose tegumentar americana é endêmica, com 99,3% dos casos registrados no Sul do Brasil. Verifica-se a distribuição geográfica da doença no norte desse estado, identificando-se as áreas territoriais de maior importância epidemiológica. O estudo foi realizado com dados registrados em fichas epidemiológicas do Laboratório de Ensino e Pesquisa em Análises Clínicas da Universidade Estadual de Maringá, de 1987 a 2004. Consideraram-se apenas os indivíduos que se infectaram nos municípios no norte do Paraná. A identificação das unidades epidemiológicas (pólos e circuitos) foi feita com base na densidade espacial dos casos, conforme o modelo da Fundação Nacional de Saúde, considerando-se as localidades mais prováveis de infecção. De 1.933 casos de leishmaniose tegumentar americana registrados, 1.611 se infectaram em áreas no norte do Paraná. A distribuição da endemia no Estado do Paraná sugere a existência de dois circuitos de produção da doença: circuito Paraná-Paranapanema, onde se destacam os pólos Cinzas-Laranjinha, Tibagi, Ivaí-Pirapó, Piquiri e Baixo Iguaçu, e circuito Ribeira, onde se destaca o pólo Alto Ribeira.