The epidemiology and control of leishmaniasis in Andean countries

Abstract

This paper reviews the current knowledge of leishmaniasis epidemiology in Venezuela, Colombia, Ecuador, Peru, and Bolivia. In all 5 countries leishmaniasis is endemic in both the Andean highlands and the Amazon basin. The sandfly vectors belong to subgenera Helcocyrtomyia, Nyssomiya, Lutzomyia, and Psychodopygus, and the Verrucarum group. Most human infections are caused by Leishmania in the Viannia subgenus. Human Leishmania infections cause cutaneous lesions, with a minority of L. (Viannia) infections leading to mucocutaneous leishmaniasis. Visceral leishmaniasis and diffuse cutaneous leishmaniasis are both rare. In each country a significant proportion of Leishmania transmission is in or around houses, often close to coffee or cacao plantations. Reservoir hosts for domestic transmission cycles are uncertain. The paper first addresses the burden of disease caused by leishmaniasis, focusing on both incidence rates and on the variability in symptoms. Such information should provide a rational basis for prioritizing control resources, and for selecting therapy regimes. Secondly, we describe the variation in transmission ecology, outlining those variables which might affect the prevention strategies. Finally, we look at the current control strategies and review the recent studies on control.

Phlebotomine Vector Ecology in the Domestic Transmission of American Cutaneous Leishmaniasis in Chaparral, Colombia

“…In the 1980s, Brazil began to record CL cases in all age groups, suggesting transmission in domestic and peridomestic environments. 3 One of the factors associated with the epidemiological change was the adaptation of some species of the subfamily Phlebotominae, vectors of Leishmania parasites, to altered ecosystems and other sources of blood meals, such as humans and domestic animals. 3,4 In Colombia, increased human movement, mainly because of political instability, encouraged the geographical spread of Leishmania species.…”

Leishmaniases in Bolivia: Comprehensive Review and Current Status

“…Given the previous review by Davies and others 12 and given the country-specific burden of CL compared with VL, our review primarily focused on studies undertaken or published in the past 10 years and on CL. Where relevant or where there are clear differences in case management, prevention, or control of CL versus VL, VL-specific data are reviewed and discussed.…”

“…[8][9][10] Also, an increasing number of patients (e.g., tourists) contracting leishmaniases in Bolivia have been reported. 11 Although some of these studies have been summarized previously in a review of CL in Colombia, Peru, Venezuela, and Bolivia published in 2000, 12 studies that have been published since then have yet to be comprehensively reviewed, together with the latest national case notification data available. Additionally, we describe operational aspects of leishmaniases' case management, prevention, and control and discuss approaches that could be undertaken in Bolivia to 1) significantly contribute to the knowledge of the leishmaniases; 2) develop a comprehensive leishmaniases prevention and control strategy; and 3) assist in managing patients that have contracted the disease.…”

Leishmaniasis in Chaparé, Bolivia

“…Data on the prevalence and effects of CL in Bolivia have been scarce, even though anecdotal and offi cial reports indicate a dramatic increase in the number of human CL cases in Bolivia in the past decade (1,3). Also, although CL was originally a sylvatic disease in Bolivia, some evidence indicates that the transmission cycle has adapted to the peridomestic habitat.…”