Evolution of American Tegumentary Leishmaniasis Cases Reported in Paraná State, Brazil

Abstract

SUMMARY Leishmaniases are infectious diseases caused by protozoa of the genus Leishmania. They are widely distributed worldwide and endemic in 88 countries in four continents. The present study analyzed the reported cases of American Tegumentary Leishmaniasis (ATL) in Paraná State (Brazil) from January 2007 to December 2013. The data were grouped according to Regional Health (RH) districts and macroregions, which allowed visualization of the reality in each region in the state. A total of 2,879 ATL cases were reported and distributed among the 22 RH districts, with an average detection rate of 3.9 cases per 100,000 inhabitants. The northwestern region accounted for 50.1% of the total cases, and the northern region accounted for 26.0-76.1% of the reported cases. The 6th RH district did not report any cases. The 7th, 9th, and 18th RH districts had a higher cure rate (> 80%), and lower cure rates were found in the 1st, 4th, and 12th RH districts. Reported unfavorable outcomes included treatment abandonment and death. Overall cure rates are based on the entire country, and unfavorable outcomes require greater attention of managers and health professionals to meet the goals of the Brazilian Ministry of Health.

American cutaneous leishmaniasis associated with degradation of native forest, regardless of economic, social and infrastructure vulnerability

“…American CL is endemic in Paraná and its distribution is irregular (Figure 2 The presented results (Figure 3) demonstrate a cyclical profile of the disease already recognized in several national and international studies (Alcântara et al, 2016;Carvalho et al, 2010;Chaves et al, 2008;Condino et al, 2009;Detoni et al, 2019;Nasser et al, 2009;Resende, 2004). In the present study, this cyclicality lasts from 3 to 4 years, which may have occurred due to El Niño (Alcântara et al, 2016;Chaves & Pascual, 2006;Rojas, 2001;Tolezano et al, 2007;WHO, 2010), a phenomenon known to increase precipitation and temperature in some regions of South America, including southern Brazil (Cardoso & Silva Dias, 2006), can occur at intervals of 2-7 years with an average 3 years. Chaves et al (2008), observed statistical significance in the performance of El Niño in the different municipalities of Costa Rica, in some municipalities leading to an increase and in others to a reduction in the incidence of ACL.…”

“…This fact suggests a pattern of inappropriate behaviour by patients and demonstrates the need for case monitoring, greater awareness of these patients and training of the professionals involved. There are few studies that explain the causes of abandonment of ACL treatment (Alcântara et al, 2016); taking into account that the treatment is offered free of charge by the Brazilian Sistema Único de Saúde and that the prognosis is good when performed properly, we suggest that the time of treatment and adverse effects are the main factors that influence the given up. In addition, the treatment must be carried out completely, injectable, in the BHU, therefore, for some, the difficulty of moving to the BHU can also be an obstacle.…”

“…Chaves et al (2008), observed statistical significance in the performance of El Niño in the different municipalities of Costa Rica, in some municipalities leading to an increase and in others to a reduction in the incidence of ACL. Alcântara et al (2016) stated that climate change favours the wide distribution of the vector, and Chaves and Pascual (2006) reported that the increase in the ambient temperature reduces the time necessary for the parasite to complete its cycle inside the vector. Both situations affect the vectorial capacity and, therefore, affect the incidence/number of cases of ACL.…”

“…), with two main circuits, Paraná-Paranapanema, which includes municipalities in the North and West regions, and Ribeira, which includes municipalities in the East region(Monteiro et al, 2009) Alcântara et al (2016). reported that the 3rd (Ribeiracircuit) and 11th, 13th, 15th, 17th and 18th (Paraná-Paranapanema circuit) were the HR that most reported cases of human ACL in the period 2007-2013.…”