Divergent Profile of Emerging Cutaneous Leishmaniasis in Subtropical Brazil: New Endemic Areas in the Southern Frontier

Abstract

BackgroundAlthough known to be highly endemic in the Amazon regions of Brazil, the presence of cutaneous leishmaniasis (CL) in the subtropical southern part of the country has largely been ignored. This study was conducted to demonstrate CL is emerging in the Brazilian state of Santa Catarina, as well as to characterize the epidemiological profile and Leishmania species involved.Methodology/Principal FindingsFor this cross-sectional study, data from all CL cases from Santa Catarina, Brazil, reported to the Brazilian National Notifiable Diseases Information System from 2001 to 2009 were investigated. Amplification of the kDNA minicircle conserved region followed by restriction fragment length polymorphism (PCR-RFLP) was conducted to screen for Leishmania species present in patient biopsy. Overall, 542 CL cases were reported, with majority resulting from autochthonous transmission (n = 401, 73.99%) and occurring in urban zones (n = 422, 77.86%). Age, gender, zone of residence, origin of case, clinical form and case outcome were found to differ significantly by region. Imported cases were over seven times more likely to relapse (95% CI 2.56–21.09). Mapping of cases revealed new endemic areas in northeastern Santa Catarina with two species present. With the exception of three L. (Leishmania) amazonensis cases (1.20%), majority of PCR positive samples were found to be L. (Viannia) braziliensis (n = 248, 98.80%).Conclusions/SignificanceCL is now endemic in the state of Santa Catarina, Brazil, with case profiles varying significantly by region. L. (V.) braziliensis has been identified as the predominant species in the region.

Leishmania in synanthropic rodents (Rattus rattus): new evidence for the urbanization of Leishmania (Leishmania) amazonensis

“…Several recent scientific studies describe this expansion; in terms of hosts, Souza et al (2005), Dorval et al, (2010) and Cardoso et al (2015) reported Felis catus domesticus (domestic cat), Mesocricetus auratus (hamster) and Necromys lasiurus (wild rodent) infection. In terms of geographical distribution, Dorval et al (2006), Marlow et al (2013) and Carvalho et al (2013) reported its detection in Mato Grosso do Sul, Santa Catarina and Rio de Janeiro states, Brazil. Regarding clinical manifestations, Barral et al (1991) and Oliveira et al (2007) (FREITAS et al, 1989;LAINSON & SHAW, 1968;BRASIL, 2013).…”

Clinical, laboratory, and therapeutic characteristics of American tegumentary leishmaniasis in the 15 th State Health Division, Northwest Paraná State, Southern Brazil

“…A small portion (5.5%) of the cases reported in the 15 th RH Division were considered to have disease related to work activities, in contrast with the value of 33% previously reported by Silveira et al (7) in a study performed in the same area. Martins et al (21) indicated that, in São Paulo State, ATL was prevalent among adult male patients and rural workers (40.4%), whereas Marlow et al (22) reported that, in the State of Santa Catarina, 67.3% of patients were male and 77.8% lived in urban zones. The presence of children (6.4%) and women (15%) among the patients indicates the possibility of peri-domiciliary transmission, and represents significant changes in vector behavior (23) .…”

Multilocus Sequence Analysis for Leishmania braziliensis Outbreak Investigation

“…Patient data from Santa Catarina used in this study were investigated as part of routine reportable disease surveillance and collection procedures have been previously described in [9]. Santa Catarina isolates were deposited in CLIOC and subjected to MLEE characterization, according to routine procedures employed by CLIOC.…”