Endemic Tegumentary Leishmaniasis in Brazil: Correlation between Level of Endemicity and Number of Cases of Mucosal Disease

Abstract

The purpose of this study was to establish a correlation between the endemic level of tegumentary leishmaniasis in different regions of Brazil during 2002–2009 and the number of cases of mucosal or mucocutaneous leishmaniasis. The proportion of mucosal leishmaniasis was inversely correlated with prevalence of infection. In areas with a lower infection prevalence, the proportion of mucosal leishmaniasis increased (P < 0.05). The hypothesis of an Amazonian origin and dissemination through human migration is considered. Our results show that in regions with lower prevalence and endemically younger, the proportion of cases that evolve to the mucosal form is higher than in regions with higher prevalence and endemically older.

Population Structure and Evidence for Both Clonality and Recombination among Brazilian Strains of the Subgenus Leishmania (Viannia)

“…The Amazon forest seems to be the central distribution area with secondary spreads to the northeast, east and south. This would be consistent with the hypothesis of an Amazon origin of CL in Brazil, with later spread to other regions, most probably through human migrations [6]. However, we cannot exclude that sampling biases are responsible for the weak resolution of the strains in Population 3.…”

“…The disease is caused by six species of the subgenus L. ( Viannia ), L. (V.) braziliensis , L. (V.) guyanensis , L. (V.) shawi , L. (V.) lainsoni , L. (V.) naiffi and L. (V.) lindenbergi plus one species of the subgenus L. (Leishmania) , L. (L.) amazonensis . Around 6–7% of the CL patients will develop symptoms of MCL [6] mainly after infection with L. (V.) braziliensis and, to a lesser extent, also with L. (V.) guyanensis [7], [8]. So far, DL has been also mainly associated with L. (V.) braziliensis , and only sporadic cases with L. (V.) guyanensis [1].…”

Burden of leishmaniasis in Brazil and federated units, 1990-2016: Findings from Global Burden of Disease Study 2016

“…Previous studies have suggested that the expansion of tegumentary leishmaniasis in Brazil is associated with migratory movements originating in the Amazon region. Dispersion of the diseases may have occurred following the return of the population to their regions of origin in the South and Southeast Brazil [ 53 , 54 ]. The return occurred in corridors with the population leaving the North, passing through the Mid-West and finally reaching the South region of the country [ 54 ].…”

“…Dispersion of the diseases may have occurred following the return of the population to their regions of origin in the South and Southeast Brazil [ 53 , 54 ]. The return occurred in corridors with the population leaving the North, passing through the Mid-West and finally reaching the South region of the country [ 54 ]. Since then, there has been an increase both in the magnitude and in the geographical expansion of CML cases, with notifications in all regions of the country [ 34 , 43 , 44 , 45 ].…”

Social stigmatization of cutaneous leishmaniasis in the state of Rio de Janeiro, Brazil

“…Transformações ambientais e ecoepidemiológicas, aliadas a mudanças climáticas e desmatamento, assim como problemas econômicos com a consequente migração de pessoas infectadas das regiões endêmicas, contribuíram para a adaptação dos vetores e a expansão geográfica da doença com aparecimento de focos endêmicos urbanos e periurbanos. [3][4][5][6] Na atualidade, a leishmaniose cutânea vem sendo observada em todo o território brasileiro, com casos autóctones registrados em todas as unidades federadas, sendo encontrados com maior prevalência em populações mais pobres. 7 A partir de 2006, a leishmaniose cutânea foi incluída na lista de doenças endêmicas negligenciadas consideradas pelo Programa de Pesquisa e Desenvolvimento em Doenças Negligenciadas no Brasil, no âmbito do Ministério de Saúde e do Ministério de Ciência e Tecnologia.…”