Epidemiological and Clinical Changes in American Tegumentary Leishmaniasis in an Area of Leishmania (Viannia) braziliensis Transmission Over a 20-Year Period

Abstract

Abstract. The Health Post of Corte de Pedra is located in a region endemic for American tegumentary leishmaniasis (ATL) in the Brazilian state of Bahia, and it treats 500-1,300 patients annually. To describe temporal changes in the epidemiology of ATL, we reviewed a random sample of 10% of patient charts (N = 1,209) from 1988 to 2008. There was a twofold increase in the number of cases over the 20-year period, with fluctuations in 10-year cycles. Patients were most frequently male, between the ages of 10 and 30 years, and engaged in agricultural labor; 4.3% of patients had mucosal disease, and 2.4% of patients had disseminated disease. Over the study period, the number of disseminated cases increased threefold, the proportion of cases in younger patients and agricultural workers decreased, and the proportion of patients residing in coastal areas increased. ATL is on the rise in Bahia, with a 10-year periodicity and evolving changes in epidemiology and manifestations of disease.

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

“…In Western São Paulo State, 4.9% of cases with mucosal involvement (20) were reported from 1998 to 2011, and on the Northern coastline, 1.6% of cases with mucocutaneous involvement were reported from 1993 to 2005 (25) . In fact, from 1988 to 2008, of 1209 patients with ATL in Bahia State, 4.3% were found to have mucosal involvement (9) . Mucocutaneous leishmaniasis can develop several months to ≥20 years after a cutaneous lesion.…”

“…In the North and Northwest regions of Paraná State, Leishmania (Viannia) braziliensis is the prevalent species responsible for ATL (7) (8) . The clinical forms of L. (V.) braziliensis infection include cutaneous, mucosal, and disseminated leishmaniasis (9) .…”

Age Modifies the Immunologic Response and Clinical Presentation of American Tegumentary Leishmaniasis

“…Leishmania (Viannia) braziliensis is the most important causal agent of leishmaniasis in Brazil and causes three clinical forms of the tegumentary disease: cutaneous leishmaniasis (CL), mucosal leishmaniasis (ML), and disseminated cutaneous leishmaniasis (DL). 2 In Brazil, more than 5,000 new cases of CL were reported in 2012. 3 Cutaneous leishmaniasis is characterized by a well-limited ulcer with raised borders.…”

Got the Travel Bug? A Review of Common Infections, Infestations, Bites, and Stings Among Returning Travelers

“…This can lead to mutilating destruction of the mucous membranes and surrounding cartilage; most classically, ulceration of the septal mucosae. Progression rates to mucocutaneous leishmaniasis range from 1 to 10 % [37,42,43]. The disseminated form of leishmaniasis, known as visceral disease or Kala-azar (black sickness) is caused by migration of infected tissue macrophages through the reticuloendothelial system.…”