Epidemiology of human visceral leishmaniasis in the urban centers of the lower-middle São Francisco Valley, Brazilian semiarid region

Diniz, Lucyo Flávio Bezerra; Souza, Carlos Dornels Freire de; Carmo, Rodrigo Feliciano do

doi:10.1590/0037-8682-0074-2018

Cited by 14 publications

(14 citation statements)

References 23 publications

(24 reference statements)

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“…In Brazil, where L. infantum is endemic, the epidemiological data have largely shown a male predominance in VL [54, 83–88]. In addition, one nationwide study found higher levels of discontinued therapy among male VL patients.…”

Section: Visceral Leishmaniasismentioning

confidence: 99%

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

Lockard

Wilson

Rodríguez

2019

Journal of Immunology Research

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Worldwide, an estimated 12 million people are infected with Leishmania spp. and an additional 350 million are at risk of infection. Leishmania are intracellular parasites that cause disease by suppressing macrophage microbicidal responses. Infection can remain asymptomatic or lead to a spectrum of diseases including cutaneous, mucocutaneous, and visceral leishmaniasis. Ultimately, the combination of both pathogen and host factors determines the outcome of infection. Leishmaniasis, as well as numerous other infectious diseases, exhibits sex-related differences that cannot be explained solely in terms of environmental exposure or healthcare access. Furthermore, transcriptomic evidence is revealing that biological sex is a variable impacting physiology, immune response, drug metabolism, and consequently, the progression of disease. Herein, we review the distribution, morbidity, and mortality among male and female leishmaniasis patients. Additionally, we discuss experimental findings and new avenues of research concerning sex-specific responses in cutaneous and visceral leishmaniasis. The limitations of current therapies and the emergence of drug-resistant parasites underscore the need for new treatments that could harness the host immune response. As such, understanding the mechanisms driving the differential immune response and disease outcome of males versus females is a necessary step in the development of safer and more effective treatments against leishmaniasis.

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Section: Visceral Leishmaniasismentioning

confidence: 99%

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

Lockard

Wilson

Rodríguez

2019

Journal of Immunology Research

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“…In addition to the urbanization process 13 , it is important to consider the environmental context and climate change in relation to the spread and maintenance of leishmaniasis. Hot and humid climates favor vector proliferation, increasing the risk of transmission, especially in urban areas with population agglomeration 13 .…”

mentioning

confidence: 99%

“…However, operational difficulties in identifying animal reservoirs allow maintenance of the transmission chain 14 . Furthermore, operational difficulties are also observed in the health system, mainly due to the difficulty of access to health services among poorer population groups, who are often at greater risks of neglected diseases, and due to the poor capacity of health services to identify cases of leishmaniasis early in the community and, consequently, to provide adequate management 13,14 .…”

mentioning

confidence: 99%

Social determinants of mortality due to visceral leishmaniasis in Brazil (2001-2015): an ecological study

Nunes

Leal

Paiva

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Introduction: We aimed to analyze the relationship between visceral leishmaniasis mortality and social determinants of health (SDH). Methods: This was an ecological study of all leishmaniasis-related deaths in Brazil, from 2001 to 2015. We analyzed 49 indicators of human development and social vulnerability. The association was tested using the classical and spatial regression model. Results: Mortality was associated with indicators that expressed low human development and high social vulnerability: lack of garbage collection, low schooling, unemployment rate, low per capita income, and income inequality (Gini index). Conclusions: There was an association between high mortality by leishmaniasis and low SDH.

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“…We performed a cross-sectional study aiming to estimate the prevalence of HIV-Leishmania coinfection in HIV-positive outpatients from the municipality of Petrolina, in the state of Pernambuco, Brazil. Petrolina is an VL-endemic area from where most VL cases in the state of Pernambuco are reported [22]. The study was conducted in a public HIV outpatient clinic, which serviced about 600 individuals regularly using HAART at the time of this investigation.…”

Section: Study Design and Samplementioning

confidence: 99%

Asymptomatic Leishmania infection in HIV-positive outpatients on antiretroviral therapy in Pernambuco, Brazil

et al. 2021

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Background Visceral leishmaniasis (VL) in HIV-positive individuals is a global health problem. HIV-Leishmania coinfection worsens prognosis and mortality risk, and HIV-Leishmania coinfected individuals are more susceptible to VL relapses. Early initiation of antiretroviral therapy can protect against Leishmania infection in individuals living in VL-endemic areas, and regular use of antiretrovirals might prevent VL relapses in these individuals. We conducted a cross-sectional study in Petrolina, Brazil, an VL-endemic area, to estimate the prevalence of asymptomatic Leishmania cases among HIV-positive outpatients. Methods We invited any HIV-positive patients, aged ≥ 18-years-old, under antiretroviral therapy, and who were asymptomatic for VL. Patients were tested for Leishmania with enzyme-linked immunosorbent assays (ELISA)-rK39, immunochromatographic test (ICT)-rK39, direct agglutination test (DAT), latex agglutination test (KAtex), and conventional polymerase chain reaction (PCR). HIV-Leishmania coinfection was diagnosed when at least one VL test was positive. Results A total of 483 patients were included. The sample was predominantly composed of single, < 48-years-old, black/pardo, heterosexual males, with fewer than 8 years of schooling. The prevalence of asymptomatic HIV-Leishmania coinfection was 9.11% (44/483). HIV mono-infected and HIV-Leishmania coinfected groups differed statistically significantly in terms of race (p = 0.045), marital status (p = 0.030), and HIV viral load (p = 0.046). Black/pardo patients, married patients, and those with an HIV viral load up to 100,000 copies/ml presented higher odds for HIV-Leishmania coinfection. Conclusions A considerable number of asymptomatic Leishmania cases were observed among HIV-positive individuals in a VL-endemic area. Given the potential impact on transmission and health costs, as well as the impact on these coinfected individuals, studies of asymptomatic Leishmania carriers can be useful for guiding public health policies in VL-endemic areas aiming to control and eliminate the disease.

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Epidemiology of human visceral leishmaniasis in the urban centers of the lower-middle São Francisco Valley, Brazilian semiarid region

Abstract: Both cities had a high incidence of VL during the studied period. The findings of this study contribute to a better understanding of the behavior of VL during recent years and may help to direct regional disease control measures.

Cited by 14 publications

References 23 publications

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection with Leishmania Species

Social determinants of mortality due to visceral leishmaniasis in Brazil (2001-2015): an ecological study

Asymptomatic Leishmania infection in HIV-positive outpatients on antiretroviral therapy in Pernambuco, Brazil

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