Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001–2011

Maia-Elkhoury, Ana Nilce Silveira; Yadón, Zaida E.; Díaz, Martha Idali Saboyá; Lucena, Francisca de Fátima; Castellanos, Luis Gerardo; Sánchez-Vázquez, Manuel J.

doi:10.1371/journal.pntd.0005086

Cited by 22 publications

(26 citation statements)

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“…Non-adherence to the surveillance system and delays in reporting have been detected in the SisLeish system, and can be traced back directly to local systems [ 13 ]. The data presented here differ significantly from those reported by Maia-Elkhoury et al [ 43 ] with regards to incidence. This is due to differences in the definition of the population at risk.…”

Section: Discussioncontrasting

confidence: 99%

Geospatial-temporal distribution of Tegumentary Leishmaniasis in Colombia (2007–2016)

et al. 2018

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BackgroundTegumentary Leishmaniasis (TL) is a neglected disease with worldwide distribution and considered a public health problem, especially in Latin America. In Colombia, the governmental epidemiological surveillance system (SIVIGILA) is responsible for collecting information on the presentation of cases of TL from each of the municipalities and departments. In absence of a study compiling and analyzing currently available metadata of TL in Colombia, this study describes the geospatial-temporal distribution of TL and identifies the regions of the country on which prevention measures should be established in order to control the disease.Methodology/Principal findingsThis is an exploratory descriptive analysis of the distribution of TL in Colombia. Information was collected on new cases of the disease during the years 2007–2016 from the Colombian reporting system (SIVIGILA). Incidence calculations were made based on population estimates by departments and biogeographical regions. Time evolution is shown in biennial maps. A 10-year series was analyzed, showing that the Amazon region is the most affected in terms of incidence, while the Andean region has the highest number of cases with a high variability among the departments that make it up. In those departments where there is a greater reported diversity of vector species, a large number of cases was observed.Conclusions/SignificanceTransmission dynamics of TL in Colombia in the past 10 years have been variable, with a greater concentration of cases in the central and southern departments. The present study contributes to improve the understanding of the patterns of distribution of TL in Colombia and can be a basis for future studies of impact evaluation of Health policies in the country and the region.

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Section: Discussioncontrasting

confidence: 99%

Geospatial-temporal distribution of Tegumentary Leishmaniasis in Colombia (2007–2016)

et al. 2018

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“…Compared to other regions, the neglect of CL is obvious. For New World CL in Latin America, the Pan American Health Organization (PAHO) has coordinated efforts to standardize and centralize surveillance data [ 110 ]. A Regional Information System called SisLeish was eventually developed to become an essential tool to prioritize areas and guide control actions [ 111 ].…”

Section: Discussionmentioning

confidence: 99%

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

et al. 2018

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IntroductionCutaneous leishmaniasis (CL) is the most frequent form of leishmaniasis, with 0.7 to 1.2 million cases per year globally. However, the burden of CL is poorly documented in some regions. We carried out this review to synthesize knowledge on the epidemiological burden of CL in sub-Saharan Africa.MethodsWe systematically searched PubMed, CABI Global health, Africa Index Medicus databases for publications on CL and its burden. There were no restrictions on language/publication date. Case series with less than ten patients, species identification studies, reviews, non-human, and non-CL focused studies were excluded. Findings were extracted and described. The review was conducted following PRISMA guidelines; the protocol was registered in PROSPERO (42016036272).ResultsFrom 289 identified records, 54 met eligibility criteria and were included in the synthesis. CL was reported from 13 of the 48 sub-Saharan African countries (3 eastern, nine western and one from southern Africa). More than half of the records (30/54; 56%) were from western Africa, notably Senegal, Burkina Faso and Mali. All studies were observational: 29 were descriptive case series (total 13,257 cases), and 24 followed a cross-sectional design. The majority (78%) of the studies were carried out before the year 2000. Forty-two studies mentioned the parasite species, but was either assumed or attributed on the historical account. Regional differences in clinical manifestations were reported. We found high variability across methodologies, leading to difficulties to compare or combine data. The prevalence in hospital settings among suspected cases ranged between 0.1 and 14.2%. At the community level, CL prevalence varied widely between studies. Outbreaks of thousands of cases occurred in Ethiopia, Ghana, and Sudan. Polymorphism of CL in HIV-infected people is a concern. Key information gaps in CL burden here include population-based CL prevalence/incidence, risk factors, and its socio-economic burden.ConclusionThe evidence on CL epidemiology in sub-Saharan Africa is scanty. The CL frequency and severity are poorly identified. There is a need for population-based studies to define the CL burden better. Endemic countries should consider research and action to improve burden estimation and essential control measures including diagnosis and treatment capacity.

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“…Cutaneous leishmaniasis (CL) is one of the 17 neglected diseases, with 350 million people at risk in 98 endemic countries [ 1 ]. Latin America is a highly endemic region with a documented 30% increase in the number of reported cases during a period of ten years (2001–2011) [ 2 ]. Brazil together with eight other countries reports 90% of all registered cases of CL [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Failure of fluconazole in treating cutaneous leishmaniasis caused by Leishmania guyanensis in the Brazilian Amazon: An open, nonrandomized phase 2 trial

Francesconi

Ramasawmy

et al. 2018

PLoS Negl Trop Dis

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BackgroundThe treatment of Leishmaniasis caused by Leishmania (Viannia) guyanensis is based on a weak strength of evidence from very few clinical trials and some case series reports. Current treatment guidelines recommend pentamidine isethionate or meglumine antimoniate (Glucantime) as the first-line choices. Both are parenteral drugs with a low therapeutic indexes leading to a high risk of undesired effects. Imidazole derivatives interfere with the production of leishmanial ergosterol, an essential component of their membrane structure. One drug that has been studied in different clinical presentations of Leishmania is fluconazole, a hydrophilic bis-triazole, which is easily absorbed through the oral route with a low toxicity profile and is considered safe for children. This drug is readily available in poor countries with a reasonable cost making it a potential option for treating leishmaniasis.Methods and findingsAn adaptive nonrandomized clinical trial with sequential groups with dose escalation of oral fluconazole was designed to treat adult men with localized cutaneous leishmaniasis (LCL) in Manaus, Brazil. Eligible participants were patients with LCL with confirmed Leishmania guyanensis infection.ResultsTwenty adult male patients were treated with 450 mg of fluconazole daily for 30 days. One patient (5%) was cured within 30 days of treatment. Of the 19 failures (95%), 13 developed a worsening of ulcers and six evolved lymphatic spreading of the disease. Planned dose escalation was suspended after the disappointing failure rate during the first stage of the trial.Conclusion/SignificanceOral fluconazole, at the dose of 450mg per day, was not efficacious against LCL caused by Leishmania guyanensis in adult men.Trial registrationBrazilian Clinical Trial Registration (ReBec)—RBR-8w292w; UTN number—1158-2421

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Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001–2011

Cited by 22 publications

References 28 publications

Geospatial-temporal distribution of Tegumentary Leishmaniasis in Colombia (2007–2016)

Geospatial-temporal distribution of Tegumentary Leishmaniasis in Colombia (2007–2016)

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

Failure of fluconazole in treating cutaneous leishmaniasis caused by Leishmania guyanensis in the Brazilian Amazon: An open, nonrandomized phase 2 trial

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