Infecção por Leishmania (Leishmania) chagasi em crianças de uma área endêmica de leishmaniose visceral americana na Ilha de São Luis-MA, Brasil

Caldas, Arlene de Jesus Mendes; Silva, Denise R.C.; Pereira, Célia C.R.; Nunes, Pedro Murilo Sales; Silva, Benedito P.; Silva, Antônio Augusto M; Barral, Aldina; Costa, Jackson Maurício Lopes

doi:10.1590/s0037-86822001000500007

Cited by 39 publications

(36 citation statements)

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“…A higher L. chagasi infection frequency among humans was established in this study (18.9%) when compared to a previous study in the same municipality (13.5%) (Caldas et al 2001). The rates of infection among humans were much higher than those observed in other surveys in the North and Northeast Regions of Brazil, such as in the states of Ceará (prevalence of 4.5%) and Pará (3.4%), but similar to those recorded in the states of Piauí (13.9%) and BA (16.1%).…”

Section: Discussioncontrasting

confidence: 59%

“…Blood samples from humans and dogs were collected for the subsequent ELISA and indirect immunofluorescence reaction (IFR) analyses, respectively. ELISA analysis for the presence of Leishmania antibodies was performed at the Laboratory of Immunopathology of the Gonçalo Muniz Research Center of Oswaldo Cruz Foundation (Fiocruz), Bahia (BA), Brazil (Caldas et al 2001) and was considered to be positive when the absorbance level exceeded 0.050.…”

Section: Patients Materials and Methodsmentioning

confidence: 99%

mentioning

confidence: 89%

“…The high frequency of Leishmania infection found in human beings, dogs and Lu. longipalpis in previous studies in the municipality of Raposa, state of Maranhão (MA), Brazil, may also be associated with poverty (Caldas et al 2001(Caldas et al , 2002.Notably, the current knowledge on the epidemiology of VL is mainly based on studies examining the prevalence of Leishmania infections only among humans. There are few studies that simultaneously examine L. chagasi infection across several known hosts and carriers.…”

mentioning

confidence: 99%

“…the Montenegro skin test. About 20% of these individuals may develop clinical manifestations and the others will remain asymptomatic or progress to the oligosymptomatic form of the disease (Badaró et al 1986a, b, Evans et al 1992, Marzochi et al 1994, Caldas et al 2001.…”

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confidence: 99%

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Leishmania infection in humans, dogs and sandflies in a visceral leishmaniasis endemic area in Maranhão, Brazil

Felipe

Aquino

Kuppinger

et al. 2011

Mem. Inst. Oswaldo Cruz

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Visceral leishmaniasis (VL) is considered an important neglected disease that affects many countries of the world (Desjeux 2004). On the American continent, VL is caused by the protozoan parasite Leishmania chagasi, which is transmitted to humans and other vertebrate hosts (e.g., dogs) through the bite of a female sandfly. Lutzomyia longipalpis is considered to be the main vector for VL in Brazil (Lainson & Rangel 2005).A high proportion of L. chagasi infected persons do not present any clinical symptoms of disease, even after a long incubation period (asymptomatic form) (Evans et al. 1992, Romero et al. 2009). Cohort studies in Brazil have described detection of asymptomatic seroconvertors with a sensitive and specific enzyme linked immunosorbent assay (ELISA) test using crude antigens from promastigotes (Badaró et al. 1986a, c) Malnutrition is considered one of the most important factors associated with the development of clinical symptoms of leishmaniasis (Alvar et al. 2006). The high frequency of Leishmania infection found in human beings, dogs and Lu. longipalpis in previous studies in the municipality of Raposa, state of Maranhão (MA), Brazil, may also be associated with poverty (Caldas et al. 2001(Caldas et al. , 2002.Notably, the current knowledge on the epidemiology of VL is mainly based on studies examining the prevalence of Leishmania infections only among humans. There are few studies that simultaneously examine L. chagasi infection across several known hosts and carriers. Therefore, the aim of the present study was to determine the asymptomatic L. chagasi infection rates in human beings, dogs and the vector Lu. longipalpis in the VL endemic area of Raposa. PATIENTS, MATERIALS AND METHODSThe study was performed from August 2006-July 2008 in Vila Maresia, Vila Marisol and Vila Pantoja; all three neighbourhoods are located in the municipality of Raposa situated in the northern coastal region of MA, approximately 28 km from the state capital, São Luis (Figure).In this study, the inclusion criteria for human subjects were the following: living in an endemic area for more than six months, no signs and symptoms of VL (fever for more than 2 weeks, hepatosplenomegaly, weight loss or mucocutaneous pallor) and no previous history of VL. As exclusion criteria, we considered a history of treatment for VL (including treatment failures and relapses), individuals with known immunodeficiency or currently using immunosuppressants and comorbidities (evidence of other conditions leading to splenomegaly, such as schistosomiasis and malaria).In a preliminary census survey, we found 1,417 inhabitants, 986 (70%) of whom participated in the study. This 30% loss was mainly due to internal and external migrations, as well as refusal to participate in the study. Overall, 986 (69.6%) out of 1,417 inhabitants that lived more than six months in the area and did not exhibit clinical VL symptoms participated in the study. From these, 857 individuals (86.9%) were from Vila Maresia, 77 individuals (7.7%) were from Vila Marisol and 52...

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Section: Discussioncontrasting

confidence: 59%

Section: Patients Materials and Methodsmentioning

confidence: 99%

mentioning

confidence: 89%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Leishmania infection in humans, dogs and sandflies in a visceral leishmaniasis endemic area in Maranhão, Brazil

Felipe

Aquino

Kuppinger

et al. 2011

Mem. Inst. Oswaldo Cruz

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A longitudinal study on the transmission dynamics of human Leishmania (Leishmania) infantum chagasi infection in Amazonian Brazil, with special reference to its prevalence and incidence

Sílveira

Lainson

Pereira³

et al. 2008

Parasitol Res

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This was a longitudinal study carried out during a period over 2 years with a cohort of 946 individuals of both sexes, aged 1 year and older, from an endemic area of American visceral leishmaniasis (AVL) in Pará State, Brazil. The object was to analyze the transmission dynamics of human Leishmania (Leishmania) infantum chagasi infection based principally on the prevalence and incidence. For diagnosis of the infection, the indirect fluorescent antibody test (IFAT) and leishmanin skin test (LST) were performed with amastigote and promastigote antigens of the parasite, respectively. The prevalence by LST (11.2%) was higher (p < 0.0001) than that (3.4%) by IFAT, and the combined prevalence by both tests was 12.6%. The incidences by LST were also higher (p < 0.05) than those by IFAT at 6 (4.7% x 0.6%), 12 (4.7% x 2.7%), and 24 months (2.9% x 0.3%). Moreover, there were no differences (p > 0.05) between the combined incidences by both tests on the same point surveys, 5.2%, 6.3%, and 3.6%. During the study, 12 infected persons showed high IFAT IgG titers with no LST reactions: five children and two adults developed AVL (2,560-10,120), and two children and three adults developed subclinical oligosymptomatic infection (1280-2560). The combined tests diagnosed a total of 231 cases of infection leading to an accumulated prevalence of 24.4%.

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Are there differences in clinical and laboratory parameters between children and adults with American visceral leishmaniasis?

Caldas¹,

Costa²,

Aquino³

et al. 2006

Acta Tropica

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A prospective study on 23 patients with American visceral leishmaniasis (VL), comparing clinical and laboratory parameters of 14 children (mean age of 3.85+/-3.39 years) to nine adults (27.4+/-10.90 years) was performed in São Luís, Maranhão, Brazil, between August 2000 and July 2002. Data were collected at entrance (day 0), end of treatment, as well as 120 and 210 days after treatment using a protocol chart containing patient identification, clinical and laboratory data. N-Methylglucamine antimonate administered at the dose of 20mg/Sb5+/kg/day for 20-30 days was successfully used in all patients. Patients were followed for 1 year after treatment, and no relapses were observed. A prolonged duration of the disease, lymphadenopathy and bleeding predominated in adult patients, while hepatomegaly and skin-mucosal pallor were more frequent in children. Disease was longer and more severe in adults than in children. Although both groups exhibited a trend toward normalization of hematological and biochemical parameters, more children returned sooner to normal values than adults. Difference in clinical or laboratory parameters between children and adults did not indicate the need for different clinical or therapeutic approaches.

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Infecção por Leishmania (Leishmania) chagasi em crianças de uma área endêmica de leishmaniose visceral americana na Ilha de São Luis-MA, Brasil

Cited by 39 publications

References 13 publications

Leishmania infection in humans, dogs and sandflies in a visceral leishmaniasis endemic area in Maranhão, Brazil

Leishmania infection in humans, dogs and sandflies in a visceral leishmaniasis endemic area in Maranhão, Brazil

A longitudinal study on the transmission dynamics of human Leishmania (Leishmania) infantum chagasi infection in Amazonian Brazil, with special reference to its prevalence and incidence

Are there differences in clinical and laboratory parameters between children and adults with American visceral leishmaniasis?

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