Leishmaniose tegumentar na Região Metropolitana de Belo Horizonte: aspectos clínicos, laboratoriais, terapêuticos e evolutivos (1989-1995)

Abstract

This study investigated clinical, laboratorial, therapeutic and prognostic aspects of American cutaneous leishmaniasis in Belo Horizonte in 358 patients with cutaneous leishmaniasis (CL) and 25 with mucocutaneous leishmaniasis (MCL). Compared to CL patients, the MCL patients reported longer duration of disease and higher frequency of other diseases, suggesting that debilitation caused by leishmaniasis or other conditions might contribute to activation and/or mucous dissemination of the parasite. The sensitivity of skin test, indirect immunofluorescence reactions and direct detection of parasites was 78.4, 79.3 and 68.3%, respectively. The treatment with meglumine antimoniate presented 100% efficacy, but 59% patients had side-effects. During two years of follow-up, there were 32/318 relapses after successful treatment. Most relapses (31/32) were of CL patients treated with 15 mg Sb5+/kg/day. The negative response to skin test was the only factor associated with a significant threefold increased risk of relapse. Higher dose or longer duration of treatment might improve the prognosis in these patients.

The effect of age on the frequency of adverse reactions caused by antimony in the treatment of American tegumentary leishmaniasis in Governador Valadares, State of Minas Gerais, Brazil

“…In this study, 67.5% of patients showed some type of adverse effect, and the most frequently reported were cases of arthralgia (42.5%), myalgia (37.5%), inappetence (25%), arrhythmias (17.5%), and fever (12.5%). These results coincide with those already described in the literature 6,9,15 . With regard to age, a higher frequency of adverse effects was observed in individuals over 50 years old, at a rate of 66%, a result higher than that of the group aged 50 years and under.…”

“…According to different authors, the success rate varies from 26% to 100% of patients treated after a first period of antimony administration [4][5][6][7][8] . In another study conducted in Cuiabá, State Major Article of Mato Grosso, Brazil, the failure rate was 47%, that is, no healing or recrudescence of skin lesions was found during the three month followup after the first treatment regimen 9 .…”

Study on phlebotomine sand fly (Diptera: Psychodidae) fauna in Belo Horizonte, state of Minas Gerais, Brazil

“…Passos et al (1998) performed an entomological survey in the Boa Vista quarter, a suburban area of BH, and in the district of Venda Nova, where the presence of Lutzomyia whitmani and L. longipalpis, the insect vectors of ACL and visceral leishmaniasis (VL), respectively, had been reported. Such studies associated with recent publications have confirmed VL (Silva et al 2001) and ACL (Passos et al 1993(Passos et al , 2001) urbanization in BH.…”

Variables associated with the post-treatment healing of lesions in patients with American cutaneous leishmaniasis in Paraná State, Brazil

“…However, the occurrence of cases in the age ranges of up to 15 and over 65 years, for both sexes, also suggests intra-or peri-domiciliary transmission occurred, corroborating data from the north of Paraná State (Roberto et al, 1997;Lima et al, 2002) and on an endemic area of the State of Minas Gerais, Brazil (Passos et al, 2001). In the present study, IFA showed a higher rate of positivity than the MST or DPS in the diagnosis of ACL, contrasting with results obtained by Silveira et al (1999), who found higher positivity for the MST in patients from the same geographical area.…”

“…The analysis showed that lesion healing was associated to negative IFA results when the evaluation was carried out in the period of up to 120 days after treatment. According to Passos et al (2001), the treatment and elimination of the parasites induces lower antigenic stimulation, which contributes to IFA negativity, and Saravia et al (1989) showed that there was an association between longer lesion evolution time and higher IFA titers in patients infected with L. braziliensis.…”