Observações sobre o diagnóstico laboratorial e a epidemiologia da leishmaniose tegumentar no Estado do Paraná, sul do Brasil

Abstract

Between 1986 and 1997 a total of 1418 patients were examined at the Clinical Analysis Teaching and Research Laboratory of Maringá State University (LEPAC/UEM) for cutaneous leishmaniasis by direct examination of stained smears made from the lesions, the Montenegro skin test and the indirect immunofluorescent antibody test. Nine hundred and fifty five patients (67.3%) were positive for at least one of the three tests and of these 804 (84.2%) were considered to have contracted the disease in Paraná State; 665 (69.6%) were between 15 and 49 years old; 658 (68.9%) were males; 523 (54.8%) sought medical advice during the first three months of their infections and 74 (7.7%) had mucosal lesions. Of the 83 counties of Paraná State, where the patients had most probably acquired their infections, 44.7% were from the counties of São Jorge do Ivaí (10.2%), Doutor Camargo (9.8%), Terra Boa (7.3%), Maringá (7.3%), Jussara (6.0%) and Cianorte (4.5%). Seventy seven strains of Leishmania (Viannia) braziliensis were isolated and 63.6% of these strains belong to serodema 1.

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 sensitivity of IFA in the present study was similar to that found in studies on other endemic areas (Marzochi et al, 1980;Lugo de Yarbuh et al, 1996).…”

“…The majority of the patients studied were from the male working-class population, suggesting an extra-domi- Variables associated with the post-treatment healing of lesions 845 ciliary transmission of ACL, as was previously observed in the north of the state of Paraná (Silveira et al, 1999;Castro et al, 2002). 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).…”

“…The serum was diluted, beginning at 1/20. Samples with titers equal to or greater than 40 were considered positive (Silveira et al, 1999).…”

“…The main species of sand flies that cause ACL in Brazil are Leishmania (Viannia) braziliensis (Vianna, 1911), Leishmania (Viannia) guyanensis (Floch, 1954) and Leishmania (Leishmania) amazonensis (Lainson, Shaw, 1972) (Brasil, 2000). 842 ACL has been recorded in the majority of cities in the state of Paraná (Roberto et al, 1997;Silveira et al, 1999;Lima et al, 2002), which accounts for 98% of cases in the southern region of Brazil (Brasil, 2000). The success of ACL treatment is limited.…”

Investigação sorológica de casos subclínicos de leishmaniose tegumentar após um surto em uma localidade endêmica

“…Os testes sorológicos são pouco utilizados para o diagnóstico da LTA 20 , sendo necessária a associação de diferentes métodos para aumentar a positividade do diagnóstico da doença 16 . Têm Têm Têm sido encontradas algumas dificuldades na utilização do teste intradérmico de Montenegro para o diagnóstico da leishmaniose, como por exemplo, o uso de diferentes espécies do parasita e de uso de diferentes espécies do parasita e de diferentes formas de preparação de antígenos além da capacidade do teste em induzir reações de hipersensibilidade tardia quando realizada pela segunda vez.…”