Situação epidemiológica da leishmaniose visceral, na Ilha de São Luís, Estado do Maranhão

Silva, Antônio Rafael da; Tauil, Pedro Luíz; Cavalcante, Maria Neuza; Medeiros, Maria Nilza Lima; Pires, Benedito; Gonçalves, Eloisa da Graça do Rosario

doi:10.1590/s0037-86822008000400007

Cited by 31 publications

(32 citation statements)

References 14 publications

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“…In the study of Silva et al 7 including patients from Ilha de São Luis with a diagnosis of visceral leishmaniasis, the dwellings visited were mainly made of mud (68%) and had a straw roof (48%) and floor of beaten earth (66%), which were in agreement with the present findings.…”

Section: Discussionsupporting

confidence: 89%

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Risk factors for Leishmania chagasi infection in an endemic area in Raposa, State of Maranhão, Brazil

Ponte

Souza

Cavalcante

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction: Infection with Leishmania chagasi is the most common clinical presentation for visceral leishmaniaisis in endemic areas. The municipality of Raposa is an endemic area in State of Maranhão, Brazil, and have had registration cases of visceral leishmaniasis disease. For this reason, a cross-sectional study was conducted to evaluate the risk factors for infection with L. chagasi detected by Montenegro skin test. Methods: The sample comprised 96% of the inhabitants of the villages of Maresia, Pantoja, and Marisol located in the municipality of Raposa, corresponding to 1,359 subjects. Data were collected using a questionnaire. Univariate and multivariate logistic regression models were applied to evaluate the association between the variables studied and infection of L. chagasi. Results: The variables associated with infection upon nonadjusted analysis were a straw roof, mud walls, floors of beaten earth, presence of sand flies inside or outside of the dwelling, and bathing outdoors. Adjusted analysis showed that the presence of sand flies inside/outside the dwelling was a risk factor, and age younger than 10 years was a protective factor against asymptomatic infection. Conclusions: The results highlight the extent to which precarious living conditions of the population strengthen the epidemiological chain of visceral leishmaniasis.Keywords: Visceral leishmaniasis. Kalazar. Leishmania chagasi. Montenegro skin test. Risk factors. RESUMO Introdução:A infecção por Leishmania chagasi é a apresentação clínica mais comum de laishmaniose visceral em áreas endêmicas. O município de Raposa é área endêmica no Estado do Maranhão, tendo registrado casos da doença. Por isso, realizou-se um estudo transversal, com o objetivo de estudar os fatores de risco para infecção por L. chagasi detectada pelo teste intradérmico de Montenegro. Métodos: O estudo envolveu 96% dos moradores das localidades de Maresia, Pantoja e Marisol do município da Raposa, totalizando 1.359 indivíduos. O levantamento dos dados foi realizado utilizando um questionário. Para verificar a associação entre as variáveis estudadas e a infecção por L. chagasi, foram utilizados os modelos de regressão logística uni e multivariada. Resultados: Na análise não ajustada, as variáveis associadas à infecção foram: cobertura da casa de palha, paredes de taipa, piso de chão batido, a presença de flebotomíneos dentro ou fora do domicílio e o local do banho fora de casa. Na análise ajustada, a presença de flebotomíneos dentro ou fora do domicílio foi considerada fator de risco e a idade menor que 10 anos revelou-se como fator de proteção para a infecção assintomática. Conclusões: Evidenciou-se também, o quanto a precariedade das condições de vida da população contribui para o fortalecimento da cadeia epidemiológica da doença. Palavras

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Section: Discussionsupporting

confidence: 89%

“…Factors that contributed to the expansion of the disease include transformation of the environment through deforestation and the migration of man from rural areas to the periphery of towns where he lives under precarious conditions of housing and sanitation 1,6,7 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for Leishmania chagasi infection in an endemic area in Raposa, State of Maranhão, Brazil

Ponte

Souza

Cavalcante

et al. 2011

Rev. Soc. Bras. Med. Trop.

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“…However, this differential susceptibility between the genders was not observed in children under four years. Hormonal factors linked to exposure to the vector have been blamed for the increased risk in males older than four years 21,6,24 . VL presented itself more frequently in children between 1-4 years, with 29.2% (56) of the total cases, followed by adults aged 20 to 29 years with 15.6% (30) and children aged 5 to 9 years with 15.1% (29) ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

Série temporal da leishmaniose visceral em Aracaju, estado de Sergipe, Brasil (1999 a 2008): aspectos humanos e caninos

Góes

Melo

Jeraldo

2012

Rev. bras. epidemiol.

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INTRODUÇÃO: Considerada doença negligenciada pela OMS, a Leishmaniose visceral (LV) tem se expandido e urbanizado, sendo sua transmissão e expansão associadas a diversos fatores. OBJETIVO: Avaliar aspectos epidemiológicos da LV no município de Aracaju/SE, por meio de estudo retrospectivo da série histórica de LV humana e canina no período de 1999-2008. MÉTODOS: Foram utilizados dados secundários do SINAN para os casos humanos, e o resultado dos inquéritos caninos e atendimentos da demanda passiva do Centro de Controle de Zoonoses (CCZ). RESULTADOS: Foram notificados 192 casos autóctones de LV humana, sendo 63,5% do gênero masculino. Crianças entre 1 e 4 anos foram mais acometidas (29,2%), seguidas de adultos entre 20-29 anos (15,6%) e de crianças entre 5-9 anos (15,1%). A letalidade geral foi de 8,9%, sendo mais acentuada em pessoas entre 60 a 69 anos (60%); 32,3% dos casos autóctones realizaram sorologia para HIV, com positividade de 6,9%. A confirmação laboratorial foi realizada principalmente mediante a imunofluorescência indireta isolada (71,1%). Dos 58.161 cães que realizaram sorologia a positividade foi de 5,4%, sendo 87,0% dos inquéritos realizados anualmente pelo CCZ, com uma positividade de 4,4%. Dos 7.501 cães trazidos ao CCZ por diversas queixas, o exame sorológico foi reagente em 12,0%. CONCLUSÃO: Os dados denotam o caráter endêmico da LV no município, mostrando a necessidade de ações que permitam a diminuição do risco para a população, principalmente aquela onde a incidência e a letalidade são maiores, como melhorias no diagnóstico da LV, assim como na co-infecção com HIV e no monitoramento da população canina, entre outros.

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“…longipalpis adaptation to peri-urban areas. The absence of sylvatic animals in the destructed area may result in altered blood feeding behaviour encouraging blood suck- (Silva et al 2008). An important limitation of this study is that both ELISA for diagnosis of asymptomatic infection in humans and genus specific PCR assay for detecting infection in sandflies may not be the most valid techniques to employ.…”

Section: Discussionmentioning

confidence: 99%

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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Situação epidemiológica da leishmaniose visceral, na Ilha de São Luís, Estado do Maranhão

Cited by 31 publications

References 14 publications

Risk factors for Leishmania chagasi infection in an endemic area in Raposa, State of Maranhão, Brazil

Risk factors for Leishmania chagasi infection in an endemic area in Raposa, State of Maranhão, Brazil

Série temporal da leishmaniose visceral em Aracaju, estado de Sergipe, Brasil (1999 a 2008): aspectos humanos e caninos

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

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