ABSTRACT
BACKGROUND In Brazil, transmission of visceral and cutaneous leishmaniasis has expanded geographically over the last decades, with both clinical forms occurring simultaneously in the same area. OBJECTIVES This study characterised the clinical, spatial, and temporal distribution, and performed entomological surveillance and natural infection analysis of a leishmaniasis-endemic area. METHODS In order to characterise the risk of leishmaniasis transmission in Altos, Piauí, we described the clinical and socio-demographic variables and the spatial and temporal distribution of cases of American visceral leishmaniasis (AVL) and American cutaneous leishmaniasis (ACL) cases and identified potential phlebotomine vectors. FINDINGS The urban area concentrated almost 54% of ACL and 86.8% of AVL cases. The temporal and spatial distribution of AVL and ACL cases in Altos show a reduction in the number of risk areas, but the presence of permanent disease transmission foci is observed especially in the urban area. 3,808 phlebotomine specimens were captured, with Lutzomyia longipalpis as the most frequent species (98.45%). Of the 35 females assessed for natural infection, one specimen of Lu. longipalpis tested positive for the presence of Leishmania infantum and Leishmania braziliensis DNA. MAIN CONCLUSION Our results indicate the presence of risk areas for ACL and AVL in the municipality of Altos and highlight the importance of entomological surveillance to further understand a possible role of Lu. longipalpis in ACL transmission.
ABSTRACT
As leishmanioses são antropozoonoses de ampla distribuição mundial e consideradas um grave problema de saúde pública. Com base nasinformações sobre os aspectos epidemiológicos, a população pode mudar seu comportamento e atitude diante de tais doenças e, assim, tomarmedidas preventivas que possam minimizar os riscos de contraí-las. Esse estudo teve como objetivo identificar o nível de conhecimentoda população de Teresina, Piauí, sobre Leishmaniose Visceral (LV) e Leishmaniose Tegumentar Americana (LTA). A coleta dos dados foirealizada por meio de questionário em 150 residências nos bairros Santo Antônio, Pedra Mole e Parque Alvorada no período de fevereiroa junho de 2013. A análise dos dados mostrou que grande maioria dos casos de leishmaniose ocorreu em indivíduos que possuíam nomáximo o ensino fundamental completo e a renda familiar, na maioria dos entrevistados, chegou a um salário mínimo. Além disso, 89,3%das residências possuíam acumulo de matéria orgânica no peridomicílio, e todas estavam localizadas próximas de matas; 78,6% citarama presença de mosquitos e de animais domésticos. 94,6% dos entrevistados desconheciam tanto a LTA, como também o transmissor dadoença. Tal fato corrobora que a população desconhece que a presença de vegetação no peridomicílio, acúmulo de matéria orgânica,presença de animais domésticos, dentre outros fatores contribuem para a proliferação do vetor e para o estabelecimento e disseminação dasleishmanioses no meio urbano.
Leishmaniases are anthropozoonoses with broad worldwide distribution, being considered a serious public health issue. Based onepidemiological aspects, the population behavior can change towards such diseases, by adopting preventive measures to minimize thecontagion risks. The present study aimed to verify the knowledge level of the population from Teresina, Piauí (Brazil) about visceralleishmaniasis (VL) and American cutaneous leishmaniasis (ATL). Data collection was accomplished through application of a questionnaireto 150 domiciles in the districts of Santo Antônio, Pedra Mole and Parque Alvorada, from February to June 2013, regarding ecoepidemiologicalaspects of these diseases. Analysis of the data revealed that the majority of leishmaniasis cases affected individuals withminima education, with household income of one minimum wage. In addition, 89.3% of the domiciles presented accumulation of organicmatter in the household surroundings, and all were located close to forests; 78.6% cited the presence of mosquitos, and 79.3% the existenceof domestic animals. Among the surveyed, most knew neither ATL nor the disease?s carrier. This fact corroborates that the populationignores the presence of vegetation in the domicile surroundings, accumulation of organic matter, presence of domestic animals, amongother factors, as contributing elements for proliferation of the vector and establishment and dissemination of leishmaniases in the urbanenvironment.