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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 14: e10086, 2022. tab, ilus, mapas
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1355011

ABSTRACT

Objetivo: analisar o perfil epidemiológico da leishmaniose tegumentar americana entre 2007 e 2017 na Paraíba, Nordeste Brasileiro. Método: Estudo ecológico dos casos de leishmaniose tegumentar americana registrados no Sistema de Informação de Agravos de Notificação. Utilizou-se o Risco Relativo, Método Scan Espacial e Método Bayesiano Empírico Local para a análise dos conglomerados. Resultados: Foram registrados 671 casos de leishmaniose tegumentar americana na Paraíba entre 2007 e 2017 com maior ocorrência em 2009 e 2010, com 121 e 91 notificações, respectivamente e no sexo masculino (341). A maioria apresentou a forma clínica cutânea e residentes na zona rural. Identificaram-se conglomerados espaciais significativos da leishmaniose tegumentar americana na Paraíba, no Litoral Norte, microrregião do Agreste e no município de Poço Dantas no Alto Sertão. Conclusões: os conglomerados espaciais de risco para a infecção demonstram a importância de ações imediatas de educação em saúde para prevenção do agravo


Objective: to analyze the epidemiological profile of american cutaneous leishmaniasis between 2007 and 2017 in Paraíba, Northeast Brazil. Method: Ecological study of cases of american cutaneous leishmaniasis registered in the Notifiable Diseases Information System. Relative Risk, Spatial Scan Method and Local Empirical Bayesian Method were used for the analysis of conglomerates.Results: 671 cases of american cutaneous leishmaniasis were registered in Paraíba between 2007 and 2017, with the highest occurrence in 2009 and 2010, with 121 and 91 notifications, respectively and among males (341). Most presented the clinical cutaneous form and lived in the rural area. Significant spatial conglomerates of american cutaneous leishmaniasis were identified in Paraíba, on the North Coast, the Agreste micro-region and in the municipality of Poço Dantas in Alto Sertão. Conclusions: thespatial conglomerates at risk for infection demonstrate the importance of immediate health education actions to prevent the disease


Objetivo: analizar el perfil epidemiológico de la leishmniosis cutánea entre 2007 y 2017 en Paraíba, noreste de Brasil. Método: Estudio ecológico de casos de leishmniosis cutánea registrados en el Sistema de Información de Enfermedades de Notificación. El riesgo relativo, el método de exploración espacial y el método bayesiano empírico local se utilizaron para el análisis del conglomerados. Resultados: se registraron 671 casos de leishmaniasis cutánea en Paraíba entre 2007 y 2017, con la mayor incidencia en 2009 y 2010, con 121 y 91 notificaciones, respectivamente, y entre hombres (341). La mayoría presentaba la forma cutánea clínica y vivía en el área rural. Se identificaron importantes conglomerados espaciales de leishmaniasis cutánea en Paraíba, en la costa norte, en la microrregión de Agreste y en el municipio de Poço Dantas en Alto Sertão. Conclusiones: los conglomerados espaciales en riesgo de infección demuestran la importancia de las acciones inmediatas de educación sanitaria para prevenir la enfermedad


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cluster Analysis , Leishmaniasis, Cutaneous/epidemiology , Spatial Analysis , Health Profile , Epidemiology, Descriptive , Bayes Theorem , Health Information Systems
2.
Braz. j. biol ; 82: e238665, 2022. tab
Article in English | LILACS | ID: biblio-1153463

ABSTRACT

Abstract Malakand region is an endemic area for cutaneous leishmaniasis (CL). However, there are limited number of studies of this disease in Pakistan. Therefore, a study was conducted to understand the level of awareness attitude and practice among the residents of Makaland towards CL and the disease vectors. This study adopted a cross-sectional approach with a total of 400 respondents (n=93 rural and n= 307 urban). Overall, the population in Malakand region (61.2%) were well-informed in the role of sand fly in transmitting diseases, but most lack knowledge on the vector's behavior and almost a quarter (24.5%) were unable to provide knowledge on proper control measures. Alarmingly, the practice and attitudes of the general population was not satisfactory as close to half (49.8%) of the population did adopt any control method. This study calls for increase in awareness through health education campaign to reduce the risk of cutaneous leishmaniasis outbreaks in the future.


Resumo A região de Malakand é uma área endêmica para leishmaniose cutânea (CL). No entanto, há um número limitado de estudos sobre esta doença no Paquistão. Portanto, foi realizado um estudo para entender o nível de atitude e prática de conscientização entre os residentes de Makaland em relação aos CL e os vetores da doença. Este estudo adotou uma abordagem transversal com um total de 400 entrevistados (n = 93 rural e n = 307 urbano). No geral, a população da região de Malakand (61,2%) estava bem informada sobre o papel da mosca na transmissão de doenças, mas a maioria não possui conhecimento sobre o comportamento do vetor e quase um quarto (24,5%) foi incapaz de fornecer conhecimento sobre medidas de controle adequadas . De maneira alarmante, a prática e as atitudes da população em geral não foram satisfatórias, pois cerca da metade (49,8%) da população adotou algum método de controle. Este estudo apela ao aumento da conscientização por meio de campanhas de educação em saúde para reduzir o risco de surtos de leishmaniose cutânea no futuro.


Subject(s)
Humans , Animals , Psychodidae , Leishmaniasis, Cutaneous/epidemiology , Pakistan/epidemiology , Rural Population , Urban Population , Health Knowledge, Attitudes, Practice , Cross-Sectional Studies
3.
Braz. j. biol ; 81(3): 557-565, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153389

ABSTRACT

Abstract Cutaneous leishmaniasis (CL) is a neglected tropical disease with a wide distribution in the Americas. Brazil is an endemic country and present cases in all states. This study aimed to describe the occurrence, the underlying clinical and epidemiological factors, and the correlation of climatic variables with the frequency of reported CL cases in the municipality of Caxias, state of Maranhão, Brazil. This is a retrospective and descriptive epidemiological study based on data extracted from the Brazilian Information System of Diseases Notification, from 2007 to 2017. Maximum and minimum temperature, precipitation, and relative air humidity data were provided by the Brazilian National Institute of Meteorology. A total of 201 reported autochthonous CL cases were analyzed. The predominance of cases was observed in males (70.1%). The age range between 31 and 60 years old was the most affected, with 96 cases (47.9%). Of the total number of registered cases, 38.8% of the affected individuals were engaged in agriculture-related activities. The georeferenced distribution revealed the heterogeneity of disease occurrence, with cases concentrated in the Western and Southern regions of the municipality. An association was detected between relative air humidity (monthly mean) and the number of CL cases per month (p = 0.04). CL continues to be a concerning public health issue in Caxias. In this context, there is a pressing need to strengthen measures of prevention and control of the disease through the network of health services of the municipality, considering local and regional particularities.


Resumo A leishmaniose cutânea (CL) é uma doença tropical negligenciada, com ampla distribuição nas Américas. O Brasil é um país endêmico e apresenta casos em todos os estados. Este estudo teve como objetivo descrever a ocorrência, os fatores clínicos e epidemiológicos subjacentes e a correlação de variáveis climáticas com a frequência de casos de CL notificados no município de Caxias, estado do Maranhão, Brasil. Este é um estudo epidemiológico retrospectivo e descritivo, com base em dados extraídos da Notificação do Sistema Brasileiro de Informação de Doenças, de 2007 a 2017. Dados máximos e mínimos de temperatura, precipitação e umidade relativa do ar foram fornecidos pelo Instituto Nacional de Meteorologia. Foram analisados 201 casos de CL autóctones relatados. A predominância de casos foi observada no sexo masculino (70,1%). A faixa etária entre 31 e 60 anos foi a mais afetada, com 96 casos (47,9%). Do número total de casos registrados, 38,8% dos indivíduos afetados estavam envolvidos em atividades relacionadas à agricultura. A distribuição georreferenciada revelou a heterogeneidade da ocorrência da doença, com casos concentrados nas regiões oeste e sul do município. Foi detectada associação entre a umidade relativa do ar (média mensal) e o número de casos de CL por mês (p = 0,04). O CL continua sendo uma questão preocupante de saúde pública em Caxias. Nesse contexto, há uma necessidade premente de fortalecer medidas de prevenção e controle da doença por meio da rede de serviços de saúde do município, considerando as particularidades locais e regionais.


Subject(s)
Humans , Male , Adult , Middle Aged , Leishmaniasis, Cutaneous/epidemiology , Brazil/epidemiology , Retrospective Studies , Cities , Environment
5.
Rev. panam. salud pública ; 45: e49, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1252005

ABSTRACT

RESUMEN Objetivo. Determinar y caracterizar áreas de riesgo potencial de la ocurrencia de leishmaniasis cutánea (LC) en América Latina (AL). Método. Estudio observacional ecológico con unidades de observación definidas por municipios con transmisión de LC entre 2014-2018. Se utilizaron variables medioambientales y socioeconómicas disponibles para al menos 85% de los municipios, combinados en una sola base de datos, a través del software R. Se combinó la metodología de análisis de componentes principales con un análisis de conglomerados jerárquicos para la formación de conglomerados de municipios en función de su similitud. Se estimó el V-test para definir la asociación positiva o negativa de las variables con los conglomerados y separación por divisiones naturales para determinar cuáles contribuyeron más a cada conglomerado. Se incorporaron los casos para atribuir el riesgo de LC para cada conglomerado. Resultados. Se incluyeron en el estudio 4 951 municipios con transmisión de LC (36,5% del total en AL) y se definieron siete conglomerados por su asociación con 18 variables medioambientales y socioeconómicas. El riesgo histórico de LC se asocia de manera positiva y en forma decreciente con los conglomerados Amazónico, Andino y Sabana; y de manera negativa con los conglomerados Boscoso/perenne, Boscoso/cultivo y Boscoso/poblado. El conglomerado Agrícola no reveló ninguna asociación con los casos de LC. Conclusiones. El estudio permitió identificar y caracterizar el riesgo de LC por conglomerados de municipios y conocer el patrón propio epidemiológico de distribución de la transmisión, lo que proporciona a los gestores una mejor información para las intervenciones intersectoriales para el control de la LC.


ABSTRACT Objective. Determine and characterize areas at potential risk for the occurrence of cutaneous leishmaniasis (CL) in Latin America. Method. Ecological observational study with observation units defined by municipalities with CL transmission during 2014-2018. Environmental and socioeconomic variables available for at least 85% of municipalities were combined in a single database, using R software. Principal component analysis was combined with hierarchical cluster analysis for the formation of clusters of municipalities according to their similarity. The V-test was used to define positive or negative association of variables with clusters and separation by natural divisions to determine which contributed more to each cluster. Cases were included to attribute CL risk for each cluster. Results. The study included 4 951 municipalities with CL transmission (36.5% of municipalities in Latin America); seven clusters were defined by their association with 18 environmental and socioeconomic variables. Historical risk of CL is associated positively and in descending order with the Amazonian, Andean, and Savanna clusters; and negatively with the Forest/perennial, Forest/cultivated, and Forest/populated clusters. The Agricultural cluster showed no association with CL cases. Conclusions. The study made it possible to identify and characterize CL risk by clusters of municipalities and to understand the characteristic epidemiological distribution patterns of transmission, providing program managers with better information for intersectoral interventions to control CL.


RESUMO Objetivo. Determinar e caracterizar as áreas de risco de ocorrência de leishmaniose cutânea na América Latina. Método. Estudo observacional ecológico com unidades de observação definidas por municípios com transmissão de leishmaniose cutânea entre 2014 e 2018. Foram usadas as variáveis ambientais e socioeconômicas disponíveis em 85% ou mais dos municípios, reunidas em uma única base de dados com o uso do software R. A metodologia de análise de componentes principais foi combinada a uma análise de conglomerados com agrupamento hierárquico para formar conglomerados de municípios por semelhança. O teste V foi usado para estabelecer a associação (positiva ou negativa) das variáveis com os conglomerados e uma separação por divisões naturais foi usada para determinar as variáveis que mais contribuíram em cada conglomerado. Os casos foram incluídos para avaliar o risco de leishmaniose cutânea em cada conglomerado. Resultados. A amostra do estudo compreendeu 4.951 municípios com transmissão de leishmaniose cutânea (36,5% do total na América Latina). Foram definidos sete conglomerados por apresentarem associação com 18 variáveis ambientais e socioeconômicas. Foi observada associação positiva e decrescente do risco histórico de leishmaniose cutânea com os conglomerados Amazônico, Andino e Savana e negativa com os conglomerados Mata/perene, Mata/cultivo e Mata/povoado. O conglomerado Agrícola não demonstrou associação com casos de leishmaniose cutânea. Conclusões. Este estudo permitiu identificar e caracterizar o risco de leishmaniose cutânea por conglomerados de municípios e conhecer o padrão epidemiológico de distribuição da transmissão da doença, oferecendo às autoridades dados melhores para subsidiar as intervenções intersetoriais para o controle da leishmaniose cutânea.


Subject(s)
Humans , Leishmaniasis, Cutaneous/epidemiology , Socioeconomic Factors , Cluster Analysis , Risk Assessment , Latin America/epidemiology
6.
An. bras. dermatol ; 95(5): 641-644, Sept.-Oct. 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130931

ABSTRACT

Abstract Genital lesions are an unusual presentation of American cutaneous leishmaniasis. Conditions such as disseminated cutaneous leishmaniasis and HIV infection may be associated with genital involvement. The authors present five cases of American cutaneous leishmaniasis with genital lesions and discuss the clinical and epidemiological aspects observed in this case series.


Subject(s)
Humans , Leishmania braziliensis , Leishmaniasis, Mucocutaneous , HIV Infections , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , United States , Genitalia
7.
Hist. ciênc. saúde-Manguinhos ; 27(3): 741-761, set. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1134073

ABSTRACT

Resumo O artigo faz análise histórica da emergência da leishmaniose tegumentar americana como objeto do conhecimento e desafio médico-sanitário no Amazonas desde a década de 1970. Fornece visão geral dessa época, as medidas sanitárias e os estudos científicos realizados no contexto de implantação dos principais projetos de desenvolvimento regionais executados em nome da política de integração nacional do governo federal. Utiliza como metodologia a análise documental de leis, produção científica, relatórios de pesquisa, boletins epidemiológicos e jornais. Os resultados da pesquisa mostram que a doença surgiu no Amazonas associando o grande problema de saúde com mudanças político-econômicas e alterações socioambientais.


Abstract The history of the emergence of American cutaneous leishmaniasis in the Brazilian state of Amazonas since the 1970s is analyzed as an object of knowledge and a medical and public health challenge. An overview of the period is provided, including the public health measures and scientific studies undertaken in the context of the execution of large-scale regional developments pursued in the name of national integration by the federal government. The methodology uses documental analysis of laws, the scientific literature, research reports, epidemiological bulletins, and newspapers. The results show that American cutaneous leishmaniasis emerged as a major health problem in Amazonas in close association with the political, economic, and socioenvironmental changes seen in the period.


Subject(s)
Humans , Animals , Public Health/history , Leishmaniasis, Cutaneous/history , Conservation of Natural Resources , Leishmania/isolation & purification , Psychodidae/parasitology , Urbanization/history , Leishmania braziliensis/isolation & purification , Brazil/epidemiology , Insect Control/history , Leishmaniasis, Cutaneous/transmission , Leishmaniasis, Cutaneous/epidemiology , Leishmania guyanensis/isolation & purification , Industrial Development/history , Insect Vectors
8.
Hist. ciênc. saúde-Manguinhos ; 27(supl.1): 95-122, Sept. 2020. tab
Article in English | LILACS | ID: biblio-1134089

ABSTRACT

Abstract The first autochthonous cases of cutaneous and mucocutaneous leishmaniasis in the Americas were described in 1909, but visceral leishmaniasis only erupted as a public health problem in the region in 1934. Today Brazil is the country with the most cases of American tegumentary leishmaniasis, and alongside India has the highest incidence of visceral leishmaniasis. Knowledge production and efforts to control these diseases have mobilized health professionals, government agencies and institutions, international agencies, and rural and urban populations. My research addresses the exchange and cooperation networks they established, and uncertainties and controversial aspects when notable changes were made in the approach to the New World leishmaniases.


Resumo Os primeiros casos de leishmaniose cutânea e mucocutânea autóctones das Américas foram descritos em 1909, e em 1934 a leishmaniose visceral irrompeu como problema de saúde pública na região. O Brasil tem hoje o maior número de casos da leishmaniose tegumentar americana e, junto com a Índia, a mais elevada incidência de leishmaniose visceral. A produção de conhecimentos e os esforços para controlar essas doenças mobilizaram, em nível global, profissionais de saúde, populações urbanas e rurais, instituições governamentais e agências internacionais. Recuperam-se aqui alguns desses agrupamentos, redes de troca e cooperação, incertezas e polêmicas, identificando-se mudanças na abordagem das leishmanioses do Novo Mundo.


Subject(s)
Humans , History, 20th Century , Public Health/history , Leishmaniasis, Cutaneous/history , Leishmania , Tropical Medicine/history , Americas/epidemiology , Leishmaniasis, Cutaneous/parasitology , Leishmaniasis, Cutaneous/prevention & control , Leishmaniasis, Cutaneous/epidemiology
9.
Ciênc. Saúde Colet ; 25(8): 2961-2971, Ago. 2020. graf
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1133097

ABSTRACT

Resumo O objetivo foi identificar e caracterizar unidades espaciais de relevância epidemiológica no estado do Rio de Janeiro, por meio das maiores concentrações de casos de leishmaniose tegumentar (LT) no período de 1980 a 2012, considerando os conceitos da geografia. Utilizou-se bancos de dados da SUCAM, FUNASA e SINAN. Foi aplicado um método de ajustamento de dados espacialmente referenciados para delimitação das regiões com as maiores concentrações de densidades de casos chamadas circuitos e polos. Estes foram sobrepostos aos mapas de indicadores socioambientais. Do total de casos registrados no período, 87% ocorreram nos municípios localizados nos circuitos e polos resultantes. As variações na ocorrência de casos nos diferentes circuitos e polos não tiveram relação com os indicadores socioambientais. A identificação dos circuitos e polos pode subsidiar o programa estadual da LT para a priorização de estratégias de ações de prevenção e controle e a otimização dos recursos do programa. Essas regiões, mais estáveis que as localidades, permitem operações de vigilância e controle nas localidades com muitos casos e nas demais da área de risco identificada, por terem as mesmas características daquelas já afetadas.


Abstract The scope of this research was to identify and characterize spatial units of epidemiological relevance in the state of Rio de Janeiro, through the highest concentrations of cutaneous leishmaniasis (CL) from 1980 to 2012, considering the geographical aspects. SUCAM, FUNASA and SINAN databases were consulted. A method of adjustment of spatially referenced data for demarcation of the regions with the highest concentrations of cases called circuits and poles was applied. These were superimposed on the socioenvironmental indicator maps. Of the total cases registered in the period, 87% occurred in the municipalities located in the resulting circuits and poles. The variations in the occurrence of cases in the different circuits and poles were not related to the socioenvironmental indicators. The identification of the circuits and poles can subsidize the state CL program of the prioritization of strategies of prevention and control actions and the optimization of the resources of the program. These regions, which are more stable than the localities, allow surveillance and control operations in locations with many cases and in other locations in the identified risk area, because they have the same characteristics as those already affected.


Subject(s)
Humans , Leishmaniasis, Cutaneous/epidemiology , Brazil/epidemiology
10.
Rev. Soc. Bras. Med. Trop ; 53: e20190373, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101447

ABSTRACT

Abstract INTRODUCTION: American cutaneous leishmaniasis (ACL) is a public health problem and has been associated with country's territory. We aimed to analyze the spatial dynamics and socioeconomic factors correlated to the incidence of ACL in Pernambuco, Brazil from 2008 to 2017. METHODS: A cross-sectional, ecological study was conducted in the Brazilian municipalities. Patient data were obtained from the Health Hazard Notification System (SINAN); indicators and incidence for the total period and for quinquennium were obtained. Socioeconomic factors were analyzed to evaluate the association between the incidence of ACL and presence of bathroom and running water, garbage collection availability, inadequate water supply, sanitation, rural population, per capita income, and vulnerability to poverty. Spatial analysis considered the gross incidence; the Bayesian local empirical method and Moran spatial autocorrelation index were applied using Terra View and QGIS. RESULTS: The incidence of ACL reduced (0.29/100,000 inhabitants per year). Individuals with ACL were young adults (30.3%), men (60.2%), brown skinned (62.9%), rural residents (70.6%), and less educated (46.7%); had autochthonous transmission (78.8%); developed the cutaneous form (97.2%); had evolution to cure (82.7%); and were diagnosed using the clinical epidemiological criterion (70.5%). ACL occurred in the large part of the state and showed heterogeneous distribution, with persistence of two high priority intervention clusters covering Health Regions I, II, III, IV, and XII. CONCLUSIONS: Spatial analysis and epidemiological indicators complement each other. The combination of these methods can improve the understanding on ACL occurrence, which will help subsidize planning and enhance the quality and effectiveness of healthcare interventions.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Aged , Aged, 80 and over , Leishmaniasis, Cutaneous/epidemiology , Rural Population , Socioeconomic Factors , Brazil/epidemiology , Incidence , Cross-Sectional Studies , Bayes Theorem , Spatial Analysis , Middle Aged
11.
Cad. Saúde Pública (Online) ; 36(7): e00136419, 2020. tab, graf
Article in English | LILACS | ID: biblio-1124311

ABSTRACT

Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients' transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.


A leishmaniose cutânea (LC) é uma doença associada a populações de baixa renda. Portanto, a inclusão do impacto financeiro sobre os pacientes é muito importante para avaliar a carga dessa doença. Tivemos como objetivo avaliar o impacto econômico da LC em pacientes afetados pela doença e tratados em um centro de referência para LC no Estado de Minas Gerais, Brasil. Foi um estudo transversal com base em análise de entrevistas e prontuários médicos para compilação dos gastos médicos e não médicos diretos relacionados à LC, desde uma perspectiva societal. Foram incluídos cem pacientes; 50% tinham renda mensal per capita de até USD 259,60. O gasto médio na doença foi de USD 187,32, o que representa um impacto mensal médio de 22,5% (USD 133,80). A doença impôs custos médicos diretos, como o pagamento por consultas médicas particulares, exames médicos, material para curativos e co-participação em seguro de saúde. Os custos não médicos diretos estiveram relacionados ao transporte dos pacientes até os centros de saúde, cuidados adicionais, alimentação e contratos com serviços terceirizados para atividades domésticas e laborais. O transporte dos pacientes para as consultas médicas representava a principal parcela dos gastos (USD 4.911,00). Embora o acesso à assistência à saúde seja um direito garantido pelo Sistema Único de Saúde, a LC ainda gera um impacto financeiro substancial para os pacientes. A descentralização dos serviços diagnósticos e terapêuticos para LC e o aumento de sua eficiência são as principais medidas que podem reduzir os gastos com essa doença.


La leishmaniosis cutánea (LC) es una enfermedad asociada a poblaciones con ingresos bajos. Por ello, incluir el impacto financiero para las personas es muy importante a la hora de evaluar la carga de esta enfermedad. Nuestro objetivo fue evaluar el impacto económico de la LC, de pacientes afectados por esta enfermedad, que fueron tratados por un servicio de referencia para el tratamiento de la LC en el Estado de Minas Gerais, Brasil. Este estudio transversal basado en entrevistas y análisis de registros médicos para la recopilación de gastos médicos y no-médicos directos, relacionados con la LC desde una a perspectiva social. Se incluyeron a cien pacientes; el 50% contaba con ingresos mensuales per cápita de hasta USD 259,60 y gastaban un promedio de USD 187,32 en la enfermedad, representando un impacto promedio mensual de 22,5% (USD 133,80). La enfermedad supuso costes médicos directos, como el pago de citas médicas privadas, medicamentos, exámenes médicos, material para vendajes, y coparticipación en seguros médicos. Los costes directos no-médicos estaban relacionados con el transporte de los pacientes a los centros de salud, el cuidado necesario, comida, y contratos con servicios externalizados para actividades domésticas y laborales. El transporte de los pacientes para citas médicas representó la principal razón para los gastos (USD 4.911,00). A pesar de que el acceso a los cuidados de salud es un derecho garantizado por el sistema de salud público brasileño, la LC todavía supone un impacto financiero importante para los pacientes. La descentralización de los servicios para el diagnóstico de LC, la aproximación terapéutica, y el incremento de su eficiencia, son las acciones con principal potencial para reducir los gastos financieros de esta enfermedad.


Subject(s)
Humans , Adult , Leishmaniasis, Cutaneous/economics , Leishmaniasis, Cutaneous/epidemiology , Health Care Costs , Referral and Consultation , Brazil/epidemiology , Cross-Sectional Studies
12.
Rev. Soc. Bras. Med. Trop ; 53: e20190291, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1136835

ABSTRACT

Abstract Cutaneous leishmaniasis (CL) is a zoonotic disease with complex transmission cycle. Some environmental and socioeconomic factors are known to be the major determinants of the transmission process, which are involved in configuring the spatiotemporal patterns and thus can be delimiting. However, the relevance of these socioeconomic and environmental determinants is still not well understood. In this study, we aimed to identify the major environmental and socioeconomic determinants of CL in Brazil by articulating a systematic literature review of studies that are based on this subject. The methodology included a search for studies according to a structured protocol using the scientific platforms, such as Scielo and PubMed. The references of each identified article were who referred to CL determinants were further screened, and so on. We extracted information from 41 articles and the determinants were grouped accordingly. Two measures were evaluated as follows: a) the frequency of citations of the determinants; and b) the proportion of determinants identified as having "significant association in analytical studies" with respect to the total number of determinants analyzed in other analytical studies using the same concept. The analyzed articles covered most of the regions of Brazil and 7 other countries bordering Brazil. We found 43 concepts of determinants. However, the final selection resulted in the identification of 14 major determinants. These results therefore contribute in the identification of major CL determinants and this information can be used to establish strategies for identifying risk prone areas for disease surveillance.


Subject(s)
Humans , Leishmaniasis, Cutaneous/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Risk Factors , Environment , Spatial Analysis
13.
Rev. Soc. Bras. Med. Trop ; 53: e20200083, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1143876

ABSTRACT

Abstract INTRODUCTION: Brazil has a high number of cases of American cutaneous leishmaniasis (ACL) in the north and northeast regions. Therefore, continuous surveillance of environmental and socioeconomic factors in endemic areas is needed to develop strategic control measures. This study aimed to describe the clinical and epidemiological profiles of patients with ACL. METHODS: All patients were from the states of Amazonas and Pernambuco, and examinations were carried out between 2015 and 2018. All patients had a clinical and epidemiological history compatible with ACL after positive diagnostic tests. Information obtained from medical records included gender, employment activity, level of education, age, and number and sites of lesions. RESULTS: A total of 213 patients were included, of whom 30.98% were female and 69.02% were male. The main employment activity was agriculture (27.56%). The most common level of education was elementary (62.42%). The average age was approximately 39 years. The majority of the patients presented only with one lesion (54.87%), and legs/feet were the most commonly affected area (48.25%), followed by the arms/hands (44.75%). CONCLUSIONS: These data demonstrated that irrespective of the patients' places of origin, interventions need to be focused on men of economically productive age, in view of the high risk of exposure to the vector in this group. Education activities need to be directed to farmers about the importance of protection against ACL vectors during work. Such information must also be directed to employers as a way of implementing and maintaining appropriate working conditions and stepping up vector control.


Subject(s)
Humans , Male , Female , Adult , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Socioeconomic Factors , United States , Brazil/epidemiology , Disease Vectors , Educational Status
14.
Rev. Soc. Bras. Med. Trop ; 53: e20200255, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1143862

ABSTRACT

Abstract INTRODUCTION: In the Belém Metropolitan Region (BMR), Pará State, Brazil, American cutaneous leishmaniasis (ACL) is endemic; however, very little is known regarding its causative agents. Therefore, we used our standard diagnostic approach combined with an RNA polymerase II largest subunit (RNAPOIILS)-polymerase chain reaction (PCR) followed by analysis of restriction fragment length polymorphism (PCR-RFLP) to identify Leishmania spp. ACL agents in this region. METHODS: Thirty-two Leishmania spp. isolates from patients with ACL in the BMR during 1995-2018 were analyzed. Leishmania spp. DNA samples were amplified using the primers RPOR2/RPOF2, and the 615-bp PCR products were subjected to enzymatic digestion using TspRI and HgaI endonucleases. RESULTS: ACL etiological agents in the BMR comprised Leishmania (Viannia) lindenbergi (43.7%) followed by Leishmania (Viannia) lainsoni (34.4%), Leishmania (Leishmania) amazonensis (12.5%), and Leishmania (Viannia) braziliensis (9.4%). CONCLUSIONS: To our knowledge, the results of the study revealed for the first time that L. (V.) lindenbergi and L. (V.) lainsoni are the main ACL agents in BMR.


Subject(s)
Humans , Leishmania braziliensis/genetics , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Leishmania/genetics , United States , Brazil/epidemiology , Leishmaniasis, Cutaneous
15.
Rev. Soc. Bras. Med. Trop ; 53: e20200006, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1136892

ABSTRACT

Abstract INTRODUCTION: We diagnose cases of cutaneous leishmaniasis (CL) among indigenous peoples of the state of Roraima, Brazil, and discuss some aspects of its epidemiology. METHODS: Skin imprints, and lesion exudate samples collected on filter paper were examined using parasitological and molecular techniques, respectively. RESULTS: Of 30 indigenous individuals, representing several ethnic groups, with suspected cases of CL, 27 (90%) tested positive for Leishmania spp. by PCR, and 21 (70%) by parasitological microscopy. CONCLUSIONS: Cutaneous leishmaniasis is indistinctly present among indigenous peoples from different regions of the state of Roraima. Individuals from seven of the ten existing ethnic groups in the state tested positive for CL, demonstrating the need for further investigation of the disease among these ethnic groups.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Leishmania/genetics , Brazil/epidemiology , Polymerase Chain Reaction , Indigenous Peoples , Middle Aged
16.
Med. leg. Costa Rica ; 36(2): 82-94, sep.-dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1040448

ABSTRACT

Resumen La Leishmaniasis es un complejo de enfermedades causadas por un grupo heterogéneo protozoos pertenecientes al género Leishmania sp. Se transmite a los humanos a través de vectores, que en nuestro país corresponden a mosquitos. En Costa Rica la provincia de Limón presenta la mayor cantidad de casos, concentrándose principalmente en el cantón de Talamanca. Existen 3 formas clínicas, centrándose esta revisión en la forma cutánea de la infección. A pesar del número importante de casos que ocurren cada año en el país, el manejo de la enfermedad así como las distintas opciones terapéuticas no se encuentran difundidas entre los médicos de atención primaria. Se cuenta con algunas guías internacionales como las de la IDSA o la OMS, sin embargo no todas las opciones terapéuticas son accesibles para todos los médicos, aún más en la Seguridad Social. La presente revisión contempla la clínica, el diagnóstico y el tratamiento de Leishmaniasis cutánea con un enfoque desde la realidad costarricense.


Abstract Leishmaniasis is a complex of diseases caused by a heterogeneous group of protozoa belonging to the genus Leishmania sp. It is transmitted to humans through vectors, which in our country corresponds to mosquitoes. In Costa Rica, the province of Limón has the highest number of cases, concentrating mainly in the canton of Talamanca. There are 3 clinical forms, focusing this review on the cutaneous infection. Despite the significant number of cases that occur every year in the country, the management of the disease and the therapeutic options are not widespread among primary care physicians. There are some international guidelines such as those from the IDSA or the WHO; however, we do not have all the therapeutic options available to all doctors, even more so in the Social Security. The present review contemplates the clinical facts, diagnosis and treatment of cutaneous leishmaniasis with a focus from the Costa Rican reality.


Subject(s)
Humans , Protozoan Infections , Leishmaniasis , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Costa Rica
17.
Rev. bras. parasitol. vet ; 28(4): 744-749, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1058001

ABSTRACT

Abstract Leishmaniasis is a disease caused by the protozoan Leishmania parasite that is disseminated by some species of sandflies and hosted by a variety of reservoirs. The objective of the present study was to evaluate the epidemiological situation of leishmaniasis in the municipalities of the Mato Grosso Pantanal. Human data were obtained from the Information System of Notifiable Diseases, and the canine and vector results from the State Department of Health of Mato Grosso. Between 2007 and 2016, 10 cases of visceral leishmaniasis and 499 cases of tegumentary leishmaniasis were identified in the Pantanal region. The surveillance studies regarding the canine reservoir demonstrated that the parasite was present in six of the seven municipalities. Vectors of visceral leishmaniasis were present in five municipalities and vectors of tegumentary leishmaniasis in six. Enhancement of services aimed at controlling this disease is fundamental to prevent an increase in the number of cases in the region.


Resumo As leishmanioses são doenças causadas por protozoários do gênero Leishmania disseminadas por algumas espécies de flebotomíneos e participação de uma variedade de reservatórios. O objetivo do presente estudo foi avaliar a situação epidemiológica das leishmanioses nos municípios abrangentes do Pantanal de Mato Grosso. Os dados humanos foram obtidos do Sistema de Informações de Agravos de Notificação e os resultados caninos e vetoriais junto à Secretaria de Estado de Saúde de Mato Grosso. A região do Pantanal registrou no período de 2007 a 2016, dez casos da forma visceral e 499 casos da forma tegumentar. As ações de vigilância para o reservatório canino demonstraram a circulação do parasito em seis dos sete municípios. A presença dos vetores de leishmaniose visceral ocorreu em cinco municípios e os da leishmaniose tegumentar em seis. O fortalecimento dos serviços voltados para controle desse agravo é fundamental para evitar o aumento no número de casos da região.


Subject(s)
Humans , Animals , Dogs , Leishmaniasis, Cutaneous/epidemiology , Dog Diseases/epidemiology , Leishmaniasis, Visceral/epidemiology , Psychodidae/classification , Brazil/epidemiology , Incidence , Leishmaniasis, Cutaneous/veterinary , Insect Vectors/classification , Leishmaniasis, Visceral/veterinary
18.
Rev. chil. infectol ; 36(6): 707-715, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058102

ABSTRACT

Resumen Introducción: La leishmaniasis es una enfermedad infecciosa que presenta una elevada prevalencia e incidencia mundial, causando alrededor de 70.000 muertes anuales. Objetivo: Determinar el perfil clínico y epidemiológico de los casos de leishmaniasis tegumentaria en la Provincia de Ambo, Departamento de Huánuco, Perú, durante el período: años 2000 a 2017. Métodos: Se realizó un estudio descriptivo, observacional, retrospectivo y transversal de base poblacional. Resultados: Se identificaron 1.312 pacientes confirmados de leishmaniasis tegumentaria. La forma clínica cutánea tuvo una mayor prevalencia en comparación a la muco-cutánea (83,2 vs 16,7%). La infección en el género masculino tuvo mayor predominio frente al femenino (53,3 vs 46,6%). La mayor tasa de incidencia anual reportada fue de 412,67/100.000 habts. durante el año 2000 mientras que la menor registrada fue en el 2015 con 24,45/100.000 habts. El Distrito de Ambo fue el más afectado con la forma clínica cutánea (43,1%) y la muco-cutánea (38,2%) de la enfermedad. El principal método diagnóstico para ambas formas clínicas fue el examen microscópico directo (82,0 vs 81,0%) y la terapia más utilizada fue con estibogluconato de sodio (85,6 vs 78,6%). Se reportó falla al tratamiento de 25% para ambas presentaciones clínicas. Conclusiones: Las condiciones eco-ambientales de esta zona del Perú han permitido el establecimiento de la leishmaniasis tegumentaria; mostrando tendencias similares a las comunicadas en la literatura mundial. Sin embargo, se necesitan más investigaciones que expliquen el comportamiento epidemiológico de esta enfermedad y permitan crear modelos de predicción epidemiológica para un control adecuado y oportuno.


Background: Leishmaniasis is an infectious disease with a high prevalence and worldwide incidence, causing around 70,000 deaths per year. Aim: To determine the clinical and epidemiological profile of cases of tegumentary leishmaniasis in the Province of Ambo, Department of Huánuco, Peru, during the period from 2000 to 2017. Methods: A descriptive, observational, retrospective and cross-sectional study was conducted population base. Results: We identified 1,312 confirmed cases of tegumentary leishmaniasis, the cutaneous clinical form had a higher prevalence compared to mucocutaneous (83.2 vs 16.7%). The infection in the masculine gender had greater predominance in front of the feminine one (53.3 vs 46.6%). The highest reported annual incidence rate was 412.67/ 100,000 inhabitants during the year 2000 while the lowest registered was in 2015 with 24.45/ 100,000 inhabitants. The Ambo district was the most affected in the clinical cutaneous form (43.1%) as mucocutaneous (38.2%) of the disease. The main diagnostic method for both clinical forms was microscopy (82.0 vs 81.0%) and the most used therapy was sodium stibogluconate (85.6 vs 78.6%). Failure to treatment was reported in 25% for both presentations clinics. Conclusions: The eco-environmental conditions of this area of Peru have allowed the establishment of tegumentary leishmaniasis; showing trends similar to world literature. However, more research is needed to explain the epidemiological behavior of this disease that allows the creation of epidemiological prediction models for timely and adequate control.


Subject(s)
Humans , Leishmaniasis , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Peru/epidemiology , Incidence , Cross-Sectional Studies , Retrospective Studies
19.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(2): 16-23, ago. 2019. ilus, tab
Article in English | LILACS, BDNPAR | ID: biblio-1008244

ABSTRACT

The objective of this study was to determine the abundance and diversity of the species and their presumed vectorial role in the transmission of Cutaneous Leishmaniasis (CL). Research on sand flies (Diptera: Psychodidae) was carried out in two municipalities in the Ribeira River Valley in the State of Paraná, southern Brazil. One, Adrianópolis, is an endemic area of CL and the other is a recent outbreak area (Cerro Azul). A total of 432 specimens were collected from residential, peri-domestic and wild environments. According to the data obtained, for each ecotope studied, the statistical analysis has shown that two lines of the Lutzomyia intermedia population coexist and that the quantity of specimens from L. intermedia s.l. is significantly different from L. intermedia s.s. in all environments (χ2=9.943; DF=2; p=0.07). The prevalence of L. intermedia (93.28%) in the ecotopes studied suggests that it is the main vector of leishmaniasis. The succession of vector species and their involvement in the epidemiological cycle of L. braziliensis is discussed in this article(AU)


El objetivo de este trabajo fue determinar la abundancia y diversidad de las especies y su supuesto papel vectorial en la transmisión de Leishmaniasis Cutánea (LC). La investigación sobre flebótomos (Diptera: Psychodidae) se llevó a cabo en dos municipios en el Valle del Río Ribeira en el Estado de Paraná, sur de Brasil. Las regiones estudiadas fueron Adrianópolis, área endémica de LC, y Cerro Azul, que se reporta como zona de brote reciente. Se recolectaron un total de 432 especímenes de ambientes residenciales, peri-domésticos y silvestres. El análisis estadístico realizado, a partir de los datos obtenidos para cada ecotopo estudiado, mostró que coexistían dos linajes de la población de Lutzomyia intermedia y que la cantidad de especímenes de L. intermedia s.l. fue significativamente diferente de L. intermedia s.s. en todos los entornos (χ2=9,943; GL=2; p=0,07). La prevalencia de L. intermedia (93,28%) en los ecotopos estudiados sugiere que es el principal vector de la leishmaniasis. La sucesión de especies de vectores y su participación en el ciclo epidemiológico de L. braziliensis se discute en este artículo(AU)


Subject(s)
Animals , Male , Female , Psychodidae , Leishmaniasis, Cutaneous/transmission , Insect Vectors , Brazil/epidemiology , Leishmaniasis, Cutaneous/epidemiology
20.
Rev. bras. parasitol. vet ; 28(2): 194-202, Apr.-June 2019. tab
Article in English | LILACS | ID: biblio-1013740

ABSTRACT

Abstract The aim of this study was to compare molecular tests used to diagnose Leishmania spp. in dogs with different stages of infection. Blood and conjunctival swab (CS) samples from dogs classified in four clinical stages were subjected to different PCR protocols (13A/13B, MC1/MC2, LITSR/L5.8S and LEISH-1/LEISH-2 primers). To the study, 22.3% (48/215) of dogs were classified as without clinical signs, 67.5% (145/215) stage I (mild disease), 7.0% (15/215) stage II (moderate disease) and 3.2% (7/215) stage III (severe disease). The results showed that in blood samples, 13A/13B detected a significant higher number of positive dogs in stage I (25/145) and in total (42/215) (p≤0.05). However, when CS samples were tested, no difference was observed (p>0.05). On the other hand, in blood samples, MC1/MC2 detected significantly fewer positive dogs classified as without clinical signs (0/48), in stage I (0/145) and in total (1/215) (p≤0.05). Likewise, in CS samples, this primers showed also lower detection (1/215) (p≤0.05). So than, we can conclude that PCR on blood samples with 13A/13B primers has greater capacity to detect positive dogs, mainly at the initial of clinical disease than do other primers and MC1/MC2 are not a good choice to detect Leishmania infantum infection in dogs.


Resumo O objetivo deste estudo foi comparar testes moleculares usados para diagnosticar Leishmania spp., em cães apresentando diferentes estágios de infecção. Amostras de sangue e suabe conjuntival (SC) de cães classificados em quatro estágios clínicos foram submetidas a diferentes PCRs (primers 13A/13B, MC1/MC2, LITSR/L5.8S e LEISH-1/LEISH-2). Para o estudo, 22,3% (48/215) dos cães foram classificados como sem sinais clínicos, 67,5% (145/215) estágio I (doença leve), 7,0% (15/215) estágio II (doença moderada) e 3,2% (7/215) estágio III (doença grave). Os resultados mostraram que, em amostras de sangue, 13A/13B detectou número significativamente maior de cães positivos no estágio I (25/145) e no total (42/215) (p≤0,05). No entanto, quando as amostras de SC foram testadas, nenhuma diferença foi observada (p>0,05). Por outro lado, no sangue, MC1/MC2 detectou significativamente menos cães positivos sem sinais clínicos (0/48), em estágio I (0/145) e no total (1/215) (p≤0,05). Da mesma forma, em amostras de SC, MC1/MC2 também apresentou menor detecção (1/215) (p≤0,05). Assim, a PCR em amostras de sangue com 13A/13B tem maior capacidade de detectar cães positivos, principalmente no início da doença do que outros primers, e o par de primers MC1/MC2 não é uma boa escolha para detectar infecção por Leishmania infantum em cães.


Subject(s)
Animals , Dogs , Leishmaniasis, Cutaneous/veterinary , Dog Diseases/diagnosis , Leishmaniasis, Visceral/veterinary , Severity of Illness Index , Brazil/epidemiology , DNA, Protozoan/genetics , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Leishmania infantum/genetics , Dog Diseases/epidemiology , Real-Time Polymerase Chain Reaction/veterinary , Leishmaniasis, Visceral/diagnosis , Leishmaniasis, Visceral/epidemiology
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