Flebotomíneos do Estado de Tocantins, Brasil (Diptera: Psychodidae) / Phlebotomine sand flies in the State of Tocantins, Brazil (Diptera: Psychodidae)

Between 1997-1998, the authors carried out sporadic collection of sand flies in the municipalities of Paraíso de Tocantins, Monte do Carmo, Porto Nacional and Monte Santo all in the Tocantins State of northern Brazil. Human bait was used in Monte Santo and a battery operated light trap in other municipalities. The ecotypes chosen for the traps were in the peridomiciles, inside the houses, in the forest and the orchard. We identified 2,677 sand flies, belonging to 32 species. The most abundant species of sand flies were Lutzomyia whitmani, Lutzomyia longipalpis, Lutzomyia carmelinoi, Lutzomyia evandroi, Lutzomyia longipennis and Lutzomyia antunesi. Collections from the forest showed greater diversity of species, while the largest number of sand flies were caught around the houses. Several species known or suspected to be vectors of Leishmania in other regions of Brazil were captured.

Nos anos de 1997 e 1998 realizaram-se capturas esporádicas de flebotomíneos nos municípios de Paraíso de Tocantins, Monte do Carmo, Porto Nacional e Monte Santo, todos localizados no estado de Tocantins, região norte do Brasil, com o intuito de conhecer a fauna flebotomínica da região. No município de Monte Santo utilizou-se isca humana e nos demais armadilhas luminosas CDC. Os ecótopos utilizados foram: peridomicílio, intradomicílio, mata e pomar. Foram capturados 2.677 flebotomíneos, pertencentes a 32 espécies. As mais freqüentes foram Lutzomyia whitmani, Lutzomyia longipalpis, Lutzomyia carmelinoi, Lutzomyia evandroi, Lutzomyia longipennis e Lutzomyia antunesi. As capturas na mata apresentaram maior diversidade de espécies, enquanto no peridomicílio houve maior número de exemplares capturados. Foram capturadas neste estado várias espécies vetoras em outras regiões do Brasil.

Leishmaniose tegumentar na Região Metropolitana de Belo Horizonte: aspectos clínicos, laboratoriais, terapêuticos e evolutivos (1989-1995) / Cutaneous leishmaniasis in the Metropolitan Region of Belo Horizonte: clinical, laboratorial, therapeutic and prognosis features (1989-1995)

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.

Foram investigados aspectos clínicos, laboratoriais, terapêuticos e evolutivos da leishmaniose tegumentar americana em Belo Horizonte. O estudo incluiu 358 pacientes com leishmaniose cutânea (LC) e 25 com leishmaniose mucosa (LM). Comparados aos pacientes com LC, aqueles com LM apresentaram maior tempo de doença e relato de outras doenças concomitantes, sugerindo que a debilitação pela leishmaniose e/ou outras doenças podem contribuir para a ativação e/ou disseminação mucosa do parasito. As sensibilidades das reações intradérmica, de imunofluorescência indireta e da pesquisa direta do parasito foram de 78,4, 79,3 e 68,3%, respectivamente. O tratamento com antimoniato de meglumina foi 100% eficaz, com 59% de efeitos colaterais ao longo do tratamento. A recidiva após tratamento ocorreu em 32 (10,1%) dos 318 casos seguidos por até dois anos. A maioria das recidivas (31 dos 32 casos) ocorreu em pacientes com LC tratados com 15mg Sb5+/kg/dia. Na investigação de critérios de cura, a reação intradérmica negativa foi o único fator associado a um risco três vezes maior de recidiva. Um aumento da dose ou do tempo de tratamento talvez melhore o prognóstico nestes pacientes.

Epidemiological aspects of American Cutaneous Leishmaniasis in a periurban area of the metropolitan region of Belo Horizonte, Minas Gerais, Brazil

In order to characterize the epidemiology of American Cutaneous Leishmaniasis (ACL) in a periurban area of the municipality of Sabará in the metropolitan region of Belo Horizonte (MRBH), an area until then considered free of the disease, a cross sectional survey was undertaken in 1990. The survey of the population consisted of 1119 interviews and 881 clinical examinations using Montenegro's skin test (MST). A low prevalence (3.7%) of positive MST was encountered. The disease had been occuring in the area for about 20 years in the form of sporadic cases. The predominant species of sandfly both in domestic areas and nearby areas of secondary vegetation was Lutzomyia whitmani. A canine survey of delayed hypersensitivity to the antigen P10,000 identified only one dog with a positive reaction out of 113 examined. The transmission of ACL in MRBH was confirmed. The occurrence of the disease in women, children and individuals with no contact with forest areas as well as the presence of potential vector species in the domiciliar environment, suggests the transmission of the disease in this environmewnt