Further insights into the eco-epidemiology of American cutaneous leishmaniasis in the Belem metropolitan region, Pará State, Brazil

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.

Prevalence of Human Papillomavirus Infection and Cervical Cancer Screening among Riverside Women of the Brazilian Amazon / Prevalência da infecção pelo papilomavírus humano e rastreamento do câncer em mulheres ribeirinhas da Amazônia brasileira

Abstract Purpose The aim of this study was to evaluate the overall and type-specific prevalence of human papillomavirus (HPV) infection among females living in riverside communities in the state of Pará, in the Eastern Brazilian Amazon. These communities are inhabited by low-income people, and are accessible only by small boats. Cervical cytology and risk factors for HPV infection were also assessed. Methods Cervical samples from 353 women of selected communities were collected both for Papanicolau (Pap) test and HPV detection. Conventional polymerase chain reaction (PCR) and real-time PCR were used to assess the overall and type-specific prevalence of HPV-16 and HPV-18, the main oncogenic types worldwide. Epidemiological questionnaires were used for the assessment of the risk factors for HPV infection. Results The mean age of the participants was 37 years (standard deviation [SD] ± 13.7). Most were married or with a fixed sexual partner (79%), and had a low educational level (80%) and family monthly income (< U$ 250; 53%). Overall, HPV prevalence was 16.4% (n = 58), with 8 cases of HPV-16 (2.3%) and 5 of HPV-18 (1.4%). Almost 70% of the women surveyed had never undergone the Pap test. Abnormal cytology results were found in 27.5% (n = 97) of the samples, with higher rates of HPV infection according to the severity of the lesions (p = 0.026). Conclusions The infections by HPV-16 and HPV-18 were not predominant in our study, despite the high prevalence of overall HPV infection. Nevertheless, the oncogenic potential of these types and the low coverage of the Pap test among women from riverside communities demonstrate a potential risk for the development of cervical lesions and their progression to cervical cancer, since the access to these communities is difficult and, in most cases, these women do not have access to primary care and public health services.

Resumo Objetivo O objetivo deste estudo foi avaliar a prevalência global e tipo-específica da infecção pelo papilomavírus humano (HPV) entre mulheres que vivem em comunidades ribeirinhas do estado do Pará, Amazônia oriental, Brasil. Estas comunidades são habitadas por pessoas de baixa renda, e são acessíveis somente por meio de pequenos barcos. A citologia cervical e os fatores de risco para a infecção por HPV também foram avaliados. Métodos Amostras cervicais de 353 mulheres de comunidades selecionadas foram coletadas para a análise citológica e para a detecção do HPV. A prevalência global e tipoespecífica dos HPV-16 e HPV-18, principais tipos oncogênicos no mundo, foram avaliadas por meio de reação em cadeia de polimerase (PCR) convencional e PCR em tempo real. Os fatores de risco para a infecção por HPV foram avaliados a partir de questionários epidemiológicos. Resultados A idade média das participantes foi de 37 anos (desvio padrão [DP] ± 13,7). A maioria era casada ou tinha um parceiro sexual fixo (79%) e baixo nível de escolaridade (80%) e de renda familiar mensal (< U$ 250; 53%). A prevalência global do HPV foi de 16,4% (n = 58), com 8 casos de HPV-16 (2,3%) e 5 casos de HPV-18 (1,4%). Aproximadamente 70% das mulheres entrevistadas nunca tinha realizado o exame preventivo de Papanicolau. Os resultados citológicos anormais foram encontrados em 27,5% (n = 97) das amostras, com taxas mais altas da infecção por HPV de acordo com a severidade das lesões (p = 0,026). Conclusões As infecções por HPV-16 e HPV-18 não foram predominantes em nosso estudo, apesar da alta prevalência global da infecção por HPV. No entanto, o potencial oncogênico desses tipos e a baixa cobertura do exame de Papanicolau entre mulheres de comunidades ribeirinhas demonstram um risco potencial para o desenvolvimento de lesões cervicais e sua progressão para o câncer de colo do útero, uma vez que o acesso a essas comunidades é difícil e, na maioria dos casos, estas mulheres não têm acesso aos serviços de atenção primária e de saúde pública.

Evaluation of agreement between tests for the diagnosis of leprosy / Avaliação de concordância entre testes para diagnóstico da hanseníase

ABSTRACT Introduction: Leprosy is a chronic infectious disease caused by the intracellular parasite Mycobacterium leprae. The diagnosis is essentially clinical, based on symptoms, skin exam, peripheral nerves and epidemiological history. Laboratory tests are carried out to complement the result of clinical diagnosis, or even serving as a confirmatory method. Objective: To investigate the positivity and agreement between skin smear, enzyme-linked immunosorbent assay (ELISA) with synthetic antigen ND-O-BSA, ML Flow test and polymerase chain reaction (PCR) for detection of Mycobacterium leprae in new cases of leprosy. Methods: We conducted a case series study assessing a convenience sample of 39 new cases of leprosy and a control group of 18 household contacts in Belém (PA) and in Igarapé-Açu (PA) from March 2014 to September 2015. Results: The agreement between ELISA, ML Flow and PCR tests combinations showed slight to absent reproducibility (Kappa ≤ 0.24). The results showed greater sensitivity in PCR assay, with higher positivity in multibacillary cases. The ELISA test showed low positivity, even in multibacillary cases, resulting in no reaction to paucibacillary cases and household contacts. Conclusion: The high sensitivity of PCR decreases the agreement with other tests.

RESUMO Introdução: A hanseníase é uma doença infecciosa crônica causada pelo parasita intracelular Mycobacterium leprae. O diagnóstico é essencialmente clínico, com base em sintomas, exame da pele, nervos periféricos e história epidemiológica. Testes laboratoriais são realizados para complementar o resultado de diagnóstico clínico, ou mesmo servindo como método de confirmação. Objetivo: Investigar a positividade e a concordância da baciloscopia, do ensaio de imunoadsorvente ligado à enzima (ELISA) com o antígeno sintético ND-O-BSA, do ML Flow e da reação em cadeia da polimerase (PCR) para a detecção de Mycobacterium leprae em casos novos de hanseníase. Métodos: Foi realizada uma série de casos, avaliando uma amostra de conveniência de 39 novos casos de hanseníase e um grupo-controle de 18 contatos domiciliares em Belém (PA) e Igarapé-Açu (PA) a partir de março 2014 a setembro de 2015. Resultados: A concordância entre as combinações ELISA, ML Flow e PCR mostrou reprodutibilidade leve a ausente (Kappa ≤ 0,24). Os resultados mostraram maior sensibilidade no ensaio de PCR, com maior positividade em casos multibacilares. O teste ELISA mostrou baixa positividade, mesmo em casos multibacilares, resultando em nenhuma reação nos casos paucibacilares e contatos domiciliares. Conclusão: A alta sensibilidade da PCR diminui a concordância com outros testes.

Scorpionism by Tityus silvestris in eastern Brazilian Amazon

Background Scorpionism is a serious public health problem in Brazil. Although cases of envenomation by scorpions are frequent in Brazil, Tityus silvestris - found throughout the Amazon region - is considered of minor medical significance and with only a few descriptions in the literature. This article aims to describe for the first time the epidemiological characteristics and clinical manifestations of scorpion stings by T. silvestris that occurred in eastern Brazilian Amazon. Methods A prospective and observational study was carried out on 13 confirmed cases of T. silvestris envenomation registered from 2007 to 2011 in the cities of Belém and Ananindeua, Pará state, Brazil. Results The stings occurred mainly during daytime, at domiciliary environment, and the scorpions were found in clothing, fruits or vegetables. Envenomation was more frequent in the age group between 21 and 30 years old, upper limbs were more affected and medical aid was usually provided within two hours. Men and women were equally affected. Regarding severity, ten patients were classified as Class I and three patients as Class II according to the Scorpion Consensus Expert Group. Local manifestations were present in all patients, being pain the most common symptom. Mild systemic manifestations including nausea, vomiting, somnolence, malaise and prostration were observed in three victims. Symptomatic treatment of pain was offered to all patients, and only one received specific antivenom. All victims had a favorable outcome. Conclusions To the best of our knowledge, this study is the first to report the systemic symptomatology of envenomation by T. silvestris in the Brazilian Amazon, highlighting the medical relevance of the species in this region. Further research on the venom and clinical manifestations of envenomation by T. silvestris should be conducted in order to verify the relevance of this species to public health.(AU)

Scorpionism by Tityus silvestris in eastern Brazilian Amazon

Scorpionism is a serious public health problem in Brazil. Although cases of envenomation by scorpions are frequent in Brazil, Tityus silvestris found throughout the Amazon region is considered of minor medical significance and with only a few descriptions in the literature. This article aims to describe for the first time the epidemiological characteristics and clinical manifestations of scorpion stings by T. silvestris that occurred in eastern Brazilian Amazon. Methods A prospective and observational study was carried out on 13 confirmed cases of T. silvestris envenomation registered from 2007 to 2011 in the cities of Belém and Ananindeua, Pará state, Brazil. Results The stings occurred mainly during daytime, at domiciliary environment, and the scorpions were found in clothing, fruits or vegetables. Envenomation was more frequent in the age group between 21 and 30 years old, upper limbs were more affected and medical aid was usually provided within two hours. Men and women were equally affected. Regarding severity, ten patients were classified as Class I and three patients as Class II according to the Scorpion Consensus Expert Group. Local manifestations were present in all patients, being pain the most common symptom. Mild systemic manifestations including nausea, vomiting, somnolence, malaise and prostration were observed in three victims. Symptomatic treatment of pain was offered to all patients, and only one received specific antivenom. All victims had a favorable outcome. Conclusions To the best of our knowledge, this study is the first to report the systemic symptomatology of envenomation by T. silvestris in the Brazilian Amazon, highlighting the medical relevance of the species in this region. Further research on the venom and clinical manifestations of envenomation by T. silvestris should be conducted in order to verify the relevance of this species to public health.

Prevalência da co-infecção por Leishmania sp. em pacientes portadores de HIV/AIDS atendidos pelo Programa Municipal de DST/AIDS no Centro de Testagem e Aconselhamento (CTA) de Imperatriz-MA / Prevalence of Co-Leishmania sp. in patients with HIV/AIDS Program Attended by Hall of STD/AIDS in the Centre of Testing and Counseling (CTA) Imperatriz of MA

Objetivo: Estimar a Prevalência da ocorrência da infecção por Leishmania sp. em indivíduos convivendo comHIV/AIDS atendidos pelo programa municipal de DST/aids no Centro de Testagem e Aconselhamento (CTA) deImperatriz-MA. Método: Foi realizado um estudo descritivo transversal, a população de estudo foi constituída por199 indivíduos. A coleta de dados foi feita por meio de um questionário para a obtenção de dados demográficos,socioeconômicos e epidemiológicos, bem como foi realizado exame de coleta de material biológico (sangue) de todosos pacientes para detecção da infecção por Leishmania sp., por meio de exames laboratoriais (contagem de CD4 eCD8) e pesquisa da PCR. Resultados:Entre os pacientes observou-se similaridade entre a frequência dos gêneros,49,2% masculino e 50,8% feminino, com média de idade de 40 anos. Foi observado que 61,8% possuem baixo nívelde instrução e 69,3% possuem renda mensal de até um salário mínimo. 2,01% (4/199) dos pacientes analisadosapresentaram co-infecçãoLeishmania/HIV. Sendo, destes, 3 que apresentaram infecção mista por Leishmania (V.) spe Leishmania (L.) amazonensis, causadores de LTA e um paciente infectado por Leishmania (L.) chagasi, causadorde LV. Conclusões:Este estudo permitiu conhecer a magnitude da prevalência da co-infecçãoLeishmania/HIV.Assim, sugerimos que o teste anti-Leishmaniaseja realizado em todos os indivíduos com HIV/Aids, e que sejamincrementadas políticas públicas voltadas para essa problemática.

Objective: To estimate the prevalence of infection with Leishmania sp. in individuals living with HIV / AIDSserved by the municipal STD / AIDS in the Counseling and Testing Center (ATC) of Imperatriz-MA. Method: Adescriptive cross-sectional study was conducted, the study population consisted of 199 individuals. Data collectionwas done through a questionnaire in order to obtain demographic, socioeconomic and epidemiological data, as wellas examination was performed to collect biological material (blood) of all patients for detection of Leishmania sp.,through laboratory tests (CD4 and CD8) and PCR research. Results:It was observed, among patients,similaritybetween the gender frequency, 49.2% male and 50.8% female, mean age 40 years. 61.8% of the surveyed have a lowlevel of education and 69.3% have a monthly income of up to minimum wage. 2.01% (4/199) of patients analyzedshowed co-infection Leishmania / HIV. From these, three showed that mixed infection by Leishmania (V.) sp andLeishmania (L.) amazonensis, causing LTA and one patient infected by Leishmania (L.) chagasi, causative of LV.Conclusions: This study showed the magnitude of prevalence of co-infection Leishmania / HIV. Thus, it is suggestedthat the anti-Leishmania test be performed on all individuals with HIV / AIDS, in which focus on public policy issuesthat are incremented.

Natural infection of phlebotomines (Diptera: Psychodidae) by Leishmania (Leishmania) amazonensis in an area of ecotourism in Central-Western Brazil

Background Bonito municipality, known as an area of ecoturism, in Mato Grosso do Sul state, Brazil, is also a focus of visceral and cutaneous leishmaniases, with cases registered in both human and canine populations. This study sought to investigate natural infection by flagellate forms of Leishmania in phlebotomines of the urban area of Bonito.Findings Sand flies were collected fortnightly from October 2005 to July 2006 with modified automatic light traps installed in peridomiciles and animal shelters in the center and on the outskirts of the city. The females were dissected and their guts observed under an optical microscope. A total of 1977 specimens were captured, Lutzomyia longipalpis (88.4 %) and Bichromomyia flaviscutelata (3.0 %) being the most frequent species. Bi. flaviscutellata was found infected by flagellates that were identified as Leishmania (Leishmania) amazonensis by indirect immunofluorescence reaction, employing monoclonal antibodies and the biotin-avidin system. This is the first report of natural infection by L. amazonensis in Bi. flaviscutellata in a Brazilian urban area.Conclusions As Bi. flaviscutellata is only slightly attracted by humans, the transmission of L. amazonensis in the study area may have a zoonotic character; however, the sympatric occurrence of this parasite andLu. longipalpis should be taken into consideration by the local health authorities since this sand fly has already been found with L. amazonensis DNA in a focus of canine visceral leishmaniasis in Bonito municipality.

Genes that encodes NAGT, MIF1 and MIF2 are not virulence factors for kala-azar caused by Leishmania infantum

Introduction Kala-azar is a disease resulting from infection by Leishmania donovani and Leishmania infantum. Most patients with the disease exhibit prolonged fever, wasting, anemia and hepatosplenomegaly without complications. However, some patients develop severe disease with hemorrhagic manifestations, bacterial infections, jaundice, and edema dyspnea, among other symptoms, followed by death. Among the parasite molecules that might influence the disease severity are the macrophage migration inhibitory factor-like proteins (MIF1 and MIF2) and N-acetylglucosamine-1-phosphotransferase (NAGT), which act in the first step of protein N-glycosylation. This study aimed to determine whether MIF1, MIF2 and NAGT are virulence factors for severe kala-azar. Methods To determine the parasite genotype in kala-azar patients from Northeastern Brazil, we sequenced the NAGT genes of L. infantum from 68 patients as well as the MIF1 and MIF2 genes from 76 different subjects with diverse clinical manifestations. After polymerase chain reaction (PCR), the fragments were sequenced, followed by polymorphism identification. Results The nucleotide sequencing of the 144 amplicons revealed the absence of genetic variability of the NAGT, MIF1 and MIF2 genes between the isolates. The conservation of these genes suggests that the clinical variability of kala-azar does not depend upon these genes. Additionally, this conservation suggests that these genes may be critical for parasite survival. Conclusions NAGT, MIF1 and MIF2 do not alter the severity of kala-azar. NAGT, MIF1 and MIF2 are highly conserved among different isolates of identical species and exhibit potential for use in phylogenetic inferences or molecular diagnosis. .

A comparison of molecular markers to detect Lutzomyia longipalpis naturally infected with Leishmania (Leishmania) infantum

The aim of the present study was to detect natural infection by Leishmania (Leishmania) infantum in Lutzomyia longipalpis captured in Barcarena, state of Pará, Brazil, through the use of three primer sets. With this approach, it is unnecessary to previously dissect the sandfly specimens. DNA of 280 Lu. longipalpis female specimens were extracted from the whole insects. PCR primers for kinetoplast minicircle DNA (kDNA), the mini-exon gene and the small subunit ribosomal RNA (SSU-rRNA) gene of Leishmania were used, generating fragments of 400 bp, 780 bp and 603 bp, respectively. Infection by the parasite was found with the kDNA primer in 8.6% of the cases, with the mini-exon gene primer in 7.1% of the cases and with the SSU-rRNA gene primer in 5.3% of the cases. These data show the importance of polymerase chain reaction as a tool for investigating the molecular epidemiology of visceral leishmaniasis by estimating the risk of disease transmission in endemic areas, with the kDNA primer representing the most reliable marker for the parasite.

Occurrence of strongyloidiasis among patients with HTLV-1/2 seen at the outpatient clinic of the Núcleo de Medicina Tropical, Belém, State of Pará, Brazil

Introduction This study investigated the occurrence of Strongyloides stercoralis infestation and coinfection with HTLV-1/2 in Belém, Brazil. Methods S. stercoralis was investigated in stool samples obtained from individuals infected with HTLV-1/2 and their uninfected relatives. Results The frequency of S. stercoralis was 9% (9/100), including six patients infected with HTLV-1 (14.3%), two patients infected with HTLV-2 (11.1%), and one uninfected relative. Two cases of hyperinfestation by S. stercoralis were characterized as HTLV-1. Conclusions These results support the need for the routine investigation of S. stercoralis in patients with HTLV-1, in an attempt to prevent the development of severe forms of strongyloidiasis. .

Distribution of phlebotomine fauna (Diptera: Psychodidae) across an urban-rural gradient in an area of endemic visceral leishmaniasis in northern Brazil

The number of visceral leishmaniasis (VL) cases has increased over the past 10 years in Brazil, especially in the North and Northeast regions of the country. The aim of this study was to evaluate the urbanisation of VL vectors in Barcarena, Pará, an area in northern Brazil where VL is endemic. Sandflies were captured using Centers for Disease Control (CDC) light traps along an urban-rural gradient. The CDC traps were installed inside hen houses at a height of 150 cm. A total of 5,089 sandflies were collected and 11 species were identified. The predominant species was Lutzomyia longipalpis (rate of 95.15 percent), which suggests its participation in the transmission of VL. A total of 1,451 Lu. longipalpis females were dissected and no Leishmania infections were detected. Most of the sandflies were captured at the border of a forest (88.25 percent) and no flies were captured in the urban area, which suggests that transmission is still restricted to rural sites. However, the fact that a specimen was collected in an intermediate area indicates that urbanisation is a real possibility and that vector monitoring is important.

Novo surto de leishmaniose tegumentar americana em área de treinamento militar na Zona da Mata norte do Estado de Pernambuco / New outbreak of American tegumentary leishmaniasis in a military training center in the Zona da Mata region, in the north of the State of Pernambuco

Relata-se novo surto de LTA em militares com 71 casos confirmados pelos critérios clínico, epidemiológico e laboratorial. Obteve-se o isolamento de sete amostras, identificadas como Leishmania (Viannia) braziliensis. A ocorrência de surtos nesta região confirma o caráter endêmico, cuja magnitude parece estar relacionada a não adoção de medidas de proteção individual.

A new outbreak of American tegumentary leishmaniasis among military personnel is reported, with 71 cases confirmed by means of clinical, epidemiological and laboratory criteria. Seven samples were isolated and were identified as Leishmania (Viannia) braziliensis. The occurrence of outbreaks in this region confirms the endemic nature of this disease, and the magnitude of the occurrence seems to be related to non-adoption of individual protection measures.

Leishmaniose tegumentar americana humana e canina no Município de Mariluz, Estado do Paraná, Brasil / Human and canine American cutaneous leishmaniasis in Mariluz, Paraná State, Brazil

Relata-se a ocorrência de um surto de leishmaniose tegumentar americana no ano de 2002, no Município de Mariluz, mesorregião noroeste do Estado do Paraná, Brasil. Das 38 pessoas investigadas, quatro tinham lesões cicatrizadas, 10 em cicatrização e 24 tinham lesões ativas. Dos 126 cães investigados, 20 (15,9 por cento) tinham lesões sugestivas e 24 (19 por cento) tiveram sorologia positiva. Os parasitos isolados de dois pacientes e de três cães foram identificados como Leishmania (Viannia) braziliensis serodema I. Os flebotomíneos coletados foram identificados como Nyssomyia whitmani, N. neivai e Migonemyia migonei. Considerando que a área onde ocorreram os casos é semelhante a outras de colonização antiga no Estado do Paraná, acredita-se que as alterações ambientais e as matas remanescentes propiciam a manutenção do ciclo enzoótico do parasito e a transmissão para o homem e para os animais domésticos, mantendo o caráter endêmico da leishmaniose tegumentar americana.

An outbreak of American cutaneous leishmaniasis was reported in 2002 in Mariluz, northwestern Paraná State, Brazil. Of 38 humans who were investigated, four had healed lesions, ten showed lesions in the healing process, and 24 had active lesions. Of the 126 dogs, 20 (15.9 percent) presented suggestive lesions and 24 (19 percent) had positive serology. Parasites isolated from two patients and three dogs were identified as Leishmania (Viannia) braziliensis serodeme I. The captured sand flies were identified as Nyssomyia whitmani, N. neivai, and Migonemyia migonei. Considering that the region where the cases occurred is similar to other old human settlements in Paraná State, the environmental alterations and remaining forests facilitate the maintenance of the parasite's enzootic cycle and transmission to humans and domestic animals, thereby maintaining the endemicity of American cutaneous leishmaniasis.

Leishmaniose tegumentar americana causada por Leishmania (Viannia) braziliensis, em área de treinamento militar na Zona da Mata de Pernambuco / American tegumentary leishmaniasis caused by Leishmania (Viannia) braziliensis in military training area of Zona da Mata in Pernambuco

Este estudo tem como objetivo geral caracterizar a epidemiologia da leishmaniose tegumentar americana em unidade de treinamento militar, localizada no Estado de Pernambuco. Entre 2002 e 2003, vinte e três casos foram diagnosticados através de exame clínico, detecção do parasita e teste de intradermoarreação de Montenegro. Sete amostras de Leishmania (Viannia) braziliensis foram isoladas destes pacientes, identificadas através de reações com anticorpos monoclonais específicos e perfil eletroforético com isoenzimas. Um inquérito epidemiológico de prevalência da infecção por IDRM foi realizado na população que realizou treinamento neste período, no qual foi identificada uma prevalência de 25,3 por cento de infecção. Os dados obtidos, associados com achados prévios nesta área, apresentam evidências da manutenção de um ciclo enzoótico, com a ocorrência de surtos periódicos de leishmaniose tegumentar americana posteriormente à realização de treinamentos nas áreas de floresta Atlântica remanescente.

Recent observations on the sand fly (Diptera: Psychodidae) fauna of the State of Rondônia, Western Amazônia, Brazil: the importance of Psychdopygus davisi as a vector of zoonotic cutaneous leishmaniasis

Sand flies were collected in the central region of the state of Rondônia (W 64 30' to 63 00' and S 10 00'to 11 00') using Shannon and CDC light traps from October 1997 to August 2000. A total of 85,850 specimens representing 78 named species were captured. Of these 14 were new records for Rondônia. The proportion of males/females was 1/1.131. Trypanosomatids, that are presently being identified, were detected in 11 species. Leishmania (Viannia) naiffi was recorded from Psychodopygus davisi and P. hirsutus. In the present study the dominant species was P. davisi (39.6 percent) followed by Lutzomyia whitmani (13.1 percent), P. carrerai (11.6 percent), and P. hirsutus (10.2 percent). The importance of P. davisi as a vector of zoonotic cutaneous leishmaniasis is discussed

Avaliação isoenzimática e molecular de cepas de leishmania (Viannia) lainsoni / Isoenzymatic and molecular evaluation of leishmania (Viannia) lainsoni strains

Introdução: A leishmaniose tegumentar americana é uma doença infecto-parasitária endêmica na região amazônica que representa um grave problema de saúde pública. A identificação correta das espécies de Leismania é importante para estudos clínicos, epidemiológicos e terapêuticos. Objetivo: Realizar a avaliação isoenzimática e molecular de cepas de L. (V.) lainsoni isoladas de pacientes do Estado do Pará. Método: Selecionou-se onze amostras de Leishmania que reagiram ou não com o anticorpo monoclonal LA2 e 6 cepas-referência. Para a caracterização isoenzimática, utilizam-se as enzimas 6PGDH, PGM, G6PD e GPI, e para a caracterização molecular, pelo PCR, os "primers" B1/B2 e SS1629/S1630. Resultados:As isoenzimas 6PGDH, G6PD e PGM distinguiram L.(V.) lainsoni das outras espácies do subgênero Viannia. Conclusão: As enzimas 6PGDH, G6PD e PGM são as melhores para a identificação de L.(V.) lainsoni. Os "primers" B1/B2 e S1629/S1630 distinguiram esta espécie dentro do subgênero Viannia, sugerindo ser ótimo marcador para identificação de L.(V.) lainsoni por PCR

Observaçöes sobre o diagnóstico laboratorial e a epidemiologia da leishmaniose tegumentar no Estado do Paraná, sul do Brasil / Observations on laboratory diagnosis and cutaneous leishmaniasis epidemiology in the State of Paraná, sul of Brazil

De 1986 a 1997 foram encaminhados ao Laboratório de Ensino e Pesquisa em Análises Clínicas, da Universidade Estadual de Maringá, 1418 pacientes suspeitos de leishmaniose tegumentar para diagnóstico laboratorial. Os testes utilizados foram a intradermorreaçäo de Montenegro, reaçäo de Imunofluorescência indireta, pesquisa direta, isolamento e identificaçäo de Leishmania. Destes pacientes, 955 (67,30 por cento) apresentaram pelo menos um dos testes positivo, entre os quais 804 (84,20 por cento) contraíram a infecçäo no Estado do Paraná, 665 (69,6 por cento) tinham de 15 a 49 anos de idade, 658 (68,9 por cento) eram do sexo masculino, 523 (54,8 por cento) foram diagnosticados nos 3 primeiros meses de evoluçäo da lesäo e 74 (7,7 por cento) apresentavam comprometimento nasobucofaríngeo. Dos 83 municípios do Estado do Paraná envolvidos, destacaram-se Säo Jorge do Ivaí (10,2 por cento), Doutor Camargo (9,80 por cento), Terra Boa (7,3 por cento), Maringá (7,3 por cento), Jussara (6,0 por cento) e Cianorte (4,5 por cento). Foram isoladas 77 cepas de Leishmania (Viannia) braziliensis, predominando (63,6 por cento) o serodema 1

Nota sobre leishmaniose canina no noroeste do Estado do Paraná, sul do Brasil / Leishmaniasis in dogs in southern Brazil

Em área endêmica de leishmaniose tegumentar americana no Município de Jussara, Estado do Paraná, Brasil, detectaram-se três cäes domésticos infectados por Leishmania (Viannia) brasiliensis