ABSTRACT
Migrant and seasonal farmworkers are at high risk for musculoskeletal and other occupational injuries. Although persons aged 40-80 years account for 40 % of all US farmworkers and as many as 50 % in certain regions, little is known about their occupational health issues. The current study examined work-related persistent musculoskeletal injuries (PMIs) and their association with clinical and functional indicators of disability and health-related quality of life (HRQOL) in 177 middle-aged and elderly US-Mexico border farmworkers. At interview, 68 % reported current PMI pain; 51 % had pain at multiple sites. PMI pain was associated with increased shoulder, knee, and lower extremity dysfunction and reduced HRQOL scores. However, fewer than 25 % of injured participants received any conventional medical treatment. The study results indicated that work-related PMIs, especially multiple PMIs, caused significant functional impairment, disability, and poorer HRQOL, adversely affecting the ability of the aging farmworkers to perform work, self-care, and other daily activities.
Subject(s)
Agriculture/statistics & numerical data , Disabled Persons/statistics & numerical data , Emigrants and Immigrants/statistics & numerical data , Mexican Americans/statistics & numerical data , Occupational Injuries/ethnology , Quality of Life , Adult , Aged , Aged, 80 and over , Disabled Persons/psychology , Emigrants and Immigrants/psychology , Female , Humans , Male , Mexican Americans/psychology , Middle Aged , Musculoskeletal Pain/epidemiology , Musculoskeletal Pain/ethnology , Occupational Injuries/epidemiology , Quality of Life/psychology , Texas/epidemiologyABSTRACT
The safety, immunogenecity, and efficacy of two doses of an autoclaved-killed, whole cell Leishmania amazonensis vaccine (IFLA/BR/67/PH8) and BCG adjuvant (n = 750) against cutaneous leishmaniasis (CL) was compared with placebo (n = 756) in a randomized, placebo-controlled, blinded study. Systemic and local side-effects were more frequent in the vaccine than placebo group. Leishmanin skin test (LST) conversion was greater in the vaccine than placebo group 2 months after the second vaccination dose (74.4% versus 14.7%; P = 0.000001). The 26-month incidence of confirmed CL (n = 25) was similar between the vaccine (2.0%) and placebo groups (2.0% versus 1.3%; P > 0.05). LST conversion was not associated with CL protection and the vaccine did not offer significant protection against CL infection caused by L. Viannia spp. compared to placebo.
Subject(s)
Adjuvants, Immunologic , BCG Vaccine/immunology , Leishmania mexicana/immunology , Leishmaniasis, Cutaneous/immunology , Leishmaniasis, Cutaneous/prevention & control , Protozoan Vaccines/immunology , Animals , BCG Vaccine/adverse effects , Child , Ecuador , Female , Follow-Up Studies , Hot Temperature , Humans , Leishmania mexicana/genetics , Male , Protozoan Vaccines/adverse effects , Reverse Transcriptase Polymerase Chain Reaction , Skin Tests , Sterilization , Treatment Outcome , VaccinationABSTRACT
OBJECTIVE: To explore the knowledge, beliefs, and practices (KBPs) regarding cutaneous leishmaniasis (CL) treatment held by an endemic population in Ecuador. METHODS: A follow-up to research done several years before, this study used random cluster sampling to select 529 adults who lived in rural northwestern Ecuador. Data were collected over a 24-month period using in-depth interviews supplemented with qualitative methods. RESULTS: Most of the subjects were familiar with CL. The interviewed persons described a large, diverse ethnomedical treatment inventory. Contrary to expectations, few treatment KBPs were predicted by gender, age, or prior CL experience. Factors reported as important in treatment decisions included female reproductive status, CL "type" (perceived form of the illness), lesion location, number of other infected household members, cost of the various treatments, treatment availability, and perceived treatment effectiveness. Subjects' strong motivation for prompt treatment appeared to be associated with beliefs regarding the inability of CL lesions to heal spontaneously, the disease's propensity to progress into fatal illnesses, and disfigurement. Despite increased familiarity with Glucantime (meglumine antimonate), the conventional pentavalent antimonial drug used to treat CL in Ecuador, the proportion of subjects who had used it in their treatment remained low (20%) while the prevalence of premature drug discontinuance appeared to have doubled in comparison to our earlier study. CONCLUSIONS: By itself, increased access to Glucantime is unlikely to increase usage of the drug and to reduce its frequent premature discontinuance unless public health planners accommodate the health and illness world views of local populations. Efficacy and safety studies should be undertaken to investigate promising traditional remedies as possible alternatives to Glucantime.
Subject(s)
Antiprotozoal Agents/therapeutic use , Leishmaniasis, Cutaneous/therapy , Medicine, Traditional , Meglumine/therapeutic use , Organometallic Compounds/therapeutic use , Adolescent , Adult , Data Interpretation, Statistical , Ecuador , Female , Health Knowledge, Attitudes, Practice , Humans , Leishmaniasis, Cutaneous/drug therapy , Male , Meglumine Antimoniate , Rural Population , Socioeconomic FactorsABSTRACT
The safety, immunogenicity, and efficacy of a vaccine against cutaneous leishmaniasis in rural Ecuadorian children was assessed in a randomized, controlled, double-blinded study. Vaccine group subjects received 2 intradermal doses of a whole, killed promastigote vaccine cocktail plus bacille Calmette-Guérin (BCG) adjuvant. Control subjects got 2 doses of BCG only. The subjects who received both vaccination doses, 438 in the vaccine group (79.3%) and 406 in the control group (83.4%), were followed for 12 months. No serious adverse side effects were identified in either group. Significantly more vaccine group subjects than controls converted to a positive Montenegro skin test (85.1% vs. 20.1%; chi2 = 279; P < .001). The incidence of cutaneous leishmaniasis was significantly reduced in the vaccine compared with the control group (2.1% vs. 7.6%; chi2 = 8.95; P < .003). The protective efficacy of the vaccine was 72.9% (95% confidence interval = 36.1%-88.5%).
Subject(s)
Leishmaniasis, Cutaneous/immunology , Leishmaniasis, Cutaneous/prevention & control , Protozoan Vaccines , Child , Child, Preschool , Double-Blind Method , Ecuador , Female , Humans , Immunization, Secondary , Injections, Intradermal , Leishmaniasis, Cutaneous/epidemiology , Male , Mycobacterium bovis , Nutritional Status , Protozoan Vaccines/administration & dosage , Protozoan Vaccines/adverse effects , Risk Factors , Rural Population , Skin TestsABSTRACT
An epidemiologic survey (n = 466) was conducted in an area of subtropical rainforest in north-west Ecuador with the following objectives: (1) to determine the prevalence of cutaneous leishmaniasis (CL), (2) to identify the Leishmania species causing human disease, (3) to investigate the major clinical manifestations of leishmaniasis, (4) to study cellular and humoral immune response indicators associated with disease status and (5) to identify risk factors for CL. Fourteen percent of subjects had parasitologically confirmed CL; 33% had evidence of prior disease. However, 17.2% of subjects with a negative CL clinical history presented with a positive Montenegro skin test (MST), indicating the possibility of subclinical infection. The species isolated from subject lesions were L. guyanensis (63%), L. panamensis (33%), and L. brazilensis (4%). Mean specific anti-Leishmania IgG and IgM OD serum levels were highest in subjects diagnosed with current CL, followed by those with prior CL, and were lowest in healthy subjects, respectively (0.56 +/- 0.27 vs 0.33 +/- 0.2 vs 0.22 +/- 0.14; F-ratio = 74; P < 0.00001) and (665 +/- 270 vs 481 +/- 220 vs 301 +/- 128.5; F-ratio = 37; P < 0.00001). Likewise, subjects with present CL had measurably higher MST reactions (13 +/- 6.7 mm) than those with prior CL (10.9 +/- 7.8 mm) or healthy individuals (2.4 +/- 2.5 mm; F-ratio = 106; P < 0.00001). Serum concentrations of IgG were predicted by lesion number (t = 2.5; P = 0.018), size (t = 3.7; P = 0.0006), and duration (t = 3.5; P = 0.0013). Furthermore, the MST induration size increased as a function of lesion number (t = 3.0; P = 0.005) and size (t = 3.4; P = 0.022). Subject age and sex did not predict serum IgG or IgM concentrations or MST reactions in the 3 disease groups. Although no sex differences were found with respect to clinical characteristics, children < or = 12 years of age were almost 3 times more likely to have CL lesions or scars located on the face and head area compared to adults (OR = 2.75; 95% CI = 1.4-5.6, P = 0.004). The risk factors associated with disease included age under 5 years (AOR = 1.5; 95% CI = 0.48-2.35), male gender in adults (AOR = 2.8; 95% CI = 1.1-7.8), and wood and/or cane exterior house walls (AOR = 1.8; 95% CI = 1.4-2.5). In contrast, electric home lighting was associated with decreased risk (AOR = 0.7; 95% CI = 0.4-2.3). The results suggest that it may be possible to modify a portion of the risk of CL by making changes in the housing environment which may help to reduce the amount of human-vector contact.
Subject(s)
Leishmaniasis, Cutaneous/epidemiology , Adolescent , Adult , Aged , Animals , Antibody Formation , Child , Child, Preschool , Ecuador/epidemiology , Female , Humans , Immunity, Cellular , Infant , Leishmania/classification , Leishmania/isolation & purification , Leishmaniasis, Cutaneous/immunology , Leishmaniasis, Cutaneous/parasitology , Male , Middle Aged , Risk Factors , Tropical ClimateABSTRACT
OBJECTIVE: The main objective of this prospective cohort study was to investigate the prevalence, risk factors and maternal-perinatal consequences of chronic asymptomatic intestinal parasitic infection during pregnancy. METHODS: Prenatal patients (n=91) attending a public clinic in Quito, Ecuador, were followed during the third trimester. Intestinal parasitic, nutritional status, sociodemographic/sanitation indicators and fetal outcome data were collected and analyzed using multivariate ANOVA and regression techniques. RESULTS: Most subjects (93%) were infected with at least one species of pathogenic intestinal parasite: 88% with Entamoeba histolytica. Greater parasite burdens were associated with poorer maternal iron status and reduced fetal growth. In particular, a high E. histolytica load was associated with decreased maternal serum hemoglobin (P=0.002) and hematocrit levels (P=0.01), iron deficiency anemia (P=0.026), and indicators of diminished intrauterine growth including a decreased ponderal index (P=0.04), mid-arm circumference (P=0.01), and mid-arm/head circumference ratio (P=0.003). CONCLUSION: Asymptomatic intestinal parasitic infection represents a hidden risk factor for maternal iron deficiency anemia and fetal growth retardation.
Subject(s)
Intestinal Diseases, Parasitic/complications , Pregnancy Complications, Parasitic , Adult , Anemia, Iron-Deficiency/epidemiology , Animals , Chronic Disease , Ecuador/epidemiology , Entamoeba histolytica , Female , Fetal Growth Retardation/epidemiology , Humans , Intestinal Diseases, Parasitic/epidemiology , Intestinal Diseases, Parasitic/parasitology , Pregnancy , Pregnancy Complications, Parasitic/epidemiology , Pregnancy Complications, Parasitic/parasitology , Pregnancy Outcome , Prospective Studies , Risk Factors , Socioeconomic FactorsABSTRACT
The relationship between nutritional status and cutaneous leishmaniasis (CL) was evaluated in 230 children living in a rural subtropical rainforest in Northwest Ecuador. One-third of the subjects had evidence of either current (13 per cent) or past CL infection (21 per cent). Subjects with current (4.71 +/- 0.44 mg) or previous disease (4.29 +/- 0.35 mg) had lower mean daily dietary iron intakes than non-infected children (5.45 +/- 0.2 mg; chi 2 = 0.048), but not energy, protein, or other micronutrients. The low dietary iron intake data was corroborated by the reduced mean haemoglobin values observed in children with current (11.7 +/- 0.3 mg/dL) or past infection (11.3 +/- 0.2 mg/dL) compared to non-infected subjects (12.7 +/- 0.15 mg/dL; F-ratio = 17.0, P < 0.0001). Mean hematocrit values were also lower in the two infected groups (37.4 +/- 0.9 per cent and 37.4 +/- 0.6 per cent v. 39.5 +/- 0.5 per cent; F-ratio = 4.23, P = 0.0175). Furthermore, they were more likely to suffer from iron-deficiency anaemia than their non-infected counterparts (chi 2 = 4.64, P = 0.03). However, the children with active disease accounted for most of the excess risk for anemia (Fisher's exact test P = 0.009; OR = 10.0, exact 95 per cent CI = 1.37-111.8). Finally, growth stunting (< -2SD height-for-age) was more common in subjects with current (54 per cent) or past infection (51 per cent) compared to those without CL history (31 per cent; chi 2 = 8.03, P = 0.004).(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Anemia, Iron-Deficiency/complications , Leishmaniasis, Cutaneous/complications , Nutritional Status , Anemia, Iron-Deficiency/epidemiology , Anemia, Iron-Deficiency/etiology , Anemia, Iron-Deficiency/prevention & control , Anthropometry , Child , Child, Preschool , Ecuador/epidemiology , Energy Intake , Female , Humans , Infant , Iron/administration & dosage , Iron Deficiencies , Leishmaniasis, Cutaneous/epidemiology , Leishmaniasis, Cutaneous/etiology , Male , Pilot Projects , Risk Factors , Rural PopulationABSTRACT
En una zona endémica de la región subtropical del coroeste del Ecuador se investigaron las creencias y conocimientos populares acerca de la leishmaniasis cutánea y su tratamiento. Aunque la mayoría de las personas adultas entrevistadas estaban familiarizadas con la enfermedad, el vector y los tratamientos tradicionales, muchas no tenían conocimientos sobre la transmisión de la enfermedad, la curación de las úlceras y el tratamiento médico convencional. Se encontro que el riesgo de contraer la enfermedad y las creencias y conocimientos sobre la misma variaban mucho según el género. Entre los varones, el riesgo de sufrir leishmaniasis cutanea fue casi el triple del observado en mujeres. Asimismo, los varones opinaron con más frecuencia que la enfermedad reducía de manera importante, la capacidad de trabajo del paciente. Por otra parte, las mujeres se mostraron más proclives a considerar a la leishmaniasis cutánea un trastorno grave capaz de menoscabar considerablemente la autoestima de quien la padece. Aunque el 80 por ciento de las personas entrevistadas conocían por lo menos uno de los métodos de tratamiento de la enfermedad, las mujeres en general conocían más métodos que los hombres. La mayoría de los 150 regímenes terapéuticos que se mencionaron se basaban en el uso de plantas autóctonas, sustancias químicas, ácidos, antibióticos, tratamientos térmicos o productos derivados del petróleo. Algunos de esos tratamientos podrían tener eficacia clínica. Sin embargo, solo el 7 por ciento de las personas entrevistadas conocían los compuestos antimoniales pentavalentes. Casi 70 por ciento de los que notificaron infección previa o activa fueron tratados únicamente con métodos tradicionales. Solo 12 por ciento recibieron el tratamiento completo con Glucantine, mientras que 7,5 por ciento recibieron un tratamiento incompleto. Los resultados indican que al planificar futuros programas de lucha contra la leishmaniasis cutánea será importante tener en cuenta aquellas áreas en las que se han detectado un deficit de conocimientos y creencias sobre la enfermedad y su tratamiento que varían según el género
Subject(s)
Leishmaniasis, Cutaneous/therapy , Tropical Climate , Medicine, Traditional , Health Knowledge, Attitudes, Practice , Ecuador/epidemiologyABSTRACT
Popular perceptions and knowledge about cutaneous leishmaniasis and its treatment were studied in an endemic area of subtropical Northwest Ecuador. Although most of the adults surveyed were familiar with the disease, the vector, and traditional treatments, many showed a lack of knowledge about transmission of the disease, ulcer healing, and conventional treatment. Gender was found to have a significant impact on disease risk, perceptions, and treatment knowledge. Males experienced a risk of contracting cutaneous leishmaniasis that was almost triple that of women. Men were also more likely to perceive that the disease seriously diminished the victim's capacity to work. Women, on the other hand, were more prone to perceive that cutaneous leishmaniasis was a serious disease that significantly decreased self-esteem. Although 80% of the subjects knew at least one method of treating the disease, women tended to know more methods than men. Most of 150 different therapies reported involved the use of indigenous plants, chemicals, acids, antibiotics, heat treatments, or petroleum by-products. Some of these treatments could have clinical value. However, only 7% of the subjects knew about pentavalent antimonials. Almost 70% of the subjects with a past or present infection history were treated solely by traditional methods; only 12% received a full course of Glucantime, while 7.5% got an incomplete course. The findings indicate that it will be important to consider the identified gaps in knowledge and gender perceptions regarding the disease and its treatment when planning future control programs.
PIP: In 1989-1991, a study of 466 children and adults (i.e., = or 18 years) living in 26 small agricultural villages in the remote subtropical forest of Northwest Pichincha Province on the western slope of the Andes Mountains in Ecuador examined perceptions and knowledge of cutaneous leishmaniasis and local methods used to treat it. 13% of all adult subjects had active cutaneous leishmaniasis. Men were 2.83 times more likely to have cutaneous leishmaniasis than women (p = .037), perhaps due to increased occupational exposure (i.e., agricultural work in the rain forest) and social exposure (i.e., outside during times of maximum vector activity). They were more likely to consider it to have a negative effect on the affected person's capacity to work (77.3% vs. 61.2%; p = .025). Women were more likely than men to perceive it as a severe disease (85.2% vs. 68%; p = .015) that reduced the victim's self- esteem (89.9% vs.75.7%; p = .017). 97.3% of subjects were familiar with the sandfly vector, yet less than 10% knew it was responsible for cutaneous leishmaniasis. 80% of adults knew at least 1 treatment option. Women could name more treatment methods than men (1.6 vs. 1.2; p .05). The adults named more than 150 treatment options, most of which were traditional methods involving the application of topical preparations or objects to the ulcers (e.g., herbs, trees, or other plants and homemade rum, wood alcohol, iodine, menthol, methiolate, and sulfur). Just 7% were familiar with antimonial drugs. Most adults and children who had either active cutaneous leishmaniasis or a history of past infection (68%) had been treated with traditional methods. 8.5% received both traditional treatments and Glucantime. Just 12% received the full course of Glucantime therapy. 7.5% received an incomplete course of glucantime therapy. These results show that public health officials need to consider the gaps in knowledge and gender perceptions of cutaneous leishmaniasis and in its treatment when they plan control programs.
Subject(s)
Leishmaniasis, Cutaneous/psychology , Leishmaniasis, Cutaneous/therapy , Adolescent , Adult , Aged , Attitude , Ecuador , Educational Status , Female , Humans , Male , Medicine, Traditional , Middle AgedABSTRACT
Popular perceptions and knowledge about cutaneous leishmaniasis and its treatment were studied in an endemic area of subtropical Northwest Ecuador. Although most of the adults surveyed were familiar with the disease, the vector, and traditional treatments, many showed a lack knowledge about transmission of the disease, ulcer healing, and conventional treatment. Gender was found to have a significant impact on disease risk, perceptions, and treatment knowledge. Males experienced a risk of contracting cutaneous leishmaniasis that was almost triple that of women. Men were also more likely to perceive that the disease seriously diminished the victim's capacity to work. Women, on the other hand were more prone to perceive that cutaneous leishmaniasis was a serious disease that significantly decreased self esteem. Although 80 percent of the subjects knew at least one method of treating the disease, women tended to know more methods than men. Most of 150 different therapies reported involved the use of indigenous plants, chemical, acids, antibiotics, heat treatments, or petroleum by products. Some of these treatments could have clinical value. However, only 7 percent of the subjects knew about pentavalent antimonials. Almost 70 percent of the subjects with a past or present infection history were treated solely by traditional methods; only 12 per cent received a full course of Glucantine, while 7.5 percent got an incomplete course. The findings indicate that it will be important to consider the identified gaps in knowledge and gender perceptions regarding the disease and its treatment when planning future control programms
Subject(s)
Leishmaniasis, Cutaneous/therapy , Medicine, Traditional , Tropical Climate , Ecuador/epidemiologyABSTRACT
En una zona endémica de la región subtropical del coroeste del Ecuador se investigaron las creencias y conocimientos populares acerca de la leishmaniasis cutánea y su tratamiento. Aunque la mayoría de las personas adultas entrevistadas estaban familiarizadas con la enfermedad, el vector y los tratamientos tradicionales, muchas no tenían conocimientos sobre la transmisión de la enfermedad, la curación de las úlceras y el tratamiento médico convencional. Se encontro que el riesgo de contraer la enfermedad y las creencias y conocimientos sobre la misma variaban mucho según el género. Entre los varones, el riesgo de sufrir leishmaniasis cutanea fue casi el triple del observado en mujeres. Asimismo, los varones opinaron con más frecuencia que la enfermedad reducía de manera importante, la capacidad de trabajo del paciente. Por otra parte, las mujeres se mostraron más proclives a considerar a la leishmaniasis cutánea un trastorno grave capaz de menoscabar considerablemente la autoestima de quien la padece. Aunque el 80 por ciento de las personas entrevistadas conocían por lo menos uno de los métodos de tratamiento de la enfermedad, las mujeres en general conocían más métodos que los hombres. La mayoría de los 150 regímenes terapéuticos que se mencionaron se basaban en el uso de plantas autóctonas, sustancias químicas, ácidos, antibióticos, tratamientos térmicos o productos derivados del petróleo. Algunos de esos tratamientos podrían tener eficacia clínica. Sin embargo, solo el 7 por ciento de las personas entrevistadas conocían los compuestos antimoniales pentavalentes. Casi 70 por ciento de los que notificaron infección previa o activa fueron tratados únicamente con métodos tradicionales. Solo 12 por ciento recibieron el tratamiento completo con Glucantine, mientras que 7,5 por ciento recibieron un tratamiento incompleto. Los resultados indican que al planificar futuros programas de lucha contra la leishmaniasis cutánea será importante tener en cuenta aquellas áreas en las que se han detectado un deficit de conocimientos y creencias sobre la enfermedad y su tratamiento que varían según el género
Se publica en inglés en el Bull. PAHO. Vol. 28(2), 1994
Subject(s)
Leishmaniasis, Cutaneous , Tropical Climate , Medicine, Traditional , Ecuador , Health Knowledge, Attitudes, PracticeABSTRACT
Popular perceptions and knowledge about cutaneous leishmaniasis and its treatment were studied in an endemic area of subtropical Northwest Ecuador. Although most of the adults surveyed were familiar with the disease, the vector, and traditional treatments, many showed a lack knowledge about transmission of the disease, ulcer healing, and conventional treatment. Gender was found to have a significant impact on disease risk, perceptions, and treatment knowledge. Males experienced a risk of contracting cutaneous leishmaniasis that was almost triple that of women. Men were also more likely to perceive that the disease seriously diminished the victim's capacity to work. Women, on the other hand were more prone to perceive that cutaneous leishmaniasis was a serious disease that significantly decreased self esteem. Although 80 percent of the subjects knew at least one method of treating the disease, women tended to know more methods than men. Most of 150 different therapies reported involved the use of indigenous plants, chemical, acids, antibiotics, heat treatments, or petroleum by products. Some of these treatments could have clinical value. However, only 7 percent of the subjects knew about pentavalent antimonials. Almost 70 percent of the subjects with a past or present infection history were treated solely by traditional methods; only 12 per cent received a full course of Glucantine, while 7.5 percent got an incomplete course. The findings indicate that it will be important to consider the identified gaps in knowledge and gender perceptions regarding the disease and its treatment when planning future control programms
This article will also be published in Spanish in the BOSP. Vol. 117, 1994
Subject(s)
Leishmaniasis, Cutaneous , Medicine, Traditional , Tropical Climate , EcuadorABSTRACT
En el presente trabajo se compara cinco diferentes métodos diagnósticos y la efectividad del tratamiento, en un estudio con 49 pacientes, a los que luego del diagnóstico clínico de la (s) lesión (es), se realizó Raspado y/o Frotis, Prueba Cutánea de Montenegro (PCM), Cultivo, Biopsia e inmunofluorescencia Indirecta (IFA). La sensibilidad de las pruebas, son confrontadas con el diagnóstico clínico y la remisión de las lesiones en un 100 por ciento posterior al tratamiento empleado (Glucantin y Pentostan), a dosis convencionales. Los resultados en cuanto a porcentajes de positividad son para el Raspado y/o Frotis 42,86 por ciento, cultivo 67,35 por ciento, Prueba Cutánea de Montenegro 97,96 por ciento, biopsia 55,10 por ciento e IFA 67,35 por ciento lo que estadisticamente nos demuestra una alta sensibilidad para la Prueba Cutánea de Montenegro.
Subject(s)
Humans , Male , Female , Dermatology , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/therapy , Skin ManifestationsABSTRACT
Twenty-six strains of Leishmania were isolated from cutaneous lesions in humans in 3 different geographical areas of Ecuador. The species were identified by enzyme electrophoresis as Leishmania braziliensis, L. panamensis, L. guyanensis, L. mexicana, and L. amazonensis.
