ABSTRACT
BACKGROUND: Although known to be highly endemic in the Amazon regions of Brazil, the presence of cutaneous leishmaniasis (CL) in the subtropical southern part of the country has largely been ignored. This study was conducted to demonstrate CL is emerging in the Brazilian state of Santa Catarina, as well as to characterize the epidemiological profile and Leishmania species involved. METHODOLOGY/PRINCIPAL FINDINGS: For this cross-sectional study, data from all CL cases from Santa Catarina, Brazil, reported to the Brazilian National Notifiable Diseases Information System from 2001 to 2009 were investigated. Amplification of the kDNA minicircle conserved region followed by restriction fragment length polymorphism (PCR-RFLP) was conducted to screen for Leishmania species present in patient biopsy. Overall, 542 CL cases were reported, with majority resulting from autochthonous transmission (nâ=â401, 73.99%) and occurring in urban zones (nâ=â422, 77.86%). Age, gender, zone of residence, origin of case, clinical form and case outcome were found to differ significantly by region. Imported cases were over seven times more likely to relapse (95% CI 2.56-21.09). Mapping of cases revealed new endemic areas in northeastern Santa Catarina with two species present. With the exception of three L. (Leishmania) amazonensis cases (1.20%), majority of PCR positive samples were found to be L. (Viannia) braziliensis (nâ=â248, 98.80%). CONCLUSIONS/SIGNIFICANCE: CL is now endemic in the state of Santa Catarina, Brazil, with case profiles varying significantly by region. L. (V.) braziliensis has been identified as the predominant species in the region.
Subject(s)
DNA, Kinetoplast/genetics , Leishmania/genetics , Leishmania/isolation & purification , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Polymorphism, Restriction Fragment Length , Adolescent , Adult , Aged , Brazil/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , DNA, Kinetoplast/isolation & purification , Female , Humans , Infant , Leishmania braziliensis/genetics , Leishmania braziliensis/isolation & purification , Male , Middle Aged , Young AdultABSTRACT
Os autores fazem uma revisao sobre os principais aspectos da síndrome da imunodeficiência adquirida. Na etiologia é estudado a participaçao do retrovírus HTLV III/LAV com algumas de suas principais características. Nos aspectos epidemiológicos sao abordados a situaçao mais recente com alguns dados dos Estados Unidos, por ser o país onde o problema é maior e seu sistema de vigilância epidemiológica ter contribuído com muitos conhecimentos sobre a doença. No Brasil é mostrado a situaçao epidemiológica com os dados disponíveis fornecidos pelo Ministério da Saúde até 20 de outubro de 1985. É apresentado também a situaçao atual de Santa Catarina. Sao discutidas nesta revisao as alteraçoes imunológicas no paciente, suas repercussoes clínicas e os procedimentos laboratoriais para o seu diagnóstico. Os autores apresentam no trabalho as principais medidas profiláticas recomendadas cientificamente e as estratégias para o controle da doença adotadas pelo Brasil.
