Intense transmission of visceral leishmaniasis in a region of northeastern Brazil: a situation analysis after the discontinuance of a zoonosis control program.

In São Luís, Maranhão, northeastern Brazil, the notification of visceral leishmaniasis (VL) cases intensified in 1982, showing endemic and epidemic patterns. In this city, the Center for Zoonoses Control (CZC) was an organization in charge of the control and prevention of the disease. However, technical and political reasons have led to a significant decline in the periodicity of its activities. Therefore, in this study we evaluated the epidemiological scenario of human visceral leishmaniasis (HVL) and the prevalence of the disease in dogs after the cessation of the CZC activities, covering the period of 2007 to 2016. The seroprevalence of canine leishmaniasis was determined based on clinical and serological profiles. HVL cases were notified using data provided by the Municipal Health Department of São Luís. A seropositivity rate of 45.8% (p = 0.0001) was found among dogs, 54% (p = 0.374) of which were asymptomatic. As for human cases, there were 415 notifications, with an increase in the incidence of the zoonosis observed during the aforementioned period. Thus, it can be inferred that after the control and surveillance activities were curtailed, there was an increase in the number of seropositive animals in circulation, acting as reservoirs of infection for dogs and humans.

Parasitological and histological aspects of Holochilus sciureus naturally infected by Schistosoma mansoni / Aspectos parasitológicos e histológicos de Holochilus sciureus naturalmente infectados por Schistosoma mansoni

Abstract Schistosomiasis is a neglected disease that affects millions of people around the world, being common in the state of Maranhão. A total of 225 rodents of the Holochilus sciureus species from the Western Lowland Maranhão were studied, of which 144 animals (64%) exhibited Schistosoma eggs in their feces samples. Macroscopic lesions characterized as well-defined whitish areas on the liver and spleen surfaces were observed. Histopathological examination revealed multifocal granulomas in the esophagus, liver, spleen, pancreas and duodenum, with structures compatible with Schistosoma mansoni eggs, as well as severe hepatic micro-vacuolar degeneration, multifocal and coalescent, with proliferation of random bile ducts and associated epithelial hyperplasia to areas of fibrosis. Adult forms of the parasite were observed in the blood vessels of the portal space. The lungs exhibited moderate and diffuse interstitial pneumonia with intralesional S. mansoni eggs. In the kidneys, hyaline cylinders were observed in the pelvis and diffuse hemorrhage. In conclusion, H. sciureus displays a pathological picture similar to human being. This rodent plays a role as sentinel in Baixada Maranhense.

Resumo A esquistossomose é uma doença negligenciada que afeta milhões de pessoas em todo o mundo, sendo comum no estado do Maranhão. Um total de 225 roedores da espécie Holochilus sciureus da Planície Ocidental do Maranhão foram estudados, dos quais 144 animais (64%) apresentaram ovos de Schistosoma em suas fezes. Lesões macroscópicas caracterizadas como áreas esbranquiçadas bem definidas nas superfícies do fígado e baço foram observadas. O exame histopatológico revelou granulomas multifocais no esôfago, fígado, baço, pâncreas e duodeno, com estruturas compatíveis com ovos de Schistosoma mansoni, degeneração micro-vacuolar hepática grave, multifocal e coalescente, com proliferação de ductos biliares aleatórios e hiperplasia epitelial associada a áreas de fibrose. Formas adultas do parasito foram observadas nos vasos sanguíneos do espaço portal. Os pulmões exibiram pneumonia intersticial moderada e difusa com ovos de S. mansoni intralesionais. Nos rins, foram observados cilindros hialinos na pelve e hemorragia difusa. Em conclusão, H. sciureus apresenta um quadro patológico semelhante ao ser humano. Este roedor desempenha um papel de sentinela na Baixada Maranhense.

Parasitological and histological aspects of Holochilus sciureus naturally infected by Schistosoma mansoni.

Schistosomiasis is a neglected disease that affects millions of people around the world, being common in the state of Maranhão. A total of 225 rodents of the Holochilus sciureus species from the Western Lowland Maranhão were studied, of which 144 animals (64%) exhibited Schistosoma eggs in their feces samples. Macroscopic lesions characterized as well-defined whitish areas on the liver and spleen surfaces were observed. Histopathological examination revealed multifocal granulomas in the esophagus, liver, spleen, pancreas and duodenum, with structures compatible with Schistosoma mansoni eggs, as well as severe hepatic micro-vacuolar degeneration, multifocal and coalescent, with proliferation of random bile ducts and associated epithelial hyperplasia to areas of fibrosis. Adult forms of the parasite were observed in the blood vessels of the portal space. The lungs exhibited moderate and diffuse interstitial pneumonia with intralesional S. mansoni eggs. In the kidneys, hyaline cylinders were observed in the pelvis and diffuse hemorrhage. In conclusion, H. sciureus displays a pathological picture similar to human being. This rodent plays a role as sentinel in Baixada Maranhense.