Epidemiologia da leishmaniose visceral no município de Fortaleza, Ceará / Epidemiology of visceral leishmaniasis in Fortaleza, Ceará, Brazil

O objetivo do trabalho foi analisar os dados relacionados à transmissão da leishmaniose visceral (LV), no município de Fortaleza, e discutir a respeito da distribuição do vetor, reservatório doméstico e casos humanos ocorridos no período de 2009 a 2013. O presente estudo é do tipo descritivo realizado por meio de levantamento de dados secundários. A correlação entre casos humanos, caninos e número de flebotomíneos foi feita pelo teste de correlação de Spearman, com nível de significância de 5%. No período de 2009 a 2013 foram confirmados 941 casos e 55 óbitos. A letalidade média no período foi de 5,84%. Na distribuição por sexo, houve uma maior proporção de casos no sexo masculino em todos os anos analisados. A faixa etária de 1 a 4 anos apresentou a maior porcentagem de casos, destacando-se o ano de 2010 com 31,5% dos casos. A distribuição média de casos por regional demonstrou um predomínio nas regionais I, V e VI. Em relação aos flebotomíneos, a espécie encontrada em maior abundância foi Lutzomyia (Lutzomyia) longipalpis, seguido de Lutzomyia (Lutzomyia) migonei e Lutzomyia (Lutzomyia) lenti. Segundo os registros da Secretaria Municipal de Saúde de Fortaleza, 39.626 cães foram soro reagentes para LV nos anos de 2009 a 2013, destes 14.313 foram eutanasiados. O ano de 2013 destacou-se com 17.808 cães soro reagentes, sendo 1.273 da SER (Secretaria Executiva Regional) III, 2.572 da SER V e 1.909 da SER VI. Não foi observada correlação significativa entre o número de flebotomíneos capturados e o número de casos caninos de LV(p>0,05). Houve correlação negativa entre casos humanos e caninos (r=-0,0388) e correlação positiva entre casos humanos e número de flebotomíneos (r=0,7469). Os achados criam perspectivas para a identificação de outros fatores que podem influenciar a incidência de casos humanos e caninos, como a participação de outros possíveis reservatórios e vetores na cadeia de transmissão da leishmaniose visceral no município de Fortaleza.(AU)

The objective was to analyze the data relating to the transmission of visceral leishmaniasis (LV) in Fortaleza municipality, and discuss about the vector distribution, domestic reservoir and human cases from 2009 to 2013.This study is descriptive conducted through a survey of secondary data. The correlation between human and canine cases and sandflies number was taken by Spearman correlation test, with 5% significance level. In the period 2009 to 2013, 941 cases and 55 deaths were confirmed. The mortality rate for the period was 5.84%. There was a higher proportion of cases among men in all the years analyzed. The age group 1-4 years old had the highest percentage of cases, highlighting the year 2010 with 31.5% of the cases. The average distribution of cases by SER demonstrated a predominance in SER I, V and VI. With regard to the vector species found in greater abundance was Lutzomyia (Lutzomyia) longipalpis, followed by Lutzomyia (Lutzomyia) migonei and Lutzomyia (Lutzomyia) lenti. According to the records, 39,626 dogs were serum reagents for LV in the years 2009-2013, these 14,313 were killed. The year 2013 stood out with 17,808 dogs serum reagents, and 1,273 of SER III, 2572 of SER V and 1909 of SER VI. There was no significant correlation between the number of sand flies and the number of canine VL cases (p?γτ;0.05). There was a negative correlation between human and canine cases (r = -0.0388) and correlation was observed between human cases and number of sand flies (r= 0.7469).Our findings create prospects for the identification of other factors that may influence the incidence of human and canine cases, such as the participation of other possible reservoirs and vectors in the transmission of the visceral leishmaniasis in Fortaleza.(AU)

In vitro effect of Aloe vera, Coriandrum sativum and Ricinus communis fractions on Leishmania infantum and on murine monocytic cells.

In South America, visceral leishmaniasis is a zoonosis caused by the protozoan species Leishmania infantum (syn. L. chagasi) and is primarily transmitted through the bite of the female Lutzomyia longipalpis. Its main reservoir in urban areas is the dog. The application of control measures recommended by health agencies have not achieved significant results in reducing the incidence of human cases, and the lack of effective drugs to treat dogs resulted in the prohibition of this course of action in Brazil. Therefore, it is necessary to search new alternatives for the treatment of canine and human visceral leishmaniasis. The objectives of this study were to evaluate the in vitro effect of fractions from Aloe vera (aloe), Coriandrum sativum (coriander), and Ricinus communis (castor) on promastigotes and amastigotes of L. infantum and to analyze the toxicity against the murine monocytic cells RAW 264.7. To determine the viability of these substances on 50% parasites (IC50), we used a tetrazolium dye (MTT) colorimetric assay (bromide 3-4.5-dimethylthiazol-2-yl-2,5-dephenyltetrazolium), and on amastigotes we performed an in situ ELISA. All fractions were effective against L. infantum promastigotes and did not differ from the positive control pentamidine (p>0.05). However, the R. communis ethyl acetate and chloroform fractions, as well as the C. sativum methanol fraction, were the most effective against amastigotes and did not differ from the positive control amphotericin B (p>0.05). The R. communis ethyl acetate fraction was the least toxic, presenting 83.5% viability of RAW 264.7 cells, which was similar to the results obtained with amphotericin B (p>0.05). Based on these results, we intend to undertake in vivo studies with R. communis ethyl acetate fractions due the high effectiveness against amastigotes and promastigotes of L. infantum and the low cytotoxicity towards murine monocytic cells.