A new focus of cutaneous leishmaniasis in the central area of Paraná State, southern Brazil

Abstract

We report a new endemic zone of cutaneous leishmaniasis (CL) in the central area of the State of Paraná (Municipality of Prudentópolis), in southern Brazil. This region was not previously considered endemic for CL, and this work constitutes the first report of CL endemicity there. Leishmaniasis was confirmed by smear, culture, and ELISA. Parasites were isolated and identified by random amplification of polymorphic DNA (PCR-RAPD). Phylogeographical analysis, based on two different criteria, was able to distinguish between RAPD profiles from different geographical regions. In total, 100 patients were diagnosed with leishmaniasis by culture and serology methods. The reported incidence rate was 4.32%. Of the 100 patients, 92% of the patients had single lesions, and 79.98% of these lesions were located on their limbs. The fact that 61% of patients were male rural workers points to an extradomiciliar type of transmission. In houses where human leishmaniasis was diagnosed, 29% of the dogs presented anti-Leishmania antibodies. A total of 1663 phlebotomines, representing 5 species, were captured in the studied area with CDC-like light minitraps. Lutzomyia intermedia s.l. was the most prevalent species (94.40%). The isolated parasites were grouped with Leishmania (V.) braziliensis. The epidemiological implications are discussed in the present article.

Can Equids Be a Reservoir of Leishmania braziliensis in Endemic Areas?

“…This resulted in the virtual disappearance of cutaneous leishmaniasis (CL) from the end of the 1950s to the 1970s. However, in the 1980s, an increased incidence of CL was observed not only in endemic areas but in new areas, and outbreaks were also reported in regions where leishmaniasis was considered eradicated [9], [10], [11], [12], [13], [14].…”

“…However, even though L. braziliensis is found throughout the neotropics, its epidemiology is poorly understood. This is because when an infected animal is diagnosed, the strain generally is not isolated and identified, so questions remain regarding the primary reservoir and other potential reservoirs of L. braziliensis [5], [14], [15]. Domestic animals, such as dogs and equines, probably play a role in the transmission of L. braziliensis since they are closely related with humans and are also present in agricultural and pastoral areas that are generated by deforestation.…”

Low Quality Evidence of Epidemiological Observational Studies on Leishmaniasis in Brazil

“…Being one of seven countries which contain 90% of leishmaniasis cases [2], Brazil's current control methods are centered around diagnosis and treatment of cases, indoor residual spraying of households with insecticide, and culling of infected canines in endemic locations [3]. An increase in the number of cases [3], continued outbreaks [4] and new endemic areas [5], [6] over the past 30 years has cast doubt on the effectiveness of this current policy. The most proactive of these methods, dog culling, remains controversial and no strong evidence in the literature has proven its effectiveness in significantly reducing cases [7], [8].…”

Clinical aspects and relevance of molecular diagnosis in late mucocutaneous leishmaniasis patients in Paraná, Brazil

“…In the north and northwest regions of the State, cases have been reported since the 1940's (when the region was colonized) and have been increasing in number (Castro et al, 2002;Curti et al, 2009). In the central region, leishmaniasis has been reported since 2003 (Thomaz-Soccol et al, 2009). The protozoan, isolated both in humans and animals, was identified by isoenzymes and RAPD-PCR as L. (V.) braziliensis and was the only autochthonous species (Silveira et al, 1999;Thomaz Soccol et al, 2003;Castro et al, 2005;Pereira et al, 2008, Thomaz Soccol et al, 2009.…”

“…In the central region, leishmaniasis has been reported since 2003 (Thomaz-Soccol et al, 2009). The protozoan, isolated both in humans and animals, was identified by isoenzymes and RAPD-PCR as L. (V.) braziliensis and was the only autochthonous species (Silveira et al, 1999;Thomaz Soccol et al, 2003;Castro et al, 2005;Pereira et al, 2008, Thomaz Soccol et al, 2009. Several phlebotomine species are present in the State of Parana, and the dominant and vector species found infected is Lutzomyia whitmani (Luz et al, 2000;Teodoro et al, 2004).…”