Cutaneous leishmaniasis in Bolivia. A study of 185 human cases from Alto Beni (La Paz Department). Isolation and isoenzyme characterization of 26 strains of Leishmania brasiliensis brasiliensis

Abstract

A clinical, serological, parasitological and therapeutic study of cutaneous leishmaniasis was carried out in a low sub-andean area (250-800 metres) of the La Paz Department, Bolivia. A team of seismic prospectors (350 workers) was surveyed for 12 months. Of 200 suspected cases of cutaneous leishmaniasis, 185 were serologically or parasitologically confirmed (incidence 52.8%). Those exposed to the greatest risk of infection were working in a virgin forest environment. Leishmanial organisms were isolated from 26 of the workers, either by in vitro cultivation or inoculation into hamsters. Isoenzyme characterization of the organisms by cellulose acetate electrophoresis showed them to be Leishmania braziliensis braziliensis [corrected]. The results of treatment of 168 patients with a pentavalent antimonial drug are also reported.

Leishmaniasis in travelers: A literature review

“…Unnecessary systemic therapy may be harmful, since it can be associated with toxic adverse effects [116]. Until recently the two existing methods for speciesspecific diagnosis of Leishmania infection were isoenzyme strains (or zymodemes) or monoclonal antibody analysis on cultured Leishmania, which are not used as routine tests in most laboratories [117]. PCR and subsequent sequencing of DNA products can permit the species identification of samples for which parasite culture remained negative or did not allow isoenzymatic characterization [118].…”

The Site ofLeishmania majorInfection Determines Disease Severity andImmuneResponses

“…The clinical manifestations of human cutaneous leishmaniasis caused by Leishmania major, Leishmania tropica, and Leishmania mexicana display a spectrum of disease severity (7). Although it is generally accepted that pathogenicity and virulence must be understood in terms of the interaction between the individual genotypes of the microorganism and its host, dissecting out the relative contributions has been difficult, especially in outbred host populations, such as humans (8,24).…”

Leishmaniases in Bolivia: Comprehensive Review and Current Status

“…In Bolivia, CL is mostly caused by L. (Viannia) braziliensis (up to 85% cases), [16][17][18][19][20][21][22][23][24][25] L. (Leishmania) amazonensis, 24,26 and L. (V.) lainsoni 22,[27][28][29] ; recently, some cases have also been found to be caused by L. (V.) guyanensis ( Table 1 ). 22 All parasite isolates that have been characterized to species have primarily been reported in the north, center, and east of the country (i.e., Departments of La Paz, Beni, Pando, Santa Cruz, and Cochabamba) ( Figure 1 ).…”

“…22 All parasite isolates that have been characterized to species have primarily been reported in the north, center, and east of the country (i.e., Departments of La Paz, Beni, Pando, Santa Cruz, and Cochabamba) ( Figure 1 ). [16][17][18][19][20][21][22][23][24][25][26][27][28][29] Leishmania (L.) infantum , the causative agent of VL, was isolated from or detected in patients, [31][32][33] dogs, 34,35 and the insect vector Lutzomyia longipalpis 36 in the Yungas region in the Department of La Paz. To our knowledge, VL remains rare in Bolivia and is restricted to this unique focus in the Yungas region in the Beni department, where the first autochthonous case was diagnosed in 1984.…”

“…Traditionally, the leishmaniases were considered a sylvatic disease, with data typically showing that both CL and VL in Bolivia are associated with sex, age, living in/close to the forest, or pursuing labor in forested areas. 16,25,33,40,41 Although this still holds true for much of the Bolivian territory, in the past few years, an increasing number of reports emerged of LCL in children and cases contracting the disease in an urban environment rather than in forested areas. 22,25 For better epidemiologic leishmaniases' surveillance in Bolivia, multidisciplinary studies will have to investigate these trends in the future, studying the extent of peridomestic transmission and determining risk factors for infection and disease.…”