Dificuldades na execução das diretrizes do Programa de Vigilância e Controle da Leishmaniose Visceral em grandes municípios brasileiros

Zuben, Andrea Paula Bruno von; Donalísio, Maria Rita

doi:10.1590/0102-311x00087415

Cited by 71 publications

(84 citation statements)

References 26 publications

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“…A interação do cirurgião-dentista com os profissionais das diferentes áreas da saúde e médica é de suma importância para o estabelecimento do diagnóstico diferencial desta doença 13,14 . Muitos autores julgam como técnicas confiáveis para o diagnóstico da LTA a realização da biópsia da lesão e o exame histopatológico propriamente dito 11,15,16,17,18 . Porém o diagnóstico pode ser dificultado quando o paciente não reside em áreas endêmicas e também pela vasta possibilidade de diagnósticos diferenciais para as lesões ou pela inexperiência da equipe clínica responsável 11 .…”

Section: Discussionunclassified

Abordagem multiprofissional no diagnóstico de leishmaniose: um relato de caso

Garbín¹,

Belila²,

Precinoti³

et al. 2017

Arch Health Invest

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Introdução: A Leishmaniose Tegumentar Americana (LTA) é uma doença crônica, grave, infecciosa e não contagiosa, sendo encontrada em quase toda a América Latina, afetando as populações autóctones e viajantes. Objetivo: Objetivou-se elucidar a importância da equipe multiprofissional para a realização do diagnóstico definitivo, de um caso de Leishmaniose Tegumentar Americana. Caso clínico: Paciente de 74 anos, sexo masculino, procurou o serviço de saúde com queixa de rouquidão e odinofagia. Ao exame médico, apresentou lesão irregular em palato duro e mole com proeminências lobuladas e ulceradas. Foram solicitados teste rápido e sorologia cujos resultados foram negativos. Para confirmação diagnóstica, foi requerido no serviço odontológico a biópsia da lesão e o teste Reação de Polimerase em Cadeia. Conclusão: Salientamos a importância da integração médico odontológica para conclusão do diagnóstico e realização do tratamento.Descritores: Leishmaniose; Leishmaniose Mucocutânea; Diagnóstico.

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Section: Discussionunclassified

Abordagem multiprofissional no diagnóstico de leishmaniose: um relato de caso

Garbín¹,

Belila²,

Precinoti³

et al. 2017

Arch Health Invest

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“…Although there is good theoretical support for these measures, there is no evidence of their effectiveness in reducing the prevalence in endemic regions nor in the expansion of new outbreaks [58–60]. …”

Section: Discussionmentioning

confidence: 99%

Visceral leishmaniasis in an environmentally protected area in southeastern Brazil: Epidemiological and laboratory cross-sectional investigation of phlebotomine fauna, wild hosts and canine cases

et al. 2017

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BackgroundLeishmaniasis is a rapidly expanding zoonosis that shows increasing urbanization. Concern exists regarding the role of wildlife in visceral leishmaniasis (VL) transmission, due to frequent natural or anthropogenic environmental changes that facilitate contact between wildlife, humans and their pets. The municipality of Campinas, in southeastern Brazil, initially recorded VL in 2009, when the first autochthonous case was confirmed in a dog living in an upscale residential condominium, located inside an environmentally protected area (EPA). Since then, disease transmission remains restricted to dogs inhabiting two geographically contiguous condominiums within the EPA.Methodology/Principal findingsWe conducted a cross-sectional study of the VL focus to investigate Leishmania spp. infection in domestic dogs, wild mammals and sand flies using molecular tools and recommended serological techniques. Canine seroprevalences of 1.5% and 1.2% were observed in 2013 and 2015, respectively. Six insect species, confirmed or suspected vectors or potential transmitters of Leishmania, were identified. Two specimens of the main L. (L.) infantum vector in Brazil, Lutzomyia longipalpis, were captured in the EPA. Natural infection by L. (L.) infantum was recorded in one Expapillata firmatoi specimen and two Pintomyia monticola. Natural infection by L. (L.) infantum and Leishmania subgenus Viannia was also detected in two white-eared opossums (Didelphis albiventris), a known reservoir of VL. Geographical coordinates of each sampling of infected animals were plotted on a map of the EPA, demonstrating proximity between these animals, human residences, including the dogs positive for VL, and forest areas.Conclusions/SignificanceThe EPA, which is inhabited by humans, has an active VL focus. The risk of establishing and maintaining disease transmission foci in similar scenarios, i.e. wild areas that undergo environmental modifications, is evident. Moreover, different epidemiological profiles of VL must be included to elaborate prevention and control measures that consider the particularities of each transmission area.

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“…Actually, what happens is the prioritization of some actions to the detriment of others, directly affecting their resolubility 26 , as in the case of actions aimed at controlling Aedes aegypti due to the Dengue-Zika-Chikungunya epidemic, which occurred during the study, to the detriment of other actions, by disregarding local realities.…”

Section: Discussionmentioning

confidence: 99%