First report of an autochthonous human visceral leishmaniasis in a child from the South of Minas Gerais State, Brazil

Abstract

American visceral leishmaniasis (VL) is a vector-borne disease transmitted by some species of phlebotomine sandflies from the genus Lutzomyia. This neglected tropical zoonosis shows increasing urbanization process, since the end of the 1980s. After the emergence of foci of the disease in urban areas, VL has assumed an important role in public health. Although VL is widely prevalent in several parts of the world, diagnosing the illness is still difficult. We present a case of a 12-year-old girl with a history of recurrent fever, anorexia, cachexia, chronic fatigue, weight loss, left palpebral unilateral edema, persistent cough and pancytopenia. A diagnosis of VL was performed using a reference immunochromatographic rapid test. Identification of the infecting protozoan was directly obtained by PCR of bone marrow. The patient responded favorably to treatment using liposomal amphotericin B. This is the first report of human visceral leishmaniasis in the city of Lavras in the South of Minas Gerais State. This first report of VL highlighted the need of maintenance of permanent surveillance and control programs in the city of Lavras, including the active search of sandflies, human and canine cases. The current situation of Lavras should also be taken as an alert to other near cities where favorable eco-epidemiological conditions may exist.

Larva Migrans: a growing public health problem highlighted by a beach tennis outbreak

“…In addition, 71.4% of the survey participants reported the circulation of stray animals in the condominium, indicating a possible risk of environmental contamination. The increasing number of stray animals represents a public health problem due to their ability to be sources of various pathogens such as intestinal parasites that release their eggs through feces, contaminating the environment and exposing humans to the risks of infection (Otranto et al, 2017). A study conducted in Fortaleza, Brazil, found a prevalence of 25.75% of A. caninum in street dogs, representing a high level of exposure to this parasite, which is the etiological agent of CLM in the region (Klimpel et al, 2010).…”

“…The study was conducted in the municipality of Lavras, which is located in the southern region of Minas Gerais State, Brazil, at an altitude of 919 m (21º14'43"S 44º59'59"W) (Narciso et al, 2018). Lavras has a population of roughly 99,229 inhabitants and the total area of the city is 564.7 km².…”

Leishmaniasis: neglected diseases also by health professionals

“…Timely notification of suspicion is crucial for the proper management of the patient, including the application of the best diagnostic methodologies to prevent fatal outcomes (Brasil, 2014;2017). Regarding Canine Visceral Leishmaniasis (CVL), there is still no unified instrument for notification.…”

“…It is relevant to highlight that out of the 26 professionals who claimed knowledge of cases of Human Visceral Leishmaniasis (HVL) in their municipalities of practice, 25 were from Lavras and one from Varginha. Although Lavras is the only municipality in the southern region of the state with autochthonous cases of HVL (NARCISO et al, 2019), one allochthonous case of HVL, originating from Belo Horizonte, was monitored by a professional from Varginha (Com. Pess.).…”

“…Given the pertinent knowledge about surveillance and control strategies of leishmaniasis, coupled with the identification of a new area of intense disease transmission in the southern state of Minas Gerais, where cases in humans and dogs have been recorded, as well as the presence of the vector (BARÇANTE et al, 2015;BARÇANTE et al, 2019;CASTRO et al, 2019;NARCISO et al, 2019;MELO et al, 2023;NARCISO et al, 2023), this study aims to assess the perceptions of health professionals regarding leishmaniasis. Understanding the perceptions of health professionals is crucial for building a participatory approach and dialogue among various health professionals (both in human and veterinary fields) and the population, thereby contributing to enhancing disease surveillance and control programs.…”