Leishmaniases of the New World: current concepts and implications for future research

Abstract

Recent epidemiologic studies indicate that leishmaniasis in the Americas is far more abundant and of greater public health importance than was previously recognized. The disease in the New World is caused by a number of different parasite species that are capable of producing a wide variety of clinical manifestations. The outcome of leishmanial infection in humans is largely dependent on the immune responsiveness of the host and the virulence of the infecting parasite strain. This article reviews current concepts of the clinical forms, immunology, pathology, laboratory diagnosis, and treatment of the disease as well as aspects of its epidemiology and control. Recommendations for future research on the disease and its control are made.

Leishmaniasis cutánea zosteriforme causada por Leishmania (Viannia) panamensis y Leishmania (Viannia) braziliensis: reporte de tres casos

“…Therefore, the spectrum of the disease varies from asymptomatic cutaneous infection to visceral involvement, which is potentially mortal (14). In the Americas, 95.7% of the cases for which clinical information is available are classified as cutaneous leishmaniasis (1).…”

Successful therapeutic response of resistant cases of mucocutaneous leishmaniasis to a very low dose of antimony

“…Several papers have been published during this time searching for a more suitable schedule of antimony therapy that is either less toxic and/or easier to apply 5 11 12 14 17 . In Rio de Janeiro State, an endemic area of Leishmania (V.) braziliensis transmission as the sole agent for tegumentary leishmaniasis 7 , the efficacy of low doses of antimony have been regularly demonstrated 10 15 , even in the treatment of mucosal lesions 13 . The majority of proposed antimony schedules are based on the antimony dose, not on the treatment period.…”

“…Its disadvantages, however, are numerous and include cost, the requirement of daily injections and the considerable morbidity of antimony therapy. In Rio de Janeiro State, Leishmania (Viannia) braziliensis (L. (V.) braziliensis) is the only species detected so far 7 . Other drugs commonly used for the treatment are amphotericin B and pentamidine, but the former is considerably toxic and the latter seems to be less effective in controlling L. (V.) braziliensis infections 1 .…”

Comparación cariotípica de cinco especies de Lutzomyia (diptera: psychodidae) de la serie townsendi grupo verrucarum en Colombia.

“…Estos insectos se encuentran en la mayor par te del neotrópico y son especialmente abundantes en áreas montañosas, donde las hembras de varias especies han sido incriminadas como vectores de Leishmania y Bartonella bacilliformis (7,8). La serie townsendi, a su vez, está conformada por 9 especies, las cuales se pueden diferenciar mediante algunas características morfológicas de los machos; las hembras son casi idénticas en forma y estructura (isomórficas) y es difícil separarlas taxonómica-mente por características externas (5,9,10).…”