Urban Transmission of American Cutaneous Leishmaniasis in Argentina: Spatial Analysis Study

Abstract

We used kernel density and scan statistics to examine the spatial distribution of cases of pediatric and adult American cutaneous leishmaniasis in an urban disease-endemic area in Salta Province, Argentina. Spatial analysis was used for the whole population and stratified by women > 14 years of age (n = 159), men > 14 years of age (n = 667), and children < 15 years of age (n = 213). Although kernel density for adults encompassed nearly the entire city, distribution in children was most prevalent in the peripheral areas of the city. Scan statistic analysis for adult males, adult females, and children found 11, 2, and 8 clusters, respectively. Clusters for children had the highest odds ratios (P < 0.05) and were located in proximity of plantations and secondary vegetation. The data from this study provide further evidence of the potential urban transmission of American cutaneous leishmaniasis in northern Argentina.

Ocorrência de casos de leishmaniose tegumentar americana: uma análise multivariada dos circuitos espaciais de produção, Minas Gerais, Brasil, 2007 a 2011

“…Resultados semelhantes corroboram o nosso resultado como, por exemplo, no estudo realizado em Caratinga (Minas Gerais) 12 , onde a transmissão da LTA estava associada a precárias instalações sanitárias e exposição ao lixo (p < 0,001). No Município de Teresina (Piauí), a mesma relação foi identificada, porém, com casos de leishmaniose visceral 24 , cuja incidência urbana estava relacionada ao percentual médio de casas sem água tratada (p < 00,1) e, por fim, no norte da Argentina o aumento da prevalência da doença estava relacionado a bairros com esgotamento sanitário deficiente (p < 0,05) 10 .…”

Restricted Outbreak of American Tegumentary Leishmaniasis with High Microfocal Transmission

“…15,30,31 Ecotones, such as fringe forest, are areas where biological activity and ecological evolutionary processes are concentrated and intensified, and have been proposed to create an edge effect that increases the risk of disease transmission. 32,33 This edge effect, compounded by the reduction of primary forest areas, which results in isolated patches of primary growth (Figure 1), can cause loss of diversity and the potential concentration of reservoirs and vectors in spatially restricted sites. 15,34 Based on this and other evidence suggesting a microfocal transmission pattern of Leishmania sp., 10,25 the most plausible explanation for the event described in this report is that the five hunters were exposed to a zoonotic "hot spot."…”

“…2 The highest incidence and the largest number of reported cases of ATL in Argentina, are found in the Department of Oran, Salta Province, where epidemic outbreaks have also been reported. [3][4][5] To date, the clinical forms of leishmaniasis reported in this region are cutaneous (CL) and mucocutaneous leishmaniasis (MCL), and the predominant species isolated from these autochthonous cases has predominantly been Leishmania (Viannia) braziliensis; though few cases caused by Leishmania (Viannia) guyanensis and Leishmania (Leishmania) amazonensis have also been reported. 6,7 Recently, autochthonous transmission of visceral leishmaniasis caused by Leishmania (Leishmania) infantum was also reported in Salta.…”

Complementary exams in the diagnosis of american tegumentary leishmaniasis

“…11 For these reasons, if there is a compatible dermatological presentation, the lack of history of traveling to areas of native vegetation should not exclude the diagnosis of ATL.…”