RESUMO
Cutaneous leishmaniases are endemic over the entire territory of French Guiana. At least 5 distinct Leishmania species coexist in the sylvatic ecotopes of this French territory. The present paper checks the advances in the ecological research field during the past 5 years. The current epidemiological situation and trends are detailed successively Links between the recrudescence of leishmaniases and gold-mining are highlighted. The potential adaptation of the pathogenic complexes to the newly anthropized habitats is also described.
Assuntos
Doenças Endêmicas/estatística & dados numéricos , Leishmaniose Cutânea/epidemiologia , Animais , Reservatórios de Doenças , Ecossistema , Guiana Francesa/epidemiologia , Humanos , Incidência , Insetos Vetores/parasitologia , Leishmania/classificaçãoRESUMO
The first time the term phlebotomine sandfly was used, was by an Italian naturalist, Philippo Bonanni, in 1691. The first description though was made by another Italian naturalist, Scopoli, under the name Bibio papatasi. The name of the genus, Phlebotomus, was not given until 1840 by Rondani and Berté. The first description of an American phlebotomine sandfly was made by Coquillett, in 1907. The discovery of the three first sandflies in Brazil is the work of Lutz and Neiva, in 1912. From this date till 1921, 11 new species were described in this country and since then their number is still increasing and has reached 229 at this time. The history of the identification of phlebotomine sandflies as vectors, in Brazil like elsewhere in South America, is as complex as the one of the leishmaniases themselves, to which it is closely linked. The knowledge of cutaneous leishmaniasis in Brazil goes back to 1909, when Gaspar Vianna proposed to name the parasites that were found Leishmania braziliensis (1911). Following the observation of the Sergent brothers on the role of Phlebotomus papatasi in the transmission of cutaneous leishmaniasis in Algeria (1921), it became obvious that phlebotomine sandflies should be incriminated as vectors of cutaneous leishmaniasis in the Americas and that proof should be sought of their role. This is what various Brazilian scientists have done, like Aragão in 1922, Pessôa and Pestana in 1940. In the 1950s evidence was produced that the different forms of leishmaniasis that infest the American continent were caused by distinct species of the parasite. Subsequently, successful searches for the specific vectors were carried out. A by-product of the epidemiological studies of leishmaniases has been the discovery of the transmission of other parasites of the Trypanosomatid families (Crithidia, Endotrypanum, Trypanosoma). More recently, since the 1960s, a large number of viruses amongst which Rhabdoviridae, Bunyaviridae and Reoviridae, have been isolated from phlebotomine sandflies. Between 1961 and 1995, 69 serotypes of different arboviruses were obtained from different zones of Brazilian Amazonia.
Assuntos
Insetos Vetores/parasitologia , Leishmaniose/história , Parasitologia/história , Psychodidae/parasitologia , Animais , Arbovírus/isolamento & purificação , Brasil , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Insetos Vetores/virologia , Leishmaniose/transmissão , Phlebotomus/parasitologia , Phlebotomus/virologia , Psychodidae/virologia , Trypanosomatina/isolamento & purificação , Viroses/história , Viroses/transmissãoRESUMO
Disseminated cutaneous leishmaniasis is characterized by the presence of a large (> or =10) number of lesions at several anatomic sites (head, limbs, and trunk). Most of the lesions are small, papular, and appear simultaneously with or secondarily to one or several ulcerated lesions of localized cutaneous leishmaniasis. We report the first case of disseminated cutaneous leishmaniasis in French Guiana. It concerns a 24-year-old woman who tested negative for human immunodeficiency virus (HIV). The disease began with three lesions that became ulcerated. One week later, multiple papulo-nodular lesions appeared. We counted a total of 425 lesions. Leishmania were observed in the lesions. The species involved was L. guyanensis, which has never been described in a case of disseminated cutaneous leishmaniasis. The patient was rapidly cured by a single course of pentamidine. Disseminated cutaneous leishmaniasis should be distinguished from other types of leishmaniasis with multiple lesions. These include anergic diffuse cutaneous leishmaniasis, post-kala-azar leishmaniasis, and leishmaniasis associated with HIV infection.
Assuntos
Leishmania guyanensis , Leishmaniose Cutânea/diagnóstico , Adulto , Animais , Antiprotozoários/uso terapêutico , Dorso , Mama , Diagnóstico Diferencial , Feminino , Dedos , Guiana Francesa , Humanos , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/patologia , Masculino , Pentamidina/uso terapêuticoRESUMO
BACKGROUND: Few data are available on cutaneous leishmaniasis caused by dermotropic species in human immunodeficiency virus (HIV)-infected patients. OBJECTIVES: To describe nine cases of cutaneous leishmaniasis in HIV+ patients and to compare their clinical features and their response to treatment with those of HIV- patients with the forms of leishmaniasis commonly found in French Guiana. METHODS: A case-control study was carried out between July 1994 and December 2000 in French Guiana. We compared the following variables in nine HIV-infected patients with leishmaniasis and 27 matched controls: clinical type of leishmaniasis, number of lesions, presence of lymphangitis and adenopathy, the rate of recovery after treatment, and recurrence or reinfection. RESULTS: Eight of the HIV-infected patients had localized cutaneous leishmaniasis and one had mucocutaneous leishmaniasis. All of the controls had localized cutaneous leishmaniasis. Leishmania guyanensis was the only species isolated from HIV-infected subjects. HIV-Leishmania coinfected patients had a higher rate of recurrence or reinfection (P < 0.02) and a lower rate of recovery after one treatment cycle with pentamidine (P < 0.02) than did HIV- subjects. The CD4+ lymphocyte counts exceeded 200 mm(-3) in all HIV+ patients at the time of the diagnosis with leishmaniasis. CONCLUSIONS: In French Guiana, cutaneous leishmaniasis in moderately immunosuppressed HIV-infected subjects (> 200 CD4+ T cells mm(-3)) is characterized by a higher rate of recurrence or reinfection and is more difficult to treat than that in HIV- subjects.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/patologia , Leishmaniose Cutânea/patologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Adulto , Idoso , Antiprotozoários/uso terapêutico , Contagem de Linfócito CD4 , Estudos de Casos e Controles , Feminino , Humanos , Hospedeiro Imunocomprometido , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/imunologia , Masculino , Pessoa de Meia-Idade , Pentamidina , Recidiva , Resultado do TratamentoRESUMO
Two cases of skin lesions similar to those caused by Leishmania parasites have been reported from Martinique. Parasites isolated from these lesions were unlike Leishmania reference strains by isoenzyme analysis and electron microscopy and were assumed to be monoxenous trypanosomatids which normally only infect invertebrates. Both strains have now been retyped by isoenzyme analysis and found to be identical to each other and distantly related to all other Leishmania species. The sequence of the 18S ribosomal RNA gene and partial sequences of the DNA polymerase alpha and RNA polymerase II largest subunit genes were obtained. These sequences indicated that the Martinique parasites clustered with L. enriettii and were basal to all other euleishmania. However, support for both the position basal to all euleishmania and the clustering with L. enriettii was low. The Martinique parasites may cluster with L. (Leishmania) or L. (Viannia) or form a novel clade within the euleishmania either with or without L. enriettii.
Assuntos
Leishmania/classificação , Leishmaniose Cutânea/parasitologia , Animais , DNA Polimerase I/química , DNA Polimerase I/genética , DNA de Protozoário/química , DNA de Protozoário/genética , DNA de Protozoário/isolamento & purificação , DNA Ribossômico/química , DNA Ribossômico/genética , DNA Ribossômico/isolamento & purificação , Eletroforese em Gel de Amido , Humanos , Isoenzimas/metabolismo , Leishmania/enzimologia , Leishmania/genética , Leishmaniose Cutânea/patologia , Martinica , Filogenia , Reação em Cadeia da Polimerase , RNA Polimerase II/química , RNA Polimerase II/genética , Alinhamento de Sequência , Análise de Sequência de DNA , Homologia de Sequência do Ácido NucleicoRESUMO
This report describes the results of epidemiological surveillance of cutaneous leishmaniasis in French military personnel in French Guiana. Data was collected regarding microscopic diagnosis, clinical manifestations, and lesion location as well as compliance with vector control measures. Year-to-year variations in the incidence in the general population have been attributed to changes in climatic conditions. Monitoring incidence and density curves, correlation of findings with local epidemiological data, and analysis of the most recent epidemic in 1998/99 (326 cases, attack rate 3.2% men years) highlight the importance of behavioral factors. The proportion of total cases involving military personnel varied widely from 20 to 85%. Investigation consistently showed that failure to apply elementary protective measures against sandfly bites was the most determinant factor in this proportion. Strict compliance with these measures appears to reduce the risk of infection considerably.
Assuntos
Leishmaniose Cutânea/epidemiologia , Militares , Animais , Clima , Estudos Epidemiológicos , Guiana Francesa/epidemiologia , Humanos , Incidência , Mordeduras e Picadas de Insetos , Controle de Insetos , Insetos Vetores , Vigilância da População , Psychodidae , Fatores de Risco , ZoonosesRESUMO
Four human cases of localized cutaneous leishmaniasis caused by Leishmania naiffi are reported. Two of the cases were infected in French Guiana, one in French Guiana or Martinique, and the other in Ecuador or Peru. The geographical distribution of L. naiffi is clearly larger than that initially reported. Three zymodemes were represented by the four isolates, confirming that there is intraspecific polymorphism in L. naiffi.
Assuntos
Leishmania/isolamento & purificação , Leishmaniose Cutânea/parasitologia , Adulto , Animais , Eletroforese em Gel de Amido/métodos , Feminino , Humanos , Leishmania/classificação , Leishmania/enzimologia , Masculino , América do SulAssuntos
Ectoparasitoses/parasitologia , Dermatoses Faciais/parasitologia , Trypanosomatina/isolamento & purificação , Animais , Ectoparasitoses/epidemiologia , Ectoparasitoses/imunologia , Dermatoses Faciais/epidemiologia , Dermatoses Faciais/imunologia , Humanos , Imunocompetência , Masculino , Martinica/epidemiologia , Pessoa de Meia-Idade , Trypanosomatina/imunologiaRESUMO
In a visceral leishmaniasis endemic locality of northeast of Brasil where all settlements were treated with cypermethrin, a follow-up of Lutzomyia longipalpis populations was carried out by regular collections. The residual effect of the insecticide was studied using biological assays on three different types of walls. The results showed that the insecticides had an effect on intradomiciliar Lu. longipalpis populations limited to two months, and had no significant effect on peridomiciliar vector populations. The mortality rates of the tested sandflies were variable according to the type of wall. The decreasing of the insecticide effect was marked since the 3rd month, and mortality rates were identical whatever the type of wall since the 4th month. Unsufficient residual effect was detected after the 4th month.
Assuntos
Bioensaio/métodos , Insetos Vetores/efeitos dos fármacos , Inseticidas/farmacologia , Resíduos de Praguicidas/farmacologia , Psychodidae/efeitos dos fármacos , Piretrinas/farmacologia , Animais , Brasil , Monitoramento Ambiental , Seguimentos , Leishmaniose Visceral/parasitologia , Fatores de TempoRESUMO
La leishmaniasis mucocutánea americana es un grave problema de salud en el Perú, particularmente en la región montañosa de Cuzco, donde se produjeron 25 por ciento de todos los nuevos casos notificados en 1989. El número de casos ha aumentado notablemente desde principios del denenio de 1980, cuando hubo una emigración estacional en gran escala a las zonas endémicas, especialmente a la región forestal de Madre de Dios, debido al descubrimiento de nuevas minas de oro en esa zona y al deterioro económico en el Perú. Ante la falta de respuesta oficial del Gobierno peruano, centenares de enfermos de leishmaniasis en la zona de Cuzco formaron asociaciones de autoayuda con el objetivo de obtener los medicamentos necesarios para tratar su afección. El logro principal de este movimiento que surgió espontáneamente, apoyado por varias instituciones públicas y privadas, fue animar a los enfermos, particularmente a los pacientes con lesiones de las mucosas, a salir del aislamiento. Como resultado, se han reducido mucho la prevalencia e incidencia de la enfermedad en ese territorio
American mucocutaneous leishmaniasis is an important health problem in Peru, particularly in the mountainous Cuzco Region, where 25% of all new cases reported in 1989 were located. Cases have increased considerably since the beginning of the 1980s, when large-scale seasonal migration to endemic zones occurred, particularly in the forest area of Madre de Dios, following the discovery of new gold deposits there and the deterioration in the economic situation in Peru. Following the lack of official response from the Peruvian government, hundreds of people suffering from leishmaniasis in the Cuzco area formed self-help associations with the objective of obtaining the drugs needed to treat their disease. The major achievement of this spontaneous movement, which was supported by several public and private institutions, was to encourage sick people, particularly patients with mucosal lesions, to emerge from isolation. As a result, the prevalence and incidence of the disease have now considerably decreased in the region.