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American leishmaniasis epidemiology in Brazil

Published online by Cambridge University Press:  19 September 2011

Almério de Castro Gomes
Almério de Castro Gomes
Affiliation:
Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr Arnaldo, 715, 01255-São Paulo/SP, Brazil
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Abstract

We have tried to demonstrate in this paper that visceral and cutaneous leishmaniasis are a great public health problem in Brazil. In relation to visceral leishmaniasis, the recognition of new foci denotes the increasing spread of endemic areas, but the areas of highest importance are located mainly at the northeastern region. It calls attention to its suburban character in cities like São Luis, Teresina and Rio de Janeiro. L. longipalpis is the only vector known for the disease in domiciliary environment. The dog constitutes the main source for L.d. chagasi, while canids such as Dusicyon vetulus and Cerdocyon thous have epidemiological roles. Other vectors for this parasite remain yet as unknown in the enzootic and sylvatic cycles.

Cutaneous leishmaniasis have a distribution in almost all the States of Brazil and, at least, two epidemiological patterns exist. The first, corresponds to the classic form of man entering in contact with the agent in virgin forests, like the Amazonian forest and so, there is a permanent risk for epidemics. The second, refers to the occurrence of this disease in areas after forest devastation as in the State of São Paulo and in other southeastern States. There are three nosological entities for the cutaneous leishmaniasis in Brazil, their agents being L.m. amazonensis, L. guyanensis and L.b. braziliensis. Five sandfly species have been incriminated as the main vectors in the transmission of the disease in different localities. They are P. flaviscutellatus, P. umbratilis, P. welcomei, P. whitmani and P. intermedius. As for the main natural reservoir of cutaneous leishmaniasis, it remains unknown the one relative to L.b. braziliensis.

Résumé

Au cours de nos travaux sur la leishmaniose viscérale et cutanée, il devient évident qu'elles réprésentent un grand problème de santé publique au Brésil nonobstant que se vraie prévalence soit encore ignorée.

En ce qui concerne à la leishmaniose viscérale, la découverte de nouveaux foyers dénote l'acroissement de la distributions des surfaces endémiques. Cependant, les plus considérables se trouvent, surtout, à la région nord-est. On signe aussi le caractère suburbain de cette maladie aux villes de São Luiz, Teresina et Rio de Janeiro. La Lutzomyia longipalpis est l'unique vecteur connu de cette maladie avec un habitat domiciliaire. Le chien rèste le principal réservoir de la Leishmania donovani chagasi mais d'autres espèces de canin, tels que le Dusicyon vetulus et le Cerdocyon thous ont un rôle epidémiologique secondaire. Au cycle biologique sylvestre, les vecteurs restent encore inconnus.

Les leishmanioses cutanées sont répandues par presque tous les états brésilens et ainsi donc, deux patrons épidémiologiques de la maladie ont été classifiés: le premier, fait rapport à la forme classique par laquelle l'home peut l'acquerir, c'est-à-dire, au contact avec l'agent, à l'Amazonie, ayant comme résultat um risque permanent d'epidémie. Le deuxiène fait égard à l'occurrence de la maladie aux régions de forêts entièrment dévastées aux États de São Paulo et d'autres de la région sud-est du pays.

On trouve au Brésil trois catégories nosologiques de la leishmaniose cutanée ayant par agents la Leishmania mexicana amazonensis, la Leishmania braziliensis guyanensis et la Leishmania braziliensis braziliensis. Cinq espèces de phlébotomes s'engagent comme vecteurs principaux en certaines régions: le Psychodopygus flaviscutellatus, le Psychodopygus umbratilis, le Psychodopygus wellcomei, le Psychodopygus whitmani et le Psychodopygus intermedius.

En ce qui concerne aux principaux réservoir de cer maladies il n'a que la L.b. braziliensis qui reste ignorée.

Keywords

Leishmaniasis ecologyepidemiologyPhlebotominaeLeishmaniavector speciesreservoir animal
Type
Special Section: Leishmaniasis Epidemiology
Information
International Journal of Tropical Insect Science , Volume 7 , Issue 2 , April 1986 , pp. 161 - 169
Copyright
Copyright © ICIPE 1986

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