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Title: Epidemiologia da leishmaniose tegumentar no município de Juruti, Pará
metadata.dc.creator: SOARES, Daniela Cristina
metadata.dc.contributor.advisor1: GARCEZ, Lourdes Maria
Keywords: Doenças transmissíveis
Leishmaniose tegumentar
Reação em cadeia da polimerase
Juruti - PA
Pará - Estado
Amazônia brasileira
Issue Date: Jul-2008
Publisher: Universidade Federal do Pará
Citation: SOARES, Daniela Cristina. Epidemiologia da leishmaniose tegumentar no município de Juruti, Pará. 2008. 93 f. Dissertação (Mestrado) – Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, 2008. Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários.
Abstract: The tegumentary leishmaniasis (TL) is expanding in Pará State, Brazil. Juruti is one of its 143 municipalities and current scenery of huge environmental changes due to bauxite mining, what can influence the transmission patterns. The aim of this study was to elucidate epidemiological features relevant for the TL control in Juruti. The TL frequency and patients profile in the Municipal Hospital Francisco Barros were determined from January to December/2007. Silvatic phlebotomines species around an area of bauxite prospection were also described during an entomological screening in January, 2008 (Shannon trap/6:00pm to 8:00pm/2 nights). In 21 individuals having cutaneous lesions suspected of TL, skin biopsies were done among February and June, 2007. In this group the parasitological (stained smear and culture), molecular diagnosis (PCR; nested-PCR) and Montenegro Skin Test were done. Primers of ribossomal enusspecific (S4, S12; S17, S18) and of G6PD DNA were used for distinguish subgenus Viannia (ISVC, ISVG) and L. (V.) braziliensis species (ISVC, ISVA; ISVC, ISVB). In 2007, there were confirmed 42 new cases of LT, with mensal average lower than four (3,5 + 0,8), highest frequency in July (11) and lowest in June and November (0). Most patients were represented by men (41/42, 98%) younger than 20 years old (<10 years old: 30%; 10-20: 57%; 20-40: 12%). Most were also resident in rural localities (33/42, 79%) including impact mining area (19/42, 45%) and performed activities of risk (28/42, 67%). The companies’ workers were 12 (29%). The molecular analyses of the 21 samples identified 12 positive for the genus Leishmania (57%), within 11(52%) were parasitologically confirmed. Most positives hybridized extracted DNA with species specific primers (9/12, 75%), while the others were incompatible with primers for subgenus Viannia and for L. (V.) braziliensis species, so the samples were cloned and sequencing, what confirmed L. Viannia) sp. Only 9/12 (75%) confirmed cases by parasitological and/or molecular methods had delayed hipersensibility in response to Montenegro antigen, which diameter varied from 7 to 40mm (16,3 + 3,2). There were captured 105 phlebotomines of 13 species in the following frequency: 1-Lutzomyia geniculata (23, 22%), 2-Lutzomyia paraensis (21, 20%), 3-Lutzomyia complexa (18, 17%), 4-Lutzomyia davisi (10, 10%), 5-Lutzomyia flaviscutellata (13, 13%) and other eight species (20, 18%). Leishmania species of the subgenus Viannia, particularly L. (V.) braziliensis, predominate in Juruti, what is compatible with the large diameter of the cutaneous lesions observed in response to Montenegro antigen and with the common reports of persistence and reactivation even though the specific treatment. Within the antropophilic phlebotomines highlighted Lu. complexa (17%) e Lu. flaviscutellata (13%) since are vectors of L. (V.) braziliensis and L. (L.) amazonensis respectively, associated to the severe forms of human TL. Control measures in Juruti should focus morbidity reduction, early diagnosis, active surveillance of human TL, entomological and microenvironmental surveillance around the impact mining area.
Appears in Collections:Dissertações em Biologia de Agentes Infecciosos e Parasitários (Mestrado) - PPGBAIP/ICB

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