Revista Brasileira de Epidemiologia
Print version ISSN 1415-790X
SILVA-NUNES, Mônica da; CAVASINI, Carlos Eugênio; SILVA, Natal Santos da and GALATI, Eunice Aparecida Bianchi. Epidemiology of Cutaneous Leishmaniasis and description of phlebotomine sandfly populations in the city of Acrelandia, Acre, Brazil. Rev. bras. epidemiol. [online]. 2008, vol.11, n.2, pp. 241-251. ISSN 1415-790X. http://dx.doi.org/10.1590/S1415-790X2008000200006.
This paper describes the distribution of cutaneous leishmaniasis (CL) in the city of Acrelandia, state of Acre, and its phlebotomine sandfly population. Epidemiological data were obtained from case reporting forms in 2001-2004, and entomological data resulted from catches performed between 2004 and 2005 using light traps. A total of 82 new cases of CL, aged between 2 and 62 years, 75.6% males, and 83.9% in the rural area, were identified. The prevailing clinical form was cutaneous (92.7%) with a single lesion (78%). Direct microscopic exams of lesions, Montenegro skin reaction tests, and biopsies resulted in 100%, 98% and 79.5% positivity rates, respectively. The therapeutic response was successful in 81.7% of subjects; treatment refractoriness was higher among CL patients with clinical diagnosis only (41.2%) and among those who received inadequate daily doses of antimonial drug (64.3%). Forty specimens of phlebotomine sandfly were collected around houses with CL cases (3 genera, 14 species); three of those species are known as vectors or possible vectors of Leishmania: Nyssomyia antunesi prevailed in the peri-domiciliary environment (59.1%) and forest borders; Nyssomyia whitmani was frequent in peri-domiciliary areas (15%) and was the only female captured in the intra-domiciliary environment; and Trichophoromyia ubiquitalis was found in the peri-domiciliary environment. The information derived from pre-existing epidemiological data, despite limitations, provided an evaluation of diagnosis and treatment efficacy, while the entomological data can be used as a guideline to develop a larger study aimed to identify both vectors and circulating Leishmania species.
Keywords : Cutaneous leishmaniasis; Phlebotomine Sandfly population; Epidemiology.