Alda Lima Falcão

Epidemiological aspects of American Cutaneous Leishmaniasis in a periurban area of the metropolitan region of Belo Horizonte, Minas Gerais, Brazil

In order to characterize the epidemiology of American Cutaneous Leishmaniasis (ACL) in a periurban area of the municipality of Sabará in the metropolitan region of Belo Horizonte (MRBH), an area until then considered free of the disease, a cross sectional survey was undertaken in 1990. The survey of the population consisted of 1119 interviews and 881 clinical examinations using Montenegros skin test (MST). A low prevalence (3.7%) of positive MST was encountered. The disease had been occurring in the area for about 20 years in the form of sporadic cases. The predominant species of sandfly both in domestic areas and nearby areas of secondary vegetation was Lutzomyia whitmani. A canine survey of delayed hypersensitivity to the antigen P10,000 identified only one dog with a positive reaction out of 113 examined. The transmission of ACL in MRBH was confirmed. The occurrence of the disease in women, children and individuals with no contact with forest areas as well as the presence of potential vector species in the domiciliar environment, suggests the transmission of the disease in this environment.

Estudo de flebotomíneos (Diptera, Psychodidae, Phlebotominae) na zona urbana da cidade de Campo Grande, Mato Grosso do Sul, Brasil, 1999-2000

De fevereiro de 1999 a fevereiro de 2000, realizaram-se capturas semanais com armadilhas luminosas do tipo CDC em cinco regioes da zona urbana da Cidade de Campo Grande, Estado de Mato Grosso do Sul, Brasil. As armadilhas foram colocadas em 11 ecotopos (copa, solo e margem nas matas) e nos peridomicilios (galinheiro e bananeiras). Foram capturados 1.245 flebotomineos de 28 especies, sendo 4 do genero Brumptomyia Franca & Parrot, 1921 e 24 do genero Lutzomyia Franca, 1924. Sao elas: B. avellari, B. brumpti, B. galindoi, B. pintoi, L. aragaoi, L. bourrouli, L. campograndensis, L. cerradincola, L. christenseni, L. claustrei, L. cortelezzii, L. corumbaensis, L. cruzi, L. damascenoi, L. flaviscutellata, L. hermanlenti, L. lenti, L. longipalpis, L. longipennis, L. migonei, L. punctigeniculata, L. quinquefer, L. renei, L. shannoni, L. sordellii, L. teratodes, L. termitophila e L. whitmani. Destaca-se a presenca em area urbana de vetores da leishmaniose visceral (L. longipalpis e L. cruzi) e da leishmaniose tegumentar (L. whitmani, L. flaviscutellata e L. migonei). As cinco especies mais frequentes foram: L. termitophila, L. aragaoi, L. lenti, L. longipennis e L. longipalpis.

Naturally Infected Lutzomyia Sand Flies in a Leishmania-Endemic Area of Brazil

In Brazil, Leishmania transmission involves several species of phlebotomine sand flies that are closely associated with different parasites and reservoirs, giving rise to different transmission cycles. The present study focused on naturally infected phlebotomines originating from Santa Luzia, a municipality near Belo Horizonte, capital of the Brazilian state of Minas Gerais, in which leishmaniasis are endemic. Systematic and non systematic approaches,involving the use of light traps and direct aspiration from resting sites, respectively, were used to collect females and flies. Identification of the captured insects and determination of natural infection by Leishmania spp. were performed using both conventional dissection methods and polymerase chain reaction (PCR). The dissection of 102 sand flies allowed five species of Lutzomyia to be identified, although no flagellate parasite forms were observed.In addition, 211 sand flies were identified, were separated according to species, and were combined into 11 pools of up to 20 individuals each. PCR analyses showed that two of these pools were infected with Leishmania:one pool of Lu. whitmani was infected with Le. (Viannia) spp. and another of Lu. cortelezzii was infected with Le. chagasi. This suggests that Lu. whitmani may be a possible vector of Leishmania in the study area, and more work needs to be performed to assess the role of Lu. cortelezzii as a vector.

Nyssomyia intermedia (Lutz & Neiva, 1912) and Nyssomyia neivai (Pinto, 1926) (Diptera: Psychodidae: Phlebotominae) geographical distribution and epidemiological importance

Nyssomyia intermedia (Lutz & Neiva 1912) and N. neivai (Pinto 1926) are possible vectors of tegumentary leishmaniasis in some regions of Brazil. Further, the latter was until recently, considered a junior synonym of the former. This study has the purpose of updating our knowledge of the geographical distribution of these species, based on specimens deposited at the collection of the Centro de Pesquisas René Rachou-Fiocruz, Faculdade de Saúde Pública-Universidade de São Paulo, and on data presented by literature as also to associate this distribution with the cutaneous leishmaniasis cases reported. It has been reported that N. intermedia occurs in the states of the Northeastern Region, in Rio de Janeiro, Espírito Santo, on the northern coast of São Paulo, in eastern Minas Gerais, Mato Grosso do Sul, and Goiás, close to the border with Minas Gerais and Bahia. N. neivai occurs in the Southern Region, southern coast and in western São Paulo, southern and western Minas Gerais, southern Goiás, and southern Pará, beyond Argentina, Bolivia, and Paraguay. It is important to highlight that N. intermedia and N. neivai occur in sympatry in Minas Gerais and São Paulo. N. intermedia or N. neivai are predominant or are captured abundantly in several cutaneous leishmaniasis foci in the Southeastern and Southern regions of Brazil.

Natural infection of Lutzomyia neivai and Lutzomyia sallesi (Diptera: Psychodidae) by Leishmania infantum chagasi in Brazil.

ABSTRACT Natural infections with Leishmania were found in females of the phlebotomine sand flies Lutzomyia neivai (Pinto) (=Nyssomyia neivai) and Lutzomyia sallesi (Galvão & Coutinho) (=Evandromyia sallesi) (Diptera: Psychodidae) from Lassance, in the Brazilian state of Minas Gerais. Promastigotes were found in the pyloric region of the former species and in the abdominal midgut of the latter species. Insects found to be infected by microscopic examination were macerated in saline solution and inoculated into hamsters. Subsequent analysis by polymerase chain reaction-restriction fragment length polymorphism revealed both isolates to belong to the species Leishmania infantum chagasi Cunha & Chagas.

Leishmaniose tegumentar na Região Metropolitana de Belo Horizonte: aspectos clínicos, laboratoriais, terapêuticos e evolutivos (1989-1995)

This study investigated clinical, laboratorial, therapeutic and prognostic aspects of American cutaneous leishmaniasis in Belo Horizonte in 358 patients with cutaneous leishmaniasis (CL) and 25 with mucocutaneous leishmaniasis (MCL). Compared to CL patients, the MCL patients reported longer duration of disease and higher frequency of other diseases, suggesting that debilitation caused by leishmaniasis or other conditions might contribute to activation and/or mucous dissemination of the parasite. The sensitivity of skin test, indirect immunofluorescence reactions and direct detection of parasites was 78.4, 79.3 and 68.3%, respectively. The treatment with meglumine antimoniate presented 100% efficacy, but 59% patients had side-effects. During two years of follow-up, there were 32/318 relapses after successful treatment. Most relapses (31/32) were of CL patients treated with 15 mg Sb 5+ /kg/day. The negative response to skin test was the only factor associated with a significant threefold increased risk of relapse. Higher dose or longer duration of treatment might improve the prognosis in these patients.This study investigated clinical, laboratorial, therapeutic and prognostic aspects of American cutaneous leishmaniasis in Belo Horizonte in 358 patients with cutaneous leishmaniasis (CL) and 25 with mucocutaneous leishmaniasis (MCL). Compared to CL patients, the MCL patients reported longer duration of disease and higher frequency of other diseases, suggesting that debilitation caused by leishmaniasis or other conditions might contribute to activation and/or mucous dissemination of the parasite. The sensitivity of skin test, indirect immunofluorescence reactions and direct detection of parasites was 78.4, 79.3 and 68.3%, respectively. The treatment with meglumine antimoniate presented 100% efficacy, but 59% patients had side-effects. During two years of follow-up, there were 32/318 relapses after successful treatment. Most relapses (31/32) were of CL patients treated with 15 mg Sb5+/kg/day. The negative response to skin test was the only factor associated with a significant threefold increased risk of relapse. Higher dose or longer duration of treatment might improve the prognosis in these patients.

Redescription of Nyssomyia intermedia (Lutz & Neiva, 1912) and Nyssomyia neivai (Pinto, 1926) (Diptera: Psychodidae)

The phlebotomine sand flies Nyssomyia intermedia and Nyssomyia neivai are the probable vectors of American tegumentary leishmaniasis in the Southern and Southeastern regions of Brazil. These species form a complex, being difficult to separate between either females or males of the two members based on recognized morphological characteristics. Both N. intermedia and N. neivai are redescribed here in the search for characters that facilitate their correct identification. It was possible to differentiate females by means of spermathecal characteristics. Males could be separated with confidence by the tips of the genital filaments, which have the form of a deep spoon, the angle of the concavity being well accentuated in N. intermedia and much shallower in N. neivai.

Flebotomíneos do Estado de Tocantins, Brasil (Diptera: Psychodidae)

Between 1997-1998, the authors carried out sporadic collection of sand flies in the municipalities of Paraíso de Tocantins, Monte do Carmo, Porto Nacional and Monte Santo all in the Tocantins State of northern Brazil. Human bait was used in Monte Santo and a battery operated light trap in other municipalities. The ecotypes chosen for the traps were in the peridomiciles, inside the houses, in the forest and the orchard. We identified 2,677 sand flies, belonging to 32 species. The most abundant species of sand flies were Lutzomyia whitmani, Lutzomyia longipalpis, Lutzomyia carmelinoi, Lutzomyia evandroi, Lutzomyia longipennis and Lutzomyia antunesi. Collections from the forest showed greater diversity of species, while the largest number of sand flies were caught around the houses. Several species known or suspected to be vectors of Leishmania in other regions of Brazil were captured.

Effect of deltamethrin spraying on the sandfly populations in a focus of American cutaneous leismaniasis

The effect of deltamethrin of the sandfly population in a focus of American Cutaneous Leishmaniasis in Viana, Espírito Santo State is described. The phlebotomine population density was determined inside and outside houses during a one year period in a treated and untreated area. The results showed a significant reduction in the number of sandflies inside houses in the treated area compared with both the untreated area and the same area before spraying. Despite having a residual action for 12 months after spraying the insecticide was ineffective outside houses. It is concluded therefore that deltamethrin is an efficient insecticide for reducing the number of phlebotomine sandflies inside houses.

Estudo dos flebotomíneos (Diptera: Psychodidae) em área de leishmaniose tegumentar americana nos municípios de Alto Caparaó e Caparaó, Estado de Minas Gerais

In the period from November of 2000 to November of 2001, a study of sand flies was realized in the municipalities of Alto Caparao and Caparao with the objective of determining their seasonal variation, comparing the points of study related to the occurrence of these insects and detecting their ideal environments. Monthly collections were carried out, with Falcao light traps at nine points, four traps per point, in the following environments: of animals shelter, forest (bush), coffee plantation and the external walls of houses. Lutzomyia intermedia (Lutz & Neiva, 1912) was the predominant species, and animal shelter the environment with the largest occurrence of sand flies. A significant difference in the composition of sand fly species was found in the studied points. Lutzomyia intermedia is the species suspected of transmitting Leishmania in the region.