Maria Elizabeth Cavalheiros Dorval

Estudo dos flebotomíneos (Diptera, Pychodidae), em área de leishmaniose tegumentar, no Estado de Mato Grosso do Sul, Brasil

Studies of the phlebotomine sandflies on the Boa Sorte farm, Corguinho county, State of Mato Grosso do Sul, Central-West region of Brazil, were carried out, with the object of identifying local fauna and a cutaneous leishmaniasis vector. At the beginning of the studies, several types of primitive vegetation covering: gallery forest, forest slopes and the cerrados: s. str. and tropical xeromorphic semideciduous broadleaf forest, locally denominated “croa”, existed. Four months after the beginning of the studies, a fire destroyed a significant part of the cerrados. Captures were made during the interval from July/91 to June/93, with a CDC trap, weekly, at 10 ecotopes: in the soil of forest slopes; in the soil and canopy of cerrado s. str., “croa” and gallery forest; in the peridomicile, in hen house and pigpen and in a storage shed. A Shannons trap was used, monthly, from 18:00-24:00 hours, in the gallery forest and “croa”. Human bait was used, monthly, for 24 hours, from June/91 to September/92. An investigation into natural infection in female phlebotomines was made through the dissection of specimens captured in the Shannons trap and on human bait. The captures with CDC totalled in 2,281 specimens of 26 species: 2 of Brumptomyia and 24 of Lutzomyia. The “croa” was the environment that contributed with the greatest number of specimens and presented the largest diversity, together with the forest slope. L. withmani was the most abundant species captured with CDC, in all the ecotopes (Standardized abundance index = 0.991). However, in the storage shed its frequence was the lowest. This species presented a prevalence of 96.0% in the Shannons trap and on human bait (3,265 and 516 specimens, respectively). It was the most frequent in the cold and dry periods. It presented almost exclusively nocturnal activity, with its peak at 18:00-19:00 hours and an infection rate by flagellates of 0.16% (613 females dissected). On the basis of its behavior, this species was incriminated as the probable vector of the cutaneous leishmaniasis in the area, which had extradomicilary transmission. L. lenti, the second most abundant species, is not anthropophilic. The phlebotomine fauna is presented by environment. Leishmaniosis mucocutaneous, transmission. Psychodidae, classification. Vectores ecology.

Abundance of Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae) and urban transmission of visceral leishmaniasis in Campo Grande, state of Mato Grosso do Sul, Brazil

The outspread and urbanization of visceral leishmaniasis (VL) in Campo Grande, state of Mato Grosso do Sul, lead us to undertake the present study over diversity and abundance of sand flies in the urban area to compare with previous search carried out during 1999/2000, before the identification of the disease in the human population. The captures were carried out with automatic light traps, weekly, from February 2004 to February 2005 on three sites including a forested area (Zé Pereira), two peridomicilies (shelters of domestic animals and cultivation areas), and intradomicilie. In the present study 110 collections were obtained during 13 months for 1320 h of collections, resulting in 5004 specimens, 3649 males and 1355 females belonging to the 20 following species: Brumptomyia avellari, Brumptomyia sp., Bichromomyia flaviscutellata, Evandromyia lenti, E. termitophila, E. cortelezzii, E. borrouli, Lutzomyia sp., L. longipalpis, Micropygomyia quinquefer, N. antunesi, N. whitmani, Pintomyia christenseni, Pi. damascenoi, Psathyromyia aragaoi, Ps. campograndensis, Ps. hermanlenti, Ps. shannoni, Pychodopygus claustrei, and Sciopemyia sordellii. L. longipalpis was the most abundant species in the anthropic environment with 92.22% of the captures. This shows an increase of sixty times in the density of L. longipalpis compared to the last sand fly evaluation in 1999/2000. The high density of L. longipalpis in Campo Grande is the main factor of risk in transmission of the disease to human in the urban area. The capture of N. antunesi, typical specie from Amazonian region, in Mato Grosso do Sul is reported for the first time.

Foco emergente de leishmaniose visceral em Mato Grosso do Sul

This study, realized from October 2000 to January 2003 describes the clinical epidemiological characteristics of visceral leishmaniasis in Tres Lagoas, Mato Grosso do Sul State, Brazil. A total of 149 cases were confirmed, with a predominance of the male gender (71.1%). The principal age group was aged 0 to 4 years old (42%). The clinical picture included fever (97.3%), esplenomegaly (85.9%) and anemia (75.8%). Associated infections were seen in 32 patients (21.5%), pneumonia being most common. Changes registered in the laboratory included a median hemoglobin level of 8mg/dl and 3,100 leucocytes/mm3. Bone marrow smears were positive in 90.6% of patients. Of the 97.9% patients treated, 78.2% used pentavalent antimony. Mortalities occurred in 8% of cases, half of these with associated infection. Taken together, these data suggest changes in the physiographical occurrence of visceral leishmaniasis in this locality, with expansion and urbanization of the disease, requiring greater attention for early diagnosis and treatment.

Phlebotomines (Diptera: Psychodidae) in forested areas of the Serra da Bodoquena, state of Mato Grosso do Sul, Brazil

Investigation was undertaken on the behaviour of the phlebotomine fauna in caves, forests, and anthropic environments of the Serra da Bodoquena, between January 1998 and January 2000. This paper reports on the phlebotomines captured in forested areas with automatic light traps (ALT), Shannon traps (ST), aspiration (AN), at natural resting sites and by human attractiveness (HA) during 24 h. The diversity and abundance of the species were investigated with ALT installed at 16 points (ground level) and 6 in the canopy. Natural infection by flagellates was investigated in females captured with ST AN, and HA. The sandfly fauna was represented by 23 species. Twenty-two of these were captured with ALT 15 of them on the western side, and 20 on the eastern. Lutzomyia longipalpis and Nyssomyia whitmani were the most abundant on the former and this species together with Lutzomyia almerioi on the latter side. On the eastern side the ecotopes located close to caves rendered a significantly greater number (P < or = 0.01) of specimens than did more distant sites. On this side Lu. almerioi contributed with 56% of the total number of specimens. Lu. almerioi females were predominantly attracted by humans (96.4%) and by ST (93.2%) and three of the 2173 dissected (0.138%) presented natural infection by flagellates. The attraction of Lu. almerioi to humans occurred during all seasons, predominantly in the summer, and in nocturnal and diurnal periods. Thus it is bothersome to inhabitants of and visitors to the Bodoquena ridge and a potential vector of flagellates.

Ocorrência de leishmaniose tegumentar americana no Estado do Mato Grosso do Sul associada à infecção por Leishmania (Leishmania) amazonensis

Nine cases of American tegumentary leishmaniasis were reported at a Training Military Unit located in Bela Vista City, State of Mato Grosso do Sul. Parasites obtained from lesions of six patients were isolated in culture media followed by identification, through isoenzymes analysis, as being Leishmania amazonensis. This is the first evidence of the presence of the parasite in Mato Grosso do Sul.

Mortalidade por leishmaniose visceral: aspectos clínicos e laboratoriais

INTRODUCTION Visceral leishmaniasis is a systemic infectious disease of broad geographical distribution, characterized by high potential for lethality. With the purpose of contributing towards reducing mortality and helping healthcare professionals in clinical management of patients with this disease, this paper aimed to investigate the clinical and laboratory characteristics of cases with a fatal outcome in hospitals in Campo Grande, Mato Grosso do Sul, between 2003 and 2008. METHODS Fifty-five medical files on patients who died due to visceral leishmaniasis were analyzed. RESULTS Among the 55 patients studied, 37 were from the municipality of Campo Grande; 41 (74.5%) were males; and age over 40 years predominated. The patients presented with fever in 89.1% of the cases. The duration of the illness from the onset of symptoms to hospitalization was 78.2 days on average. Leukopenia was seen in 85.5% of the patients. Comorbidities were present in 39 (70.9%) patients; malnutrition and alcoholism were the most frequent of these. Confirmation of the diagnosis occurred on average 6.7 days after admission. Pentavalent antimoniate was the drug most used, and 87.5% of the patients presented some type of adverse reaction. Bacterial infections occurred in 36 patients and were one of the causes of death in 27 (49%). CONCLUSIONS The data showed that early identification of these clinical and laboratory characteristics, at the time when patients are first attended, is extremely important for reducing mortality through instituting efficient therapeutic and prophylactic measures.

Phlebotomines (Diptera, Psychodidae) in caves of the Serra da Bodoquena, Mato Grosso do Sul State, Brazil

The present paper deals with the phlebotomine species captured during the period from January 1998 to June 2000 in 12 caves located in the Serra da Bodoquena, situated in the south central region of Mato Grosso do Sul State, Brazil. Three of the caves are situated further north (in Bodoquena county), seven in the central area (Bonito county) and two in the south (Jardim county). These last two caves and three of those in Bonito are located at the west side of the ridge. Eighteen species of phlebotomines were captured within the caves: Brumptomyia avellari (Costa Lima, 1932), Brumptomyia brumpti (Larrousse, 1920), Brumptomyia cunhai (Mangabeira, 1942), Brumptomyia galindoi (Fairchild & Hertig, 1947), Evandromyia corumbaensis (Galati, Nunes, Oshiro & Rego, 1989), Lutzomyia almerioi Galati & Nunes, 1999, Lutzomyia longipalpis (Lutz & Neiva, 1912), Martinsmyia oliveirai (Martins, Falcao & Silva, 1970), Micropygomyia acanthopharynx (Martins, Falcao & Silva, 1962), Micropygomyia peresi (Mangabeira, 1942), Micropygomyia quinquefer (Dyar, 1929), Nyssomyia whitmani (Antunes & Coutinho, 1939), Psathyromyia campograndensis (Oliveira, Andrade-Filho, Falcao & Brazil, 2001), Psathyromyia punctigeniculata (Floch & Abonnenc, 1944), Psathyromyia shannoni (Dyar, 1929), Pintomyia kuscheli (Le Pont, Martinez, Torrez-Espejo & Dujardin, 1998), Sciopemyia sordellii (Shannon & Del Ponte, 1927) and Sciopemyia sp. A total of 29,599 phlebotomine sandflies was obtained. Lutzomyia almerioi was absolutely predominant (91.5%) over the other species on both sides of the Bodoquena ridge, with the exception of the southern caves in which it was absent. It presents summer predominance, with nocturnal and diurnal activities. The species breeds in the caves and was captured during daytime both in the dark area and in the mouth of the caves. Martinsmyia oliveirai, the second most frequent sandfly, also presents a summer peak and only predominated over the other species in one cave, in which there were human residues.0

Estudo epidemiológico sobre Leishmaniose tegumentar (LT) no município de Corguinho, Mato Grosso do Sul: estudos na população humana

A study on the resident population of 150 inhabitants of Boa Sorte in the Municipality of Corguinho, Mato Grosso do Sul State, Brazil was made, from March 1991 to March 1994, to establish the prevalence of South American Cutaneous Leishmaniasis (SACL), and to characterize the affected population, in an area of recent transmission. Twelve of the inhabitants showed lesions suspected to be SACL, and in 8 cases it was possible to confirm this by biopsy and parasitology. The mucosal form was found in one patient only, the rest showed the following cutaneous forms: ulcerated (3), ulcero-verrucose (1), hyperkeratotic ulcer (1), infiltrated maccule (1), nodule with florid regional adenopathy (1). All patients reacted favorably to treatment with glucantime, with lesion scarring. Side-effects were rare. The parasite isolated from all patients was identified as Leishmania (Viannia) braziliensis. The Montenegro skin test, applied to the 150 inhabitants, showed 32 reactive ones. Of these, six were carriers of the disease, 21 showed sequelae suggestive of the disease and five showed no signs of infection. The age grouping of the cohort ranged from 22 to 78 years, 75% being male. To date, transmission is suspected to be in the peridomicile.

Leishmaniose tegumentar americana: estudo clínico, epidemiológico e laboratorial realizado no Hospital Universitário de Campo Grande, Mato Grosso do Sul, Brasil

BACKGROUND: American cutaneous leishmaniasis is a disease with a wide variety of clinical manifestations that is expanding throughout Brazil, the state of Mato Grosso do Sul constituting a significant endemic area. OBJECTIVES: To evaluate the clinical, epidemiological and laboratory characteristics of patients with American cutaneous leishmaniasis. Patients were recruited among those attending the Maria Aparecida Pedrossian Teaching Hospital of the Federal University of Mato Grosso do Sul, Brazil. METHODS: This was a cross-sectional, observational study conducted using a descriptive and analytical approach. Data from patients suspected of having American cutaneous leishmaniasis who were receiving care at this institute between 1998 and 2008 and were referred to the institutes parasitology laboratory for confirmation of diagnosis were evaluated retrospectively. Clinical and laboratory criteria were taken into consideration for the inclusion of patients to the study. RESULTS: Forty-seven patients were included in the study, the majority of whom were male and between 45 and 59 years of age. Most had the cutaneous form of the disease with a single, ulcerated lesion on exposed areas of the body, which had generally been present for periods of less than six months. Mucosal involvement increased with age and was highest in patients who had sought medical care at a later stage. The Montenegro skin test showed the highest sensitivity. Finding the parasite was more difficult in older lesions. CONCLUSION: Suspicion of the disease at an early stage is of extreme importance for a precise diagnosis. A combination of parasitological and immunological tests renders laboratory diagnosis more reliable.

Synthetic sex pheromone attracts the leishmaniasis vector Lutzomyia longipalpis to experimental chicken sheds treated with insecticide

BackgroundCurrent strategies for controlling American visceral leishmaniasis (AVL) have been unable to prevent the spread of the disease across Brazil. With no effective vaccine and culling of infected dogs an unpopular and unsuccessful alternative, new tools are urgently needed to manage populations of the sand fly vector, Lutzomyia longipalpis Lutz and Neiva (Diptera: Psychodidae). Here, we test two potential strategies for improving L. longipalpis control using the synthetic sand fly pheromone (±)-9-methylgermacrene-B: the first in conjunction with spraying of animal houses with insecticide, the second using coloured sticky traps.ResultsAddition of synthetic pheromone resulted in greater numbers of male and female sand flies being caught and killed at experimental chicken sheds sprayed with insecticide, compared to pheromone-less controls. Furthermore, a ten-fold increase in the amount of sex pheromone released from test sheds increased the number of females attracted and subsequently killed. Treating sheds with insecticide alone resulted in a significant decrease in numbers of males attracted to sheds (compared to pre-spraying levels), and a near significant decrease in numbers of females. However, this effect was reversed through addition of synthetic pheromone at the time of insecticide spraying, leading to an increase in number of flies attracted post-treatment.In field trials of commercially available different coloured sticky traps, yellow traps caught more males than blue traps when placed in chicken sheds. In addition, yellow traps fitted with 10 pheromone lures caught significantly more males than pheromone-less controls. However, while female sand flies showed a preference for both blue and yellow pheromone traps sticky traps over white traps in the laboratory, neither colour caught significant numbers of females in chicken sheds, either with or without pheromone.ConclusionsWe conclude that synthetic pheromone could currently be most effectively deployed for sand fly control through combination with existing insecticide spraying regimes. Development of a standalone pheromone trap remains a possibility, but such devices may require an additional attractive host odour component to be fully effective.