Mauro Célio de Almeida Marzochi

Canine Visceral Leishmaniasis in Rio de Janeiro, Brazil: clinical, parasitological, therapeutical and epidemiological findings (1977-1983)

Forty dogs from the periphery of the city of Rio de Janeiro were studied. All dogs where diagnosed as positive for leishmaniasis either parasitologically and/or serologically. Among them, 19 came from areas where only Visceral Leishmaniasis (VL) occurs (Realengo, Bangu, Senador Camará). Clinical signs of the disease were seen in 36.8% of the cases, including emaciation - 100%, lymphadenopathy and depilation - 85.7%. The other 21 dogs came from an area (Campo Grande) where both diseases (VL, and American Cutaneous Leishmaniasis - ACL) occur. Clinical signs of the disease, mainly cutaneous or mucocutaneous ulcers were seen in 76.2% of the cases. Leishmania parasites were found in 39 cases: 22% in viscera, 42.5% in viscera and normal skin and 35% in cutaneous or mucocutaneous ulcers. All the Leishmania stocks isolated from dogs which came from Realengo, Bangu, Senador Camará (VL area), and from Campo Grande (VL + ACL area) were characterized as L. donovani (except in one case) according to their schizodeme, zymodeme and serodeme. The only stock characterized as L. b. braziliensis, was isolated from the lymph node of a dog from Campo Grande with visceral disease and without skin lesions. Antimony therapy attempted in eight Leishmania donovani positive dogs was unsuccessful.

A surgery for American cuteneous and visceral leishmaniasis among 1,342 dogs from areas in Rio de Janeiro (Brazil) where the human diseases occur

There are areas in the periphery of Rio de Janeiro city where human cases of Visceral and/or Cutaneous Leishmaniasis occur. The parasites have been identified as Leishmania donovani and Leishmania braziliensis braziliensis respectively. A survey for Leishmaniasis was done among 1,342 dogs from those areas using an indirect immunofluorescent test. From the dogs, 616 came from areas where only human cases of Visceral Leishmaniasis occurred, 373 from an area where all human cases were of Cutaneous Leishmaniasis and 353 from a third area (Campo Grande) where both visceral and cutaneous human cases were detected. The prevalence of parasite antibody titers among dogs from areas of Cutaneous Leishmaniasis was significantly higher than that of Visceral Leishmaniasis (8.6% vs. 4.3%, p less than 0.02). The highest prevalence was observed among dogs from the area where both diseases are present (12.7%).

Indirect immunofluorescence test in new world Leishmaniasis: serological and clinical relation-ship

The indirect immunofluorescence test (IF) for anti-Leishmania antibodies (IgG and IgM) was performed with sera from the following groups of individuals: 214 cutaneous leishmaniasis patients, 28 healthy subjects with positive Montenegros skin test (MST), 29 healthy subjects with negative MST and 16 visceral leishmaniasis patients. The first four groups came from a suburban area of Rio de Janeiro (Jacarepaguá) where cutaneous leishmaniasis caused by Leishmania braziliensis braziliensis is endemic. It was observed that IF-IgM titers were significantly higher amongst the cutaneous leishmaniasis patients with less than four months of disease as compared to those with longer periods and that IF-IgG titers were significantly higher in patients with multiple lesions as compared to those with single lesions. The visceral leishmaniasis patients had IF-IgG titers significantly higher than those from cutaneous leishmaniasis patients. A group of 28 individuals selected amongst the 214 cutaneous leishmaniasis patients had their IF-titers (IgG and IgM) compared to those of the two control groups of healthy subjects from the endemic area, respectively with positive and negative MST. Significantly higher titers of IF-IgG and IF-IgM were found in the group with active disease. The same group of patients showed IF-IgG titers significantly lower at the end of the antimonial therapy than those observed during this treatment.

Prevalência da infecção pelo Toxoplasma gondii em animais domésticos, silvestres e grupamentos humanos da Amazônia

Serological examination for Toxoplasma gondii in human blood samples and in blood samples from ten different species of animals obtained in Manaus, State of Amazonas-Brazil, are compared with results obtained from similar examinations of blood from humans living in other areas of the Amazon basin. The domestic cat (Felis catus) showed the highest levels of antibody for Toxoplasma gondii, whereas the domestic chicken (Gallus domesticus) and duck (Cairina sp) the lowest. The other animals showed similar intermediate levels of antibody to this protozoa. The authors discuss the results and several aspects of the involvement in epidemiology of toxoplasmosis and call attention to some transmission mechanisms not yet elucidated.

Prevalência da infecção canina em áreas endêmicas de leishmaniose tegumentar americana, do município de Paracambi, Estado do Rio de Janeiro, no período entre 1992 e 1993

In the district of Paracambi, State of Rio de Janeiro an epidemiological survey for American tegumentary leishmaniasis in canine population was carried out in endemic localities. A total of 179 dogs was registered and 138 (77.1%) examined for their clinical aspects, development of delayed hypersensitivity (DHS) with Imunoleish® antigen and serological responses by indirect immunofluorescent reaction and enzyme-linked immunosorbent assay. In 9 (6.5%) dogs with active cutaneous lesions or suspect scars, 66.7% were caused by Leishmania sp; 44.4% produced infection in hamsters and showed growth in culture media, which was considered to be compatible with the species of Leishmania braziliensis complex. The molecular characterization (isoenzyme and KDNA restriction profiles) defined two strains with similar profiles for L. (Viannia) braziliensis. The prevalence of canine infection estimated by the cutaneous test, IFR and ELISA was 10.1%, 16.7% and 27.8%, respectively. The presence of clinical / sub-clinical form of ATL in canine population associated with human infections suggested that the dog can act as source of infection as well as for dissemination of the disease.

Leishmaniose visceral no Rio de Janeiro: 1 - Flebotomíneos da área de procedência de caso humano autóctone

An entomological survey was performed during the period of August to December, 1977 in Rio da Prata, region of Bangu, Rio de Janeiro. Manual insect capturing devices were utilized to study the peri-domiciliar area from 13 of 27 houses. The insects were captured mainly from 4 sites which were selected as being most productive. During 22 captures (73.3 hrs/person) 1585 sandflies were collected. They were identified as Lutzomya intermedia 828 (52.2%), Lutzomyia longipalpis 687 (43,1%), Lutzomyia migonei 57 (3.6%), Lutozmyia cortelezzii 5 (0.3%), Lutzomyia fischeri 5 (0.3%), Lutzomyia micropyga 3 (0.2%), Lutzomyi firmatoi 1 (0.1%), and Brumptomyia sp. 2 (0.2%). L. longipalpis were predominant at altitudes much higher than 100 merters either in chicken houses or piggeries. Most of them were collected form 6:00 to 9:00 pm, but occasionally were captured also from 3:00 to 5: pm. L. intermedia were predominant at altitudes much lower than 100 meters. They were captured more frequently in piggeries than in chicken houses, compared to L. longipalpis. The authors stress the necessity to implement control measures since there is a potential risk of visceral leishmaniasis transmission in areas near Rio de Janeiro city.

EPIDEMIOLOGICAL SURVEY ON CANINE POPULATION WITH THE USE OF IMMUNOLEISH SKIN TEST IN ENDEMIC AREAS OF HUMAN AMERICAN CUTANEOUS LEISHMANIASIS IN THE STATE OF RIO DE JANEIRO, BRAZIL

A survey for canine tegumentary leishmaniasis (CTL) has been carried out between 1986 and 1993 in seven endemic localities for American cutaneous leishmaniasis in the State of Rio de Janeiro. 270 dogs have been examined for their clinical aspects, the development of delayed hypersensitivity (DHS) with Immunoleish antigen and with immunofluorescent antibody research of IgG (IF). 28.2% of them had ulcer lesions and 3.3% had scars. The lesions consisted of single (39.5%) and mucocutaneous lesions (31.6%), multiple cutaneous (25.0%) and mucocutaneous lesions associated with cutaneous ulcers (4.0%). Twelve (15.8%) isolates from biopsies were analyzed by zimodeme and schizodeme and identified as L. (V) braziliensis. The overall prevalence of canine infection that was evaluated with the skin test was of 40.5% and with IF it was of 25.5%. Both tests showed a high positive rate with relation to the animals with mucosal lesions, as in the case of human mucocutaneous leishmaniasis. The comparison of the two tests showed the skin test to have a better performance although there was no statistical difference (p > 0.05) between them. The proportional sensitivity and specificity was of 84.0% and 74.0%, respectively. The Immunoleish skin test and IF are useful tools to be employed in CTL field epidemiological surveys.

Is Leishmania (Viannia) braziliensis preferentially restricted to the cutaneous lesions of naturally infected dogs

Nineteen dogs naturally infected with Leishmania (Viannia) braziliensis were studied in order to determine the presence of the parasite outside cutaneous lesions. Eleven (57.9%) animals showed single cutaneous or mucosal lesions and eight (42.1%) presented two or three lesions. Twenty-eight active lesions were biopsied. Isolation in culture and characterization by enzyme electrophoresis were possible in 100% of cases and amastigote forms were visualized upon histopathological examination in three samples (n=25, 12%). Isolation of the parasite in culture from peripheral blood and intact skin fragments obtained from the scapular region was negative in all animals, as was the histopathological analysis of skin from this region. Serological reactivity determined by an immunofluorescent antibody test and/or enzyme-linked immunosorbent assay was demonstrated in 15 animals. The results obtained suggest that L. braziliensis preferentially remains at the site of lesion, in contrast to the systemic distribution of parasites observed in dogs infected with L. (Leishmania) chagasi. A better understanding of this aspect may help direct diagnostic and control strategies applicable to areas characterized by the simultaneous occurrence of the cutaneous and visceral forms of leishmaniasis, as is the case for the Municipality of Rio de Janeiro, Brazil.

Utilização da reação de imunofluorescência indireta no acompanhamento da terapêutica da leishmaniose tegumentar americana

Seventeen persons, from 2 to 78 years of age, with clinical, epidemiological,immunological and parasitological diagnosis of american tegumentary leishmaniasis, were studied. All came from the endemic area of Jacarepagua, a suburb of the city of Rio de Janeiro. The patients were treated with n-methylglucanine antimonate, using a dosage of 60 mg/kg/day, in three series of ten days duration each series, with intervals of ten days between each series, venous blood samples having been taken for the indirect immunefluorescent tests (IF-IgG) before, during and after medication. The seventeen individuals were reactive to the intradermal reaction of Montenegro (= 5 mm) and serum-reactive (= 1:45 mm) to the IF-IgG test; Leishmania b. braziliensis ssp was demonstrated or isolated in six cases (31.7%). Before treatment, the IF-IgG test showed positive in 76.4% of the cases (13 cases with titers = 1:90). The geometric averages of the reciprocal titer were as follows: before the first antimonial series (89,9); during treatment (63.6 to 29.3) and 10, 30 and 120 days after medication which revealed a clearly decreasing scale (14.9; 2.1 and 1.2), respectively. All lesions were healed upon termination of treatment, the scarring being most evident after the second series. Only 120 days after therapy were titers lower than 1:45 in all patients (16 cases - 94.1%). This suggests that, when the IF-IgG test is used as a control of cures, serological follow up is necessary during a minimum of three to four months.

Endemic tegumentary leishmaniasis in Brazil: correlation between level of endemicity and number of cases of mucosal disease.

The purpose of this study was to establish a correlation between the endemic level of tegumentary leishmaniasis in different regions of Brazil during 2002-2009 and the number of cases of mucosal or mucocutaneous leishmaniasis. The proportion of mucosal leishmaniasis was inversely correlated with prevalence of infection. In areas with a lower infection prevalence, the proportion of mucosal leishmaniasis increased (P < 0.05). The hypothesis of an Amazonian origin and dissemination through human migration is considered. Our results show that in regions with lower prevalence and endemically younger, the proportion of cases that evolve to the mucosal form is higher than in regions with higher prevalence and endemically older.