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      Tegumentary and visceral leishmaniases in Brazil: emerging anthropozoonosis and possibilities for their control Translated title: Leishmanioses tegumentar e visceral no Brasil: antropozoonoses emergentes e perspectivas de controle

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          Abstract

          The existence of a number of different species of Leishmania, the persistent increase in the infection rate of diseases caused by this parasite (tegumentary and visceral forms), the different epidemiological situations found in regions of both recent and older colonization, and the trend towards urbanization have led to the adoption of different strategies to control leishmaniases in Brazil. The control measures involve studies related to the parasite, vectors, sources of infection (animal and human), clinical aspects, geographical distribution, historical and socioeconomic factors, integration of health services, and adequate technologies for diagnosis, treatment, and immunoprophylaxis. Finally, successful control requires work with human communities, involving education, provision of information, health promotion, and participation of these communities in the planning, development, and maintenance of control programs.

          Translated abstract

          A ocorrência de várias espécies de Leishmania, o contínuo aumento das afecções causadas por esses parasitas (formas tegumentares e visceral) e as diferentes situações epidemiológicas encontradas, tanto em regiões de colonização recente quanto de colonização antiga, com tendência a urbanização, vem requerendo a adoção de diferentes estratégias para o controle dessas endemias no Brasil. Essas medidas demandam estudos relacionados aos parasitas, insetos vetores, fontes de infecção, aspectos clínicos, distribuição geográfica, fatores históricos e sócio-econômicos, integração dos serviços de saúde, tecnologias apropriadas de diagnóstico, tratamento e imunoprofilaxia. Finalmente, para o sucesso do controle, são requeridos esforços junto as comunidades humanas, envolvendo educação, provisão de informação, promoção da saúde e participação dessas comunidades no planejamento, desenvolvimento e manutenção dos programas adotados.

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          Most cited references66

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          New perspectives on a subclinical form of visceral leishmaniasis.

          During an epidemiological study of visceral leishmaniasis in an endemic region of Brazil, new perspectives emerged on a subclinical form of the disease. A group of 86 children with antibody to Leishmania were identified. None of these children had a history of leishmaniasis. The children were segregated into four groups: One group remained asymptomatic (n = 20), whereas another developed classic kala-azar within weeks of the index serology (n = 15). The remaining 51 patients initially had subclinical disease; 13 (25%) of these patients progressed to classic kala-azar (mean, five months). The others (75%) resolved their illness after a prolonged period (mean, 35 months). The initial illness in the subclinical group was characterized by hepatomegaly, frequent splenomegaly, intermittent cough, diarrhea, and low-grade fever. Malaise and poor weight gain were common. Giemsa-stained smears and cultures of bone marrow aspirates were usually negative for Leishmania in the absence of symptoms of classic kala-azar.
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            Estimation of population at risk of infection and number of cases of Leishmaniasis.

            In this paper, Dick Ashford, Philippe Desjeux and Peter deRaadt attempt to estimate the total number of people at risk of acquiring disease caused by infection with Leishmania spp. In many areas a very small risk is distributed among large numbers of people so, although the number of people at risk may be large, the number of infections may be very small. An estimate of the global annual incidence of new cases has also been made. This refers to reported clinical disease and probably grossly underestimates the number of infections. The methods by which the estimates have been made are specified so that they, as well as the estimates themselves, may be criticized and modified with some degree of objectivity.
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              Disseminated cutaneous leishmaniasis in a field clinic in Bahia, Brazil: a report of eight cases.

              Eight Bahian patients with cutaneous leishmaniasis who had 20 or more ulcerative lesions of short duration are described. Of five identifications of isolated parasites, four were Leishmania braziliensis braziliensis and one was L. mexicana amazonensis. All but one had positive Montenegro tests initially, and all did after treatment. All had circulating anti-leishmanial antibodies and five responded well to glucantime therapy suggesting a functioning immune response. This is quite different to the anergic hansenoid leishmaniasis seen with L. mexicana amazonensis infections in Brazil. Possible reasons for the occurrence of this type of leishmaniasis are briefly discussed.
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                Author and article information

                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro, RJ, Brazil )
                0102-311X
                1678-4464
                July 1994
                : 10
                : suppl 2
                : S359-S375
                Affiliations
                [01] Rio de Janeiro RJ orgnameEscola Nacional de Saúde Pública orgdiv1Departamento de Ciências Biológicas
                Article
                S0102-311X1994000800014 S0102-311X(94)01000014
                7ec72095-5737-4eca-b998-98eccd5489c1

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                SciELO Brazil

                Self URI: Full text available only in PDF format (EN)
                Categories
                Articles

                Leishmanioses,Community Participation,Lutzomyia sp.,Vector Control,Clinical Classification,Leishmaniases,Participação Comunitária,Lutzmoyia sp.,Controle de Vetores,Classificação Clínica

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