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      Study on the zoonotic cycle of tegumentary leishmaniasis in an endemic area of a metropolitan region in the Northeastern region of Brazil

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          ABSTRACT

          This study was conducted to characterize the transmission cycle of the tegumentary leishmaniasis (TL) in an old colonization area at Pernambuco State, Brazil. The aims were to identify autochthonous cases, sandflies fauna, domestic animals as possible reservoir hosts and the Leishmania species involved in this endemic area. A total of 168 suspected human cases of TL and 272 domestic animals (canine, feline, equine, goat, and sheep) were included. The sandflies were captured and identified by species. Patients were predominantly male and the average age was 37 +18.1 years old. Of 85 patients who had skin lesions, 25.6% of them had direct positive smears for TL and 34 isolates were identified as Leishmania ( Viannia) braziliensis. The confirmation for TL diagnosed by molecular detection (PCR) was almost three times more sensitive than the direct test [p < 0.001; PR = 2.72] associated with clinical examination. The Kappa test on PCR between two different specimens, biopsy, and skin lesion swab was 60.8% (p < 0.001). More than 200 specimens of sandflies (80 males and 159 females) were captured and identified as Lutzomyia whitmani (99.6%) and Lu. evandroi (0.4%). The detection of L. (V.) braziliensis by Real-Time PCR in the blood of a captured fed female was positive in 59.3% of Lu. whitmani. Of the 272 domestic animals included, 61.76% were male (n = 168). Thirty-six animals (13.2%) had lesions compatible with TL (34 dogs, 1 cat and 1 sheep) and 3 of them, all dogs, had lesions on the snout, showing destruction of cartilage and mucosa. The study suggests the participation of domestic animals as possible reservoirs. However, further studies are necessary to better understand the transmission cycle and take recommended measures in order to control the disease.

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          Most cited references47

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          The Measurement of Observer Agreement for Categorical Data

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            The measurement of observer agreement for categorical data.

            This paper presents a general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies. The procedure essentially involves the construction of functions of the observed proportions which are directed at the extent to which the observers agree among themselves and the construction of test statistics for hypotheses involving these functions. Tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interobserver agreement are developed as generalized kappa-type statistics. These procedures are illustrated with a clinical diagnosis example from the epidemiological literature.
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              Leishmaniasis

              Leishmaniasis is a poverty-related disease with two main clinical forms: visceral leishmaniasis and cutaneous leishmaniasis. An estimated 0·7-1 million new cases of leishmaniasis per year are reported from nearly 100 endemic countries. The number of reported visceral leishmaniasis cases has decreased substantially in the past decade as a result of better access to diagnosis and treatment and more intense vector control within an elimination initiative in Asia, although natural cycles in transmission intensity might play a role. In east Africa however, the case numbers of this fatal disease continue to be sustained. Increased conflict in endemic areas of cutaneous leishmaniasis and forced displacement has resulted in a surge in these endemic areas as well as clinics across the world. WHO lists leishmaniasis as one of the neglected tropical diseases for which the development of new treatments is a priority. Major evidence gaps remain, and new tools are needed before leishmaniasis can be definitively controlled.
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                Author and article information

                Journal
                Rev Inst Med Trop Sao Paulo
                Rev Inst Med Trop Sao Paulo
                rimtsp
                Revista do Instituto de Medicina Tropical de São Paulo
                Instituto de Medicina Tropical de São Paulo
                0036-4665
                1678-9946
                30 September 2022
                2022
                : 64
                : e60
                Affiliations
                [1 ]Centro de Vigilância em Saúde Ambiental, Moreno, Pernambuco, Brazil
                [2 ]Universidade Fernando Pessoa, Faculdade de Ciência e Tecnologia, Porto, Portugal
                [3 ]Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
                [4 ]Universidade Fernando Pessoa, Unidade de Pesquisa em Energia, Saúde e Ambiente, Porto, Portugal
                [5 ]Universidade de Pernambuco, Faculdade de Ciências Médicas, Hospital Universitário Oswaldo Cruz, Departmento de Dermatologia, Recife, Pernambuco, Brazil
                Author notes
                Correspondence to: Maria Edileuza Felinto de Brito Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Cidade Universitária, CEP 50740-465, Recife, PE, Brazil E-mail: edileuza.brito@ 123456fiocruz.br

                CONFLICT OF INTERESTS

                None to declare.

                Author information
                http://orcid.org/0000-0003-4419-9480
                http://orcid.org/0000-0002-9087-358X
                http://orcid.org/0000-0002-0598-1587
                http://orcid.org/0000-0001-9777-8406
                http://orcid.org/0000-0001-6059-4945
                http://orcid.org/0000-0003-2043-5311
                http://orcid.org/0000-0003-3144-9145
                http://orcid.org/0000-0002-5860-9367
                http://orcid.org/0000-0003-3768-2810
                http://orcid.org/0000-0002-2540-1316
                http://orcid.org/0000-0002-9691-6763
                Article
                00232
                10.1590/S1678-9946202264060
                9528310
                36197421
                cb64b5ea-e927-4547-bd80-78505eeea8ce

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 February 2022
                : 26 July 2022
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 40, Pages: NaN
                Categories
                Original Article

                transmission cycle,eco-epidemiology,tegumentary leishmaniasis,leishmania (viannia) braziliensis

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