RESUMO
Endemic cutaneous leishmaniasis (CL) in northern Argentina has traditionally been caused by Leishmania braziliensis. This study aims to describe an outbreak of Leishmania infantum-caused human CL in the Department Capital of Corrientes Province, Argentina. We retrospectively analyzed the reported cases of CL in this area from May 2015 to December 2016. Eighty cases of CL were clinically and analytically diagnosed, and there was one case of visceral leishmaniasis in a boy who also had CL. Patients' median age was 33.6 years (range 1-89 years), and 18.5% were younger than 15 years; the male:female ratio was 3.5:1. Cases lived mostly in the municipality of Corrientes (72.8%), whereas 27.2% resided in Riachuelo. Although 67.9% had a single lesion, 32.1% had several. Molecular analyses showed that L. infantum was the causative species in all cases. Our results show that for the first time, there was an outbreak of CL by L. infantum in an urban area of Argentina.
Assuntos
Surtos de Doenças , Leishmania infantum , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , População Urbana , Adulto JovemRESUMO
In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae, Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.
Assuntos
Leishmania/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Mycobacterium leprae/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Honduras/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nicarágua/epidemiologia , Reação em Cadeia da PolimeraseRESUMO
OBJECTIVES: To explore clinical and socioeconomic factors related to congenital syphilis in Posadas, Argentina. METHODS: Data were collected from 102 mothers who had given birth to an infant with congenital syphilis at Dr. Ramón Madariaga Central Hospital (2005-2007) and 306 control mothers. Clinical and demographic information were collected from clinical records, and socioeconomic details were obtained by interview. Multivariable logistic regression was used to explore the relationships between congenital syphilis and clinical and socioeconomic factors. RESULTS: Receiving the recommended number of prenatal health checks had a clear protective effect on congenital syphilis in the univariate analysis (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.31-0.86), as did being in a stable relationship (OR 0.23, 95% CI 0.14-0.38). Furthermore, women with secondary education or above were over four-times less likely to have a child with congenital syphilis compared to women who had not completed primary school education, even after controlling for the number of prenatal health checks and other factors (adjusted OR 0.24, 95% CI 0.08-0.72). In addition, women with previous stillborn births were over three-times more likely to have a baby with congenital syphilis after controlling for education and prenatal care (adjusted OR 3.37, 95% CI 1.24-9.16). CONCLUSIONS: There is a clear opportunity for reducing the burden of congenital syphilis by promoting syphilis screening and treatment in women with previous stillborn births. In addition, the potential impact of more general policies addressing social determinants of health, such as those improving education, must not be overlooked.