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DIVERGENT PROFILES OF EMERGING AMERICAN CUTANEOUS LEISHMANIASIS IN SOUTHERN BRAZIL: A CROSS-SECTIONAL STUDY WITH GEOGRAPHICAL EVIDENCE
Author
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Universidade Federal de Santa Catarina. Department of Microbiology, Immunology and Parasitology. Florianópolis, SC, Brazil.
Universidade Federal de Rio de Janeiro. Instituto de Biofísica Carlos Chagas Filho. Rio de Janeiro, RJ, Brasil.
Secretaria Estadual de Saúde de Santa Catarina. Diretoria de Vigilância Epidemiológica. Department of Zoonoses. Florianópolis, SC, Brasil.
Universidade do Vale do Itajaí. Center for Health Sciences. Itajaí, SC, Brazil.
Universidade do Vale do Itajaí. Center for Health Sciences. Itajaí, SC, Brazil.
Universidade Federal de Santa Catarina. Department of Microbiology, Immunology and Parasitology. Florianópolis, SC, Brazil.
Universidade Federal de Santa Catarina. Department of Microbiology, Immunology and Parasitology. Florianópolis, SC, Brazil.
Universidade Federal de Rio de Janeiro. Instituto de Biofísica Carlos Chagas Filho. Rio de Janeiro, RJ, Brasil.
Secretaria Estadual de Saúde de Santa Catarina. Diretoria de Vigilância Epidemiológica. Department of Zoonoses. Florianópolis, SC, Brasil.
Universidade do Vale do Itajaí. Center for Health Sciences. Itajaí, SC, Brazil.
Universidade do Vale do Itajaí. Center for Health Sciences. Itajaí, SC, Brazil.
Universidade Federal de Santa Catarina. Department of Microbiology, Immunology and Parasitology. Florianópolis, SC, Brazil.
Universidade Federal de Santa Catarina. Department of Microbiology, Immunology and Parasitology. Florianópolis, SC, Brazil.
Abstract
Background: Although known to be highly endemic in the Amazon regions of Brazil, the presence of cutaneous
leishmaniasis (CL) in the subtropical southern part of the country has largely been ignored. This study was conducted to demonstrate CL is emerging in the Brazilian state of Santa Catarina, as well as to characterize the epidemiological profile and Leishmania species involved. Methodology/Principal Findings: For this cross-sectional study, data from all CL cases from Santa Catarina, Brazil, reported to the Brazilian National Notifiable Diseases Information System from 2001 to 2009 were investigated. Amplification of the kDNA minicircle conserved region followed by restriction fragment length polymorphism (PCR-RFLP) was conducted to screen for Leishmania species present in patient biopsy. Overall, 542 CL cases were reported, with majority resulting from autochthonous transmission (n = 401, 73.99%) and occurring in urban zones (n = 422, 77.86%). Age, gender, zone of residence, origin of case, clinical form and case outcome were found to differ significantly by region. Imported cases were over seven times more likely to relapse (95% CI 2.56–21.09). Mapping of cases revealed new endemic areas in northeastern Santa Catarina with two species present. With the exception of three L. (Leishmania) amazonensis cases (1.20%), majority of PCR positive samples were found to be L. (Viannia) braziliensis (n = 248, 98.80%). Conclusions/Significance: CL is now endemic in the state of Santa Catarina, Brazil, with case profiles varying significantly by region. L. (V.) braziliensis has been identified as the predominant species in the region.
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