Visceral leishmaniasis in Rio de Janeiro, Brazil: eco-epidemiological aspects and control

Revista da Sociedade Brasileira de Medicina Tropical

Mauro Celio De Almeida Marzochi²  Aline Fagundes²  Moacir Vieira De Andrade¹  Marcos Barbosa De Souza¹  Maria De Fátima Madeira²  Eliame Mouta-confort²  Armando De Oliveira Schubach²  Keyla Belizia Feldman Marzochi² 

[1],Fiocruz Evandro Chagas Clinical Research Institute Laboratory for Leishmaniasis SurveillanceRio de Janeiro RJ ,Brazil

关键词: Visceral leishmaniasis;    Eco-epidemiology;    Environmental factors;    Control;    Rio de Janeiro;    Leishmaniose visceral;    Eco-epidemiologia;    Fatores ambientais;    Controle;    Rio de Janeiro;   

DOI  :  10.1590/S0037-86822009000500017

来源: SciELO

【 摘 要 】

From 1977 (index case) to 2006, 87 cases of visceral leishmaniasis were confirmed in the municipality of Rio de Janeiro, Brazil, in periurban areas on the continental and coastal slopes of the Pedra Branca massif and the continental slopes of the Gericinó massif. The majority (65.5%) of the patients were more than five years old, predominantly males (61.5%), but without any difference between the sexes below the age of 14 years. The overall fatality rate was 10.4%. Two cases of visceral leishmaniasis/human immunodeficiency virus coinfection were detected. Leishmania chagasi was isolated from human and canine cases. The associations between the presence of phlebotomines and human and canine migrations, disorderly occupation involving degradation of environmental preservation areas and poor socioeconomic conditions may have created a favorable setting for the establishment and propagation of the disease. Close epidemiological surveillance associated with traditional control measures and others (active case researches, land clearing and health education), reduced the incidence of human cases from 2.8 per 100,000 inhabitants in 1981 to less than 0.01 per 100,000 since 1997. The canine infection rates decreased from 4.6% in 1984 to 1.6% in 2008. Lutzomyia longipalpis was not detected in some locations where human and canine cases occurred. In the years 2007 and 2008, no new human cases were reported, but there is a persistent and worrisome residual canine seroprevalence.

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