Effect of vegetation on cutaneous leishmaniasis in Paraná, Brazil.

BACKGROUND: Cutaneous leishmaniasis (CL) is endemic in the state of Paraná, Brazil. OBJECTIVE: This study aimed at analysing the influence of the remaining native vegetation on the prevalence of CL in Paraná. METHODS: Global testing was used for spatial autocorrelation along with simultaneous autoregressive model (SAR). The regression was based on the CL coefficient (cases/100,000 inhabitants) as a function of the percentage of natural vegetation cover, altitude, total number of cases, and spatial density (SD) per km2; the location data of the Paraná state municipalities and the detection coefficient (DC) (cases/100,000 inhabitants) of autochthonous cases of CL were obtained from the SINAN in 2012 and 2016. Data on the remaining forests were collected from the Fundação SOS Mata Atlântica and Instituto Nacional de Pesquisas Espaciais. FINDINGS: The spatial regression of DC revealed statistical significance for SD (Z = 24.1359, p < 0.05, 2012-2013; Z = 24.0817, p < 0.05, 2013-2014; Z = 33.4824, p < 0.05, 2014-2015; and Z = 27.1515, p < 0.05, 2015-2016. CONCLUSIONS: CL cases are reported in areas with native vegetation, such as in riparian forests. However, vegetation is not the only variable that influences the incidence of CL.

Dispersal and memory of sand flies in an endemic area of cutaneous leishmaniasis, southern Brazil.

The dispersal of and the existence of memory in sand flies were measured in a transmission area of cutaneous leishmaniasis, in the municipality of Bandeirantes, Paraná, Brazil. Sand flies were caught in a rural area, with Shannon trap installed in the forest and three Falcão traps installed in a human-inhabited environment (HIE) and three others in an impacted environment presently uninhabited by humans (EUH), from 1800 to 0600 hours. The captured sand flies were marked with yellow, blue, or red fluorescent powder, according to the environments where they were captured. All marked sand flies were released at 0700 hours at a point between the three environments. The recaptures were made with 28 Falcão traps, distributed in the environments from for 10 consecutive days. The sand flies recaptured were examined under a stereomicroscope and later identified. It was concluded that sand flies are able to disperse over an average distance of 73 m, reaching 130 m in 24 h, showing that: 1) the sand flies were attracted with different intensities to each environment, and the ability to move among different environments allows the existence of enzootic cycle of Leishmania; 2) the sand flies possess a spatial memory, olfactory memory, or both, that enable them to return to the environment where they were captured initially, although the distances were different.

[Evaluation of sandfly control measures]. / Avaliação de medidas de controle de flebotomíneos.

Collections of sandflies were made between May 2005 and April 2006. The results were compared with those from collections undertaken between April 2001 and September 2002, in order to evaluate the measures used to decrease the density of these insects in Recanto Marista, municipality of Doutor Camargo, State of Paraná. The collections were carried out by Falcão traps inside domiciles and hen sheds, from 10 p.m. to 2 a.m. once a week, four times a month. In 2005 and 2006, 213,195 sandflies were collected (average of 1,113.8 per hour), compared with 199,821 (average of 1,653.5 per hour) in 2001 and 2002. Nyssomyia neivai predominated (75.4%) in all the ecotopes. Nyssomyia neivai, Nyssomyia whitmani, Migonemyia migonei and Pintomyia fischeri accounted for 99.7% of all the sandflies collected. The ecotope of hencoops accounted for 88.7% of the sandflies collected. It was observed that the sandfly density had decreased between the 2001-2002 and 2005-2006 collections, especially in homes.

[Research of natural infection of phlebotomines for Leishmania, in the State of Paraná]. / Pesquisa de infecção natural de flebotomíneos por Leishmania, no Estado do Paraná.

American cutaneous leishmaniasis has been reported in all Brazilian states and in the Paraná this disease is endemic. The objective of this work was to detect natural infections in phlebotomines to verify the vector competence of these insects and the identification of the parasite species. Phlebotomines were collected using Falcão and Shannon traps, in the municipalities of Doutor Camargo, Fênix and Mandaguari, between November 2005 and August 2006. from 12,930 phlebotomines were collected, 2,487 females were dissected and 1,230 dissected females had been submitted to polymerase chain reaction. Flagellates were detected in a female Nyssomyia whitmani that had been dissected and for polymerase chain reaction failed to detect Leishmania DNA in any females. Even though flagellates were not detected in Nyssomyia neivai it should still be considered as a potential vector.

[Geographic distribution and epidemiological features of American tegumentary leishmaniasis in old rural settlements in Paraná State, Southern Brazil]. / Distribuição geográfica e características epidemiológicas da leishmaniose tegumentar americana em áreas de colonização antiga do Estado do Paraná, Sul do Brasil.

This study analyzes the epidemiology of American tegumentary leishmaniasis in the municipalities of the Central North, Central West, and Northwest mesoregions of Paraná State, Brazil. Diagnosis of American tegumentary leishmaniasis cases was performed at the State University in Maringá from 1987 to 2004. According to the probable site of infection, cases were classified as autochthonous (infection inside the household domain) or allochthonous (outside the household domain). Municipalities with the most cases were Maringá (458), Doutor Camargo (126), São Jorge do Ivaí (121), Terra Boa (114), Cianorte (98), and Colorado (95). Of the total of 1,938 cases, 66.9% were male. Among the 667 autochthonous cases, similar numbers of men and women were infected, with cases in minors as young as five years of age, with the latter not occurring in the 794 allochthonous cases. Conditions favoring American tegumentary leishmaniasis were created in the processes involved in occupying the rural areas of these mesoregions, particularly in the agricultural settlement model and the crisis in coffee monoculture.

Multiplex Polymerase Chain Reaction for Detection of Leishmania Sp. in Sandflies of the Paraná River Islands, Southern Brazil.

Leishmaniases are classified as tegumentary leishmaniasis (TL) and visceral leishmaniasis (VL). Brazil is among the countries with the highest number of TL and VL cases. This study was undertaken to standardize the multiplex polymerase chain reaction (PCR) for the detection of the genus Leishmania in sandflies of endemic regions, on islands in the Upper Paraná River, northwestern Paraná. The sandflies were collected on 10 islands, from November 2012 to November 2014, with Falcão light traps, identified and conserved in tubes containing isopropanol, for subsequent DNA extraction. Two pairs of primers were used for multiplex PCR: A1/A2 and 5Llcac/3Llcac. Nyssomyia neivai was the predominant species of the collected specimens. A total of 3870 samples of female sandflies were analyzed and submitted to multiplex PCR, for the validation of the technique. All pools showed the 220 bp fragment for sandfly DNA detection, but no ∼120 bp fragment of Leishmania DNA was found. Although no natural infection of Ny. neivai by Leishmania was found in this study, the interaction of sandflies with Leishmania and its natural reservoirs continues in these Paraná River islands, despite the low diversity of the sandfly fauna. Some of these islands have permanent residents and are frequented by tourists.

[Treatment of patients with American cutaneous leishmaniasis: health services evaluation in northwestern Paraná State, Brazil]. / Atendimento de pacientes com leishmaniose tegumentar americana: avaliação nos serviços de saúde de municípios do noroeste do Estado do Paraná, Brasil.

The current study focuses on outpatient treatment of patients (n = 229) with American cutaneous leishmaniasis from 2001 to 2004, before and after decentralization of treatment to the municipal level in northwestern Paraná State, Brazil. While the treatment was still centralized, clinical evaluation and medical records were more complete and detailed, treatment was initiated earlier, and follow-up of the outcome was evaluated in 95% of patients and 100% of cases that received two treatment cycles. Treatment also complied with the guidelines of the American Cutaneous Leishmaniasis Control Manual. After decentralization, treatment was less rigorous: 32% of patients were treated with two cycles of N-methyl glucamine antimoniate without complying with the guidelines; 72.6% of patients received inadequate treatment; 84% of cases failed to received proper clinical follow-up. Lack of information on patient clinical records posed a serious obstacle to evaluation. The current study failed to identify any benefit in decentralizing treatment of American cutaneous leishmaniasis to the local level.

[Evaluation of sandfly control measures in northern Paraná State, Brazil]. / Avaliação de medidas de controle de flebotomíneos no norte do Estado do Paraná, Brasil.

Sandfly captures from April 2001-September 2002 were compared to those from October 1996-September 1997 and October 1998-April 2000 in order to evaluate control procedures conducted in Recanto Marista in the county of Doutor Camargo, Paraná State, Brazil. Sandflies were captured with Falcão traps twice a month, both in the domiciles and henhouses, from 10 PM to 2 AM. In 2001-2002, 199,821 sandflies were captured, with an hourly average of 1,625.5 insects; average captures in 1996-1997 and 1997-1998 were 1,641.9 and 806.7, respectively. Nyssomyia neivai was the most abundant species (90.4%) in all habitats. This species, together N. whitmani, Migonemyia migonei, and Pintomyia fischeri, accounted for 99.9% of all the specimens captured. The total hourly average sandfly captures increased, but 85% of these insects were captured in henhouses built with the purpose of attracting sandfly specimens, while the density decreased in other environments, especially intradomiciliary.

[Light and hens as attraction factors of Nyssomyia whitmani in a rural area, Southern Brazil]. / Luz e galinhas como fatores de atração de Nyssomyia whitmani em ambiente rural, Paraná, Brasil.

OBJECTIVE: To verify the influence of traps with electric light and hens as factors that attract sandflies and compare results between capture methods. METHODS: The study was conducted in the Palmital Farm, Southern Brazil. Sandfly collections were conducted with Falcão traps and an electric aspirator, fortnightly, between 8 p.m. and 11 p.m. in the presence or absence of light and hens in peridomiciliary areas, from September 1998 to June 1999. RESULTS: A total of 43,767 specimens from eight species of sandflies were collected: Nyssomyia whitmani, N. neivai and Migonemyia migonei constituting 99.9% of the total collected, with predominance of N. whitmani. The number of this species collected inside the hen's shed in the presence of hens (21,045) was greater than in their absence (10,434). In the presence of hens, with distinct intensities of light, a larger number of N. whitmani samples were collected with 3W light. In the presence of hens and light (3W), the number of N. whitmani collected with the electric aspirator (5,141) was superior to that collected with the Falcão trap (1,675). In the absence of light, with or without the presence hens, there was no difference between the numbers of N. whitmani collected with the electric aspirator or the Falcão trap. CONCLUSIONS: Hens and electric light together attract more N. whitmani to peridomicilary areas. The number of N. whitmani collected with an electric aspirator inside a hen's shed with the presence of hens and light is greater than those collected with a Falcão trap in the same conditions.

Spatial distribution of cutaneous leishmaniasis in the state of Paraná, Brazil.

The geographic distribution of cutaneous leishmaniasis (CL) makes it a disease of major clinical importance in Brazil, where it is endemic in the state of Paraná. The objective of this study was to analyze the spatial distribution of CL in Paraná between 2001 and 2015, based on data from the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) regarding autochthonous CL cases. Spatial autocorrelation was performed using Moran's Global Index and the Local Indicator of Spatial Association (LISA). The construction of maps was based on categories of association (high-high, low-low, high-low, and low-high). A total of 4,557 autochthonous cases of CL were registered in the state of Paraná, with an annual average of 303.8 (± 135.2) and a detection coefficient of 2.91. No correlation was found between global indices and their respective significance in 2001 (I = -0.456, p = 0.676), but evidence of spatial autocorrelation was found in other years (p< 0.05). In the construction and analysis of the cluster maps, areas with a high-high positive association were found in the Ivaí-Pirapó, Tibagi, Cinzas-Laranjinha, and Ribeira areas. The state of Paraná should keep a constant surveillance over CL due to the prominent presence of socioeconomic and environmental factors such as the favorable circumstances for the vectors present in peri-urban and agriculture áreas.

Disseminated cutaneous leishmaniasis caused by Leishmania braziliensis in Southern Brazil.

The authors report a case of disseminated cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis, in a 55 years old patient with 1,119 lesions distributed throughout the body. The patient resides in Sabáudia municipality, North of Paraná State, Southern Brazil, where there was no previous report of this form of leishmaniasis. Treatment with meglumine antimoniate was successful, although the diagnosis was made only five months later.

Considerations of potential vectors and animal reservoirs in an emerging cutaneous leishmaniasis area in São Domingos ranch, Paraná State in Southearn Brazil.

The aim of this study was to better understand the dynamics of Leishmania sand flies and reservoirs in São Domingos ranch, Arapongas municipality, Paraná State, an anthropic environment in an endemic area of cutaneous leishmaniasis (CL). Sand flies were collected in wild animal burrows, residences and in the forest, with Falcão light trap (FA), Shannon trap (SH) and quadrangular pyramidal trap (QP). The search for Leishmania was made on sand flies, biological samples of wild rodents and dogs using PCR and culture; while parasite direct search (DS) was carried out on animal skin lesions; infection of gold hamsters; and indirect immunofluorescence (IIF) test in dog blood samples. Eighty eight (88) sand flies were collected with FA traps and 526 sand flies using the SH trap, with a predominance of Pintomyia fischeri. Six hundred and one (601) specimens of Brumptomyia brumpti were collected in armadillo burrows, with the QP trap. Seventeen (17) wild rodents were captured, six of them had skin lesions with characteristics of Leishmania infection. Even though no positive test was found for Leishmania, epidemiological surveillance should be maintained, remembering that the human buildings are situated only 50 m from the forest. Considering the species of wild animals and sandflies found in São Domingos, the negative test found do not exclude the existence of the Leishmania transmission cycle in this preservation area.

Genetic variability of populations of Nyssomyia neivai in the Northern State of Paraná, Brazil.

The genetic study of sandfly populations needs to be further explored given the importance of these insects for public health. Were sequenced the NDH4 mitochondrial gene from populations of Nyssomyia neivai from Doutor Camargo, Lobato, Japira, and Porto Rico, municipalities in the State of Paraná, Brazil, to understand the genetic structure and gene flow. Eighty specimens of Ny. Neivai were sequenced, 20 from each municipality, and 269 base pairs were obtained. A total of 27 haplotypes and 28 polymorphic sites were found, along with a haplotypic diversity of 0.80696 and a nucleotide diversity of 0.00567. Haplotype H5, with 33 specimens, was the most common among the four populations. Only haplotypes H5 and H7 were present in all four populations. The population from Doutor Camargo showed the highest genetic diversity, and only this population shared haplotypes with those from the other municipalities. The highest number of haplotypes was sheared with Lobato which also had the highest number of unique haplotypes. This probably occurred because of constant anthropic changes that happened in the environment during the first half of the twentieth century, mainly after 1998. There was no significant correlation between genetic and geographical distances regarding these populations. However, the highest genetic and geographical distances, and the lowest gene flow were observed between Japira and Porto Rico. Geographical distance is a possible barrier between these municipalities through the blocking of haplotype sharing.

PCR in the investigation of canine American tegumentary leishmaniasis in northwestern Paraná State, Brazil.

American tegumentary leishmaniasis (ATL) was studied in 143 dogs in a rural area in the county of Mariluz, northwestern Paraná State, Brazil, using direct parasite search, indirect immunofluorescence (IIF), and polymerase chain reaction (PCR). Thirty-nine dogs (27.3%) presented lesions suggestive of the disease, 5 (12.8%) of which were positive in direct parasite search and PCR (lesion), and of these 5, 4 were also positive by IIF. Of the 34 dogs with negative direct parasite search, 12 (35.3%) had PCR-positive lesions, and of these, 5 were also IIF-positive. One hundred and four dogs had no lesions, but 17/101 (16.8%) were IIF-positive. PCR in blood was positive in 10/38 (26.3%) of the dogs with lesions and in 16/104 (15.4%) of dogs without lesions. The association between PCR (lesion or blood), direct parasite search, and IIF detected 24/39 (61.5%) positive results among symptomatic dogs and 31/104 (29.8%) among asymptomatic animals. PCR was useful for diagnosing ATL, but there was no correlation between lesions, serology, and plasma PCR. Furthermore, detection of parasite DNA in the blood may indicate hematogenous parasite dissemination.

[Evaluation of sandfly control in Lobato municipality, Paraná State, southern Brazil]. / Avaliação de medidas de controle de flebotomíneos no Município de Lobato, Estado do Paraná, Sul do Brasil.

Sandfly control measures were evaluated at the Da Barra Ranch, Lobato municipality, Paraná State, Brazil. The insects were captured with Falcão traps in houses, a cattle corral, and a forest area from July to November 1999 and from February to June 2000. In December 1999 and January 2000 the following measures were taken to decrease the sandfly density in peridomiciliary areas and domiciles: (i) screens were placed on windows of buildings (domiciles, dormitory, cafeteria); (ii) all organic material was cleaned from the peridomiciliary area; and (iii) buildings were sprayed for insects. There were more Nyssomyia whitmani, Pintomyia fischeri, P. monticola, and Brumptomyia brumpti specimens in the former period, while N. neivai, Migonemyia migonei, and N. pessoai predominated in the latter. In the initial period most of the sandflies were captured in the forest and in the latter period in the houses. The sandfly control measures did not reduce the sandfly population on the Da Barra Ranch, but they led to significant proportional changes in the insect fauna composition.

[Human and canine American cutaneous leishmaniasis in Mariluz, Paraná State, Brazil]. / Leishmaniose tegumentar americana humana e canina no Município de Mariluz, Estado do Paraná, Brasil.

An outbreak of American cutaneous leishmaniasis was reported in 2002 in Mariluz, northwestern Paraná State, Brazil. Of 38 humans who were investigated, four had healed lesions, ten showed lesions in the healing process, and 24 had active lesions. Of the 126 dogs, 20 (15.9%) presented suggestive lesions and 24 (19%) had positive serology. Parasites isolated from two patients and three dogs were identified as Leishmania (Viannia) braziliensis serodeme I. The captured sand flies were identified as Nyssomyia whitmani, N. neivai, and Migonemyia migonei. Considering that the region where the cases occurred is similar to other old human settlements in Paraná State, the environmental alterations and remaining forests facilitate the maintenance of the parasite's enzootic cycle and transmission to humans and domestic animals, thereby maintaining the endemicity of American cutaneous leishmaniasis.

[Host feeding preferences of sandflies in rural area, Southern Brazil]. / Estudo dos hábitos alimentares de flebotomíneos em área rural no sul do Brasil.

OBJECTIVE: To investigate the fauna and host feeding preferences of sandflies as for domestic animals in an endemic area of American cutaneous leishmaniasis. METHODS: The sandflies collections were carried out from 8:00 pm to 12:00 am in an area 40 meters away from one of the residences in a farm in Southern Brazil, between January and April, 2004. Collection was performed using four Falcão light traps, placed 5 m apart from each other beside a cage, each one of them containing an animal bait (swine, dog, rabbit, and chicken). RESULTS: A total of 1,697 specimens of sandflies were collected as follows: Nyssomyia whitmani, Pintomyia fischeri, Migonemyia migonei, Nyssomyia neivai, Pintomyia pessoai and Psathromyia shannoni. The prevalent species was N. whitmani. There were no feeding preferences of sandflies as for the animals studied. CONCLUSIONS: N. whitmani and P. fischeri are opportunistic species and female insects probably adjust their eating habits to host availability, suggesting eating eclecticism of these insects in anthropic environments.

[Preliminary information on sandflies in the north of Paraná State, Brazil]. / Informações preliminares sobre flebotomíneos do norte do Paraná.

The results from sandfly collections in 10 municipalities in Paraná State, Brazil are reported. The captures were done using Falcão traps in homes, domestic animal shelters and forested areas, from 1999 to 2002. A total of 13,653 sandflies were collected from 10 species of the genera Brumptomyia, Expapillata, Evandromyia, Migonemyia, Pintomyia, Nyssomyia and Psathyromyia. The species Nyssomyia neivai was predominant in five municipalities. N. whitmani predominated in the other five, in greater numbers than for N. neivai in the first five municipalities. High frequencies of sand flies were found in forests, homes, pigpens and henhouses. Investigations on the participation of domestic animals and phlebotomine fauna in the epidemiology of tegumentary leishmaniasis should be routine in health surveillance, especially where this disease is endemic.

Probability of occurrence of the Brazilian spotted fever in northeast of Paraná state, Brazil.

Brazilian spotted fever (BSF) is a fatal zoonosis because of the difficulties in its early diagnosis and treatment. Occurrences of BSF in the northeast of the state of Paraná prompted investigation of areas at risk of this rickettsiosis in the municipalities of Japira, Jaboti, Pinhalão and Tomazina. To determine the areas at risk, 592 serum samples from dogs and 230 from equids were analyzed by means of the indirect immunofluorescence assay (IFA) for Rickettsia rickettsii and R. parkeri . In addition, risk probability maps were drawn up using the kriging indicator technique. Among the samples tested, 5.3% (43/822) indicated presence of antibodies reactive to at least one of the two Rickettsia species tested: 7.8% of the equids (18/230) and 4.2% of the dogs (25/592) were positive. Geostatistical analysis showed that the average seropositivity rate was 5 to 6%. Although the average seropositivity rates observed among these dogs and equids were lower than those reported from endemic areas of Brazil, the biotic components (etiological agent, vector and reservoirs) and environmental aspects of BSF epidemiology were present in these municipalities.

[Canine American cutaneous leishmaniasis in municipalities of northern Paraná State, Brazil]. / Leishmaniose tegumentar Americana canina em municípios do norte do Estado do Paraná, Brasil.

American cutaneous leishmaniasis (ACL) is an endemic disease in northern Paraná State, where it affects humans and dogs. This study aimed to verify the occurrence of the canine disease in ACL endemic areas. From September 1999 to July 2002, dogs were investigated in 7 rural areas of 5 municipalities where autochthonous human cases of ACL had been reported. Parasitological and serological methods were used. Fourteen of 67 dogs studied (20.9%) had lesions suggestive of ACL, of which 3 (21.4%) were infected with Leishmania sp. Indirect immunofluorescence for Leishmania (Viannia) braziliensis was positive in 37 (55.2%) of 67 dogs. The results showed that human and canine ACL occur simultaneously and indicate the need for additional studies to elucidate the role of dogs in the ACL transmission cycle in the area studied.