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Am J Trop Med Hyg ; 93(2): 340-346, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26078320

RESUMO

Military personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2-36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (~70%; P < 0.001). After emphasizing pre-deployment education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries.


Assuntos
Surtos de Doenças , Leishmania braziliensis/isolamento & purificação , Leishmaniose Cutânea/epidemiologia , Militares , Adolescente , Gluconato de Antimônio e Sódio/uso terapêutico , Feminino , Humanos , Leishmania guyanensis/isolamento & purificação , Leishmaniose Cutânea/tratamento farmacológico , Masculino , Peru/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real , Inquéritos e Questionários , Adulto Jovem
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