The epidemiology of cutaneour leishmaniasis / The epidemiology of cutaneous leishmaniasis

ABSTRACT

An epidemiologic survey was conducted in an area of sutrolical rainforest in Northwest Ecuador with followin objectives; (1) to determine the prevalencie of cutaneous leishmaniasis (CL), (2) to identify the leishmania species cusing human disease, (3) to investigate the major CL clinical manifestations, (4) to study cellular and humoral inmune response indicators, and (5) to identify risk factors associated with the disease, Half of the 466 subjects had laboratory and clinical evidencie of either current (14 for cent) or piror disease (33 for cent). Subjects with c urrent disease had an average of 2.6+-1.9 lesions with a mean size of 8.4 +-19.4 cms. The parasite species isolated from subject lesions were Leismania guyanesis (63 for cent. L. panamensis (33 for cent) and L. brazilensis (4 for cent). Subjects with CL exhibited the highest serum IgG an IgM concentrations (p<0.0001). Lesion number (t=2.9, p=0.007) and size (t=3.8, p=0.0004) was predictive or serum IgG levels. The Montenegro skin test induration size was correlated positively with ulcer number (t=2.2, p=0.038). Age<5 yrs (AOR=1.5, 95 for cent C.I.=0.48-2.35), adult male gender (AOR=2.8.95 for centC.I.=1.1-7.8), and wood and/or cane exterior house walls (AOR=1.8,95 for cent CI=1.4-2.5) were associated with an increased for CL. In contrast, electric home lighting was associated with decreased risk (AOR=0.7, 95 for cent CI=0.4-2.3). The results suggest that it may be possible to modify a portion of the risk for CL by making changes in the housing evironment which may help to reduce the amount of contact with the vector...