ABSTRACT
A leishmaniose tegumentar americana é um grave problema de saúde pública em vários países do mundo. O presente trabalho visou realizar o levantamento descritivo das características epidemiológicas da doença no estado de Goiás entre os anos de 2007 e 2009. Este trabalho consistiu em uma pesquisa retrospectiva descritiva com base nos dados notificados e cadastrados no Sistema de Informação de Agravos de Notificação (SINAN). O estudo mostrou a distribuição dos casos autóctones por município, evidenciando a expansão da doença no estado. Assim, foram notificados 1.285 casos confirmados de leishmaniose tegumentar americana, dos quais 848 eram autóctones em 130 municípios. Em 2007, foram notificados 233 casos autóctones em 75 municípios; em 2008, 276 casos em 81 municípios e, em 2009, 349 casos em 85 municípios. Estes dados sugerem uma leve tendência de aumento de casos e uma ampla distribuição geográfica. Houve predominância de casos que envolviam indivíduos habitantes da área urbana, do sexo masculino, de raça parda e escolaridade inferior ao ensino médio. O resultado da pesquisa sugere a necessidade de uma investigação mais profunda das causas dessas infecções, o que demonstra a importância deste estudo, uma vez que oferece dados que podem subsidiar programas voltados à informação e profilaxia deste tipo de infecção...
The American cutaneous leishmaniasis is a serious public health problem in many countries. This study aimed to survey descriptive epidemiological characteristics of the disease in the State of Goias between the years 2007 and 2009. This study consisted of retrospective descriptive research based on data reported to and registered in the Information System for Notifiable Diseases. The study showed the distribution of autochthonous cases by municipality, showing the spread of the disease in the state, thus, 1,285 confirmed cases of cutaneous leishmaniasis were reported, from which 848 cases were autochthonous, in 130 municipalities. In 2007, 233 cases were reported in 75 municipalities, in 2008 there were 276 cases in 81 municipalities and in 2009 there were 349 cases in 85 municipalities. These data suggest a slight upward trend of cases and a wide geographical distribution. There was a predominance of cases involving individuals who inhabited urban areas, were male, of mixed race and with less than high school education. The results of this search suggest further investigation of the causes of these infections, thus justifying the importance of this study, since it provides data that may support programs aimed at prevention of this type of infection...
Subject(s)
Humans , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/epidemiology , Leishmaniasis, Cutaneous/ethnology , Leishmaniasis, Visceral , Public HealthABSTRACT
En Venezuela se utiliza la inmunoterapia por su bondad terapéutica y operacional en el tratamiento de la leishmaniasis cutánea y se aprecian diferencias de su efectividad entre los servicios locales de salud que la emplean. En el estado Mérida, donde se tiene un bajo nivel de falla terapéutica, se desconocen los factores de riesgo ó de protección que la determinan. Por ello se planteó realizar un estudio epidemiológico de casos y controles para evaluar los factores individuales demográficos, clínicos, inmunológicos y adherencia terapéutica que influyen en dicha efectividad. El ajuste con regresión logística determinó según definición: a) Demográfica: como riesgo las edades extremas, tabaquismo y de oficio doméstico, con protección en el alfabeto educativamente, b) Clínica: como riesgo la forma intermedia, cinco o más lesiones, infección secundaria y ubicación en pié, con protección en la forma localizada y tamaño menor a 60 mm, c) Inmunológica: de riesgo las bajas respuestas a leishmánina y PPD, d) Adherencia terapéutica: son riesgo la aplicación tópica y aseo local inadecuados. Se concluye, hay factores de riesgo y protección que modelan la eficacia de la inmunoterapia, lo que en consecuencia demanda una dinámica vigilancia clínico-epidemiológica para potenciar dicha terapéutica.
Immunotherapy is used in Venezuela as treatment of cutaneous leishmaniasis and there are differences among the health services that use it. In Merida State there are a low proportion of failures, but the factors that are related to this failure are unknown. A case-control study was planned to evaluate the demographics, clinical, immunological factors and the treatment compliance that can be related to the effectiveness. Logistic regression showed that the factors related to failure were: a) demographics: lower and older ages, smoking, domestic labor and illiteracy; b) clinical: intermediate leishmaniasis, five or more lesions, aggregated infection, lesions in feet, and lesion size above 60 mm; c) Immunology: low reactivity to Montenegro and tuberculin tests; d) treatment compliance: use of incorrect topical substances and inadequate cleaning of ulcer. As a conclusion, there are several factors that influence treatment response, that require clinical and epidemiological surveillance to increase the effect of therapy.
Subject(s)
Humans , Male , Female , Leishmaniasis, Cutaneous/epidemiology , Leishmaniasis, Cutaneous/ethnology , Leishmaniasis, Cutaneous/immunology , Leishmaniasis, Cutaneous/prevention & control , Leishmaniasis, Cutaneous/drug therapy , Immunotherapy , Skin Ulcer/epidemiology , Skin Ulcer/parasitology , Skin Ulcer/prevention & control , Skin Ulcer/drug therapyABSTRACT
La leishmaniosis tegumentaria americana (LTA) como enfermedad endémica crónica continúa afectando a la población del medio rural venezolano, ocasionándole morbilidad y limitaciones laborales. Mediantes la descripción de casos clínicos se evaluaron 38 pacientes con LTA que recibieron atención hospitalaria por úlceras leishmánica en miembros inferiores. De los pacientes descriptos 63% eran niños, 84% procedía del Estado Miranda, 66% tenía una lesión ulcerosa única, 45% recibió cefadroxilo previo al tratamiento antiparasitario específico y el 24% había recibio inmunoterapia previa para la enfermedad. Treinta y siete pacientes (97%) recibieron antimoniato de meglumina en series terapéuticas de aiez días y uno anfoterecina B, por contraindicación cardiovascular para el uso del antimonial. Todos presentaron re-epitelización adecuada de sus lesiones, por lo que el antimoniato de meglumina demuestra una vez más su utilidad en la terapéutica de esta zoonosis parasitaria.
American tequmentary leishmaniasis (ATL) endemic chronic disease continues to affect the population of rural Venezuela, causing morbidity and labor constraints. By the description of clinical were evaluated 38 patients with ATL who received hospital care for leishmanial ulcers in lower limbs. Sixty-three percent of the patients were children, 84% came from Miranda state, 66% had a unique ulcerated lesion, 45% received cefadroxil prior to parasite specific treatment and 24% had received immunotherapy for the diseaes. Thirtyseven patients (97%) received meglumine antimoniate in series of ten days and one patient received anfotericine B, due to cardiovascular contraindication for the use of the antimonial. All ulcers healed. The antimoniate of meglumine demonstrates once again its usefulness in the treatment of this parasitic zoonosis.
Subject(s)
Humans , Male , Adult , Female , Child , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/pathology , Lower Extremity/pathology , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/ethnology , Meglumine , Endemic Diseases , Infectious Disease MedicineABSTRACT
Se realizó un estudio descriptivo retrospectivo en el área metropolitana de la Región Sanitaria No. 3 de Honduras, con el propósito de identificar características sociodemográficas, clínicas y epidemiológicas de la leishmaniosis. Los datos se obtuvieron de las fichas de vigilancia existentes en el área de salud. Para el análisis se utilizaron las distribuciones de frecuencias y el test de comparación de proporciones. El sexo masculino resultó ser el más afectado por esta enfermedad, así como los estudiantes. La forma clínica que predominó fue la úlcera, con lesiones únicas situadas fundamentalmente en piernas y brazos. La solicitud de servicios médicos se produjo entre 1 y 3 meses después de presentarse las lesiones. La entrada a zonas boscosas fue fundamental para la aparición de la enfermedad. No hubo recaídas en los pacientes que hicieron un tratamiento adecuado. La leishmaniosis es una enfermedad más que todo social en Honduras y nuestros médicos deben poder reconocerla.
A descriptive study was conducted in metropolitan area of Health Region No. 3 of Honduras to identify the sociodemographic, clinical and epidemiological features of leishmaniasis. Data were collected from surveillance record cards available in health area. In analysis frequencies distribution and ratio comparison test were used. The more affected sex was the male one as well as the students. Clinical form predominant was the ulcer with single lesions located mainly in legs and arms. Medical services request was between 1 and 3 months after lesions appearance. Entry to wooded zones was the main cause of disease appearance. There were not relapses between patients who fulfilled with the treatment parameters. In Honduras, leishmaniasis is a social disease and our physicians must to know it.