Chagas Disease and Leishmaniasis, Sympatric Zoonoses Present in Human from Rural Communities of Venezuela.

PURPOSE: Trypanosoma cruzi and Leishmania spp. coexist in several endemic areas, and there are few studies of Chagas disease and leishmaniasis coinfection worldwide; for this reason, the objective of this work was to determine the Chagas disease and leishmaniasis coinfection in several rural communities co-endemic for these diseases. METHODS: A total of 1107 human samples from six co-endemic rural communities of Cojedes state, Venezuela, were analyzed. Serum samples were evaluated by ELISA, indirect hemagglutination, and indirect immunofluorescence for Chagas disease diagnosis, and individuals were evaluated for leishmaniasis by leishmanin skin test (LST). Approximately, 30% of the individuals were also analyzed by PCR (blood clot samples) for T. cruzi and for Leishmania spp. RESULTS: The 14.7% of the individuals were positive to Trypanosoma cruzi infection by serology, and 25.8% were positive to Leishmania spp. current or past infection by LST. Among the group with PCR results, 7.8% were positive for T. cruzi, and 9.4% for Leishmania spp. The coinfection T. cruzi/Leishmania spp. was 6.5%. The T. cruzi DTUs of the positive blood clot samples were TcI, revealed using the molecular markers: (i) intergenic region of the miniexon, (ii) D7 divergent domain of the 24Sα rDNA, (iii) size-variable domain of the 18S rDNA, and (iv) hsp60-PCR-RFLP (EcoRV). The Leishmania species identified were L. (Leishmania) mexicana and L. (Viannia) braziliensis. CONCLUSION: A high prevalence was found for T. cruzi and Leishmania spp. single and coinfections in almost all communities studied, being these results of relevance for the implementation of control programs in co-endemic areas.

Prevalence of Toxocara eggs in Latin American parks: a systematic review and meta-analysis.

Introduction: Toxocariasis is an infection caused in canines, felines, humans, and other vertebrates by species of the genus Toxocara, such as T. canis and T. cati. The embryonated eggs of these parasites are the main form of acquisition of the infection both for definitive hosts, such as the dog and the cat, respectively and for paratenic hosts, such as humans and other vertebrates. Toxocariasis infection in humans causes visceral larva migrans syndrome. When deposited on park soils, environmental contamination becomes a risk for environmental, human, and animal health. Objective: To systemically estimate the prevalence of Toxocara spp. eggs in park soils in Latin America. Methods: A systematic review and meta-analysis were performed to evaluate the prevalence of Toxocara eggs in park soils in Latin America, defined by copro-parasitological, molecular and immunological techniques. We searched PubMed, Scopus, Web of Sciences, Embase, LILACS and SciELO for studies published from 1900 through 28 January 2023. A meta-analysis was performed using a random-effects model to calculate the pooled prevalence and 95% confidence intervals (95% CI). Heterogeneity was measured through I2 statistics. Results: Forty-nine studies (2,508 parks and 12,833 samples) were included, of whom 44 had a low risk of bias. The pooled prevalence of Toxocara eggs in parks in Latin America was 50.0% (95% CI: 40.0%-60.0%). Argentina had the highest prevalence of Toxocara eggs in parks (100%), followed by Brazil (66%) and Venezuela (63%). The pooled prevalence of Toxocara eggs in soil samples was 20.0% (95% CI: 14.0%-26.0%); in faecal samples, it was 13.0% (95% CI: 6.0%-23.0%). Conclusion: The presence of Toxocara canis eggs in public parks in Latin America is a zoonotic and public health threat for the people who go to these places, especially if children play on the ground with dirt or contaminated objects; since many pet owners and general public are not adequately informed about the mode of transmission of this parasite.

Human visceral leishmaniasis prevalence by different diagnostic methods in Latin America: a systematic review and meta-analysis.

Visceral leishmaniasis is a neglected zoonotic disease that affects animals and humans in different tropical and subtropical regions and even beyond, with variable prevalence among infected hosts. To date, there have been no systematic reviews on human visceral leishmaniasis prevalence in Latin America. We therefore performed a systematic literature review with meta-analysis, using six databases to assess prevalence of visceral leishmaniasis in human patients in Latin American countries. Observational studies were included but analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). In all, 10,435 articles were retrieved for the time frame (1950-2019). After initial screening, 120 articles were selected for full-text assessment, 97 being finally included for qualitative and quantitative analyses. Overall, VL pooled prevalence was estimated at 38.8% (95% CI 33.8-43.8%), derived from 97 studies, including 44,986 individuals. Many aspects of the transmission dynamics of Leishmania and the exact burden of this parasitosis on public health remain largely unknown. Although the elimination of zoonotic VL in the Americas appears an unrealistic goal, additional efforts need to be put in place to achieve better diagnosis, treatment, and prevention of VL.

Surveillance for Leishmania asymptomatic infection in endemic foci of cutaneous leishmaniasis in Venezuela: a combination of leishmanin skin test and PCR using blood clots improves detection and enables identification of species.

BACKGROUND: Little is known about the prevalence of asymptomatic leishmaniasis in Venezuela. The objective of this study was to quantify Leishmania asymptomatic infection in six endemic foci of cutaneous leishmaniasis (CL) in Portuguesa State, Venezuela, where no previous data were available. METHODS: Study of the prevalence of Leishmania asymptomatic infection was carried out in 841 individuals from six endemic foci of CL in the municipalities Sucre and Ospino, Portuguesa State. We applied the leishmanin skin test (LST) and the internal transcribed spacer 1 (ITS1) PCR to DNA from sera and blood clots of all LST-positive and 20% of LST-negative patients. RESULTS: Of 841 inhabitants tested by LST, 197 returned a positive reaction (23.42%); all of the LST-positives (197) and 121 negatives were screened by nested PCR using serum and blood clots. Among the LST-positive group, 2.54% were PCR-positive with sera, while 44.67% were positive with blood clots. In the LST-negative group, PCR was positive in 2.48% of serum samples and in 38.84% of blood clots. CONCLUSIONS: It is recommended that LST and PCR on blood clots are used together to detect exposure and asymptomatic infection and for identification of the Leishmania species.

Molecular typing reveals the co-existence of two transmission cycles of American cutaneous leishmaniasis in the Andean Region of Venezuela with Lutzomyia migonei as the vector.

BACKGROUND The transmission routes for American cutaneous leishmaniasis (ACL) are in flux, so studies examining its transmission in humans, mammalian hosts, and sand fly vectors are urgently needed. OBJECTIVES The aim of this work was understand the epidemiological cycles of Leishmania spp., which causes ACL in the Andean Region of Venezuela, by identifying the Leishmania and the sand fly species involved in human and dog infections. METHODS Thirty-one biopsies from patients in Mérida and Táchira states with suspected ACL were studied by both parasitological tests (cultures and hamster inoculation) and a molecular test [Internal transcribed spacer 1 (ITS1) nested polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)]. We also conducted a survey to detect Leishmania infection in dogs (Immunifluorescence antibody test and ITS1 nested PCR-RFLP) and sand flies (ITS1 nested PCR-RFLP) from El Carrizal, a highly endemic focus of ACL in Venezuela. FINDINGS Three different Leishmania species were identified in the clinical samples from humans (Leishmania braziliensis, L. guyanensis, and L. mexicana) and dogs (L. guyanensis and L. mexicana). The predominant sand fly species found were those from the Verrucarum group (infected with L. mexicana) and Lutzomyia migonei (infected with L. guyanensis and L. mexicana). MAIN CONCLUSIONS We show that Lu. migonei may be the putative vector in two ACL epidemiological cycles, involving L. guyanensis and L. mexicana. We also report for the first time the presence of L. guyanensis in domestic animals.

Molecular typing reveals the co-existence of two transmission cycles of American cutaneous leishmaniasis in the Andean Region of Venezuela with Lutzomyia migonei as the vector

BACKGROUND The transmission routes for American cutaneous leishmaniasis (ACL) are in flux, so studies examining its transmission in humans, mammalian hosts, and sand fly vectors are urgently needed. OBJECTIVES The aim of this work was understand the epidemiological cycles of Leishmania spp., which causes ACL in the Andean Region of Venezuela, by identifying the Leishmania and the sand fly species involved in human and dog infections. METHODS Thirty-one biopsies from patients in Mérida and Táchira states with suspected ACL were studied by both parasitological tests (cultures and hamster inoculation) and a molecular test [Internal transcribed spacer 1 (ITS1) nested polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)]. We also conducted a survey to detect Leishmania infection in dogs (Immunifluorescence antibody test and ITS1 nested PCR-RFLP) and sand flies (ITS1 nested PCR-RFLP) from El Carrizal, a highly endemic focus of ACL in Venezuela. FINDINGS Three different Leishmania species were identified in the clinical samples from humans (Leishmania braziliensis, L. guyanensis, and L. mexicana) and dogs (L. guyanensis and L. mexicana). The predominant sand fly species found were those from the Verrucarum group (infected with L. mexicana) and Lutzomyia migonei (infected with L. guyanensis and L. mexicana). MAIN CONCLUSIONS We show that Lu. migonei may be the putative vector in two ACL epidemiological cycles, involving L. guyanensis and L. mexicana. We also report for the first time the presence of L. guyanensis in domestic animals.

Ocular toxocariasis: new diagnostic and therapeutic perspectives.

PURPOSE: To provide an updated insight of concepts regarding the overview, epidemiology, risk factors, clinical manifestations, diagnosis, treatment and prevention of ocular toxocariasis. DESIGN: Perspective of literature review. METHODS: Review and synthesis of literature about toxocariasis, with interpretation and perspective. A literature search for "ocular toxocariasis" was performed using PubMed, ScienceDirect, Scopus, SciELO and LILACS databases. RESULTS: Mild to moderate infections are frequently reported in ocular toxocariasis which usually occurs in children and typically presents as unilateral vision impairment, blindness is common and could present invasion of the retina. There are three groups of presentation of toxocariasis (according to the physical examination): chronic endophthalmitis, posterior granuloma and peripheral granuloma. Standard diagnosis of ocular toxocariasis is based on the identification of clinical signs, supported by additional diagnostic methods. Regarding treatment, there is no commonly accepted regimen but most of the authors prefer to use steroids and anthelminthic agents, but nowadays there are no standardized parameters in terms of dosage, duration and route of administration. Surgery has been recommended in some cases. CONCLUSION: Toxocariasis is still a problem of public health, particularly in developing countries with an increasing epidemiological burden in terms of morbidity and mortality and most of the authors agree on the utmost relevance of its prevention. Clinical experience and suspicion of ophthalmologists make an important role in its diagnosis, but always with supportive diagnostic methods. Additional studies should explore new therapeutic options for toxocariasis.

Manifestaciones cardiovasculares de la toxocariasis humana / Cardiovascular manifestations of human toxocariasis

La toxocariasis es una infección parasitaria producida por un helminto que en el ser humano no alcanza su estadio adulto. El hombre es para sus especies, Toxocara canis y Toxocara cati, un hospedador paraténico. Dicha infección puede producir el síndrome de larva migrans visceral, el síndrome de larva migrans ocular y la toxocariasis inaparente. En el síndrome de larva migrans visceral el compromiso de órganos puede incluir hígado, pulmón, piel, sistema nervioso, musculoesquelético, riñón y corazón. Sobre este último, cada vez se reconoce más la importancia que pueden tener las manifestaciones cardiovasculares de la toxocariasis y la relevancia clínica de considerarlas. En el presente artículo, haciendo una búsqueda sistemática de información, se revisan los principales aspectos clinicopatológicos de las manifestaciones cardiovasculares de la toxocariasis incluyendo su fisiopatología, hallazgos de laboratorio, diagnóstico y opciones terapéuticas, con el objeto de llamar la atención acerca de la importancia de esta zoonosis y su relevancia para la medicina cardiovascular en adultos y en niños.

Toxocariasis is a parasitic infection produced by helminths that cannot reach their adult stage in humans. For their etiological species (Toxocara canis and Toxocara cati), man is a paratenic host. Infection by such helminths can produce a variety of clinical manifestations, such as: visceral larvae migrans syndrome, ocular larvae migrans syndrome and covert toxoca-riasis. In the visceral larvae migrans syndrome, the organs that are mainly involved include liver, lungs, skin, nervous system, muscles, kidneys and the heart. Regarding the latter, the importance of cardiovascular manifestations in toxocariasis, as well as its clinical relevance, has increasingly begun to be recognized. The current article is based on a systematic information search, focused mainly on the clinical and pathological aspects of cardiovascular manifestations in toxocariasis, including its pathophysiology, laboratory findings, diagnosis and therapeutical options, with the objective of highlighting its importance as a zoonosis and its relevance to the fields of cardiovascular medicine in adults and children.

[Cardiovascular manifestations of human toxocariasis]. / Manifestaciones cardiovasculares de la toxocariasis humana.

Toxocariasis is a parasitic infection produced by helminths that cannot reach their adult stage in humans. For their etiological species (Toxocara canis and Toxocara cati), man is a paratenic host. Infection by such helminths can produce a variety of clinical manifestations, such as: visceral larvae migrans syndrome, ocular larvae migrans syndrome and covert toxocariasis. In the visceral larvae migrans syndrome, the organs that are mainly involved include liver, lungs, skin, nervous system, muscles, kidneys and the heart. Regarding the latter, the importance of cardiovascular manifestations in toxocariasis, as well as its clinical relevance, has increasingly begun to be recognized. The current article is based on a systematic information search, focused mainly on the clinical and pathological aspects of cardiovascular manifestations in toxocariasis, including its pathophysiology, laboratory findings, diagnosis and therapeutical options, with the objective of highlighting its importance as a zoonosis and its relevance to the fields of cardiovascular medicine in adults and children.

Meglumina en series terapéuticas de 10 días en niños con leishmaniosis tegumentaria americana / Meglumine therapeutic series of 10 days in children with american tegumentary leishmaniasis

La cátedra de Medicina Tropical de la Universidad Central de Venezuela viene empleando el antimoniato de meglumina en series terapéuticas de 10 días en el tratamiento de leishmaniosis tegumentaria americana, la cual continúa como problema de salud del medio rural venezolano. Se evalúa una experiencia con una dosis de 70 mg/kg/día de meglumina en niños con la enfermendad. A los pacientes con presunción diagnóstica de leishmaniosis tegumentaria americana (clínica y antecedentes epidemiológicos) se les efectuó la prueba de leishmania, la demostración de anticuerpos flurescentes antileishmania y la visualización de amastigotes en frotis teñidos con Giemsa. Los casos identificados ingresaron al Hospital Universitario (Pediatría médica infecciosa), recibieron 70 mg/kg/día de antimoniato de meglumina en series terapéuticas de 10 días con reposo intercalados por el mismo número de días. Se incluyeron 33 niños con la enfermedad, 21 de género femenino (64%) con promedio de edad 7,12 años y predominio de escolar (70%). Del Estado Miranda procedía el 85%, una sola úlcera la tenía el 88%, localizada en miembros inferiores (49%). La Leishmanina y los anticuerpos fluorescentes antileishmania fueron positivos en todos los pacientes y el frotis para amastigotes en 45%. Dos series de antimoniato de meglumina las recibió 91% de los pacientes; una de 10 días 6%. Egresaron con cicatrizaciones de sus procesos ulcerosos y fueron evaluados durante seis meses en la consulta de endemias rurales y no se evidenciaron recaídas. La variedad cutánea localizada de la enfermedad fue la única identificada, el Estado Miranda continúa aportando la mayoría de los pacientes atendidos en medicina tropical. El antimoniato de meglumina en leishmaniosis tegumentaria americana a la dosis de 70 mg/kg/día en series terapéuticas fue tan eficaz como la anterior de 100 mg/kg/día que dejó de administrarse hace ocho años.

The Tropical Medicine Department of the Universidad Central de Venezuela employs the meglumine pentavalent antimonial in series of 10 days of treatment for American Tegumentary Leishmaniosis, which continues being a health problem in the Venezuelan rural areas. We are reporting a clinical experience of treatment in children at a dose of 70 mg/kg/day. Patients with diagnostic suspición of American Tegumentary Leishmaniosis (clinical and epidemiologic antecedents) who attended the Rural Endemics Clinic at the Instituto de Medicina Tropical of the Universidad Central de Venezuela and to the Medical Infectious Pediatrics Service at the Hospital Universitario de Caracas (HUC), were tested for leishmanine, fluorescent antileishmania antibodies and for the presence of amastigotes of the parasite in smear for apposition from the ulcer that were treated by the Giemsa method. Patients hospitalized at the Medical Infectious Pediatric Service (Hospital Universitario de Caracas) received 70 mg/kg/day of meglumine pentavalent antimonial during 10 days, a rest period of 10 days without treatment and, if 20 days after ulcers were unhealed, was administred a new 10 days meglumine pentavalent antimonial series. We included 33 children with the disease with a mean age of 7,12 years, 70% in school age and 30% preschool children, and 21 (64%) were girls. The 85% of patients came from Miranda`s state, 88% had only ulcer and in 49% of them the lesions where localized in the legs. The apposition smear showed Leishmania amastigotes in 45% od cases. One series of treatment was given to 91% of cases, two children received two series and one three. At discharge from the hospital all ulcers were healed and follow-up control for a 6 months period showed no relapses. The cutaneous localized from was the clinical form of presentation in the children studied. The great majority of patients that assits to the Tropical Medicine Institute come from the Miranda`s state area...

Leishmaniosis tegumentaria americana: efectividad del antimoniato de meglumina en series terapéuticas de 10 días / American tegumentary leishmaniasis: effectiveness of meglumine antimoniate in 10-day treatment series

La leishmaniosis tegumentaria americana es un problema de salud en el medio rural venezolano. La Cátedra de Medicina Tropical (UCV) y el Hospital Universitario de Caracas reciben pacientes con diagnóstico presuntivo, se realiza el diagnóstico de certeza y son tratados ambulatoria u hospitalariamente con antimoniato de meglumina en series terapéuticas de 10 días, a dosis de 3 000 mg/día a 4 500 mg/día. Se evalúan los resultados de 221 pacientes, la mayoría adultos masculinos, con úlcera única en miembros inferiores, procedentes del medio rural del Estado Miranda. Predominó la variedad cutánea localizada, seguida de la cutáneo mucosa con 4 pacientes y cutáneo difusa con 3. Hubo cicatrización de las úlceras y desaparición de los nódulos cutáneos, excepto en 1 paciente (0,3 por ciento) que requirió anfotericina B por falla terapéutica. En el estudio participan estudiantes del curso regular de la cátedra, integrantes del programa: docencia en medicina tropical basada en publicaciones periódicas

American tegumentary leishmaniasis (ATL) is a health problem in the rural areas of Venezuela. Patients are referred to the Tropical Medicine Department (UCV) and to the University Hospital of Caracas with presumptive diagnosis of the disease, are studied to confirm the diagnosis and treated with antimoniate of meglumine in 10 days course at dose of 3 000 mg./day to 4 500 mg./day according to complications as outpatients or hospitalized. We report the results of 221 patients treated, mostly male adults from the rural area of the Miranda state with a sole ulcer in the limbs. Among the clinical presentation the cutaneous-localized form was predominating, followed by the localized muco-cutaneous with 4 and cutaneous-diffuse variety with 3. They responded with healing of the ulcers and disappearance of skin nodules, except one (0.3 percent) who required anfotericine B due to lack of response to meglumine therapy. In this investigation there was the participation of students from the Tropical Medicine course: learning based on periodic publications with students

Aspectos clínico-epidemiológicos de la toxocariasis: una enfermedad desatendida en Venezuela y América Latina / Clinical and epidemiological aspects of toxocariasis: A disease neglected in Venezuela and Latin America

La toxocariasis es una enfermedad zoonótica de gran importancia en términos de la morbilidad que puede producir en el ser humano y por lo difícil que puede resultar su control para la salud pública. Recientes hallazgos en cuanto a su asociación con otras patologías, el avance en técnicas diagnósticas y nuevos descubrimientos terapéuticos generan la inquietud de revisar un tópico de actualidad que puede ser considerado olvidado y desatendido por la escasez de estudios nacionales y latinos. En el presente artículo se hace una revisión de diferentes aspectos relacionados a la biología del parásito Toxocara canis y su relevancia clínico-epidemiológica en el ser humano, con énfasis en Venezuela y América Latina

Toxocariasis is a zoonotic disease of great importance in terms of its morbidity that it produces inthe human beings, as well the difficulty that results itscontrol for the public health. Recent findings in regardto its association with other pathologies, the advance indiagnostic techniques and new therapeutic discoverieshave generated the interest in reviewing a topic ofcurrent attention that would be considered neglecteddue to scarcity of national and Latin American studies.In the current article a review of different aspectsrelated to the biology of the parasite Toxocara canisand its clinical and epidemiological relevance in thehuman beings, with emphasis on Venezuela and Latin America is presented

Leishmaniasis tegumentaria americana en brotes epidérmicos familiares diagnóstico y terapèutica / Cutaneous leishmaniasis in epidermal outbreaks diagnostic and therapeutic family

Describir y evaluar cinco brotes epidémicos de leishmaniasis tegumentaria americana (LTA) en grupos familiares de los estados Miranda y Aragua y de la República de Colombia. Trece pacientes de grupos familiares diferentes acudieron al Instituto de Medicina Tropical por lesiones ulcerosas en regiones anatómicas expuestas; siete del sexo masculino en edades entre 2 y 66 años. La leishmanina, los anticuerpos fluorescentes anti-leishmania y los frotis por aposición de segmentos de piel de las úlceras revelaron la presencia del parásito leishmania spp. Se efectuaron exámenes bioanalíticos y cardiovasculares recomendados para el tratamiento con antimoniatos pentavalentes. Siete pacietes fueron tratados ambulatoriamente con meglumina intramuscular a la dosis de 3000 mg/día en series terapéuticas de 10 días con una segunda serie luego del reposo de 10 días. Una paciente adulta recibió tres series de AM, la última de ellas de 4500 mg/kg/día 10 días en hospitalización. Cinco niños fueron hospitalizados y recibieron AM a la dosis de 70 mg/día/10 días con reposo intermedio y una segunda serie. Los pacientes respondieron adecuadamente a la terapia empleada con la cicatrización completa de los procesos ulcerosos. La LTA siguen adquiriéndola pobladores y viajeros de las áreas rurales de Venezuela y Colombia y frecuentemente se presenta como brotes epidémicos familiares, lo cual facilita el diagnóstico presuntivo. El caso índice permite el diagnóstico de la enfermedad entre otros familiares. Los casos tratados comprueban una vez más las ventajas terapéuticas de la meglumina en LTA.

Leishmaniasis is an infectious disease acquired with relative frequency in the rural areas of Venezuela and Colombia. When there is the antecedent of another member of the family with a similar symptom "at home there is somebody with a similar ulcer" is a frequent statement that facilitates the diagnosis. To describe and evaluate five epidemic autbreaks of cutaneous leishmaniasis of the New World (CLNW) in family groups of Miranda and Aragua states in Venezuela and North Santander Department in Colombia, including diagnosis and treatment with meglumine. This disease is relatively frequently acquired by inhabitants and travelers to these geographical regions. Thirteen patients of different family groups, attended to the "Instituto de Medicina Tropical" (IMT) and to the "Hospital Universitario de Caracas" (HUC) presenting an ulcerative lesión on an exposed area of skin, compatible with the clínical diagnosis of this parasitic disease. Seven patients were females with age between 2 and 66 years. Laboratory diagnostic exams included the intradermal reaction test "leishmanina" serology tests for determination of antibodies anti-leismania and apposition smear from the ulcers stained by the Giemsa method, resulted positive for the infection produced by parasites of the species Leishmania spp. Six patients adults received treatment as outpatients with two series of the pentavalent antimony meglumine at a dose of 3000 mg/day during 10 days, one patient received the dose of 4500 mg/day as a last series of treatment. Children were given a dose of meglumine of 70 mg/kg/day, in series of treatment with their respective rest period. All patients responded adequately. Once again, we can demonstrate the advantages of the treatment of CLNW with the pentavalent antimony meglumine.

Producción, purificación y caracterización de un anticuerpo anti IgG canino como sonda en el diagnóstico de leishmaniasis visceral canina / Production and characterization of anti dog IgG antibody as a diagnostic probe in canine visceral leishmaniasis

La leishmaniasis visceral (LV) es una enfermedad parasitaria producida por protozoarios del género leishmania, es endémica en muchos países a nivel mundial y representa un problema de salud pública pudiendo ser fatal si no se diagnostica y trata a tiempo. El perro doméstico es el principal reservorio de leishmanias viscerotropas en el Nuevo Mundo y juega un papel muy importante en la transmisión a humanos. Debido a esto es imperante el diagnóstico temprano de los reservorios, mediante la demostración de anticuerpos específicos en el suero con pruebas sensibles, rápidas y costo - efectivas como la ELISA, Dot-ELISA, MABA e IFI que requieren para su realización de un anticuerpo secundario. En el presente trabajo se produjo un anticuerpo anti-IgG canino conjugado con proteínas reporteras para ser evaluado en las técnicas antes mencionadas. Se demostró una mayor sensibilidad de este anticuerpo conjugado con peroxidasa en las pruebas de MABA y ELISA así como el conjugado con fluoresceína en IFI al comparar con el anticuerpo comercial. El uso de estos conjugados en el diagnóstico de la LV canina mostró ser de gran utilidad y costo efectivos si se considera que los volúmenes a preparar se pueden ajustar a los requerimientos de las diversas técnicas diagnósticas siendo altamente sensibles y económicos en comparación con los comerciales.

Visceral leishmaniasis (VL) is a parasitic disease caused by protozoan parasites of the Leishmania genus. Endemic in many countries worldwide, VL represents a serious public health issue and might be fatal if untreated. Infected domestic dogs are the main reservoir of viscerotropic species of Leishmania in the New World and plays an important role as source of infection to humans. Early diagnosis of dog reservoirs are therefore required by demonstrating specific serum antibodies against the parasite with rapid, sensitive and cost-effective test like ELISA, Dot - ELISA, IFI and Multiple Antigen Binding Assay (MABA). Here we produce an anti canine IgG antibody and tested it in those assays by conjugating with reporter proteins. Results demonstrated a higher sensitivity of this antibody conjugated with HRP in MABA and ELISA test, as well as conjugated with FITC on the IFI test, when compare to the commercial peroxidaseconjugated antibody. The use of this conjugate on canine VL diagnosis proved to be useful, highly sensitive and cost effective.

Cutaneous leishmaniasis imported from Colombia to Northcentral Venezuela: implications for travel advice.

BACKGROUND: Imported leishmaniasis could be defined as any case acquired outside of a defined area in which the diagnosis of leishmaniasis is made. This definition has been used for the diagnosis of disease in a patient who arrives from an endemic area and displays symptoms or seeks medical attention in a nonendemic zone. However, this phenomenon can also occur between two endemic zones. METHODS: We evaluated the epidemiologic features of imported cases of cutaneous leishmaniasis imported from Colombia into Northcentral Venezuela from 2001 to 2006. A total of 29 patients with the clinical diagnosis of cutaneous leishmaniasis arriving from Colombia were evaluated at our referral center. Different diagnostic methods were used to confirm the diagnosis (the Montenegro skin test; an indirect immunofluorescence test and smear of cutaneous lesion). Clinical and epidemiological features of cutaneous leishmaniasis among these patients were evaluated. RESULTS: We identified that most identified patients were male with a mean age of 35 years (age range was 7-64); all cases were from northern departments of Colombia. These patients presented a mean clinical evolution of 3 months. Most patients presented with one cutaneous lesion (17%), which were located mostly in extremities (20%). Of the 29 patients, in 16 (55%) cutaneous leishmaniasis was confirmed by different diagnostic techniques. In 2 patients the diagnosis was made by smear. In the rest, 14 (100%) patients were positive by the Montenegro skin test and 11 (79%) were positive by the indirect immunofluorescence test (79% were positive simultaneously by both tests). DISCUSSION: The identification of imported cutaneous leishmaniasis in our setting becomes important, given the differences in the epidemiology of the disease and the clinical severity of leishmaniasis between both zones (ecological characteristics, circulating Leishmania spp., and population characteristics) and the risk of the mucocutaneous forms of the disease.

American cutaneous leishmaniasis in children and adolescents from Northcentral Venezuela.

American Cutaneous Leishmaniasis (ACL) comprises a broad range of cutaneous manifestations caused by different Leishmania species which may produce severe and chronic sequelae in adults. However, it has been suggested that ACL may show different clinical and epidemiological features in children and adolescents that need to be further elucidated. We evaluated the epidemiological features of ACL in a cohort of pediatric patients from Northcentral Venezuela between years 1997 and 2005. Mean age of patients was 9 years old, with a mean clinical evolution of 3 months. Lesions were located mostly in extremities. Forty patients (93%) were positive by MST, 97.7% by IFAT and 48.8% by smear. MST values tended to be related to patients' age, higher values being recorded in older patients (p=0.153).