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Caracteriza??o epidemiol?gica de munic?pio sem autoctonia para leishmaniose tegumentar americana. / Epidemiological characterization of a non-disease municipality for american cutaneous leishmaniasis.

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Previous issue date: 2009-12-19 / Funda??o Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / The knowledge about epidemiology of American Cutaneous Leishmaniasis - ACL still has
gaps. The influences of environmental and peridomestic characteristics over its occurrence are
not well defined. This study aimed to investigate the asymptomatic occurrence of Leishmania
(Viannia) braziliensis in humans and dogs, and to evaluate the natural infection of
phlebotomine vectors at Engenheiro Paulo de Frontin, a disease-free of autochthonous ACL
municipality, part of an endemic region. An epidemiological inquiry was developed from
march/2006 to december/2007 with the support of the Family Health Program of the
Municipality Health Secretary Office in the five sanitary areas. Fifty families participated in
the study, yielding a total of 95 volunteers who were exposed or not to known risk factors.
Procedures involved structured interviews, Montenegro skin Test (IDRM), serology done by
Enzime Linked Immunossorbent Assay (ELISA), and Indirect Immunofluorescence (IIF). All
the volunteers had their dogs examined by the serology procedures and including a clinical
exam. The existing environment was reported and phlebotomine sand flies were captured in
the peridomestic environment to have all the present species identified. Infection by L. (V.)
braziliensis was also determined by using polymerase chain reaction (PCR). Observed
frequencies for positive results in humans were: 9%, 6.4% and 13.8% for IDRM, ELISA and
IFI, respectively. Of 39 dogs examined, 5.1% were positive for ELISA and 23% for IFI, and
from the seven species of phlebotomine sand flies captured, Lutzomyia migonei (59%) and L.
intermedia (20.9%) were the most frequent. Natural infection rate of phlebotomine vectors
were 5% or less, by PCR. The absence of active cases and the low percentage of positive tests
found in humans and dogs, and the non-matching results, lead to the suggestion that there is
no extra forest transmission of L. (V.) braziliensis in the county, despite of the high natural
infection rate of phlebotomines sand flies. Large areas of preserved forests scattered around
52% of the municipality appears to be the only and main difference from the surrounding
municipality, thus allowing maintenance of the ecological niches of the phlebotomine sand
flies and reducing the pressure for adaptive changes. / O conhecimento acerca da epidemiologia da Leishmaniose Tegumentar Americana (LTA)
ainda possui lacunas. As influ?ncias de caracter?sticas ambientais e peridom?sticas sobre sua
ocorr?ncia n?o est?o bem definidas. Este estudo buscou investigar a poss?vel ocorr?ncia de
infec??o assintom?tica por Leishmania (Viannia) braziliensis em humanos e c?es e a infec??o
natural dos flebotom?neos vetores no munic?pio de Engenheiro Paulo de Frontin, indene para
LTA aut?ctone e circundado por munic?pios end?micos. Foi realizado um inqu?rito
epidemiol?gico entre mar?o de 2006 e dezembro de 2007, sendo investigadas as cinco ?reas
de sa?de do munic?pio, com apoio do Programa de Sa?de da Fam?lia da Secretaria Municipal
de Sa?de. Participaram do estudo cinq?enta fam?lias expostas ou n?o aos fatores de risco
conhecidos, totalizando noventa e cinco volunt?rios. Entrevistas estruturadas,
Intradermorrea??o de Montenegro (IDRM) e sorologia para leishmaniose, por ELISA e por
Imunofluoresc?ncia Indireta (IFI) foram realizadas nos volunt?rios, cujos c?es foram tamb?m
submetidos a exame cl?nico e sorologia pelos mesmos m?todos. O ambiente circundante foi
descrito e flebotom?neos foram capturados nos peridomic?lios para identifica??o das esp?cies
presentes e de infec??o por L. (V.) braziliensis pela t?cnica de rea??o em cadeia de polimerase
(RCP). As freq??ncias encontradas de positividade nos testes em humanos foram de: 9%,
6,4% e 13,8% para IDRM, ELISA e IFI, respectivamente. Dos trinta e nove c?es examinados
5,1%, foram positivos ao ELISA e 23% ? IFI. Das sete esp?cies de flebotom?neos capturadas,
predominaram Lutzomyia migonei (59%) e L. intermedia (20,9%). A taxa de infec??o natural
dos flebotom?neos foi de at? 5% ? RCP. A aus?ncia de casos ativos e as baixas positividades
verificadas nos testes em humanos e em c?es e a discord?ncia entre os resultados levam a
supor que n?o ocorre transmiss?o extraflorestal de L. (V.) braziliensis no munic?pio, a
despeito da alta taxa de infec??o natural dos flebotom?neos. Grandes ?reas de mata preservada
dispersas pelo territ?rio (52% do munic?pio) parecem ser o ?nico diferencial em rela??o aos
munic?pios circundantes, permitindo a manuten??o dos nichos ecol?gicos dos flebotom?neos e
reduzindo a press?o por mudan?as adaptativas.

Identiferoai:union.ndltd.org:IBICT/oai:localhost:tede/847
Date19 December 2009
CreatorsBustamante, Maria Cristina Fortes Santos de
ContributorsPereira, Maria Julia Salim, Fonseca, Adevair Henrique da
PublisherUniversidade Federal Rural do Rio de Janeiro, Curso de P?s-Gradua??o em Ci?ncias Veterin?rias, UFRRJ, Brasil, Parasitologia Veterin?ria
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da UFRRJ, instname:Universidade Federal Rural do Rio de Janeiro, instacron:UFRRJ
Rightsinfo:eu-repo/semantics/openAccess

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