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Revista del Instituto de Medicina Tropical
Print version ISSN 1996-3696
Abstract
BENITEZ, Irene R. et al. Analyses of evidence-based data for epidemiological characterization of leishmaniasis in Paraguay - I: Tegumentary leishmaniasis. Rev. Inst. Med. Trop. [online]. 2020, vol.15, n.2, pp.29-44. ISSN 1996-3696. https://doi.org/10.18004/imt/2020.15.2.29.
Leishmaniasis is a neglected disease transmitted by sandflies of the genera Phlebotomus and Lutzomyia. There are three main clinical forms of leishmaniasis: one visceral and two tegumentary, differentiated between cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (ML), all present in Paraguay. The objective of this work is to describe the epidemiologic characteristics of tegumentary leishmaniasis in Paraguay. Here we analyzed epidemiological data of tegumentary leishmaniasis (including CL and ML), taken from 2006 to 2017. Patients’ identities were kept confidential. A total of 2,918 cases of positive leishmaniasis infection were studied. The peak of reported cases was in 2007. An overview shows a decrease in the trend of tegumentary leishmaniasis, where males are more affected than females, and the endemic area located on the east and north-eastern parts of Paraguay. Cases in the Chaco (west of Paraguay river) are increasing. The incidence of tegumentary leishmaniasis for the country is 4 persons per 100,000 inhabitants. This is considered an occupational disease since 67% of the infected patients were rural workers. During the period of study CL was more common than ML, except for the years 2010, 2014, and 2017. Most of the patients affected by ML are elders.
Conclusion.
We remark that leishmaniasis is not only restricted to the humid area of eastern Paraguay, since it is also present in xerophytic areas of Paraguay and Bolivia. Male rural workers are the most susceptible group. The high frequency of ML in some years indicates that more educational programs have to be carried out by national agencies to prevent and reduce the burden of CL (and thus also ML) in the country.
Keywords : Cutaneous leishmaniasis; occupational duties; gender; mucocutaneous leishmaniasis; neglected disease; Neotropical region.