Leishmaniose Tegumentar Americana na região Centro-Oeste: avaliação de dados clínicos, epidemiológicos, laboratoriais e moleculares
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2014-04-30
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Universidade Federal de Goiás
Resumo
Protozoa of the genus Leishmania, which affects the skin and/or mucous
membranes, cause American Cutaneous Leishmaniasis (ACL). It is an
endemic zoonosis whose numbers of cases in the Brazil Midwest region are
growing. In the Goiás state, 2798 ACL cases were been reported between
2007 and 2013. In the present study, our proposal was to investigate the
epidemiological and molecular characteristics of ACL patients attended at the
ambulatory of the Hospital Anuar Auad in the period 2000 at 2006 and
identify the species of Leishmania sp. The study included 152 patients with
ACL, 124 were from of the state of Goiás and 28 at Mato Grosso, aged
between 6-79 years, and center and thirteen these individuals were male. For
diagnosis, clinical, epidemiological and laboratory data were collected, such
as direct examination (ED), histopathology (AH), Montenegro skin test
(MST), indirect immunofluorescence (IIF). ELISA using crude extract of L.
(Viannia) braziliensis was performing. Characterization of Leishmania
species was carried out by polymerase chain reaction (PCR). The positivity
of ED, AH, MST, IIF and ELISA was 70.6%, 80.9%, 68.9%, 44.2% and
73.0%, respectively. Specific IgG to L. (V.) braziliensis were detecting in
84.7% of patients with mucosal leishmaniasis (ML), significantly higher than
those found in patients with cutaneous leishmaniasis (CL), which was 69.0%
(p < 0.05). Detection of IgG before and after treatment was performed using
ELISA and was observed a statistically significant difference only in samples
obtained from patients with CL after 6 and 18 months of treatment. The data
serological monitoring of patients with ACL before and after treatment
indicates that the total IgG levels tend to decrease after 6 months of
treatment. PCR was performed on 69 samples obtained from scraping the
edge of lesions of patients with ATL, these, 62 (89.8%) were positive, 53
patients with LC and 9 patients with ML. The samples were characterized by
PCR as L. (V.) braziliensis (93.5%) and L. (L.) amazonensis (6.5%). It was
found that 25.8% of cases of leishmaniasis in the state of Goiás occurred in
Campestre, Goiânia, Aparecida de Goiânia and Niquelândia. By analyzing
the frequency of cases of ATL over the months during the years analyzed, it
was observed that there was a distribution of ACL in all seasons from 2000 to
2006, with a larger number of cases in winter. PCR represents important and
powerful tool in the diagnosis and species identification in ACL in endemic
areas. ACL controlling in endemic areas is difficult and requires an accurate
idea of its epidemiology.
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Citação
BALIAN, Rosana Pereira Morais. Leishmaniose Tegumentar Americana na região Centro-Oeste: avaliação de dados clínicos, epidemiológicos, laboratoriais e moleculares. 2014. 76 f. Dissertação (Mestrado em Biologia das Relaçções Parasito-Hospedeiro) - Universidade Federal de Goiás, Goiânia, 2014.