Eco-epidemiology of cutaneous leishmaniasis in Argentina

SALOMON OD; QUINTANA MG; MASTRÁNGELO AV; ROSA JR; LIOTTA DJ ; FERNÁNDEZ MS; YADÓN ZE

Congreso; Ecohealth and Climate Change: Connections for Health, Ecosystems and Society; 2014

Cutaneous leishmaniasis (CL) was reported in Argentina since 1915, but the first outbreak took place in 1985 (7300 accumulated cases). Since 1985 CL eco-epidemiological studies are carried on in 14 provinces, in the three endemic bio-regions: North West, Chaco (dry and wet) and North East (500,000 km2). Leishmania braziliensis was identified from outbreak related isolates, from cases and Phlebotomine, L.(Viannia)sp. was also detected in free-ranging owl monkeys (Aotus azarai azarai). The species of phlebotomine incriminated as vectors up to now were Nyssomyia neivai in moderate to intense modified environments, in the dry Chaco both Migonemyia migonei and Evandromyia cortelezzii, and in the NE subtropical forest Ny.whitmani. At micro-scale in the NW the border effect in the interface primary forest-crop cultures was assessed for Ny.neivai, while in NE recently deforested areas Ny.whitmani, and Mg.migonei highest abundances were associated with domestic animals. There are also ongoing studies of canopy populations, potential breeding sites, association with wild animals, and pattern of activity by hour and season in different landscapes, during regular and exceptional climate fluctuations. These results showed that the spatial distribution of these phlebotomine is driven by microhabitat heterogeneities as shelter and food availability, but also by the heterogeneities of macrohabitat related to urbanization-land use, residual forest patches, and animal management, suggesting metapopulation dynamics structures. The discourses, perceptions and practices related to risk-health-environment, peridomestic management, and subsistence farming, as to the health-illness-care process were analyzed. The integration of both social and bio-ecological research aimed to identify the drivers of endemic and epidemic transmission and to develop surveillance and control new strategies will be carried out at the border with Paraguay and Brazil from 2014. The study will be execute together with policy makers, local health system agents, stakeholders and community with the financial support of the Canadian International Development Research Centre (IDRC).