A recent outbreak of American Tegumentary Leishmaniasis in the main transmission area of Leishmania (Viannia) braziliensis in Argentina

CAJAL, SILVANA P; CANABIRE MARIA; MOYA ALVAREZ A; BARROSO PA; CARO NICOLÁS; BRACAMONTE M E; KROLEWIECKI, A J; MARCO, J DIEGO; JUAREZ, MARISA; HOYOS, CARLOS L; GIL, JOSE F; NASSER, JULIO R

Toledo

Congreso; 6th World Congress on Leishmaniasis; 2017

Instituto de Salud Carlos III (ISCIII), Spain and Drugs for Neglected Diseases initiative (DNDi)

Background.American tegumentary leishmaniasis (ATL), due mainly by Leishmania (Viannia) braziliensis, is an emerging - reemerging endemic disease in the northwest of Argentina. This study describes the clinical-epidemiologicalcharacteristics of the disease in the last three years. Methods. Five hundred and fifty eight patients with cutaneous or mucocutaneous lesions were recruited in three periods, P1: November 2013 - October 2014, P2: Nov 2014 - Oct 2015, P3: Nov 2015 - Oct 2016. The diagnosis of ATL was based on the finding of Leishmania amastigotes on smears of dermal scrapings from the border of their lesions. Results. Three hundred forty-six out of 588 (62%) were diagnosed as ATL cases, 48/91, during P1 (52.7%), 154/230 (67%) in P2 and 144/237 (60.8%) in P3. The ATL cases increased 3.2 and 3-fold in the in periods P2 and P3 comparing to P1, whereas the increases in the no ATL diagnosed cases were 1.8 and 2.2 folds, respectively for the same periods (p = 0.02 ). The 80.6% of the patients with ATL were males. Only 9.5% of them were under 15 years old. The single cutaneous form was the most frequent one, 74% of the cases, while the mucocutaneous one reached 5.2%. The highest LTA cases peak was observed between July and September2015, in P2. In addition, two smaller peaks were observed: one in January - February and the other in May - June 2016. Conclusions. The increase in ATL cases found could be due to an outbreak in rural areas of northwestern Argentina and in areas of the northern border with the neighbor country Bolivia, mainly affecting farming workers. Further studies of the transmission cycles involving L. (V.) braziliensis are needed for a better understanding of the pathology in this area.