Multidisciplinary Approach for Cutaneous Leishmaniasis Prevention Through Community Participation, Iguazu Fall Area, Argentina.

SALOMON OD; MASTRANGELO A; FERNANDEZ MS; MANTECA ACOSTA M; ACARDI SA; QUINTANA MG; GOMEZ A

Melbourne Australia

Congreso; 1st International One Health Congress; 2011

An outbreak of American Cutaneous Leishmaniasis (ACL) was reported during 2004, at Iguazu Falls area, Argentina, among settlers in a recent deforested area, also vulnerable to malaria and yellow fever. Vectors of ACL in Argentina have metapopulation structure, microfocal distribution, and high abundance in land use interfaces. II) Interactive multidisciplinary base-line research (partial results discussion between disciplines): Vector/ reservoir incrimination: Lu. whitmani (PCR), Akodon sp.-forest,  Rattus rattus-synanthropic (space association, compatible lesions. Time and space distribution of vectors/reservoirs (trapping) at different scales (weather correlations, seasonality, forest-edge and animal dwellings related risk). Practices and representations: In-depth interviews (ACL cases, householders up to 300 m from forest, cue informants) and participant observation (local market) about ACL disease meaning, origin and treatment; vector prevention/control; environment and risk; land use and distribution of house-animal dwelling-forest in space; water, animal and forest related activities: householders overnight inside houses, out of the forest (62% houses ¡Ü 100 m forest), the diseases come from abroad/city garbage and 44% farming free of pesticides as main income (nature=forest=health). III) Qualitative risk assessment and identification of possible multi-approach interventions. IV) Discussion with the community and the NGO ¡°Mundo Sano¡± to select the strategy-design on surveillance (native medicine sellers), insect diseases intervention (environment-animal breeding management according to each domestic unity, permethrin impregnated curtains for houses), validation (minilight low-cost insect-traps operated by supervised householders), and sustainability (impregnation by three trained and supervised local leaders, re-impregnation with agreed costs to seed a cooperative). V). Ongoing implementation with informed consent and active surveillance by health local agents.