Eco-epidemiology of cutaneous leishmaniasis in argentina

SALOMON OD; QUINTANA MG; ROSA JR; ACARDI SA; LIOTTA DJ; FUENZALIDA D; SZELAG EA; PARRAS MA; MARTINEZ MF; MANTECA ACOSTA M; FERNÁNDEZ MS; SANTINI MS

Porto de Galinhas

Congreso; 5 th World Congress On Leishmaniasis; 2013

Cutaneous leishmaniasis (CL) was reported in Argentina since1915, but the first outbreak took place in 1985 (7300 accumulated cases up to now). After the last main outbreak in 2002 started an inter-epidemic period (< 200 cases/year), but keeping the number of mucosal cases steady (≈20/year). Since 1985 CL eco-epidemiological studies are carried on in 14 provinces, in the three endemic areas: NW, Chaco (dry and wet) and NE (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 captures of phlebotomine allowed to record 34 species in the whole country, the species incriminated as vectors up to now were Nissomyia 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. The analysis of the abundance of Phlebotominae was performed using spatial-temporal increasing scales. At micro-scale in the NW the border effect in the interface between primary forest and crop cultures was assessed for Lu. neivai, while in NE recently deforested areas Ny. whitmani, and Lu. migonei highest abundances were associated with domestic animals. There are also ongoing studies of canopy/tree base populations, potential breeding sites, association with wild animals, and pattern of activity by hour and season. These results showed that the spatial distribution of these phlebotomine is driven by microhabitat heterogeneities as shelter and food availability, but also by macrohabitat heterogeneities related to urbanization-land use, residual forest patches, and animal management, suggesting metapopulation dynamics structures. Afterward, the historical CL outbreaks could be associated with these macrohabitat variables, climate events, environment changes (natural or anthropogenic), and the human behaviors that increase the probability of contact with vectors. At regional scale exploratory maps were developed for Ny. neivai and Mi. migonei potential distributions with a Maximum Entropy's Modeling System in the NW CL hyper-endemic area, and the strategy will be applied to larger scenarios. The conclusions of the eco-epidemiological studies are used to build risk maps, stratify the localities according to risk, and to propose surveillance measures.