Environmental community based strategy to prevent Leishmaniasis, Iguazú falls area, Argentina

SALOMÓN, OD, MASTRANGELO, AV, FERNÁNDEZ, MS, ACARDI, SA, LIOTTA, DJ; WEINBERG, D

Vancouver

Congreso; 11th World Congress on Environmental Health; 2010

International Federation on Environmental Health

American Cutaneous Leishmaniasis (ACL) in humans could develop as a long-lasting ulcer, further severe when metastasizes in the face’s mucosa (Leishmania braziliensis), with health and social consequences. ACL is transmitted by Phlebotominae sandflies, and close related to environmental anthropogenic interventions. In the Argentinean Iguazú Falls area, on the border between Brazil and Paraguay, the incidence of ACL has risen sharply since 2004. Most of the cases involve males over 15 years old infected during deforestation to establish individual farms, within an area known as “2000 hectáreas”. The most prevalent species of sandfly found there was Nyssomyia whitmani (87.4%). Identical Leishmania infections were detected by DNA kinetoplast amplification in Ny. whitmani, and in smears from human cases. Cluster analysis of the captures, and satellite image analysis, showed that the highest abundance of Ny. whitmani was in traps located in recently deforested places, in pig and chicken dwellings located in houses that had ACL cases. Interviews made to the settlers showed that the representations of the ‘landscape of risk’ did not include those that generates actual risk of human-vector effective contact (deforestation, animal management in the border of the forest), although some practices of prevention could be useful (smoke from burning garbage). Therefore, a preventive project with the consent of settlers and groups involved in local development was developed, that will start in January 2010: 1) To perform intensive sandfly trapping in domestic and peridomestic environments (houses stratified by ecological and anthropological criteria). 2) To discuss the results of the trapping with the community (spatial distribution of vectors, human dwellings and activities). 3) To develop vector control and environmental management strategies together with the community, taking into account the farming projects (organic certification, animal breeding practices, controlled deforestation). 4) To evaluate the control with community-based vector surveillance tools.