Dados do Trabalho

Título

American Cutaneous Leishmaniasis in Sobral, Brazil: ACL urbanization brings new challenges for diagnosis and control

Introdução

American Cutaneous Leishmaniasis (ACL) is caused by different species of Leishmania spp, affecting the skin and mucosa. The municipality of Sobral, Ceará, Brazil, is characterized as endemic for Visceral Leishmaniasis, but has reported cases of ACL in recent years in urban and rural areas. The urbanization of ACL in this area is new and there are no studies to understand it.

Objetivo (s)

To characterize patients with suspected ACL lesions through different parasitological tests in the city of Sobral – Ceará.

Material e Métodos

The study involves collecting samples from lesions suggestive of ACL. The study included all patients who sought care at the city's Family Health Centers (FHC), before starting drug therapy and residing in urban, peri-urban and rural areas (2022-2024). The appearance of the lesion was registered, laboratory results of the samples were analyzed through direct parasitological tests, biopsy for histopathology and molecular biology detection of the parasite. The study was evaluated by the Scientific Committee of the Health Department of Sobral and the Research Ethics Committee (CEP), and registered on Plataforma Brasil (CAAE: 5874821.9.0000.8109), number 5.643.496.

Resultados e Conclusão

Thirty-five samples were collected: 22 samples were negative in the direct parasitological examination. Thirteen (n=13) samples were positive in direct examination (printing), biopsy and clinical evaluation. Nine ACL cases were from the urban area and four were from the rural area. Even in suggestive lesions, it is difficult to visualize the parasite under direct examination. However, in the tissue sample, it was possible to visualize amastigote forms through histopathology and describe the cell population present. A discrete inflammatory infiltrate with lymphohistiocytic predominance was observed inside the stroma with mild fibrosis and vessels. Macrophages were also observed, with the presence of parasites inside the vacuole on the periphery. Patients treated with available drugs responded well to treatment. We are currently standardizing real-time PCR to improve the diagnosis and identify the circulating parasite. An increase in ATL cases is observed in Sobral, with attention to urbanization, where the standardization of diagnosis to assist the clinic and control the pathology is urgent.An increase in ATL cases is observed in Sobral, with attention to urbanization, where the standardization of diagnosis to assist the clinic and control the pathology is urgent.

Palavras Chave

Leishmania; Leishmaniasis; Cutaneous leishmaniasis; Neglected diseases; Public health.