American tegumentary leishmaniosis: disease profile and control in the extrem west of Brazil

Abstract

American Tegumentary Leishmaniasis, caused by the protozoan Leishmania and transmitted by the vector phlebotomine, is an important disease in Brazil, especially in Acre. This study describes the epidemiological profile and evaluates the American Tegumentary Leishmaniasis (LTA) control program in Mâncio Lima (AC) between 2012 and 2013. Leishmaniasis case files were reviewed and frequencies compared using the Fisher Exact Test or Chi-square. There were 45 cases recorded, with a detection coefficient of 29.6 cases per 10,000 inhabitants (45 cases, and population of 15,206). Cases were more frequent in males (97.8%), rural dwellers (64.4%) and agriculture-related occupations (60%). There was only one allochthonous case (Cruzeiro do Sul), with predominance of cutaneous form (84.4%) and a considerable number of recurrences (42.9%). The diagnosis was confirmed preferentially by direct parasitological examination (68.9%), with intradermal test being poorly used (31.1%). A disease control assessment form was created with 15 dimensions to be analyzed, in which the municipality complied with only 41.9% of that proposed by government. There is an apparent lack of human resources for diagnosis and case notification, and therefore improvements in the basic public health system are needed for efficient disease control.