Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area

This was an open cohort prospective study (2016–2018) that analyzed the prevalence and incidence rates of human <i>Leishmania</i> (<i>L.</i>) <i>infantum chagasi</i>-infection and the evolution of their clinical-immunological profiles in distinct urban and rural s...

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Main Authors: Rodrigo R. Furtado, Ana Camila Alves, Luciana V. R. Lima, Thiago Vasconcelos dos Santos, Marliane B. Campos, Patrícia Karla S. Ramos, Claudia Maria C. Gomes, Márcia D. Laurenti, Vânia Lucia da Matta, Carlos Eduardo Corbett, Fernando T. Silveira
Format: Article
Language:English
Published: MDPI AG 2022-11-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/10/11/2188
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author Rodrigo R. Furtado
Ana Camila Alves
Luciana V. R. Lima
Thiago Vasconcelos dos Santos
Marliane B. Campos
Patrícia Karla S. Ramos
Claudia Maria C. Gomes
Márcia D. Laurenti
Vânia Lucia da Matta
Carlos Eduardo Corbett
Fernando T. Silveira
author_facet Rodrigo R. Furtado
Ana Camila Alves
Luciana V. R. Lima
Thiago Vasconcelos dos Santos
Marliane B. Campos
Patrícia Karla S. Ramos
Claudia Maria C. Gomes
Márcia D. Laurenti
Vânia Lucia da Matta
Carlos Eduardo Corbett
Fernando T. Silveira
author_sort Rodrigo R. Furtado
collection DOAJ
description This was an open cohort prospective study (2016–2018) that analyzed the prevalence and incidence rates of human <i>Leishmania</i> (<i>L.</i>) <i>infantum chagasi</i>-infection and the evolution of their clinical-immunological profiles in distinct urban and rural scenarios of American visceral leishmaniasis (AVL) in Pará State, in the Brazilian Amazon. These infection profiles were based on species-specific DTH/IFAT-IgG assays and clinical evaluation of infected individuals, comprising five profiles: three asymptomatic, Asymptomatic Infection [AI], Subclinical Resistant Infection [SRI], and Indeterminate Initial Infection [III]; and two symptomatic, Subclinical Oligosymptomatic Infection [SOI] and Symptomatic Infection [SI = AVL]. The two distinct scenarios (900 km away) were the urban area of Conceição do Araguaia municipality and the rural area of Bujaru municipality in the southeast and northeast of Pará State. Human populations were chosen based on a simple convenience sampling design (5–10% in each setting), with 1723 individuals (5.3%) of the population (32,464) in the urban area and 1568 individuals (8.9%) of the population (17,596) in the rural one. A serological survey (IFAT-IgG) of canine infection was also performed in both scenarios: 195 dogs in the urban area and 381 in the rural one. Prevalence and incidence rates of human infection were higher in the urban area (20.3% and 13.6/100 person-years [py]) than in the rural setting (14.1% and 6.8/100-py). The AI profile was the most prevalent and incident in both urban (13.4% and 8.1/100-py) and rural (8.3% and 4.2/100-py) scenarios, but with higher rates in the former. An III profile case evolved to SOI profile after four weeks of incubation and another to SI (=AVL) after six. The prevalence of canine infection in an urban setting (39.2%) was also higher (<i>p</i> < 0.05) than that (32%) in the rural zone. AVL urbanization in Pará State, in the Brazilian Amazon, has led to infection rates significantly higher than those in rural sites, requiring more intense control measures.
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spelling doaj.art-01f33710986440ec91c438b37e5a23c12023-11-24T05:57:10ZengMDPI AGMicroorganisms2076-26072022-11-011011218810.3390/microorganisms10112188Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural AreaRodrigo R. Furtado0Ana Camila Alves1Luciana V. R. Lima2Thiago Vasconcelos dos Santos3Marliane B. Campos4Patrícia Karla S. Ramos5Claudia Maria C. Gomes6Márcia D. Laurenti7Vânia Lucia da Matta8Carlos Eduardo Corbett9Fernando T. Silveira10Parasitology Department, Evandro Chagas Institute (Secretary of Science, Technology and Innovation, Ministry of Health), Ananindeua 67030-000, Pará, BrazilParasitology Department, Evandro Chagas Institute (Secretary of Science, Technology and Innovation, Ministry of Health), Ananindeua 67030-000, Pará, BrazilParasitology Department, Evandro Chagas Institute (Secretary of Science, Technology and Innovation, Ministry of Health), Ananindeua 67030-000, Pará, BrazilParasitology Department, Evandro Chagas Institute (Secretary of Science, Technology and Innovation, Ministry of Health), Ananindeua 67030-000, Pará, BrazilParasitology Department, Evandro Chagas Institute (Secretary of Science, Technology and Innovation, Ministry of Health), Ananindeua 67030-000, Pará, BrazilParasitology Department, Evandro Chagas Institute (Secretary of Science, Technology and Innovation, Ministry of Health), Ananindeua 67030-000, Pará, BrazilPathology Department, Medical School of São Paulo University, São Paulo 1246-903, Paulo, BrazilPathology Department, Medical School of São Paulo University, São Paulo 1246-903, Paulo, BrazilPathology Department, Medical School of São Paulo University, São Paulo 1246-903, Paulo, BrazilPathology Department, Medical School of São Paulo University, São Paulo 1246-903, Paulo, BrazilParasitology Department, Evandro Chagas Institute (Secretary of Science, Technology and Innovation, Ministry of Health), Ananindeua 67030-000, Pará, BrazilThis was an open cohort prospective study (2016–2018) that analyzed the prevalence and incidence rates of human <i>Leishmania</i> (<i>L.</i>) <i>infantum chagasi</i>-infection and the evolution of their clinical-immunological profiles in distinct urban and rural scenarios of American visceral leishmaniasis (AVL) in Pará State, in the Brazilian Amazon. These infection profiles were based on species-specific DTH/IFAT-IgG assays and clinical evaluation of infected individuals, comprising five profiles: three asymptomatic, Asymptomatic Infection [AI], Subclinical Resistant Infection [SRI], and Indeterminate Initial Infection [III]; and two symptomatic, Subclinical Oligosymptomatic Infection [SOI] and Symptomatic Infection [SI = AVL]. The two distinct scenarios (900 km away) were the urban area of Conceição do Araguaia municipality and the rural area of Bujaru municipality in the southeast and northeast of Pará State. Human populations were chosen based on a simple convenience sampling design (5–10% in each setting), with 1723 individuals (5.3%) of the population (32,464) in the urban area and 1568 individuals (8.9%) of the population (17,596) in the rural one. A serological survey (IFAT-IgG) of canine infection was also performed in both scenarios: 195 dogs in the urban area and 381 in the rural one. Prevalence and incidence rates of human infection were higher in the urban area (20.3% and 13.6/100 person-years [py]) than in the rural setting (14.1% and 6.8/100-py). The AI profile was the most prevalent and incident in both urban (13.4% and 8.1/100-py) and rural (8.3% and 4.2/100-py) scenarios, but with higher rates in the former. An III profile case evolved to SOI profile after four weeks of incubation and another to SI (=AVL) after six. The prevalence of canine infection in an urban setting (39.2%) was also higher (<i>p</i> < 0.05) than that (32%) in the rural zone. AVL urbanization in Pará State, in the Brazilian Amazon, has led to infection rates significantly higher than those in rural sites, requiring more intense control measures.https://www.mdpi.com/2076-2607/10/11/2188<i>Leishmania</i> (<i>L.</i>) <i>infantum chagasi</i>human infectionprevalence and incidenceclinical-immunological profilesurban and rural scenariosBrazilian Amazon
spellingShingle Rodrigo R. Furtado
Ana Camila Alves
Luciana V. R. Lima
Thiago Vasconcelos dos Santos
Marliane B. Campos
Patrícia Karla S. Ramos
Claudia Maria C. Gomes
Márcia D. Laurenti
Vânia Lucia da Matta
Carlos Eduardo Corbett
Fernando T. Silveira
Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area
Microorganisms
<i>Leishmania</i> (<i>L.</i>) <i>infantum chagasi</i>
human infection
prevalence and incidence
clinical-immunological profiles
urban and rural scenarios
Brazilian Amazon
title Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area
title_full Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area
title_fullStr Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area
title_full_unstemmed Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area
title_short Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area
title_sort visceral leishmaniasis urbanization in the brazilian amazon is supported by significantly higher infection transmission rates than in rural area
topic <i>Leishmania</i> (<i>L.</i>) <i>infantum chagasi</i>
human infection
prevalence and incidence
clinical-immunological profiles
urban and rural scenarios
Brazilian Amazon
url https://www.mdpi.com/2076-2607/10/11/2188
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