Salomón O D, Sosa Estani S, Canini L, Cordoba Lanus E
Centro Nacional de Diagnóstico e Investigación en Endemo-Epidemias (CeNDIE), Administración Nacional de Laboratorios e Institutos de Salud Dr. Carlos G. Malbrán (ANLIS), Ministerio de Salud, Buenos Aires.
Medicina (B Aires). 2001;61(3):284-90.
The incidence of tegumentary leishmaniasis increased in October 1997, in an area close to Oran city, province of Salta. The leishmaniasis' epidemiology and the entomology of this outbreak were studied during June 1998 at Paraje Las Carmelitas and Río Blanco, places with high reported incidence. The prevalence of infection (Montenegro Skin Test reactive) was 171/1000 inhabitants in Paraje Las Carmelitas and 790/1000 in Río Blanco, while the rates of leishmaniasis' incidence (active ulcers) were 72/1000 and 790/1000. The prevalence differences among sex and age groups were not significant. The clinical and epidemiologic patterns were consistent with those reported in the area for Leishmania (Viannia) braziliensis. Lutzomyia intermedia was the prevalent species (96%) among 2577 Phlebotominae collected, Lu. shannoni, Lu. cortelezzii y Lu. migonei were also present. The results about distribution of prevalence by age, and spatial distribution of Phlebotominae supported deforestation-residual primary forest transmission hypotheses. Therefore, in Salta the epidemic outbreaks generated by extensive deforestation could be sustained and amplified because the human settlements are located close to the remaining primary forest "spots". Furthermore, in this scenario the risk of human-vector contact increases by the subsistence or recreational activities performed in secondary transitional forests, and the presence of domestic animals around the houses. The results are discussed in the frame of possible control strategies.
1997年10月，在萨尔塔省奥兰市附近的一个地区，皮肤利什曼病的发病率有所上升。1998年6月，在报告发病率较高的帕拉耶·拉斯·卡梅利塔斯和里奥布兰科，对此次利什曼病疫情的流行病学和昆虫学进行了研究。在帕拉耶·拉斯·卡梅利塔斯，感染率（蒙特内格罗皮肤试验呈阳性）为每1000名居民中有171人，在里奥布兰科为每1000名居民中有790人，而利什曼病的发病率（活动性溃疡）分别为每1000人中有72例和790例。不同性别和年龄组之间的患病率差异不显著。临床和流行病学模式与该地区报告的巴西利什曼原虫（维阿尼亚利什曼原虫）病例一致。在采集的2577只白蛉中，中间卢蛉是优势种（96%），还发现了香农卢蛉、科尔特莱齐卢蛉和米戈内卢蛉。按年龄划分的患病率分布以及白蛉的空间分布结果支持了森林砍伐 - 残留原始森林传播假说。因此，在萨尔塔，由于人类住区靠近剩余的原始森林“斑块”，大规模森林砍伐引发的疫情可能会持续并扩大。此外，在这种情况下，人类在次生过渡森林中进行的生存或娱乐活动以及房屋周围家畜的存在增加了人与病媒接触的风险。本文在可能的控制策略框架内对结果进行了讨论。
