Machado-Coelho George L L, Caiaffa Waleska T, Genaro Odair, Magalhães Paulo A, Mayrink Wilson
Department of Pharmacy, Federal University of Ouro Preto, Rua Costa Sena 171, 35400-000 Ouro Preto, Minas Gerais, Brazil.
Trans R Soc Trop Med Hyg. 2005 Jan;99(1):55-61. doi: 10.1016/j.trstmh.2003.08.001.
A case-comparison study was carried out to identify risk factors for mucosal manifestations of American cutaneous leishmaniasis (ACL) in southeast Brazil, using a series of 2820 patients, diagnosed with ACL between 1966 and 1999. The significant factors independently associated with mucosal leishmaniasis were: gender, age, nutritional status and length of disease. Mucosal leishmaniasis occurred 1.7 times more frequently among males than females; twice as often in individuals older than 22 years compared with the younger group; almost four times as often in individuals with severe malnutrition compared with those who were well nourished; and almost four times more frequently in individuals reporting the disease for more than 4 months compared with those reporting a shorter duration of the disease. Among individuals older than 22 years the risk of mucosal leishmaniasis increased significantly (from 1.9 to 9.6) as the nutritional status decreased, when compared with younger and well-nourished patients. The characteristics herein described and correlated with severe forms could be used as diagnostic markers as part of clinical screening in areas endemic for ACL.
一项病例对照研究对巴西东南部2820例1966年至1999年间被诊断为美洲皮肤利什曼病（ACL）的患者进行，以确定ACL黏膜表现的危险因素。与黏膜利什曼病独立相关的显著因素为：性别、年龄、营养状况和病程。黏膜利什曼病在男性中的发生率比女性高1.7倍；22岁以上人群的发生率是较年轻人群的两倍；严重营养不良者的发生率几乎是营养良好者的四倍；病程超过4个月者的发生率几乎是病程较短者的四倍。在22岁以上人群中，与年轻且营养良好的患者相比，随着营养状况下降，黏膜利什曼病的风险显著增加（从1.9增至9.6）。本文所述的与严重形式相关的特征可作为诊断标志物，用于ACL流行地区临床筛查的一部分。
