García Ana L, Parrado Rudy, Rojas Ernesto, Delgado Raúl, Dujardin Jean-Claude, Reithinger Richard
CUMETROP, Universidad Mayor de San Simón, Cochabamba, Bolivia.
Am J Trop Med Hyg. 2009 May;80(5):704-11.
The leishmaniases are protozoan, zoonotic diseases transmitted to human and other mammal hosts by the bite of phlebotomine sandflies. Bolivia has the highest incidence of cutaneous leishmaniasis (CL) in Latin America (LA), with 33 cases per 100,000 population reported in 2006. CL is endemic in seven of the country's nine administrative departments. Visceral leishmaniasis (VL) is comparatively rare and is restricted to one single focus. Most CL cases are caused by Leishmania (Viannia) braziliensis (85% cases); VL is caused by L. (L.) infantum. Seven sandfly species are incriminated as vectors and Leishmania infections have been detected in several non-human mammal hosts. Transmission is associated with forest-related activities, but recently, cases of autochthonous, urban transmission were reported. Because most cases are caused by L. (V.) braziliensis, Bolivia reports the greatest ratio (i.e., up to 20% of all cases) of mucosal leishmaniasis to localized CL cases in LA. Per national guidelines, both CL and VL cases are microscopically diagnosed and treated with pentavalent antimony.
利什曼病是由白蛉叮咬传播给人类和其他哺乳动物宿主的原生动物性人畜共患病。玻利维亚是拉丁美洲皮肤利什曼病（CL）发病率最高的国家，2006年报告的发病率为每10万人中有33例。CL在该国9个行政区中的7个为地方病。内脏利什曼病（VL）相对少见，仅局限于一个单一疫源地。大多数CL病例由巴西利什曼原虫（维氏亚属）（85%的病例）引起；VL由婴儿利什曼原虫（利什曼亚属）引起。七种白蛉被认为是传播媒介，并且在几种非人类哺乳动物宿主中检测到了利什曼原虫感染。传播与森林相关活动有关，但最近报告了本土城市传播的病例。由于大多数病例由巴西利什曼原虫（维氏亚属）引起，玻利维亚报告的黏膜利什曼病与局部CL病例的比例在拉丁美洲最高（即高达所有病例的20%）。根据国家指南，CL和VL病例均通过显微镜诊断并用五价锑进行治疗。
