Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Paraná, Brazil.
PLoS One. 2012;7(11):e47050. doi: 10.1371/journal.pone.0047050. Epub 2012 Nov 5.
The aim of the study was to investigate the importance of dogs, other domesticated animals and environmental characteristics as risk factors in the epidemiology of American cutaneous leishmaniasis (ACL). A retrospective survey of cases of human ACL in the last ten years and visits to homes in rural locations were carried out in the municipality of Arapongas (southern Brazil) from 2008 to 2010. ACL in humans was significantly associated with a distance of up to 25 meters from the residence to a forest area (OR 5.08; 95% CI: 1.35-21.04), undergrowth area (OR 6.80; 95% CI: 1.69-45.33) and stream (OR 5.87; 95% CI: 1.15-24.59); banana plants near the residence (OR 5.98; 95% CI: 1.49-39.84), absence of ceiling below the roof in the residence (OR 7.30; 95% CI: 1.26-158.1), the dumping of trash in the forest area (OR 26.33; 95% CI: 7.32-93.46) and presence of ACL in dogs in the surrounding area (OR 4.39; 95% CI: 1.37-13.45). In dogs, ACL was associated with a distance of 25 to 50 meters and 51 to 100 meters, respectively, from the residence to a forest area (OR 2.59; 95% CI: 1.08-5.98; OR 3.29; 95% CI: 1.64-6.62), the presence of a stream up to 25 m from the residence (OR 6.23; 95% CI: 2.34-16.54) and banana plants near the residence (OR 0.45; 95% CI: 0.25-0.80). In the locations studied in the municipality of Arapongas (Brazil), the results reveal that canine infection increases the risk of human infection by ACL and the characteristics surrounding the residence increase the risk of infection in both humans and dogs. Thus, integrated environmental management could be a useful measure to avoid contact between humans and phlebotomines.
本研究旨在探讨狗、其他家养动物和环境特征作为美洲皮肤利什曼病(ACL)流行病学的危险因素的重要性。2008 年至 2010 年期间,在巴西南部阿拉蓬加斯市对过去十年的人类 ACL 病例进行了回顾性调查,并对农村家庭进行了家访。人类 ACL 与距离住宅 25 米以内的森林地区(OR 5.08;95%CI:1.35-21.04)、灌木丛地区(OR 6.80;95%CI:1.69-45.33)和溪流(OR 5.87;95%CI:1.15-24.59)显著相关;住宅附近有香蕉植物(OR 5.98;95%CI:1.49-39.84)、住宅屋顶下无天花板(OR 7.30;95%CI:1.26-158.1)、森林地区倾倒垃圾(OR 26.33;95%CI:7.32-93.46)和周边地区犬类存在 ACL(OR 4.39;95%CI:1.37-13.45)。在犬类中,ACL 分别与住宅到森林地区的距离为 25 至 50 米和 51 至 100 米相关(OR 2.59;95%CI:1.08-5.98;OR 3.29;95%CI:1.64-6.62),住宅到溪流的距离为 25 米以内(OR 6.23;95%CI:2.34-16.54)和住宅附近有香蕉植物(OR 0.45;95%CI:0.25-0.80)。在阿拉蓬加斯市(巴西)研究的地点,结果表明犬类感染增加了人类感染 ACL 的风险,而住宅周围的特征增加了人类和犬类感染的风险。因此,综合环境管理可能是避免人与白蛉接触的有用措施。
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