Gomez Eduardo A, Kato Hirotomo, Torres-Romero Edison X, Velez Lenin N, Villegas Nancy V, Martillo Virginia P, Zambrano Flavio C, Kubo Makoto, Hashiguchi Kazue, Hashiguchi Yoshihisa
Departamento de Parasitologia y Medicina Tropical, Carrera de Medicina, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Leishmaniasis Project, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Ministerio de Salud Publica, Guayaquil, Ecuador.
Division of Medical Zoology, Department of Infection and Immunity, School of Medicine, Jichi Medical University, Tochigi, Japan.
Acta Trop. 2018 Sep;185:204-211. doi: 10.1016/j.actatropica.2018.05.016. Epub 2018 May 28.
The current four year study was undertaken to investigate the clinical and epidemiological features of Leishmania (Viannia) guyanensis infections in Valle Hermoso, Santo Domingo de Los Tsachilas province, north-central Pacific areas of Ecuador. A total of 155 parasitologically confirmed (Leishmania-amastigote-positive) clinical cases diagnosed at a rural health center during January 2014-December 2017 were analyzed thoroughly. Molecular characterization of the causative Leishmania parasites from different endemic sites within the study areas was performed by PCR amplification of cytochrome b (cyt b) sequencing. All the FTA-card and/or smear impregnated materials tested were characterized, and identified as L. (V.) guyanensis, without detecting any other Leishmania species. The following features were described: 1) the majority of patients were suffered from a single ulcer lesion (simple and mild to chronic), followed by multiple lesions, including recidiva cutis-"like" and Chiclero's ulcer-"like" clinical forms; 2) the majority (65.70%) of lesions were less than 10 mm in size, and distributed mainly on the upper body regions (arm, forearm, face, and neck including ear and head); 3) about 30% (29.68%) of the subjects tested were less than 10 years of age, strongly suggesting the intra- and/or peri-domestic transmission of the disease in the areas. The current clinico-epidemiological feature detected emphasizes the need for further such investigations of the L. (V.) guyanensis infections prevalent at different Pacific ecoregions of Ecuador, including Amazon regions.
本为期四年的研究旨在调查厄瓜多尔中北部太平洋地区圣多明各德洛萨奇拉斯省瓦耶埃尔莫索市圭亚那利什曼原虫（维阿尼利什曼原虫）感染的临床和流行病学特征。对2014年1月至2017年12月期间在一家农村卫生中心确诊的155例经寄生虫学证实（利什曼原虫无鞭毛体阳性）的临床病例进行了全面分析。通过细胞色素b（cyt b）测序的PCR扩增，对研究区域内不同流行地点的致病性利什曼原虫进行了分子特征分析。对所有测试的FTA卡和/或涂片浸渍材料进行了特征鉴定，确定为圭亚那利什曼原虫（维阿尼利什曼原虫），未检测到任何其他利什曼原虫物种。描述了以下特征：1）大多数患者患有单个溃疡病变（简单且轻度至慢性），其次是多个病变，包括类皮肤复发型和类契克罗溃疡型临床形式；2）大多数（65.70%）病变大小小于10毫米，主要分布在上半身区域（手臂、前臂、面部以及包括耳朵和头部的颈部）；3）约30%（29.68%）的受测对象年龄小于10岁，强烈表明该疾病在这些地区存在家庭内和/或家庭周围传播。目前检测到的临床流行病学特征强调有必要对厄瓜多尔不同太平洋生态区域（包括亚马逊地区）流行的圭亚那利什曼原虫（维阿尼利什曼原虫）感染进行进一步此类调查。
