Rocha Rafael, Conceição Cláudia, Gonçalves Luzia, Carvalho Ana Cláudia, Maia André, Martins André, Carujo António, Maio António, Forra Catarina, Melita Catarina, Couto Daniela, Fernandes Diana, Pereira Dulce, Leal Ema, Sarmento Helena, Sousa Inês, Gonçalves Jean-Pierre, Marinho Joana, Vasconcelos Joana, Cunha João, Rodrigues João, Silva José Miguel, Caley Lídia, Malheiro Luís, Santos Luís, Garcia Margarida, Cunha Maria, Lima Maria, Andrade Maria Margarida, Marques Marta, Alpalhão Miguel, Silva Mónica, Ferraz Rita, Soares Rui, Fernandes Salomão, Llobet Samuel, Cruz Sofia, Guimarães Teresa, Branco Tiago, Robalo-Nunes Tomás, Almeida Vasco, Maia Carla
Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal.
Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira N°100, 1349-008 Lisboa, Portugal.
Microorganisms. 2024 Apr 18;12(4):819. doi: 10.3390/microorganisms12040819.
, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM SPSS Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.
利什曼原虫是一种人畜共患的媒介传播寄生虫，在地中海地区流行，主要表现为内脏利什曼病（VL），但也有皮肤利什曼病（CL）和黏膜利什曼病（ML）。本研究旨在描述2010年至2020年在葡萄牙大陆诊断出的CL和ML病例的流行病学和临床特征。向葡萄牙国家卫生系统的每家医院请求合作。通过搜索诊断出院代码或感染的阳性实验室结果对病例进行筛查。同时，进行了全面的文献检索。使用IBM SPSS Statistics进行描述性统计和假设检验。共识别出43例CL病例和7例ML病例，以本地病例为主（86%）。在CL中，免疫抑制个体占患者的很大比例（48%），在该组中，播散性CL（22%）和同时发生的VL（54%）很常见。在本地病例中，病变大多为丘疹/结节（62%），经常出现在头部（48%）。治疗方法非常不一致。ML病例均为本地病例，主要在老年免疫抑制个体中诊断出来，通常用脂质体两性霉素B治疗。研究结果表明，需要加强对这些利什曼病形式的监测和报告、临床认识以及诊断能力，以减少漏诊并改善患者预后。提倡采用整体的“同一健康”方法来应对葡萄牙及其他地区利什曼病带来的多方面挑战。
