de Sá Tayana Patrícia Santana Oliveira, Bedoya-Pacheco Sandro Javier, Cunha-E-Silva Rafael Ramalho, Vasconcelos Alex de Oliveira, Magalhães Mônica de Avelar Figueiredo Mafra, Dias Cristina Maria Giordano, Dos Reis Juliana Gonçalves, Oliveira Liliane de Fátima Antonio, Marcelino Andreza Pain, Pimentel Maria Inês Fernandes
Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Rio de Janeiro, Rio de Janeiro, Brazil.
Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sérgio Arouca, Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Rio de Janeiro, Rio de Janeiro, Brazil.
Rev Inst Med Trop Sao Paulo. 2025 Apr 4;67:e23. doi: 10.1590/S1678-9946202567023. eCollection 2025.
Cutaneous leishmaniasis (CL) has substantial epidemiological and clinical differences depending on host characteristics, Leishmania species and geographic areas. CL in Rio de Janeiro State was evaluated. Mandatory notifications of confirmed cases from 2001-2020 were analyzed considering sociodemographic and clinical variables, temporal trends, the Cutaneous Leishmaniasis Composite Indicator (CLCI) for each affected city in relation to the total of affected cities in the state, and each triennium from the beginning to the end of the time series (2001-2003, 2002-2004 until 2018-2020, sequentially). The number of cases decreased over time. High average incidence rates occurred in contiguous cities from the Southernmost to the Northernmost regions of Rio de Janeiro State, following areas where the Atlantic Forest persists. The CLCI showed temporal variations in the intensity of the risk of CL in the affected cities. Rio de Janeiro city was the only one with intense or very intense risk of CL throughout the studied period. The disease predominantly affected people residing in urban areas and in the middle age groups (20-59 years). CL also predominated in males, regardless of age. The mucosal clinical form was also significantly associated with men, with an 80% chance of them being more affected than women. Regarding diagnostic tests, the Leishmanin Skin Test showed higher positivity than the direct parasitological exam and the histopathological exam. No differences regarding cure between sexes were found. This study may guide control actions in areas where they are most needed in Rio de Janeiro State.
皮肤利什曼病(CL)因宿主特征、利什曼原虫种类和地理区域的不同而存在显著的流行病学和临床差异。对里约热内卢州的皮肤利什曼病进行了评估。分析了2001年至2020年确诊病例的强制报告数据,考虑了社会人口统计学和临床变量、时间趋势、每个受影响城市相对于该州受影响城市总数的皮肤利什曼病综合指标(CLCI),以及时间序列开始到结束的每个三年期(2001 - 2003年、2002 - 2004年直至2018 - 2020年,依次类推)。病例数随时间减少。里约热内卢州最南端到最北端的相邻城市出现了较高的平均发病率,这些地区是大西洋森林持续存在的区域。CLCI显示了受影响城市中皮肤利什曼病风险强度的时间变化。里约热内卢市是整个研究期间唯一皮肤利什曼病风险强度为高强度或非常高强度的城市。该疾病主要影响居住在城市地区和中年人群(20 - 59岁)。无论年龄如何,男性中皮肤利什曼病也占主导。黏膜临床形式也与男性显著相关,男性受影响的几率比女性高80%。关于诊断测试,利什曼菌素皮肤试验的阳性率高于直接寄生虫学检查和组织病理学检查。未发现两性在治愈率方面存在差异。本研究可为里约热内卢州最需要的地区的控制行动提供指导。
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