Endemic Tegumentary Leishmaniasis in Brazil: Correlation between Level of Endemicity and Number of Cases of Mucosal Disease

Sandro J. Bedoya-Pacheco Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;

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Maria H. Araujo-Melo Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;

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Claudia M. Valete-Rosalino Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;

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Maria Inês F. Pimentel Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;

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Fátima Conceição-Silva Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;

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Armando O. Schubach Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;

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Mauro C. A. Marzochi Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;

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The purpose of this study was to establish a correlation between the endemic level of tegumentary leishmaniasis in different regions of Brazil during 2002–2009 and the number of cases of mucosal or mucocutaneous leishmaniasis. The proportion of mucosal leishmaniasis was inversely correlated with prevalence of infection. In areas with a lower infection prevalence, the proportion of mucosal leishmaniasis increased (P < 0.05). The hypothesis of an Amazonian origin and dissemination through human migration is considered. Our results show that in regions with lower prevalence and endemically younger, the proportion of cases that evolve to the mucosal form is higher than in regions with higher prevalence and endemically older.

Author Notes

*Address correspondence to Sandro J. Bedoya-Pacheco, Laboratório de Vigilância em Leishmanioses, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, Brazil CEP 21040-900. E-mail: sandro.bedoya@ipec.fiocruz.br

Financial support: This study was supported by the Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation.

Authors' addresses: Sandro J. Bedoya-Pacheco, Claudia M. Valete-Rosalino, Maria Inês F. Pimentel, Armando O. Schubach, and Mauro C. A. Marzochi, Laboratório de Vigilância em Leishmanioses, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, Brazil CEP 21040-900, E-mails: sandro.bedoya@ipec.fiocruz.br, claudia.valete@ipec.fiocruz.br, maria.pimentel@ipec.fiocruz.br, armando.schubach@ipec.fiocruz.br, and mauro.marzochi@ipec.fiocruz.br. Maria H. Araujo-Melo, Oto-Rhino-Laryngology Department, Federal University of Rio de Janeiro State, R. Mariz e Barros 775, Tijuca, Rio de Janeiro, Brazil CEP 20270-002, E-mail: mh.melo@terra.com.br. Fátima Conceição-Silva, Instituto Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, Brazil CEP 21040-900, E-mail: fconcei@ioc.fiocruz.br.

Reprint requests: Sandro J. Bedoya-Pacheco, Laboratório de Vigilância em Leishmanioses, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil 4365, Manguinhos, Rio de Janeiro, Brazil CEP 21040-900, E-mail: sandro.bedoya@ipec.fiocruz.br.

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