Descriptive study of American tegumentary leishmaniasis in the urban area of the Municipality of Governador Valadares, Minas Gerais State, Brazil.

Abstract

To understand the emergence and re-emergence pattern of American tegumentary leishmaniasis (ATL), the clinical and epidemiological profiles and the spatial distribution of the disease were evaluated between 2001 and 2006 in an endemic area located in the Rio Doce valley in the north-eastern part of the Minas Gerais State, Brazil. The number of reported cases increased from six in the first year to 111 in the last year during this period. Disease cases predominated in the urban area (75.9%) and affected males and females equally in all age groups. The transmission of ATL occurred within dwellings and the surrounding areas, with the largest number of reported cases originating from poor areas, particularly those located on the margins of the Rio Doce lacking suitable sanitary infrastructure. Diagnosis was based on clinical criteria and the Montenegro skin test, with most patients (93.8%) exhibiting the cutaneous form of ATL. First-line treatment involved administration of pentavalent antimonial drugs (99.1%), and these provided a cure for > 75% of patients. The prevalence of ATL varied between 11.38 and 15.99 cases per 100,000 inhabitants, which is high in comparison with the national average. Urgent measures, including improved means of diagnosis at the local health units, education of schoolchildren and motivation of the general population, are required to decrease transmission and control the disease.