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. 2017 Dec 21:59:e91.
doi: 10.1590/S1678-9946201759091.

American tegumentary leishmaniasis: epidemiological and molecular characterization of prevalent Leishmania species in the State of Tocantins, Brazil, 2011-2015

Carina Scolari Gosch  1   2 , Cálita Pollyanna Marques  2 , Bruna Silva Resende  1 , Joandson Dos Santos Souza  1 , Ray Ameida da Silva Rocha  1 , Deyse Sabrinne Souza Lopes  1 , Marcelo Scolari Gosch  2 , Fátima Ribeiro Dias  2 , Miriam Leandro Dorta  2
Affiliations

American tegumentary leishmaniasis: epidemiological and molecular characterization of prevalent Leishmania species in the State of Tocantins, Brazil, 2011-2015

Carina Scolari Gosch et al. Rev Inst Med Trop Sao Paulo. .

Abstract

Determination of the epidemiological profile of the American tegumentary leishmaniasis (ATL) and identification of Leishmania species that are prevalent in the State of Tocantins were carried out through a retrospective and descriptive study based on data reported in SINAN, in the period from 2011 to 2015. Molecular techniques such as PCR-RFLP and PCR-G6PD to amplify Leishmania DNA were performed on stored on Giemsa-stained slides from lesion scarifications of ATL patients who were amastigote-positive by the direct microscopic examination. There were 1,434 ATL cases in Tocantins reported in this period. The highest incidence was reported in men aged over 60 years, rural residents, the most affected ethnic group was mixed ethnicity (mixed black and white) and the ones with lower education. The predominant clinical form was cutaneous, being diagnosed mainly by laboratory methods. Pentavalent antimonial was effective in resolving cases. The predominant species found in 271 analyzed samples from 32 municipalities located in 8 different health regions of Tocantins was Leishmania (Viannia) braziliensis. Identifying the epidemiological profile and characterizing the Leishmania spp species on regional level is essential to establish control and prevention behaviors, minimizing the number of cases and treatment resistance, recurrence and evolution to mucosal forms.

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Figures

Figure 1
Figure 1. Location of the eight health regions in the State of Tocantins in Brazil, South America. They are the regions of Augustinópolis, Araguaína, Guaraí, Paraíso, Palmas, Porto Nacional, Gurupi and Dianópolis
Figure 2
Figure 2. Geographical distribution of ATL in the State of Tocantins. Location of municipalities reporting cases of ATL in humans at SINAN, from 2011 to 2015. Number of municipalities reporting ATL cases in the years of study: 2011 (81 municipalities), 2012 (84 municipalities), 2013 (85 municipalities), 2014 (96 municipalities), 2015 (86 municipalities)
Figure 3
Figure 3. ATL notification incidence by municipality. Stratification of municipalities by incidence of reported cases of ATL, period 2011-2015, performed in the eight health regions that make up the State of Tocantins, in Brazil
Figure 4
Figure 4. Frequency of ATL notifications per year. The stratification per year of reported ATL cases, period 2011-2015, performed in the eight health regions that make up the State of Tocantins, Brazil
Figure 5
Figure 5. Representative image of PCR amplified products from the conserved region of the Leishmania minicircle kDNA before and after Hae III digestion. In A: PCR amplicons, B: PCR product after HAE III digestion. In A1 and B1: molecular weight standard of 25 bp; In A2 and B2: L. (V.) braziliensis MHOM / BR / 1975 / M2903, WHO reference; In A3 and B3: L. (L.) amazonensis IFA / BR / 1967 / PH8, WHO reference; In A4-A10 and B4-B10: Isolate samples; In A11, negative control of the PCR. Polyacrylamide gel 8 and 15%, respectively, stained by silver
Figure 6
Figure 6. PCR amplified products obtained with oligonucleotides G6PD-ISVC and G6PD-ISB. In 1: molecular weight standard of 100bp; 2: Negative Control; 3: L. (V.) braziliensis MHOM / BR / 1975 / M2903, WHO reference; 4-8: Samples. 8% polyacrylamide gel stained with silver
Figure 7
Figure 7. Territorial distribution of Leishmania species in the State of Tocantins. Positive samples of DME were collected from 32 municipalities distributed homogeneously in the eight health regions of the State and characterized molecularly by PCR-RFLP and PCR-G6PD
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References

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