地域医療と健康教育

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Mucosal Leishmaniasis - Clinical and Epidemiological Aspects of 234 Cases Treated in a Tertiary Reference Center in the Brazilian Amazon

Jorge Augusto de Oliveira Guerra, Maria das Graças Vale Barbosa, Marcilene Gomes Paes, Renato Teles de Sousa, Pricila Gama da Silva, Maria José Silva, Alexandre Ribera Macião, Rafael Siqueira de Carvalho, Leila Inês de Aguiar Raposo da Câmara Coelho and Luiz Carlos de Lima Ferreira

Presented here is a retrospective study including patients of the Brazilian Amazon region who were diagnosed with mucosal leishmaniasis (ML) and treated in a tertiary referral center between July 1992 to December 2008. In total, 234 patients fulfilled the inclusion criteria. There was a clear predominance of males, comprising 193 (82.5%) cases, and the mean age was 48 years. No fewer than 186 (79.5%) patients had undertaken activities that are considered to place one at risk of acquiring American Tegumentary Leishmaniasis (ATL) – agriculture, animal raising, or mineral extraction. Furthermore, 193 (82.5%) presented with a prior history of cutaneous leishmaniasis (CL); the average time between the onset of CL and the first symptoms of ML in 138 cases was 16.3 years. Finally, 156 cases (66.7%) were located in municipalities that lie on the south bank of the Amazon River, suggesting that Leishmania (Viannia) braziliensis was the likely etiological agent in these cases.