title: Visceral leishmaniasis in Rio de Janeiro, Brazil: eco-epidemiological aspects and control.
abstract: From 1977 (index case) to 2006, 87 cases of visceral leishmaniasis were confirmed in the municipality of Rio de Janeiro, Brazil, in periurban areas on the continental and coastal slopes of the Pedra Branca massif and the continental slopes of the Gericinó massif. The majority (65.5%) of the patients were more than five years old, predominantly males (61.5%), but without any difference between the sexes below the age of 14 years. The overall fatality rate was 10.4%. Two cases of visceral leishmaniasis/human immunodeficiency virus coinfection were detected. Leishmania chagasi was isolated from human and canine cases. The associations between the presence of phlebotomines and human and canine migrations, disorderly occupation involving degradation of environmental preservation areas and poor socioeconomic conditions may have created a favorable setting for the establishment and propagation of the disease. Close epidemiological surveillance associated with traditional control measures and others (active case researches, land clearing and health education), reduced the incidence of human cases from 2.8 per 100,000 inhabitants in 1981 to less than 0.01 per 100,000 since 1997. The canine infection rates decreased from 4.6% in 1984 to 1.6% in 2008. Lutzomyia longipalpis was not detected in some locations where human and canine cases occurred. In the years 2007 and 2008, no new human cases were reported, but there is a persistent and worrisome residual canine seroprevalence.
authors: Laboratory for Leishmaniasis Surveillance, Evandro Chagas Clinical Research Institute, Fiocruz, Rio de Janeiro, RJ, Brazil. mauro.marzochi@ipec.fiocruz.br
authors: Mauro Celio de Almeida
authors: MC
authors: Marzochi
authors: Aline
authors: A
authors: Fagundes
authors: Moacir Vieira de
authors: MV
authors: Andrade
authors: Marcos Barbosa de
authors: MB
authors: Souza
authors: Maria de Fátima
authors: Mde F
authors: Madeira
authors: Eliame
authors: E
authors: Mouta-Confort
authors: Armando de Oliveira
authors: Ade O
authors: Schubach
authors: Keyla Belizia Feldman
authors: KB
authors: Marzochi
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004285:Dogs; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007300:Insect Control; D007303:Insect Vectors / Q000145:classification*; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000662:veterinary; D008297:Male; D011576:Psychodidae / Q000145:classification*; D012621:Seasons; D055815:Young Adult