title: Epidemiological and clinical changes in American tegumentary leishmaniasis in an area of Leishmania (Viannia) braziliensis transmission over a 20-year period.
abstract: The Health Post of Corte de Pedra is located in a region endemic for American tegumentary leishmaniasis (ATL) in the Brazilian state of Bahia, and it treats 500-1,300 patients annually. To describe temporal changes in the epidemiology of ATL, we reviewed a random sample of 10% of patient charts (N = 1,209) from 1988 to 2008. There was a twofold increase in the number of cases over the 20-year period, with fluctuations in 10-year cycles. Patients were most frequently male, between the ages of 10 and 30 years, and engaged in agricultural labor; 4.3% of patients had mucosal disease, and 2.4% of patients had disseminated disease. Over the study period, the number of disseminated cases increased threefold, the proportion of cases in younger patients and agricultural workers decreased, and the proportion of patients residing in coastal areas increased. ATL is on the rise in Bahia, with a 10-year periodicity and evolving changes in epidemiology and manifestations of disease.
authors.affiliation: Serviço de Imunologia, Complexo Hospitalar Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil. Lara.Jirmanus@bmc.org
authors.forename: Lara
authors.initials: L
authors.lastname: Jirmanus
authors.forename: Marshall J
authors.initials: MJ
authors.lastname: Glesby
authors.forename: Luiz H
authors.initials: LH
authors.lastname: Guimarães
authors.forename: Ednaldo
authors.initials: E
authors.lastname: Lago
authors.forename: Maria Elisa
authors.initials: ME
authors.lastname: Rosa
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Machado
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Carvalho
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007892:Leishmania braziliensis / Q000472:pathogenicity*; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult