title: Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases.
abstract: Leishmaniasis is a parasitic disease caused by hemoflagellates of the genus Leishmania and is transmitted to humans by the bite of infected phlebotomine sandflies. Depending on the Leishmania species, the disease has different clinical forms including cutaneous, mucocutaneous, and visceral manifestations. Previous studies performed in endemic zones of northwestern-Argentina, during epidemic outbreaks, have been important for detecting patients suffering from the acute phase of the disease, but have not given a complete representation of the clinical and epidemiological features in the region. Furthermore, due to the resurgence of leishmaniasis worldwide and in particular the large increase of international tourism to the region, it seems pertinent to update the current epidemiological and clinical profile of leishmaniasis in northwestern-Argentina. Here we present a retrospective analysis of 95 Leishmania positive cases, presenting between 2000 and 2014. Patients were derived from hospitals and diagnosed in our lab at the University of Salta, located in a non-endemic area in Salta, Argentina. We detected numerous extensive mucocutaneous cases (34/95, 35.8%) distinct from mucosal affected patients, some instances originating in locations with no previously reported human cases. Additionally patients suffering from concomitant diseases, besides leishmaniasis, were assessed. These included Chagas disease, syphilis, deep mycoses, tuberculosis, toxoplasmosis and intestinal parasitosis. This study updates the clinical and epidemiological features of leishmaniasis in northwestern-Argentina, and discusses the implications and management strategy for patients who acquire the disease in this region.
authors.affiliation: Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas, Salta, Argentina; Consejo de Investigación, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: María F
authors.initials: MF
authors.lastname: García Bustos
authors.affiliation: Consejo de Investigación, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: Gabriela
authors.initials: G
authors.lastname: González-Prieto
authors.affiliation: Consejo de Investigación, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: Federico
authors.initials: F
authors.lastname: Ramos
authors.affiliation: Consejo de Investigación, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: María C
authors.initials: MC
authors.lastname: Mora
authors.affiliation: Centro de Biomedicina, Universidad Central del Ecuador y Proyecto Prometeo, SNESCYT, Ecuador; Department of Parasitology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hashiguchi
authors.affiliation: Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas, Salta, Argentina.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Parodi
authors.affiliation: Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas, Salta, Argentina.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Basombrío
authors.affiliation: Hospital Señor del Milagro, Salta, Argentina.
authors.forename: Sonia
authors.initials: S
authors.lastname: Moreno
authors.affiliation: Hospital San Bernardo, Salta, Argentina.
authors.forename: Sibila
authors.initials: S
authors.lastname: Monroig
authors.affiliation: Hospital San Bernardo, Salta, Argentina.
authors.forename: Josefina
authors.initials: J
authors.lastname: Beckar
authors.affiliation: Hospital Joaquín Castellanos, Güemes, Salta, Argentina.
authors.forename: Daniela
authors.initials: D
authors.lastname: Jaime
authors.affiliation: Facultad de Ciencias Naturales, Universidad Nacional de Salta, Salta, Argentina.
authors.forename: Jesús
authors.initials: J
authors.lastname: Sajama
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Yeo
authors.affiliation: Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas, Salta, Argentina.
authors.forename: Jorge D
authors.initials: JD
authors.lastname: Marco
authors.affiliation: Department of Parasitology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan.
authors.forename: Fabricio M
authors.initials: FM
authors.lastname: Locatelli
authors.affiliation: Consejo de Investigación, Universidad Nacional de Salta, Salta, Argentina. Electronic address: aleba05@yahoo.com.ar.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Barrio
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000276:immunology; D001118:Argentina / Q000453:epidemiology; D014355:Chagas Disease / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007891:Leishmania; D007892:Leishmania braziliensis; D018314:Leishmania infantum; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology; D007897:Leishmaniasis, Mucocutaneous / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology; D011576:Psychodidae / Q000469:parasitology; D012189:Retrospective Studies; D013587:Syphilis / Q000453:epidemiology; D014123:Toxoplasmosis / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan
keywords: Cutaneous leishmaniasis; Leishmania (L.) amazonensis; Leishmania (L.) infantum; Leishmania (V.) braziliensis; Mucocutaneous leishmaniasis; Visceral leishmaniasis