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EPIDEMIOLOGY OF ANDEAN CUTANEOUS LEISHMANIASIS: INCRIMINATION OF LUTZOMYIA AYACUCHENSIS (DIPTERA: PSYCHODIDAE) AS A VECTOR OF LEISHMANIA IN GEOGRAPHICALLY ISOLATED, UPLAND VALLEYS OF PERU

The southernmost limit of the distribution of endemic Andean cutaneous leishmaniasis (CL), commonly known as Uta, is localized in the western Andean valleys of Ayacucho, Peru. This area is completely isolated from other regions endemic for this disease. Identification of the insect vector for Andean CL was carried out by combining entomologic and parasitologic approaches. Two Lutzomyia species were captured: Lutzomyia ayacuchensis and Lu. noguchii. The former species was considered responsible for transmission of Leishmania because 1) there was a coincidence in space and time between the presence of this insect and the distribution of Andean CL, 2) it was shown to be highly anthropophilic, 3) Leishmania parasites of the subgenus Viannia were detected by a specific polymerase chain reaction assay, 4) promastigotes isolated from this insect were shown by multilocus enzyme electrophoresis and molecular karyotyping to belong to the same deme of Leishmania (Viannia) peruviana as the one circulating in humans living in the study area, and 5) the complete cycle of L. (V.) peruviana was observed in experimental infections of Lu. ayacuchensis. Parasite and vector homogeneity found in Ayacucho contrasted with the heterogeneity reported for other areas endemic for Andean CL. The potential influence of ecologic determinants on this geographically isolated area is discussed.

Received January 10, 2003. Accepted for publication May 3, 2003.

Acknowledgments: We thank Luz Mendizabal (Instituto de Medicina Tropical Alexander von Humboldt) for feeding and maintaining the sand fly colony, and to the people of Sancos for their kind support.

Financial support: This investigation was funded by the UNDP/World Bank/World Health Organization Special Program for Research and Training in Tropical Diseases (L30/18/59, ID:890424), the European Community (contracts TS2-CT90-0315 and TS2-CT92-0129) and the Belgian Agency for Co-operation to Development.

Authors’ addresses: Abraham G. Caceres and Pablo Villaseca, Instituto Nacional de Salud, PO Box 451, Lima 100, Peru. Jean Claude Dujardin and Dominique Le Ray, Laboratoire de Parasitologie Moleculaire, Instituut voor Tropische Geneeskunde, 155 Nation-alestraat, 2000 Antwerp, Belgium. Anne Laure Bañuls, Institut Re-cherche pour le Développement, BP 5045, Montpellier, France. Ro-cio Inga, Martin Lopez, Margarita Arana, and Jorge Arevalo, Universidad Peruana Cayetano Heredia, PO Box 4314, Lima 100, Peru.

Reprint requests: Abraham G. Caceres, Instituto Nacional de Salud, Calle Capac Yupanqui 1400, Jesús Maria, Lima, Peru, Telephone: 51-1-471-9920, Fax: 51-1-264-0535, E-mail: acaceres31{at}hotmail.com.

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