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To evaluate whether familial clustering occurs in mucosal leishmaniasis (ML), patients with ML (index cases) were randomly selected from medical records at a health post in an endemic area for Leishmania braziliensis infection. Control individuals (index controls) matched by age, gender, and place of residence to index cases were selected. Family members of index cases and controls were compared with respect to environmental factors and the incidence of cutaneous leishmaniasis (CL) and ML. Delayed type hypersensitivity test (DTH) to Leishmania antigen was tested in selected families. Among 289 members of 46 families enrolled, significant differences were found in the frequencies of CL (37% versus 20%) and ML (5% versus 0) in case versus control families, respectively. Families with 2 cases of ML had a higher frequency (29.6%) of DTH-positive individuals than control families (9.4%). These data demonstrate familial clustering of CL, ML, and positive DTH skin tests in an area endemic for L. braziliensis infection.
Received April 27, 2004. Accepted for publication January 13, 2005.
Acknowledgments: The authors thank Ednaldo Lago, Levy Moraes da Silva, and Maria Neuza Souza for their important work in the endemic area of leishmaniasis. We also acknowledge the physicians Roque Almeida and Albert Schriefer for their clinical support and parasite culturing in the endemic area. The authors thank students Flavia R. Esteve, Juliana Passos, Adriana A. Jesus, and Andreia B. Cruz who helped to visit the families in the endemic area. We also thank Edson Duarte and Marco A. V. Rêgo for their suggestions in study design.
Financial support: This work was supported by an International Scholars Grant from the Howard Hughes Medical Institute (EMC), by grants AI-30639-11A (P.M., W.D.J., M.E.W., A.R.J., E.M.C.) and AI048822 (M.E.W.) from the National Institutes of Health.
* Address correspondence to Léa Castellucci, Serviço de Imunologia Hospital Universitário Prof. Edgard, Universidade Federal da Bahia, Salvador-Bahia, Brazil. E-mail: imuno{at}ufba.br
Authors’ addresses: Léa Castellucci, Lay Har Cheng, Cibele Araújo, Luiz Henreque Guimarães, Hélio Lessa, Mirelio Frederico Almeida, Adja Oliveira, Edgar M. Carvalho, and Amélia Ribeiro de Jesus, Serviço de Imunologia Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador-Bahia, Brazil, Telephone: 71-237-7353, Fax: 71-245-7110, E-mail: imuno{at}ufba.br. Albert Ko, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador-Bahia, Brazil, Telephone: 71-356-4320, E- mail: aik2001{at}med.cornell.edu. Warren D. Johnson, Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, New York, New York, Telephone: 212-746-6320, Fax: 212-746-8675, E-mail: wdjohnso{at}med.cornell.edu. Mary E. Wilson, Departments of Internal Medicine and Microbiology, University of Iowa, Iowa City, Iowa, Telephone: 319-356-3169, Fax: 319-384-7208, E-mail: mary-wilson{at}uiowa.edu.
Reprint requests: Amelia Ribeiro de Jesus, Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, 5° Andar, Rua João das Botas s/n, Canela, CEP 40110-160, Salvador-Bahia, Brazil, Telephone: 71-237-7353, Fax: 71-245-7110, E-mail: imuno{at}ufba.br or amelia{at}ufba.br.
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