Volume 93, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The Amazon is responsible for approximately 40% of the American tegumentary leishmaniasis (ATL) in Brazil. Herein the sustained presence of ATL in Manaus, the largest settlement in the Amazon, was investigated. Records of notification of historic cases, and data from cases prospectively enrolled in the Tropical Medicine Foundation of the Amazonas State were used. Geographic coordinates of prospective patients' living sites were used to detect inner-city clusters of ATL. Infecting species was determined by polymerase chain reaction. Among prospectively enrolled subjects, 94.8% were infected with () , 76.7% were male, 30.2% were 0–20 years old, and 69.8% had an urban residence. Historic cases showed a profile similar to that of prospectively enrolled subjects. Several clusters of ATL, widely distributed within the city of Manaus, could be detected. In conclusion, there was a high frequency of disease in young age groups and cases clustered in urban neighborhoods. It cannot be determined from these data whether transmission of these cases occurred within or outside the city of Manaus.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Mathers CD, Ezzati M, Lopez AD, , 2007. Measuring the burden of neglected tropical diseases: the global burden of disease framework. PLoS Negl Trop Dis 1: e114.[Crossref] [Google Scholar]
  2. Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S, , 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7: 581596.[Crossref] [Google Scholar]
  3. Hotez PJ, Bottazzi ME, Franco-Paredes C, Ault SK, Periago MR, , 2008. The neglected tropical diseases of Latin America and the Caribbean: a review of disease burden and distribution and a roadmap for control and elimination. PLoS Negl Trop Dis 2: e300.[Crossref] [Google Scholar]
  4. Brazil Ministry of Health, 2014. Portal da Saúde. Available at: http://portalsaude.saude.gov.br/images/pdf/2014/setembro/09/LT-Casos.pdf. Accessed July 1, 2015. [Google Scholar]
  5. Harhay MO, Olliaro PL, Costa DL, Costa CH, , 2011. Urban parasitology: visceral leishmaniasis in Brazil. Trends Parasitol 27: 403409.[Crossref] [Google Scholar]
  6. Albuquerque PL, Silva Junior GB, Freire CC, Oliveira SB, Almeida DM, Silva HF, Cavalcante M do S, Sousa A de Q, , 2009. Urbanization of visceral leishmaniasis (kala-azar) in Fortaleza, Ceara, Brazil. Rev Panam Salud Publica 26: 330333.[Crossref] [Google Scholar]
  7. Silva ES, Gontijo CM, Pacheco RS, Fiuza VO, Brazil RP, , 2001. Visceral leishmaniasis in the metropolitan region of Belo Horizonte, State of Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 96: 285291.[Crossref] [Google Scholar]
  8. Jeronimo SM, Duggal P, Braz RF, Cheng C, Monteiro GR, Nascimento ET, Martins DR, Karplus TM, Ximenes MF, Oliveira CC, Pinheiro VG, Pereira W, Peralta JM, Sousa J, Medeiros IM, Pearsoni RD, Burns TL, Pugh EW, Wilson ME, , 2004. An emerging peri-urban pattern of infection with Leishmania chagasi, the protozoan causing visceral leishmaniasis in northeast Brazil. Scand J Infect Dis 36: 443449.[Crossref] [Google Scholar]
  9. Penna G, Pinto LF, Soranz D, Glatt R, , 2009. High incidence of diseases endemic to the Amazon region of Brazil, 2001–2006. Emerg Infect Dis 15: 626632.[Crossref] [Google Scholar]
  10. Guerra JA, Ribeiro JA, Coelho LI, Barbosa MG, Paes MG, , 2006. Epidemiology of tegumentary leishmaniasis in Sao Joao, Manaus, Amazonas, Brazil [in Portuguese]. Cad Saude Publica 22: 23192327.[Crossref] [Google Scholar]
  11. Barrett TV, Senra MS, , 1989. Leishmaniasis in Manaus, Brazil. Parasitol Today 5: 255257.[Crossref] [Google Scholar]
  12. Brazil Ministry of Health, 2011. DATASUS. Available at: http://www.datasus.gov.br. Accessed July 1, 2015. [Google Scholar]
  13. Garcia L, Kindt A, Bermudez H, Llanos-Cuentas A, De Doncker S, Arevalo J, Wilber Quispe Tintaya K, Dujardin JC, , 2004. Culture-independent species typing of neotropical Leishmania for clinical validation of a PCR-based assay targeting heat shock protein 70 genes. J Clin Microbiol 42: 22942297.[Crossref] [Google Scholar]
  14. Montalvo AM, Fraga J, Monzote L, Montano I, De Doncker S, Dujardin JC, Van der Auwera G, , 2010. Heat-shock protein 70 PCR-RFLP: a universal simple tool for Leishmania species discrimination in the New and Old World. Parasitology 137: 11591168.[Crossref] [Google Scholar]
  15. Brazil Ministry of Health, 2011. SINAN. Available at: http://dtr2004.saude.gov.br/sinanweb/. Accessed July 1, 2015. [Google Scholar]
  16. SUDAM, 2014. Amazônia Legal Demografia. Available at: http://www.sudam.gov.br/amazonia-legal/demografia. Accessed July 1, 2015. [Google Scholar]
  17. Barbosa MGV, NF, Marcião AHR, Silva APT, Monteiro WM, Guerra JAO, , 2008. Fauna de flebotomíneos (Diptera: Psychodidae) em um foco de leishmaniose tegumentar americana na área periurbana de Manaus, Estado do Amazonas. Rev Soc Bras Med Trop 41: 485491.[Crossref] [Google Scholar]
  18. Lainson R, Shaw JJ, Silveira FT, de Souza AA, Braga RR, Ishikawa EA, , 1994. The dermal leishmaniases of Brazil, with special reference to the eco-epidemiology of the disease in Amazonia. Mem Inst Oswaldo Cruz 89: 435443.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 18 Mar 2014
  • Accepted : 20 Jul 2015
  • Published online : 09 Dec 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error