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Sustained Presence of Cutaneous Leishmaniasis in Urban Manaus, the Largest Human Settlement in the Amazon

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  • Fundação de Medicina Tropical do Amazonas, Manaus, Brazil; Pontifícia Universidade Católica do Paraná, Curitiba, Brazil; Universidade Federal da Bahia, Salvador, Brazil; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Brazil
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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 Leishmania species was determined by polymerase chain reaction. Among prospectively enrolled subjects, 94.8% were infected with Leishmania (Viannia) guyanensis, 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.

Author Notes

* Address correspondence to Albert Schriefer, Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Rua João das Botas s/n, 5° Andar, Canela, Salvador, Bahia, Brazil 40.110-160. E-mail: aschriefer@globo.com

Financial support: This work was funded by the Fundação de Amparo à Pesquisa do Estado do Amazonas–FAPEAM, Brazil and by the NIH grant P50AI030639. Albert Schriefer and Marcelo Távora Mira were recipients of research scholarships from FAPEAM. Ednelza Benício, Mayara Cordeiro, and Hannah Monteiro were recipients of PAIC scholarships from FAPEAM.

Authors' addresses: Ednelza Benício, Mayara Cordeiro, Hannah Monteiro, and Cintia Oliveira, Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical do Amazonas, Amazonas, Brazil, E-mails: ednelza.benicio@hotmail.com, mayara.cord89@gmail.com, nanahhg@hotmail.com, and cmaraoliveira@hotmail.com. Marco Antônio Saboia Moura, Departamento de Tecnologia da Informação, Fundação de Medicina Tropical do Amazonas, Amazonas, Brazil, E-mail: marco@fmt.am.gov.br. Ellen Pricilla Nunes Gadelha, Anette Chrusciak-Talhari, and Sinésio Talhari, Gerência de Dermatologia, Fundação de Medicina Tropical do Amazonas, Amazonas, Brazil, E-mails: ellenpriscilla@ig.com.br, anette@dermatologiatalhari.com.br, and sinesio@dermatologiatalhari.com.br. Carolina Talhari, Diretoria de Ensino e Pesquisa, Fundação de Dermatologia Tropical e Venereologia Alfredo da Mata, Amazonas, Brazil, E-mail: carolinatalhari@gmail.com. Luiz Carlos de Lima Ferreira, Gerência de Patologia, Fundação de Medicina Tropical do Amazonas, Amazonas, Brazil, E-mail: ferreira@fmt.am.gov.br. Marcelo Távora Mira, PPGCS/CCBS, Pontificia Universidade Católica do Paraná, Paraná, Brazil, E-mail: m.mira@pucpr.br. Paulo Roberto Lima Machado and Albert Schriefer, Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Bahia, Brazil, E-mails: prlmachado@uol.com.br and aschriefer@globo.com.

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