Leishmaniose visceral americana : perpepção do conhecimento, distribuição espacial e avaliação morfológica da pele de cães com infecção natural por Leishmania infantum (Nicole, 1908).

Abstract

Brazil faces the expansion and urbanization of American Visceral Leishmaniasis (AVL), and the Northeast Region has the highest series of the disease and the dog considered the main reservoir in the urban environment. Among the states of the Northeast Region, Pernambuco registered a total of 1,465 cases of AVL in the period from 2000 to 2010 and of the municipalities, Petrolina has been highlighted by the expansion of the disease. Thus, was conducted a retrospective cross-sectional study of reported cases of the disease between 2001 and 2010 in Petrolina. Of the total of 117, have been located and obtained interviews with 42 patients. 59.52% (25/42) were male and 40.47% (17/42) were female. Children between 0 and 12 years represented 45.60% (19/42). 100% (42/42) reported that the first symptoms appeared within six months. 4.7% reported having up to two family members affected and 13% (2/42) reported the euthanasia of dogs. Only 33.3% (14/42) reported having dogs at home and 14.2% (6/42) said they raising pigs and chickens. 95.3% (40/42) reported that the activity of phlebotomine was greater at night, but only 26.1% (11/42) reported the use of mosquito nets and 2% (1/42) repellents. The collection of solid waste was reported by 90.48% (38/42) and only 4% of homes had sewage system. Only 38.09% (16/42) said they understand the role of the accumulation of organic matter in the disease cycle, but 95.23% (40/42) had some knowledge about the role of dogs and vector. The county has several epidemiologic factors that favor the spread of the disease, but knowledge about the relationship of organic matter accumulated is superficial proved by patients interviewed, referring the need for health education campaigns. The use of tools such as Geographic Information System allows you to map and identify areas at high risk for the occurrence of new cases of the disease. Therefore, was conducted a cross-sectional study of human cases and was found 117 patients registered with AVL. Of these, 35.89% (42/117) were located and geocoded. The serological survey showed that of the 600 dogs evaluated, 19.16% (115/600) were positive for the disease, and 73.04% (84/115) belonged to urban area. After spatial analysis of human and canine cases, we observed the presence of clusters in both rural and urban area. However, in both cases, the concentration was higher in urban areas, mainly in the southwestern region of the map of the city of Petrolina. A large number of cases were observed in places where there was a decrease in vegetation cover and poor housing conditions. However, when it was carried out the overlap of maps, no close association between canine and human cases of the disease have been found. In conclusion, spatial analysis of LVA in Petrolina concluded that the disease is not urbanized, though the association between canine and human disease. The Canine Visceral Leishmaniasis is considered an immune-mediated disease and viscerotropic despite the nature of the parasite, the skin is the main organ involved in the disease progression. Between the most dermatological alterations reported are: exfoliative dermatitis, hyperkeratosis, ulcers and alopecia, however, hyperpigmentation of the skin can also be present. The aim of this study was to evaluate the structural and ultrastructural morphological changes and pigmentary skin of dogs Leishmania infantum. Fragments of intact skin, and hyperpigmented lesions in the abdominal region were removed with the aid of a punch, each of the 11 dogs evaluated and tested positive for Enzyme linked immunosorbent and parasitological examination by bone marrow biopsy. Subsequently, the tissues collected were subjected to routine histological techniques for analysis in light microscopy and transmission electron microscopy. After analysis by light microscopy, was found mononuclear cell infiltrate in the dermis lesions and amastigostas forms of Leishmania infantum within macrophages of 81.8% (9/11) dogs. Parakeratosis and hyperkeratosis was observed in lesional skin of 54.5% (6/11) dogs. Excess melanin granules was noted both in the epidermis and in dermis of the skin hyperpigmented 36.3% (4/11) dogs. In the electron micrographs, it was possible to display a large amount of melanin granules around the nucleus of keratinocytes of the stratum spinosum. The results of this study suggest a possible relationship between inflammatory mediators produced in Canine Visceral Leishmaniasis and stimulation of melanogenesis.