Epidemiological profile of American cutaneous leishmaniasis in the amazonian frontier: a retrospective study in Assis Brasil, Acre, Brazil

Abstract

This study describes the epidemiological profile of American cutaneous leishmaniasis in Assis Brasil, a town located at the border of Brazil, Peru and Bolivia, between 2003 and 2010. Leishmaniasis case files were reviewed and frequencies compared using the Fisher Exact Test or Chi-square. There were 579 cases recorded, with a detection coefficient of 191 and 82 cases per 10,000 inhabitants in 2003 and 2010, respectively. Cases were more frequent in males (63.0%), in persons living in rural areas (72.3%), and in those with environment-related jobs (52.5%). Around
81% of patients resided in Assis Brasil, 3.6% lived in neighboring Brazilian towns, 10.4% in Peru, 1.7% in Bolivia and 3.8% had an unknown address. The cutaneous form was more prevalent (53.5%), and there were few cases of relapse (1.7%) recorded during this period. The diagnosis was most commonly confirmed by the intradermal test, while the direct microscopic test was seldom used. Treatment deficiencies occurred due to inadequate prescribed doses (56.3% of mucosal cases)
and shortened length of treatment (2.6% of cases). There is an apparent lack of human resources for diagnosis and case notification, and therefore improvements in the basic public health system are needed for efficient disease control.