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American cutaneous leishmaniasis: Epidemiological indices in Valle Hermoso, Santo Domingo de Los Tsachilas province

Abstract:

Leishmaniases are caused by approximately 15 species of protozoa of the genus Leishmania. They prevail in tropical and subtropical areas of the Old and New World human mobility also makes them a medical problem in nonendemic areas. Clinical manifestations may comprise cutaneous forms that may be localized. Diagnosis and treatment vary according to the clinical manifestations, geographic area, and species involved. This article highlights epidemiological and clinical aspects in the province of Santo Domingo de los Tsachilas, Ecuador. Clinical and epidemiological records of patients who presented ulcerated lesions or not, with an evolution time equal to or greater than 2 weeks were used. The largest numbers of cases are between the successive groups of adolescents from 11 to 19 years old and young adults between 20 and 39 years old. 81.79% of the positives came from rural or peri-urban areas. Two thirds of the patients were male. There was a predominance of single lesions (87.79%); located in the neck and cervical region, and lower extremities (24.84 and 24.20%, respectively). About 88% of the patients did not present any type of symptomatology associated with the parasitic infection. 97.86% of laboratory diagnoses were by direct microscopic observation. 81.80% obtained complete cure of the lesions and 22% of the patients abandoned antiparasitic therapy. Rapid and accessible tests that can define Leishmania species are required, as discrimination is of significant importance for species-specific prognosis and treatment.