Leishmania%20brasiliensis - PowerPoint PPT Presentation
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Leishmania%20brasiliensis
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Leads to destruction of mucosa and cartilage ... Pentavalent antimony: treatment of choice. Inhibits adenosine triphosphate synthesis ... – PowerPoint PPT presentation
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Title: Leishmania%20brasiliensis
1
Leishmania brasiliensis
- Lida Shaygan
2
Background
- Transmitted by female sand fly
- Leads to destruction of mucosa and cartilage
- scarring ,disfigurement, pulmonary aspiration and
death - Incubation of 2-8 weeks
3
Historical Accounts
- tablets in library of King Ashurbanipal from the
7th century BC - Illustrations in pre- Inca sculptures
- existence in Peru and Ecuador in 1st century AD
- Texts from 15-16th century Inca period and
Spanish conquests - referred to as espundia
Statue of King Ashurbanipal
4
Development of Scientific Knowledge
- In 1911, Gaspar Vianna found difference in
parasites in South America from those in Africa -
Leishmania brasiliensis - 1922- new genus named Lutzomyia.
- complex elaborations by Ralph Lainson and
colleagues.
5
Cultural Practices
- Native Amazonians have lived for over 20,000
years. - sharing the hunt and the food they gather
- live in houses made of tree bark / palm leaves
- Sharing key to survival
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Prevalence
- 50 to 100 cases in US
- 90 of cases found in Brazil, Bolivia, and Peru
- Found in temperate and tropical climates around
the world. - (except Australia)
- Afghanistan, Algeria, Brazil, Peru, Iran, Iraq,
Syria, and Saudi Arabia
7
Historical Movements
- World War II
- Gulf War (1901-1991)
- 697,000 troops
- 19 cases of leishmaniasis and 12 cases of
visceral - Soldiers serving in Iraq 2003
- gt600 cases in American soldiers in 2004 alone
- More are expected
8
Effect of Infrastructure
- Extracting timber
- Mining
- Building dams
- Widening areas under cultivation
- Creating new irrigation schemes
- . . . all increase exposure to sand fly vector
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Anthropogenic Environmental Changes
- rural to urban areas
- fast urbanization worldwide
- Coexistence with HIV
- Spreading as result of rapidly spreading epidemic
of AIDS - accelerates onset of AIDS
Countries reporting Leishmania / HIV co-infection
10
Response of Healthcare Community
- diagnosed in travelers, immigrants, military
personal - Physicians in US must be alert to diagnosis in
travelers - Diagnostic Methods
- Skin Scrape
- Punch Biopsy
- Needle aspiration of tissue fluid
- Immunological tests
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Treatments
- Pentavalent antimony treatment of choice
- Inhibits adenosine triphosphate synthesis
- side effects
- Aching, fatigue, gastrointestinal upset,
elevation of liver enzyme levels, anemia,
electrocardiographic abnormalities - Amphotericin B (Fungizone)
- Pentamidine isethionate (Pentam 300)
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Prevention
- Early case detection
- Vector control (insecticides)
- environmental sanitation
- Reservoir Control
- Toxic plant extracts
- Vaccine development
- fine weave bednets
- More dermatologists in rural areas
- More adequate supply of appropriate drugs
13
References
- http//www.emedicine.com/DERM/topic219.htm
- http//www.ciesin.org/docs/001-613/001-613.html
- http//www.bookrags.com/Leishmaniasis
- www.cdc.gov
- www.who.int/
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