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Master's Dissertation
DOI
https://doi.org/10.11606/D.85.2020.tde-21092020-145701
Document
Author
Full name
Silvestre Júlio Souza da Silveira
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2020
Supervisor
Committee
Spencer, Patrick Jack (President)
Galisteo Junior, Andrés Jimenez
Senna, André Machado de
Title in Portuguese
Perfil clínico e epidemiológico da Leishmaniose Tegumentar Americana no Hospital de Doenças Tropicais da Universidade Federal do Tocantins
Keywords in Portuguese
cutânea
leishmaniose tegumentar
mucosa
Abstract in Portuguese
As lesões de pele e mucosas da Leishmaniose Tegumentar são indolores, o que retarda sua busca por tratamento, podendo sobrevir deformidades estigmatizantes. No Tocantins, flebotomíneas Lutzomyia sp transmitem principalmente a Leishmania braziliensis. Foram analisados os prontuários dos 331 pacientes notificados por LTA ao SINAN pelo HDT/UFT, no período de 2010 a 2016, objetivando apresentar seu perfil clínico-epidemiológico. Encontrando 92,14% de residentes no Tocantins, os 83,99% de casos autóctones corroboraram a endemicidade na região. Com 83,08% de moradores urbanos, a zona periurbana foi subestimada. As três faixas etárias mais prevalentes somaram dos 20 aos 49 anos, 51,65%, equivalente à idade predominante da população economicamente ativa. O sexo masculino predominou com 76,43%; as ocupações com atividades agro-pecuárias responderam pela metade dos casos; 13,90% como doenças ocupacionais. A forma cutânea ocorreu em 88,82%, a mucosa em 11,18%, e destas, 35,13% mostraram cicatrizes cutâneas. Coinfecção LTA-HIV foi confirmada em 1,81% dos casos. O critério clínico-laboratorial (94,26%) foi o mais utilizado para confirmar o diagnóstico: 75,83% dos pacientes realizaram o exame parasitológico direto por escarificação da lesão, com positividade de 83,66%. A terapêutica usada: 82,17% com meglumina e 13,60% com anfotericina B; falha terapêutica em 0,6% dos casos. Mas sucedeu-se evolução para cura em 95,47% dos casos notificados. O deslocamento populacional, por obras de impacto ambiental, como a usina hidrelétrica de Estreito-MA inaugurada em 2012, ou pelo próprio florescimento das cidades tocantinenses, avultando as zonas periurbanas, favoreceram a ocorrência de antropozoonoses como a LTA.
Title in English
Clinical and epidemiological profile of American Tegumentary Leishmaniasis at the Tropical Diseases Hospital of the Federal University of Tocantins
Keywords in English
cutaneous
mucosa
tegumentary leishmaniasis
Abstract in English
Skin and mucosal lesions of Cutaneous Leishmaniasis are painless, which delays their search for treatment and may result in stigma-deformities. In Tocantins, sandflies Lutzomyia sp transmit mainly Leishmania braziliensis. Medical records of all 331 patients notified by ATL to SINAN by HDT/UFT were analyzed, from 2010 to 2016, aiming to present their clinical and epidemiological profile. Finding that 92.14% were residents in Tocantins, the 83.99% of autochthonous cases corroborated endemicity in the region. With 83.08% of urban dwellers, the periurban zone was underestimated. The three most prevalent age groups were from 20 to 49 years old with 51.65%, equivalent to the predominant age of the economically active population. The male gender predominated with 76.43%; occupations with farming activities accounted for half of the cases; 13.90% as occupational diseases. The cutaneous form occurred in 88.82%, the mucosa in 11.18%, and of these, 35.13% showed cutaneous scars. ATL-HIV coinfection was confirmed in 1.81% of cases. The clinical-laboratory criterion (94.26%) was the most used to confirm the diagnosis: 75.83% of the patients underwent direct parasitological examination for scarification of the lesion, with a positivity of 83.66%. The therapy used: 82.17% with meglumine and 13.60% with amphotericin B; therapeutic failure in 0.6% of cases. Outcom of cure succeeded in 95.47% of reported cases. Population displacement, by constructions of environmental impact, such as the Estreito-MA hydroelectric power plant inaugurated in 2012, or by the flowering of Tocantins cities, enlarging periurban areas, fomented the occurrence of anthropozoonoses such as ATL.
 
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Publishing Date
2020-09-22
 
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