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There is an urgent need to improve the diagnostic capacity of cutaneous leishmaniasis (CL) in rural health centers to improve the management of the disease in patients from remote regions where the infection is endemic. Microscopy of Giemsa-stained lesion smears is the standard-of-care diagnostic test in virtually all health centers, but its sensitivity is suboptimal (50–70%) and prone to false negative results. We evaluated the performance of a low-cost DNA extraction buffer (LAB) using a portable miniPCR™ equipment coupled with an inexpensive fluorescence viewer to detect Leishmania DNA with the naked eye or using a commercial photo app. Using ten-fold serial dilutions of Leishmania (V.) panamensis promastigotes the miniPCR-F test detected 10 parasites per µL, which was comparable to real-time PCR. Utilization of DNA from retrospective clinical samples preserved at -80 °C from Colombia (n = 28) or lesion exudate preserved in filter papers from Peru (n = 48) showed that the miniPCR-fluorescent test had a 100% sensitivity and > 90% specificity compared to real-time PCR. This study demonstrated the utility of LAB DNA extraction method for direct amplification of Leishmania using the miniPCR and reading of P51 results with the naked eye or via digital reading with a photo app. These preliminary results indicated that the miniPCR-F test workflow could be amenable to implementation in resource-limited health centers. [ABSTRACT FROM AUTHOR]

Lonomism is the envenomation caused by accidental contact with Lonomia caterpillars, and this is a public health priority in South America since it is relatively common but remains underestimated. This study presents an updated and integrative analysis of reliable global data from 1960 to 2020 on the epidemiology of this envenomation in the whole continent. A total of 13,186 notifications were recorded for South America: 13,056 (99.01%) in Brazil, 49 (0.37%) in Argentina, 43 (0.33%) in Colombia, 29 (0.22%) in Venezuela, 6 (0.05%) in Peru and 3 (0.02%) in French Guiana. The number of new locations reporting accidents has increased since the first formally notifications at the middle of the last century. Most of these locations are situated in Brazil, the pioneer in deeply researching the Lonomia genus and its impacts in public health. Most victims were males, in the economically productive age group, and accidental contact occurred more frequently in the upper limbs while doing activities outdoors in urban/rural areas. Regarding the determinants of clinical outcome, countries where patients received delayed medical care were associated with a higher number of moderate and/or severe cases, as well as a higher chance of progressing to death. Additionally, the longer the delay for accessing medical care, the higher the risk of developing systemic complications, thereby increasing the need for specific treatment. Our study also shows that accidents globally occurred more frequently in the summer months and in the beginning of autumn. Although having identified several shortcomings in the documents selected and verified that notifications are strongly biased by public policies adopted by each South American country, this study provides the first comprehensive assessment of lonomism in South America, demonstrating the increase in the number of accidents, and their expansion to other areas of the continent over time. Our findings will undoubtedly help guide the appropriate allocation of resources and implementation of prevention strategies and define priority criteria for epidemiological surveillance of this neglected tropical disease., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (Copyright © 2022 Elsevier B.V. All rights reserved.)