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Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020.

Authors :
Rocha, Rafael
Conceição, Cláudia
Gonçalves, Luzia
Carvalho, Ana Cláudia
Maia, André
Martins, André
Carujo, António
Maio, António
Forra, Catarina
Melita, Catarina
Couto, Daniela
Fernandes, Diana
Pereira, Dulce
Leal, Ema
Sarmento, Helena
Sousa, Inês
Gonçalves, Jean-Pierre
Marinho, Joana
Vasconcelos, Joana
Cunha, João
Source :
Microorganisms; Apr2024, Vol. 12 Issue 4, p819, 16p
Publication Year :
2024

Abstract

Leishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM<superscript>®</superscript> SPSS<superscript>®</superscript> Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20762607
Volume :
12
Issue :
4
Database :
Complementary Index
Journal :
Microorganisms
Publication Type :
Academic Journal
Accession number :
176907849
Full Text :
https://doi.org/10.3390/microorganisms12040819