ESTUDIO DE UN BROTE EPIDEMICO DE LEISHMANIASIS TEGUMENTARIA AMERICANA EN EL MUNICIPIO CHORONI (ESTADO ARAGUA)

Resumen

Se ha estudiado un foco activo de leishmaniasis tegumentaria americana
en el Municipio Choroní del Estado Aragua, al norte de Venezuela. Es
esta una zona endémica de la enfermedad, donde, posiblemente, factores
ecológicos en relación a reservorios infectados que han llegado a la vecindad
de los domicilios semiurbanos permitieron la aparición de nuevos casos,
especialmente en gente joven (94 menores de quince años) y del sexo femenino
en los adultos (43 mujeres en 65 personas mayores de quince años), quienes
posiblemente no habían adquirido una franca inmunización natural previa.
El municipio tiene una población total estimada de 1.200 habitantes,
ubicado en la vertiente Norte de la Cordillera de la Costa, en sus
estribaciones hacia el mar, donde limita un pequeño valle boscoso y cálido
de difícil acceso.
Un total de 153 casos fue observado en dos años de estudio, 110 de
ellos con lesiones únicas, 43 pacientes con lesiones múltiples, la mayoría del
total en miembros y con predominio de formas ulcerosas. No se reportaron
lesiones mucosas. Fueron tratados con glucantime (una a cuatro series) .
Se realizó encuesta con test a leishmanina, a la población general, que
demostró un alto índice de posibilidades en mayores de diecinueve años
(40%, que sube al 60% en las personas de cincuenta años).
No obstante la fumigación del área, continuaron apareciendo algunos
otros casos, por lo cual se estudia la posibilidad de realizar una inmunización
activa del área con la asesoría del Instituto de Medicina Tropical
de la Universidad Central de Venezuela.

SUMMARY
An active focus of American Cutaneous Leishmaniasis has been studied
carefully in Choroni's Borough, an area located in Aragua State, north of
Venezuela. This particular place is considered to be an endemic zone of this
disease. It has been thought that ecological factors in relation to infected
streams have reached the localities near by, mainly the semi-urban
communities, making possible the development of new cases, specially
young people (85 were younger than 15 years of age) of the female sex; in
adults we found 25 cases older than 15 years of age. These persons in all
probability had not developed yet a true active immunization.
The Choroni's Borough has a total population of 1.200 inhabitants. This
is a region lying to the north of Venezuelan coastal mountain range, situated
near by the small river that flows into sea. This is a small valley, with a
warm climate and difficult to reach due to the heavy forest.
A total of 153 cases were under observation during a year to six
months; 96 of these cases had one lesion, 43 patients were found with
multiple lesions. The mayority of the total number of lesions were found in
upper and lower extremities. The ulcerous form was predominant. The cases
were treated with Glucantime (1 to 4 series).
A survey throughout the area, the Leishmanina Test, was used. It was
applied to the general population which showed a high index of probabilities
in persons older than 19 years of age (40% goes up to 60% in persons of 50
years of age).
In spite of fumigation, some cases continued to appear. At present, we
are studying the possibilities of conducting positive immunization
throughout the whole area. We expect to this with the assistance of the
Institute of Tropical Medicine at Central University.