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Integrated Tools for American Cutaneous Leishmaniasis Surveillance and Control: Intervention in an Endemic Area in Rio de Janeiro, RJ, Brazil

DOI: 10.1155/2012/568312

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Abstract:

American cutaneous leishmaniasis (ACL) is a focal disease whose surveillance and control require complex actions. The present study aimed to apply integrated tools related to entomological surveillance, environmental management, and health education practices in an ACL-endemic area in Rio de Janeiro city, RJ, Brazil. The distribution of the disease, the particular characteristics of the localities, and entomological data were used as additional information about ACL determinants. Environmental management actions were evaluated after health education practices. The frequency of ACL vectors Lutzomyia (N.) intermedia and L. migonei inside and outside houses varied according to environment characteristics, probably influenced by the way of life of the popular groups. In this kind of situation environmental management and community mobilization become essential, as they help both specialists and residents create strategies that can interfere in the dynamics of vector’s population and the contact between man and vectors. 1. Introduction American cutaneous leishmaniasis (ACL) is among the six most important infectious diseases and the 15 most neglected diseases of the world [1]. It presents a diversity of transmission cycles that involve different species of parasites, vectors, and hosts in restricted ecological niches [2]. Thus, the indication of control measures must consider the entomological and epidemiological characteristics of each locality. According to Sabroza et al. [3], for each disease and particular situation there are environmental and behavioral factors related to the production of endemic or epidemic processes. To explain these factors, Sabroza et al. [3, page 216] used the concept of conditions receptivity, defined as the “set of environmental, social and behavioral characteristics that allow the reproduction of the parasites and its maintenance in the communities.” The city of Rio de Janeiro presents many areas where these conditions are met, mainly because of human occupation of hillsides, which modifies the landscape and favors the installation of ACL transmission cycles. The number of cases in the city has been increasing since the 1980s, with the west zone presenting the highest indices, more specifically the region of Jacarepaguá [4]. Most of the cases in the study area (Campus FIOCRUZ da Mata Atlantica - CFMA, Rio de Janeiro) are related to the occupation of hillsides in Maci?o da Pedra Branca, an Atlantic Forest area. The present study aimed to discuss an experience on ACL surveillance based on integrated tools related to entomological

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