CLINICAL CHARACTERIZATION AND EPIDEMIOLOGICAL ASPECTS OF HUMAN VISCERAL LEISHMANIASIS IN THE PROVINCE OF SALTA. PERIOD 2008 - 2022

• DOI: https://doi.org/10.22533/at.ed.1594872424095

• Palavras-chave: Leishmaniasis visceral; LV; Estratificación de riesgo; Riesgo de transmisión, Índice Combinado Trienio de Leishmaniasis visceral, ICTLv

• Keywords: Visceral leishmaniasis; VL; Risk stratification; Transmission risk, Triennial Combined Index of Visceral Leishmaniasis, ICTLv.

• Abstract:

  Leishmaniasis, a group of zoonotic-vectorial parasitic diseases, in humans the visceral pre-sentation is the severe clinical form. In the province of Salta, the causal agent has been iden-tified as Leishmania (Leishmania) infantum with Lutzomyia longipalpis as the main vector in-volved in urban transmission, with no reports on the epidemiological aspects of the same. This research generates knowledge on the clinical characteristics and its possible eco-epidemiological scenarios. Thirty-eight autochthonous cases of VL were reported between 2008 and 2022, with 3 isolated cases between 2008-2011 and in the period 2016-2022 the remaining cases in clusters and transmission foci in the Departments General San Martín and Rivadavia fulfilling criteria of vulnerability, receptivity and transmission, defining risk sce-narios for acquiring the disease at an increasing transmission speed according to density of cases per 100 km2 per triennium (0.1415 and 0.0116 cases/100km2 to the year 2022 respec-tively) and a Triennial Composite Index of Visceral Leishmaniasis comprised between 1.51-3.00 (High Risk) for both in the same period. The 84.21% (32/38) of the cases have residen-ce in General San Martín, 10.53% (4/38) in Rivadavia and 5.26% (2/38) in Anta with nexus in the previous one. The average age was 15.37±3.56 years (range between 0 and 77 years). 68.42% (26/38) are under 10 years old, and 84.61% (22/26) under 5 years old; 68.42% (26/38) are male. 68.42% (26/38) presented prolonged febrile syndrome with weight loss. Fo-llowed by hepatosplenomegaly (p<0.0003) and p=0.0079 when associated with fever and anemia. The average number of days between the onset of symptoms and the first consulta-tion was 33 𝐼𝐶95% [23 - 43 days]; 86.84% (33/38) required hospitalization and 9.09% (3/33) required intensive care and mechanical ventilation, 57.89% (22/28) were discharged from hospital and only one death was recorded. Specific treatment was recorded in 78.95% (30/38). All reported patients had at least one laboratory study. The detection of specific anti-bodies by ELISA showed a sensitivity of 100% and the specificity is 100% with the exception of ELISA. Positive and negative predictive values had satisfactory results for all techniques and serological test concordance yields a Kappa of 0.84 𝐼𝐶95% [1.05-0.64].