Monografia (especialização)
Retrospectiva e perspectiva no diagnóstico da Leishmaniose visceral humana
Fecha
2010-11-03Autor
Ariane Campos de Souza
Institución
Resumen
The leishmaniases are a group of vector-borne diseases caused by obligate intracellular protozoan of different species of the genus Leishmania, and its peculiarities of the diversity and complexity. They can be divided into two groups: cutaneous and visceral
leishmaniasis (VL). In Brazil, the cutaneous form is usually caused by species: L.
braziliensis, L. amazonensis and L. guyanensis, while the visceral form is caused by L.
infantum (= L. chagasi). There are two types of VL that differ in their transmission
characteristics: the zoonotic VL is transmitted from animals to and from this vector to
humans, and antroponótico which is transmitted from human to human through the
vector. The zoonotic form, initially, was known as a rural disease in a wild environment,
affecting man or animals that have contact with this environment. Recently, it was
characterized as a reemerging disease have been established in urban or peripheral is
a good environment for the life cycle of the vector. The disease is a public health
problem in at least 88 countries and is considered among the six priority endemic
diseases in the world. The clinical evaluation of new tests is fraught with difficulties. The
lack of a gold standard makes studies of diagnostic accuracy of VL extremely complex.
A gold standard in diagnosing VL splenic aspirate culture. However, obtaining
splenic aspirates are invasive and culture techniques are often not available in endemic
areas of VL. In the routine the clinical epidemiological diagnosis is associated with
serological tests before initiating treatment. In the atual era of molecular biology, there is
great prospect for the use of molecular diagnostics, especially the detection of parasite’
DNA in blood of patients by using the polymerase chain reaction. This is a method of
high sensitivity and specificity that has increasingly reduced cost.