Universidad Peruana Cayetano Heredia

Risk factors for cutaneous leishmaniasis in a high-altitude forest region of Peru

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dc.contributor.author Lana, Justin T.
dc.contributor.author Mallipudi, Andrés
dc.contributor.author Ortiz, Ernesto J.
dc.contributor.author Arevalo, Jairo H.
dc.contributor.author Llanos Cuentas, Elmer Alejandro
dc.contributor.author Pan, William K.
dc.date.accessioned 2021-06-08T15:46:14Z
dc.date.available 2021-06-08T15:46:14Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9508
dc.description.abstract BACKGROUND: American cutaneous leishmaniasis (CL) is a neglected tropical disease typically associated with men working in remote, sylvatic environments. We sought to identify CL risk factors in a highly deforested region where anecdotal reports suggested an atypical proportion of women and children were infected with CL raising concern among authorities that transmission was shifting towards domestic spaces and population centers. METHODS: We describe the characteristics of CL patients from four participating clinics after digitizing up to 10 years of patient data from each clinic's CL registries. We assessed risk factors of CL associated with intradomestic, peridomestic, or non-domestic transmission through a matched case-control study with 63 patients who had visited these same clinics for CL (cases) or other medical reasons (controls) between January 2014 and August 2016. The study consisted of an in-home interview of participants by a trained field worker using a standard questionnaire. Risk factors were identified using bivariable and multivariable conditional logistic regression. RESULTS: Between 2007 and 2016, a total of 529 confirmed CL positives were recorded in the available CL registries. Children and working aged women made up 58.6% of the cases. Our final model suggests that the odds of sleeping in or very near an agricultural field were five times greater in cases than controls (p = 0.025). Survey data indicate that women, children, and men have similar propensities to both visit and sleep in or near agricultural fields. CONCLUSIONS: Women and children may be underappreciated as CL risk groups in agriculturally dependent regions. Despite the age-sex breakdown of clinical CL patients and high rates of deforestation occurring in the study area, transmission is mostly occurring outside of the largest population centers. Curbing transmission in non-domestic spaces may be limited to decreasing exposure to sandflies during the evening, nighttime, and early morning hours. Our paper serves as a cautionary tale for those relying solely on the demographic information obtained from clinic-based data to understand basic epidemiological trends of vector-borne infections en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartofseries Tropical Medicine and Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Deforestation en_US
dc.subject Epidemiology en_US
dc.subject Agriculture en_US
dc.subject American tegumentary leishmaniasis en_US
dc.subject Urbanization en_US
dc.subject Case control en_US
dc.subject CLASlite en_US
dc.subject Coffee en_US
dc.subject Neglected tropical disease en_US
dc.subject Vector-borne disease en_US
dc.title Risk factors for cutaneous leishmaniasis in a high-altitude forest region of Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s41182-021-00332-0
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1349-4147


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