| American cutaneous leishmaniasis in Guyana, South America. | |
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MedLine Citation:
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PMID: 11339884 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The 185 patients who presented at the dermatology clinic of Georgetown Public Hospital, Guyana, between 1992 and 1998, with skin ulcers indicative of American cutaneous leishmaniasis (ACL) were retrospectively reviewed. The laboratory-confirmed cases of ACL were identified and the corresponding data were analysed for risk factors such as age, gender, areas of residence and of possible exposure to the causative agent (Leishmania braziliensis guyanensis), ethnic origin, longevity of the ulcers, and treatment regimes prior to the definitive diagnosis. Eighty-one (43%) of the 185 subjects were confirmed to be infected with Le. b. guyanensis. Although 53 (66%) of the cases lived in or close to the capital city, Georgetown, most of the cases had travelled to (and probably been infected in) region X in the interior of Guyana (32%) or regions VII (23%), VIII (23%), IX (11%), VI (5%), I (3%) or III (3%), usually because they were involved in the mining (41%) or lumber (21%) industries, the army or hunting. Almost all (95%) of the cases were male and most (58%) were aged 20-39 years. In general, the cases had had their skin lesions for many days before presenting for treatment: 46% for 1-5 weeks and 3% for > 6 months. Prior to presentation at the clinic, many of the cases had attempted to cure themselves, using local herbal remedies (37%), antibiotics and antifungal remedies (39%), other creams (5%), household chemicals (9%) or miscellaneous remedies such as lead salts (especially lead sulphate) and battery acid, all without success. Recommendations are made for an epidemiological study of active ACL among forest workers, eco-tourists and residents of high-risk areas. Diagnostic centres need to be sited in the regions most at-risk, particularly in or near environments in which the main vectors - sandflies such as Lutzomyia umbratilis, Lu. anduzei and Lu. whitmani - are known to be prevalent. |
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Authors:
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S C Rawlins; T Tiwari; D D Chadee; L Validum; H Alexander; R Nazeer; S R Rawlins |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of tropical medicine and parasitology Volume: 95 ISSN: 0003-4983 ISO Abbreviation: Ann Trop Med Parasitol Publication Date: 2001 Apr |
Date Detail:
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Created Date: 2001-05-07 Completed Date: 2001-07-05 Revised Date: 2009-05-18 |
Medline Journal Info:
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Nlm Unique ID: 2985178R Medline TA: Ann Trop Med Parasitol Country: England |
Other Details:
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Languages: eng Pagination: 245-51 Citation Subset: IM |
Affiliation:
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Caribbean Epidemiology Centre (CAREC), P.O. Box 164, Port of Spain, Trinidad. rawlinsa@carec.paho.org. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Aged Child Child, Preschool Endemic Diseases* Female Guyana / epidemiology Household Products Humans Infant Infant, Newborn Leishmaniasis, Cutaneous / epidemiology*, etiology, therapy Male Middle Aged Occupations Phytotherapy Retrospective Studies Risk Factors Seasons Sex Factors Travel |
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