Studies on leishmaniasis and its transmission in Central and South Americas

为了掌握关于新世界利什曼病的信息，特别是在厄瓜多尔，从多学科的角度进行了深入的研究，包括对不同类型药物的化疗进行试验。为此，在本研究项目期间，由流行病学家、寄生虫学家、皮肤科医生、免疫学家、分子生物学家和媒介昆虫学家等多学科专家对几乎所有疑似利什曼病流行区进行了彻底调查。除病原体和病媒外，还披露了许多临床流行病学特征：利什曼原虫(Leishmania)amazonensis、L.(L.)墨西哥，L.(L.)(Viannia Braziliensis)，L.(V.)Guyanensis，L.(V.)Panamens，L.(V.)赤眼蜂为利什曼原虫，雅古氏丝虫Lutzmyia ayacuchensis，Lu.戈麦兹，卢。太棒了，卢。哈特马尼就像太阳苍蝇。在1998年至2000年的研究期间，收集了全国范围内的流行病学和临床资料，并对皮肤利什曼病进行了诊断和治疗。应用聚合酶链式反应技术对从病人、病媒和宿主动物体内分离到的利什曼原虫进行了鉴定。根据所获得的结果，已经进行了一项试验，以描绘厄瓜多尔利什马尼亚属每一种的地理分布。此外，为了获得更灵敏、更特异的诊断方法，本研究还比较了不同引物的聚合酶链式反应与传统的涂片、培养、组织标本等检测方法的异同。在厄瓜多尔不同海拔的几个利什曼病流行区进行了临床流行病学调查，对皮肤利什曼病与农村地区发现的其他皮肤病进行了鉴别诊断。

In order to have an information on the New World leishmaniasis, especially in Ecuador, an intensive study has been done from the multidisciplinary view points, including trials of the chemotherapy with different types of drugs. For this purpose, during the present research project terms, almost all of the suspected leishmaniasis-endemic areas were thoroughly surveyed by multidiscip linary experts, such as epidemiologists, parasitologists, dermatologists, immunologists, molecular biologists and vector entomologists. Many clinico-epidemiological features are disclosed, in addtion to causative agents and vectors : Leishmania (Leishmania) amazonensis, L.(L.) mexicana, L.(L.) major-like, L.(Viannia) braziliensis, L.(V.) guyanensis, L.(V.) panamensis, L.(V.) equatorensis as the leishmanial parasites and Lutzomyia ayacuchensis, Lu. gomezi, Lu. trapidoi, Lu. hartmani as sundflies. In this research term from 1998 to 2000, epidemiological and clinical data were collected country-wide, and diagnosis and treatment of patients with cutaneous leishmanial lesions were also performed. Leishmania parasites isolated from patients, vectors and reservoir animals, were characterized by using PCR techniques. Based on the results obtained, a trial has been done to depict the geographical distribution of each species of the genus Leishmania in Ecuador. Furthermore, in order to get more sensitive and specific method applicable for diagnosis under field conditions, PCR using different primers was compared with traditionally-used techniques, such as smears, cultures, histopathological specimens and others. Clinico-epidemiological surveys were carried out in several leishmaniasis-endemic areas located at different altitudes of Ecuador, employing differential diagnosis between cutaneous leishmaniasis and other skin diseases found in the rural areas.