Studies on leishmaniasis and its transmission in Central and South Americas

为了了解新大陆的利什曼病，特别是厄瓜多尔的利什曼病，从多学科的角度进行了深入研究，包括用不同类型的药物进行化疗试验。为此目的，在本研究项目期间，几乎所有疑似利什曼病流行地区都由流行病学家、寄生虫学家、皮肤病学家、免疫学家、分子生物学家和媒介昆虫学家等多学科专家进行了彻底调查。除了病原体和媒介外，还揭示了许多临床流行病学特征：亚马逊利什曼原虫、墨西哥利什曼原虫、大样利什曼原虫、巴西利什曼原虫、古yanensis、巴拿马利什曼原虫、赤道利什曼原虫等利什曼原虫和ayacuchenlutzomyia、Lu。gomezi,陆。trapidoi,陆。哈特马尼像苍蝇一样。本研究收集1998 - 2000年全国流行病学和临床资料，并对皮肤利什曼病患者进行诊断和治疗。采用PCR技术对从患者、病媒和宿主动物中分离的利什曼原虫进行鉴定。根据所获得的结果，已进行了一次试验，以描绘厄瓜多尔利什曼原虫属每个物种的地理分布。此外，为了获得更敏感和特异的方法，适用于野外条件下的诊断，将不同引物的PCR与传统的方法，如涂片、培养、组织病理标本等进行比较。在厄瓜多尔不同海拔地区的几个利什曼病流行区进行了临床流行病学调查，对皮肤利什曼病和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.