Cutaneous leishmaniasis in south-eastern Paraguay: a study of an endemic area at Limoy

An epidemiological study was performed on leishmaniasis in a newly established community in south-eastern Paraguay. 149 persons, of 172 inhabitants, were thoroughly examined by clinical, parasitological and immunological (leishmanin skin test) examinations. 88 of those examined (59%) were clinically positive for dermal and nasal (mucosal) lesions or dermal scars, while 74 (50%) were positive by the leishmanin test. Of the 88 persons, 66 (75%) were positive for both leishmanial (dermal and nasal) signs and skin test; these subjects were therefore considered to be leishmaniasis patients. Most of the patients (60%) had a single dermal lesion. Among the 66 leishmaniasis patients, serious mucosal (nasal septum) lesions were observed in the 41 subjects: 2 had destruction of the septum, 8 had ulceration and 31 had erythema. In this community the persons with dermal and/or nasal problems had been treated with meglumine antimonate (Glucantime), without any precise diagnosis having been made by parasitological or immunological examination. The socio-economical and socio-medical points of view aspects are discussed.