Visceral Leishmaniasis in Bolivia: Current Status

Juan Sergio Mollinedo,Wilson Julio Gironda,Pavel Mollinedo,Oscar D. Salomón,Zoraida Aymara Mollinedo,René Edmundo Mollinedo

doi:10.1590/0037-8682-0421-2019

Abstract

INTRODUCTION In Bolivia, before 1982 there were no records of visceral leishmaniasis (VL) cases that would allow us to review and describe the temporospatial occurrence of VL by ecoregions in provinces and departments of Bolivia to evaluate its impact on public health, risk of outbreaks, or dispersion. METHODS This update on VL in Bolivia is based on research, reviews, and retrospective literature analyses of online data and libraries and institutional reports, from 1939 to the present. RESULTS In Bolivia, 56 cases of VL have been reported. Until 2014, only three endemic departments had been identified (La Paz, Santa Cruz, and Tarija). Since then, further cases have been recorded in Pando, Cochabamba, and Beni, and in Chuquisaca in 2015. In Yungas, a VL focus was confirmed by isolating and comparing parasites from human and dog cases, and from the Lu. longipalpis vector. VL cases from seven departments, involving 12 different ecoregions were located within the Amazon and Plata basins.CONCLUSIONS We confirmed that dogs are its primary reservoir, and Lutzomyia longipalpis is its main vector (currently dispersed in six departments). The primary vectors in areas where Lutzomyia longipalpis is absent are Migonemyia migonei and Lutzomyia cruzi.

Highlights

In Bolivia, before 1982 there were no records of visceral leishmaniasis (VL) cases that would allow us to review and describe the temporospatial occurrence of VL by ecoregions in provinces and departments of Bolivia to evaluate its impact on public health, risk of outbreaks, or dispersion
One hundred and eighteen years after the discovery of the first VL case in South America, this disease is currently one of the most neglected, and mainly affects disadvantaged human populations, such as those living in developing countries with poor sanitary conditions, and populations involved in anthropic environmental transformations in subtropical and tropical areas
In Bolivia, there is a significant presence of dogs infected with L. infantum[24], high densities of the main vector Lu. longipalpis[2,17] and other potential vectors (Lu. cruzi and Mg. migonei), in addition to a number of homogeneous ecological areas shared with neighboring countries with well known established VL foci, including Mato Grosso do Sul, Brazil[27,28] and Salta, Argentina[16,22,29]

Summary

Introduction

In Bolivia, before 1982 there were no records of visceral leishmaniasis (VL) cases that would allow us to review and describe the temporospatial occurrence of VL by ecoregions in provinces and departments of Bolivia to evaluate its impact on public health, risk of outbreaks, or dispersion. Conclusions: We confirmed that dogs are its primary reservoir, and Lutzomyia longipalpis is its main vector (currently dispersed in six departments). Official attention to neglected tropical diseases (NTD) in Bolivia, including leishmaniasis, has been limited in focus due to the misconception of "highland country" (Andean country); Authorities, Visceral leishmaniasis (VL) researchers, and health care professionals need to better understand the vulnerability of the native population, which inhabits an endemic tropical area that covers 60% of the nation’s territory. Our purpose is to contribute evidence to broaden public awareness of the population’s exposure to Visceral leishmaniasis in Bolivia[1]

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