Reviewing the trajectory of American visceral leishmaniasis in Brazilian Amazon: from Evandro Chagas to the current days

Abstract

This study reviewed the trajectory of American visceral leishmaniasis (AVL) in Brazilian Amazon, since that time of Dr. Evandro Chagas, who founded the Instituto de Pathologia Experimental do Norte, in 1936, which following the tragic death of its patron, in 1940, was renamed Instituto Evandro Chagas till the actual days, aiming the best visibility on the medical-scientific legacy left by that distinguished person, as well as trying to describe the ways that made AVL leaves the epidemiologic anonymity five decades ago for arising as one of greatest parasitic disease at the beginning of this century. In this context, Chagas et al have left three marked contributions: i) described a new parasitic species responsible for AVL, Leishmania chagasi; ii) incriminated the phlebotomine species Phlebotomus longipalpis as the likely vector of AVL; and iii) postulated that the human disease origin should be in any forest animal. The AVL situation in Brazilian Amazon has not changed in the following decades, however, in the early 1980s the disease resurfaced with a greater frequency in rural foci and in the suburban and urban areas of medium-size cities as Santarém, Pará State. In the last two decades, the expansive process increased due to the deforestation, socio-economic factor and unorganized occupation in the outskirts of cities, where the presence of Lutzomyia longipalpis in the peridomiciliar human area and the domestic dog highly susceptible to infection have facilitated its dissemination. Actually, AVL has already arrived in the Metropolitan Region of Belém (Cotijuba island), capital of Pará.