Geographic distribution and epidemiological features of American tegumentary leishmaniasis in old rural settlements in Parana State, Southern Brazil

This study analyzes the epidemiology of American tegumentary leishmaniasis in the municipalities of the Central North, Central West, and Northwest mesoregions of Parana State, Brazil. Diagnosis of American tegumentary leishmaniasis cases was performed at the State University in Maringa from 198 7 to 2004. According to the probable site of infection, cases were classified as autochthonous (infection inside the household domain) or allochthonous (outside the household domain). Municipalities with the most cases were Maringa (458), Doutor Camargo (126), Sao Jorge do Ivai (121), Terra Boa (114), Cianorte (98), and Colorado (95). Of the total of 1,938 cases, 66.9% were male. Among the 667 autochthonous cases, similar numbers of men and women were infected, with cases in minors as young as five years of age, with the latter not occurring in the 794 allochthonous cases. Conditions favoring American tegumentary leishmaniasis were created in the processes involved in occupying the rural areas of these mesoregions, particularly in the agricultural settlement model and the crisis in coffee monoculture.