Cutaneous leishmaniasis in Tupí-Mondé amerindians from the Brazilian Amazonia

This paper reports the results of a cross-sectional survey aimed at characterizing the epidemiology of American cutaneous leihsmaniasis (ACL) in 3 Tupí-Mondé-speaking Amerindian groups from the Brazilian Amazon region. Data include results of Montenegro skin tests (n=550), serology (n=223), and physical examinations (n=676). Rates of skin test positivity were higher for males and differed between the groups (Gavião 43.0%, Suruí 52.8%, Zoró 68.1%), with a trend toward increase with age. Strong associations were also detected for the presence of suggestive ACL scars, on the one hand, and age, sex, and tribal affiliation, on the other. Although 14.7% of the subjects showed typical scars of past ACL disease, only 3 cases of active primary leishmanial ulcers were observed. The results did not indicate any clear association between seropositivity and positivity to the Montenegro intradermal test or presence of scars. The authors discuss the epidemiology of ACL in the Tupí-Mondé in the light of their ecology and recent history.