298:. In 1827, before the Great Drought, Rabello cites reports from missionaries in the Amazon region seeing people with skin lesions that fit the description of the disease. In 1909, the newly graduated medical student at the time of the drought, Studart, reported a skin condition that has the potential of being leishmaniasis. It is also possible that, in combination with a lack of general information and knowledge of the disease to the public plus the mass deaths and burials that occurred from 1877 to 1879, that people were dying of leishmaniasis without knowing the true cause of their death.
302:
of half a million who died, crediting the cause of death for the remaining 70 thousand to "various diseases". Because not many primary sources were preserved, as stated candidly by drought writer Joao Eudes da Costa, it is very difficult to find sources during this time that directly point to the presence of leishmaniasis during the Great
Drought. Regardless, there is evidence of the disease before and after the drought, so it is highly likely that it was present and exacerbated during the Grande Seca.
37:
319:
behaviors are what pose major risks to humans as well as manmade risks like migration, deforestation, urbanization, climate change, and immunosuppression. Environmental conditions such as high humidity, higher temperatures, and deforestation add an increased risk because they cause increased reproduction and geographic distribution of the parasite-carrying sandflies and, consequently, of the infectious disease.
194:. About 80 percent of patients with cutaneous leishmaniasis respond successfully to the drug, but for disseminated leishmaniasis only 40 percent are successfully cured of the disease after one treatment, so in these cases the patients are treated for longer periods of standard therapy. Some patients undergo multiple treatments that last 60 days each time. When resistance is suspected an alternative treatment is
327:; this estimate is like an underestimate since it is difficult to report the number of cases in rural areas. Those suffering from the disease are living the same lifestyle and with the same vulnerabilities as the Brazilians with leishmaniasis directly after the Great Drought. The diseased in modern-day Ceará are commonly poor teenagers aged 15 to 19, working in agriculture, and are male.
301:
On
December 10, 1879, Studart reported seeing more than a thousand people die in one day. It is very possible that a portion of those could have died because of leishmaniasis. An unknown disease is also mentioned by Herbert Huntington Smith, to which he attributes the death of 430 thousand people out
260:
vector, the sandfly, is dependent on environmental conditions. Environmental conditions such as high humidity, higher temperatures, deforestation add an increased risk because it causes increased reproduction of the parasite carrying sandflies. These environmental changes put more people at risk with
341:
or "shanty towns" as the residents have increased risks and live in "overcrowded conditions with inadequate housing and sanitary facilities" (Arias, J R et al.). In addition, domestic stray dogs are the "principal animal reservoir" for the disease, which makes urban areas like the favelas at an even
333:
is usually referred to as a rural problem since the increased risk factors are common in rural areas of Ceará. The people of the
Northeast are still the most vulnerable. The drivers of the disease target those that live in crowded and underdeveloped housing near rubbish, sewage, and polluted water
293:
Direct and primary evidence of leishmaniasis' existence is extremely minimal as the disease was not known to the
Northeast and therefore was not identified and labeled until 1895 in Bahia. However, even though there was a lack of name-calling evidence, there are still reports of a disease that
318:
Visceral leishmaniasis, which is the most common in the
Northeast region of Brazil, causes the infected to have fever, skin lesions, skin tumors, loss in weight, spleen and liver enlargement, and if left untreated, death. Environmental conditions, socio-economic status, demographic and human
314:
The environmental conditions and the socio-economic factors of the drought-stricken Ceará made the area perfect and the people vulnerable to the spread of leishmaniasis. The migrants and those that remained in Ceará were malnourished, immunocompromised, and suffered from poor or even lack of
281:
or leishmaniasis that has emerged in
Northeast Brazil. It is an infectious disease that is spread by a parasite in sandflies that use domestic dogs as hosts. The emergence of leishmaniasis in Brazil, specifically the Northeast state of Ceará, is theorized to date back to the
322:
Leishmaniasis has made its appearance in 1981 to 1985 in
Teresina; it reached epidemic levels in 1992 with a peak in 1994. These epidemics were preceded by long and severe droughts in the region. From 1986 to 2005, Ceará has had more than 49 thousand new cases of
289:
The Grande Seca of 1877 to 1878 led to the mass migration of approximately 55 thousand
Brazilians from Ceará to the Amazon for employment on rubber plantations. The disease is easily and mostly transmitted on plantations in which the people live and work.
578:
Rougeron, Virginie; De Meeûs, Thierry; Hide, Mallorie; Waleckx, Etienne; Bermudez, Herman; Arevalo, Jorge; Llanos-Cuentas, Alejandro; Dujardin, Jean-Claude; De
Doncker, Simone; Le Ray, Dominique; Ayala, Francisco J.; Bañuls, Anne-Laure (23 June 2009).
315:
sanitation and housing. In addition to the fact that the state is a semiarid region, the condition of Ceará after the Grande Seca made it a breeding ground for leishmaniasis infections that resulted in the disease being cemented into the state.
334:
sources. Though the disease targets Ceará the hardest because of its conditions, migration has spread the disease to larger cities, as more droughts, famine, and lack of usable farmland have led to large migrations from rural areas to cities.
1248:
Alcazar, Wilmer; LĂłpez, Adrian Silva; Alakurtti, Sami; Tuononen, Maija-Liisa; Yli-Kauhaluoma, Jari; Ponte-Sucre, Alicia (November 2014). "Betulin derivatives impair
Leishmania braziliensis viability and host–parasite interaction".
913:
Rondon, F.C.M.; Bevilaqua, C.M.L.; Franke, C.R.; Barros, R.S.; Oliveira, F.R.; Alcântara, A.C.; Diniz, A.T. (August 2008). "Cross-sectional serological study of canine Leishmania infection in Fortaleza, Ceará state, Brazil".
818:
Schriefer, Albert; GuimarĂŁes, Luiz H.; Machado, Paulo R.L.; Lessa, Marcus; Lessa, HĂ©lio A.; Lago, Ednaldo; Ritt, Guilherme; GĂłes-Neto, AristĂłteles; Schriefer, Ana L.F.; Riley, Lee W.; Carvalho, Edgar M. (June 2009).
305:
After contracting and spreading the disease within the plantations, workers later left the Amazon and returned to the Northeast carrying the parasite and introducing the first cases of leishmaniasis to the state.
435:
Turetz, Meredith L.; Machado, Paulo R.; Ko, Albert I.; Alves, Fábio; Bittencourt, Achiléa; Almeida, Roque P.; Mobashery, Niloufar; Johnson, Jr., Warren D.; Carvalho, Edgar M. (15 December 2002).
521:
Peters, Nathan C.; Egen, Jackson G.; Secundino, Nagila; Debrabant, Alain; Kimblin, Nicola; Kamhawi, Shaden; Lawyer, Phillip; Fay, Michael P.; Germain, Ronald N.; Sacks, David (15 August 2008).
168:
Visceral leishmaniasis causes the infected to have a fever, skin lesions, skin tumors, loss in weight, spleen and liver enlargement, and if left untreated, death.
1356:
253:) are capable of sexual reproduction in the gut of the sandfly vector. More work is needed to establish a clear pattern of sexual reproduction in the genus.
967:
476:
Olliaro P, Guerin P, Gerstl S (2005). "Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980–2004".
1343:
640:"'Everything You Always Wanted to Know about Sex (but Were Afraid to Ask)' in Leishmania after Two Decades of Laboratory and Field Analyses"
1407:
1144:
337:
This massive influx of people creates a space for the disease to spread and infect easily. Leishmaniasis is found more commonly in
960:
221:
in the intermediate mammalian host to greatly increase population density. Such reproduction is often witnessed in mononuclear
1397:
1412:
1330:
1093:
1321:
365:
Infection Induces Dendritic Cell Activation, ISG15 Transcription, and the Generation of Protective Immune Responses"
36:
953:
638:
Rougeron, Virginie; De Meeûs, Thierry; Kako Ouraga, Sandrine; Hide, Mallorie; Bañuls, Anne-Laure (19 August 2010).
1361:
261:
the vector and cause a greater geographic distribution of the sandfly and, consequently, the infectious disease.
1402:
1079:
1024:
1283:
1113:
1203:
1068:
191:
111:
868:
Moreira, Juliano (1895). "Existe na Bahia o botĂŁo de Biskra" [Biskra button exists in Bahia].
523:"In vivo imaging reveals an essential role for neutrophils in Leishmaniasis transmitted by sand flies"
437:"Disseminated Leishmaniasis: A New and Emerging Form of Leishmaniasis Observed in Northeastern Brazil"
1217:
592:
534:
218:
245:
of the parasite. Recently, it has been hypothesized through two studies that certain members of the
1106:
1102:
1064:
983:
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31:
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671:
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503:
458:
394:
190:
In Brazil, currently, the most common treatment for humans to cure leishmaniasis is the drug
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1258:
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68:
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Proceedings of the National Academy of Sciences of the United States of America
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88:
58:
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causes oral and nasal lesions causing severe damage to the mucous membranes.
1160:
899:
605:
546:
222:
176:
157:
Within a few months of infection, an ulcer forms. After healing there is an
48:
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935:
854:
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564:
507:
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398:
777:
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498:
359:
Vargas-Inchaustegui, Diego A.; Xin, Lijun; Soong, Lynn (1 June 2008).
338:
1277:
453:
436:
821:"Geographic Clustering of Leishmaniasis in Northeastern Brazil1"
1281:
949:
813:
811:
809:
342:
greater risk because strays are common in these areas.
145:
species found in South America. It is associated with
744:"The Reemergence of Visceral Leishmaniasis in Brazil"
894:] (in Portuguese). Fundação Waldemar Alcântara.
1290:
1193:
1168:
1159:
1128:
1049:
1008:
999:
990:
430:
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426:
161:phase for three to twenty years. At this time, the
737:
735:
733:
731:
689:
687:
685:
581:"Extreme inbreeding in Leishmania braziliensis"
881:
879:
179:, liposomal and lipid complex preparations of
961:
8:
892:Climatology, epidemics and endemics in Ceará
789:
787:
888:Climatologia, epidemias e endemias do Ceará
1278:
1165:
1005:
996:
968:
954:
946:
700:Asian Pacific Journal of Tropical Medicine
20:
844:
767:
711:
696:"Worldwide risk factors in leishmaniasis"
665:
655:
614:
604:
554:
497:
452:
388:
802:. C. Scribner's Sons. pp. 398–435.
351:
198:, some times associated with liposomal
694:Oryan, A.; Akbari, M. (October 2016).
7:
1251:Bioorganic & Medicinal Chemistry
1145:Primary amoebic meningoencephalitis
886:Studart, Guilherme Studart (1997).
270:Historical introduction into Brazil
794:Smith, Herbert Huntington (1879).
441:The Journal of Infectious Diseases
237:) of the mammalian host, with the
14:
800:Brazil, the Amazons and the Coast
35:
1:
490:10.1016/S1473-3099(05)70296-6
928:10.1016/j.vetpar.2008.04.014
825:Emerging Infectious Diseases
748:Emerging Infectious Diseases
657:10.1371/journal.ppat.1001004
381:10.4049/jimmunol.180.11.7537
294:matches the descriptions of
286:of the 19th century Brazil.
1094:Mucocutaneous leishmaniasis
713:10.1016/j.apjtm.2016.06.021
1429:
1408:Protists described in 1911
742:Arias, Jorge (June 1996).
1263:10.1016/j.bmc.2014.08.023
369:The Journal of Immunology
117:
110:
32:Scientific classification
30:
23:
256:The reproduction of the
213:, like other species of
16:Species of Kinetoplastea
1336:Leishmania_braziliensis
1322:Leishmania braziliensis
1292:Leishmania braziliensis
1080:Cutaneous leishmaniasis
1025:African trypanosomiasis
916:Veterinary Parasitology
872:(in Portuguese): 254–8.
796:"Ceará and the Drought"
606:10.1073/pnas.0904420106
547:10.1126/science.1159194
363:Leishmania braziliensis
331:Leishmania braziliensis
325:Leishmania braziliensis
296:Leishmania braziliensis
275:Leishmania braziliensis
258:Leishmania braziliensis
211:Leishmania braziliensis
136:Leishmania braziliensis
121:Leishmania braziliensis
25:Leishmania braziliensis
1114:Visceral leishmaniasis
837:10.3201/eid1506.080406
760:10.3201/eid0202.960213
1204:Trichomonas vaginalis
413:"About Leishmaniasis"
192:meglumine antimoniate
1218:Dientamoeba fragilis
419:. 12 September 2019.
219:asexual reproduction
103:L. braziliensis
1398:Parasitic excavates
597:2009PNAS..10610224R
591:(25): 10224–10229.
539:2008Sci...321..970P
206:Sexual reproduction
1413:Euglenozoa species
153:Signs and symptoms
1385:
1384:
1370:Open Tree of Life
1284:Taxon identifiers
1257:(21): 6220–6226.
1238:
1237:
1234:
1233:
1155:
1154:
1139:Naegleria fowleri
1124:
1123:
977:Parasitic disease
533:(5891): 970–974.
478:Lancet Infect Dis
447:(12): 1829–1834.
375:(11): 7537–7545.
241:being the target
132:
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1326:
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1110:
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1061:Leishmania major
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277:is a species of
243:white blood cell
123:
40:
39:
21:
1428:
1427:
1423:
1422:
1421:
1419:
1418:
1417:
1403:Trypanosomatida
1388:
1387:
1386:
1381:
1373:
1368:
1360:
1355:
1347:
1342:
1334:
1329:
1320:
1319:
1314:
1305:
1304:
1299:
1286:
1247:
1244:
1242:Further reading
1239:
1230:
1224:Dientamoebiasis
1189:
1179:Giardia lamblia
1151:
1120:
1100:
1088:L. braziliensis
1058:
1045:
1010:Trypanosomiasis
1001:Trypanosomatida
986:
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912:
911:
907:
885:
884:
877:
867:
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862:
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807:
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785:
741:
740:
729:
706:(10): 925–932.
693:
692:
683:
650:(8): e1001004.
637:
636:
632:
577:
576:
572:
520:
519:
515:
484:(12): 763–774.
475:
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470:
434:
433:
424:
411:
410:
406:
358:
357:
353:
348:
312:
272:
267:
251:L. braziliensis
227:dendritic cells
208:
174:
155:
128:
125:
119:
106:
79:Trypanosomatida
34:
17:
12:
11:
5:
1426:
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1416:
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1410:
1405:
1400:
1390:
1389:
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1236:
1235:
1232:
1231:
1229:
1228:
1227:
1226:
1214:
1213:
1212:
1210:Trichomoniasis
1199:
1197:
1195:Trichomonadida
1191:
1190:
1188:
1187:
1174:
1172:
1163:
1157:
1156:
1153:
1152:
1150:
1149:
1148:
1147:
1134:
1132:
1130:Schizopyrenida
1126:
1125:
1122:
1121:
1119:
1118:
1117:
1116:
1098:
1097:
1096:
1084:
1083:
1082:
1055:
1053:
1047:
1046:
1044:
1043:
1042:
1041:
1039:Chagas disease
1029:
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1027:
1014:
1012:
1003:
994:
988:
987:
975:
973:
972:
965:
958:
950:
942:
941:
922:(1–2): 24–31.
905:
875:
860:
831:(6): 871–876.
805:
783:
754:(2): 145–146.
727:
681:
644:PLOS Pathogens
630:
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454:10.1086/345772
422:
404:
350:
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187:can be given.
181:amphotericin B
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1185:
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1170:Diplomonadida
1167:
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1074:
1070:
1069:L. aethiopica
1066:
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1057:
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1054:
1052:
1051:Leishmaniasis
1048:
1040:
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1026:
1023:
1022:
1021:
1020:
1016:
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992:Discicristata
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870:Gaz MĂ©d Bahia
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284:Great Drought
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147:leishmaniasis
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112:Binomial name
109:
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69:Kinetoplastea
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29:
26:
22:
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588:
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127:Vianna, 1911
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1316:Wikispecies
1103:L. donovani
1065:L. mexicana
499:10144/66036
239:macrophages
235:neutrophils
196:miltefosine
185:paromomycin
1392:Categories
1184:Giardiasis
1073:L. tropica
979:caused by
346:References
279:Leishmania
247:Leishmania
223:phagocytes
217:, rely on
215:Leishmania
142:Leishmania
90:Leishmania
59:Euglenozoa
1161:Trichozoa
1019:T. brucei
231:monocytes
177:Pentostam
172:Treatment
97:Species:
49:Eukaryota
1307:Q2493699
1301:Wikidata
1271:25240731
1107:infantum
1033:T. cruzi
984:protozoa
981:Excavata
936:18565676
900:44549307
855:19523284
722:27794384
676:20808896
625:19497885
565:18703742
508:16310148
463:12447770
399:18490754
163:parasite
55:Phylum:
45:Domain:
1349:9369332
846:2727348
778:8903218
769:2639817
667:2924324
616:2700931
593:Bibcode
556:2606057
535:Bibcode
527:Science
390:2641013
339:favelas
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183:, or
139:is a
1362:5660
1357:NCBI
1344:GBIF
1267:PMID
932:PMID
896:OCLC
851:PMID
774:PMID
718:PMID
672:PMID
621:PMID
561:PMID
504:PMID
459:PMID
417:DNDi
395:PMID
1331:AFD
1259:doi
924:doi
920:155
841:PMC
833:doi
764:PMC
756:doi
708:doi
662:PMC
652:doi
611:PMC
601:doi
589:106
551:PMC
543:doi
531:321
494:hdl
486:doi
449:doi
445:186
385:PMC
377:doi
373:180
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