Epidemiology of cutaneous leishmaniasis in Colombia: a longitudinal study of the natural history, prevalence. and incidence of infection and clinical manifestations

Through a longitudinal, active surveillance for Leishmania (Viannia) braziliensis and Leish-mania (Viannia) panamensis infection and lesions on the Pacific Coast of Colombia, risk factors for infection (leishmanin skin test conversion), leishmaniallesions, and pathogenicity were exam-ined. Risk factor information was obtained prior to and independently of case ascertainment. Similar factors were associated with acquisition of infection and of leishmaniasis, including male sex, age> 10 years, and farming occupation. The behaviors of entering the forest after sunset, hunting, and lumbering were most strongly associated with Leishmania infection independently ofage, sex, and farming occupation. Environmental conditions associated with infection, includ-ing tall trees near the home, home located>15 m from the nearest neighbor, and floor and roof made of open material, were less strong predictors of risk. Pathogenicity, the risk of lesion given a new infection, was reduced in those>30 years of age and those entering the forest frequently. The leishmaniases, a group of diseases produced by hemo-flagellate protozoa, genus Leishmania, are distributed world-wide [1]. Leishmania (Viannia) braziliensis and Leishmania (Viannia) panamensis produce chronic mucosal and cutane