Estudo Entomológico na principal área endêmica de Leishmaniose Tegumentar Americana do estado da Bahia,

Abstract

Leishmaniasis is an infectious disease of significant clinical and epidemiological diversity, with a wide geographical distribution in the world. Bahia is one of the most affected Brazilian states for American Tegumentary Leishmaniasis (ATL). We present this doctoral thesis in three articles that aim to describe the results of an entomological study carried out in the main endemic area of ATL in the state of Bahia. The Article 1 – “Diversity and natural infection of phlebotomine sand flies (Diptera, Psychodidae) in an endemic area of American Tegumentary Leishmaniasis in southern Bahia, Brazil.” – consists of a prospective study of the phlebotomine fauna found in the homes of index ATL-cases, recently diagnosed in a region with high endemicity, in southern Bahia. The Article 2 – “Invertebrate-Derived DNA (iDNA) to identify sand flies’ bloodmeal: A Molecular Approach to Identifying Hosts in Blood-Feeding Vectors.” – is a continuation of the results of the Entomological Survey presented in Article 1, where we used the metabarcoding methodology to identify food sources of preferentially engorged sand flies found in these residences of newly diagnosed cases of ATL. The Article 3 – “Empowering people with Cutaneous Leishmaniasis (ECLIPSE): The Brazilian experience with in-formation and knowledge exchange training courses to primary care and educational professionals from endemic areas in southern Bahia, Brazil.” – brings the experience of the ECLIPSE/BRASIL project team in building the In-formation and knowledge exchange training courses about Cutaneous Leishmaniasis which, from an intersectoral perspective, included professionals of health, education and the environment. Our findings suggest that in areas affected by outbreaks of ATL in southern Bahia, there are high proportions of infected sand flies involving a variety of proven and putative vector species. Analyzing iDNA through metabarcoding paired with Next Generation Sequence to determine the food sources of sand flies has allowed us to accurately sample a large diversity of vertebrate species. The experiences gained through the ECLIPSE project showed that the effectiveness of our health interventions presupposes that the exchanges and relationships that supported community engagement were reciprocal, equal and mutually beneficial for the communities and the research teams.