Filarial disease in the Brazilian Amazon and emerging opportunities for treatment and control.

Autor:	Portela CS; Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil.; Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil., Mendes de Araújo CP; Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil.; Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil., Moura Sousa P; Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil.; Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil., Gomes Simão CL; Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil.; Programa de Mestrado em Condições de Vida e Situações de Saúde na Amazônia, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil., Silva de Oliveira JC; Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil.; Programa de Doutorado em Saúde Pública na Amazônia, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Manaus, Amazonas, Brazil., Crainey JL; Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil.
Jazyk:	angličtina
Zdroj:	Current research in parasitology & vector-borne diseases [Curr Res Parasitol Vector Borne Dis] 2023 Dec 23; Vol. 5, pp. 100168. Date of Electronic Publication: 2023 Dec 23 (Print Publication: 2024).
DOI:	10.1016/j.crpvbd.2023.100168
Abstrakt:	Following the successful eradication of Wuchereria bancrofti , there are now just three species of conventional microfilaremic human filarial parasites endemic to the Brazilian Amazon region: Mansonella ozzardi , Mansonella perstans and Onchocerca volvulus. The zoonotic filarial parasite Dirofilaria immitis is also found in the Amazon region as are several sylvatic filarial parasites, some of which have been recorded causing zoonoses and some of which have never been recorded outside the region. Onchocerca volvulus is only found in the Amazonia onchocerciasis focus in the Brazilian state of Roraima where it affects the people of the Yanomami tribe living around the densely forested Venezuela border region. Mansonella ozzardi is by far the most common filarial parasite in Brazil and has a broad but patchy distribution throughout the western Amazon region. Recorded in the Brazilian states of Acre, Roraima, Matto Grosso, and within almost every municipality of Amazonas state, it is believed that pollution of the urban stream and river systems prevents the development of the simuliid vectors of M. ozzardi and explains the parasite's reduced distribution within urban areas and an absence of recent reports from the state capital Manaus. Decades of WHO-led periodic ivermectin treatment of Yanomami tribe's people have resulted in the partial suppression of O. volvulus transmission in this focus and has also probably affected the transmission of M. ozzardi in the region. Mansonella perstans , O. volvulus and very probably M. ozzardi infections can all be treated and most likely cured with a 4-6-week treatment course of doxycycline. The Brazilian Ministry of Health does not, however, presently recommend any treatment for mansonellosis infections and thus parasitic infections outside the Amazonia focus are typically left untreated. While the long treatment courses required for doxycycline-based mansonellosis therapies preclude their use in control programmes, new fast-acting filarial drug treatments are likely to soon become available for the treatment of both onchocerciasis and mansonellosis in the Amazon region. Filarial disease management in the Brazilian Amazon is thus likely to become dramatically more viable at a time when the public health importance of these diseases is increasingly being recognized. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Authors.)
Databáze:	MEDLINE
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