LEISHMANIASIS IN ECUADOR .1. INCIDENCE IN THE PACIFIC FOOTHILLS

A clinico-epidemiologic survey on cutaneous leishmaniasis, due to Leis hmania panamensis, was carried out on 961 persons in two study areas o f the Pacific coast of Ecuador, to estimate the prevalence and the inc idence of the disease. In the preandean hills, at Paraiso Escondido, t he prevalence of active lesions was 4.8 %; in the hills of the coastal cordillera, at La Tablada, it was 3.6 %. The incidence of new cases i n 1991 was high : 147 parts per thousand in the first village, and 106 parts per thousand in the second. These data are far higher than the Health Ministry statistics. The cumulated prevalence, obtained by addi tion of the scars and active lesions of leishmaniasis, was as high as 66 % at Paraiso Escondido, and 47 % at La Tablada. Most of the patient s (62 %) had only one ulcer or scar. Most of the people are contaminat ed during the first five years they live in these endemic areas. Never theless, the incidence remains high in all the age groups, because lar ge numbers of migrants coming from non endemic regions are continuousl y settling in these colonization areas. Interviews have shown that the contaminations had occurred in the dry season, between July and Decem ber. These findings were confirmed by passive case detection at the Ho spital A. Egas of Santo Domingo which covered the region. Contaminatio n of young children and position of the lesions on the face suggested a domiciliary transmission, like in Panama and on the Pacific coast of Colombia.