EPIDEMIOLOGY OF CUTANEOUS LEISHMANIASIS IN COLOMBIA - ENVIRONMENTAL AND BEHAVIORAL RISK-FACTORS FOR INFECTION, CLINICAL MANIFESTATIONS, ANDPATHOGENICITY

Through a longitudinal, active surveillance for Leishmania (Viannia) b raziliensis and Leishmania (Viannia) panamensis infection and lesions on the Pacific Coast of Colombia, risk factors for infection (leishman in skin test conversion), leishmanial lesions, and pathogenicity were examined. Risk factor information was obtained prior to and independen tly of case ascertainment. Similar factors were associated with acquis ition of infection and of leishmaniasis, including male sex, age >10 y ears, and farming occupation. The behaviors of entering the forest aft er sunset, hunting, and lumbering were most strongly associated with L eishmania infection independently of age, sex, and farming occupation. Environmental conditions associated with infection, including tall tr ees near the home, home located >15 m from the nearest neighbor, and f loor and roof made of open material, were less strong predictors of ri sk. Pathogenicity, the risk of lesion given a new infection, was reduc ed in those >30 years of age and those entering the forest frequently.