RISK-FACTORS FOR ONSET OF CUTANEOUS AND MUCOCUTANEOUS LEISHMANIASIS IN BOLIVIA

A survival analysis was performed on data from an endemic area of Boli via where two populations, natives and highland migrants, were living, to investigate risk factors for onset of cutaneous leishmaniasis (CL) and its mucosal form (MCL). In a first data set (703 subjects with 24 2 CL patients), significant risk factors for CL were gender, native/mi grant status, activity, and home-forest distance. The instantaneous ri sk of CL increased until adolescence in both populations, and rapidly decreased thereafter. This risk was 3-10 times higher in migrants than in natives until 20 years of age, and became similar thereafter. Envi ronmental and behavioral factors did not seem sufficient to explain th is contrast between the two populations, and this evolution with age m ay suggest differences in the mechanisms involved in the development o f individual protection during childhood. In a second data set (446 CL patients with 34 mucosal forms) the native/migrant status was the mai n factor associated with the onset of mucosal form.