Abstract The occurrence of cutaneous leishmaniasis (CL) in the municipalities of Jaboti, Japira, Pinhalão, and Tomazina in the North Pioneer of the State of Paraná, where this disease is endemic, prompted the investigation of sandfly fauna, their population changes throughout the year, and their behavior in and around human accommodation. In these municipalities, the collection of sandflies was conducted using Falcão traps from 7 pm to 6 am once a month. 32,994 sandflies, 18,442 males and 14,552 females, were collected and represented by the species Brumptomyia brumpti, Brumptomyia cunhai, Evandromyia correalimai, Evandromyia cortelezzii, Expapillata firmatoi, Micropygomyia ferreirana, Migonemyia migonei, Nyssomyia neivai, Nyssomyia whitmani, Pintomyia fischeri, Pintomyia monticola, Pintomyia pessoai, and Psathyromyia bigeniculata. Ny. neivai (SISA = 0.9808) predominated in Japira (46.9%), Pinhalão (53.1%), and Tomazina (38.9%), while Ny. whitmani (SISA = 0.9423) predominated in Jaboti (53.8%). Most sandflies were captured in domestic animal shelters, with a peak in September. The high number of sandflies collected in domestic animal shelters, species richness, and presence of species involved in the epidemiology of CL reveal the need for permanent entomological surveillance in the municipalities mentioned. The use of phlebotomine control measures in these municipalities should be considered in conjunction with the anthropogenic actions that have resulted in changes to sandfly fauna and behavior.

BACKGROUND Cutaneous leishmaniasis (CL) is endemic in the state of Paraná, Brazil. OBJECTIVE This study aimed at analysing the influence of the remaining native vegetation on the prevalence of CL in Paraná. METHODS Global testing was used for spatial autocorrelation along with simultaneous autoregressive model (SAR). The regression was based on the CL coefficient (cases/100,000 inhabitants) as a function of the percentage of natural vegetation cover, altitude, total number of cases, and spatial density (SD) per km2; the location data of the Paraná state municipalities and the detection coefficient (DC) (cases/100,000 inhabitants) of autochthonous cases of CL were obtained from the SINAN in 2012 and 2016. Data on the remaining forests were collected from the Fundação SOS Mata Atlântica and Instituto Nacional de Pesquisas Espaciais. FINDINGS The spatial regression of DC revealed statistical significance for SD (Z = 24.1359, p < 0.05, 2012-2013; Z = 24.0817, p < 0.05, 2013-2014; Z = 33.4824, p < 0.05, 2014-2015; and Z = 27.1515, p < 0.05, 2015-2016. CONCLUSIONS CL cases are reported in areas with native vegetation, such as in riparian forests. However, vegetation is not the only variable that influences the incidence of CL.

ABSTRACT The aim of this study was to better understand the dynamics of Leishmania sand flies and reservoirs in São Domingos ranch, Arapongas municipality, Paraná State, an anthropic environment in an endemic area of cutaneous leishmaniasis (CL). Sand flies were collected in wild animal burrows, residences and in the forest, with Falcão light trap (FA), Shannon trap (SH) and quadrangular pyramidal trap (QP). The search for Leishmania was made on sand flies, biological samples of wild rodents and dogs using PCR and culture; while parasite direct search (DS) was carried out on animal skin lesions; infection of gold hamsters; and indirect immunofluorescence (IIF) test in dog blood samples. Eighty eight (88) sand flies were collected with FA traps and 526 sand flies using the SH trap, with a predominance of Pintomyia fischeri. Six hundred and one (601) specimens of Brumptomyia brumpti were collected in armadillo burrows, with the QP trap. Seventeen (17) wild rodents were captured, six of them had skin lesions with characteristics of Leishmania infection. Even though no positive test was found for Leishmania, epidemiological surveillance should be maintained, remembering that the human buildings are situated only 50 m from the forest. Considering the species of wild animals and sandflies found in São Domingos, the negative test found do not exclude the existence of the Leishmania transmission cycle in this preservation area.

ABSTRACT The genetic study of sandfly populations needs to be further explored given the importance of these insects for public health. Were sequenced the NDH4 mitochondrial gene from populations of Nyssomyia neivai from Doutor Camargo, Lobato, Japira, and Porto Rico, municipalities in the State of Paraná, Brazil, to understand the genetic structure and gene flow. Eighty specimens of Ny. Neivai were sequenced, 20 from each municipality, and 269 base pairs were obtained. A total of 27 haplotypes and 28 polymorphic sites were found, along with a haplotypic diversity of 0.80696 and a nucleotide diversity of 0.00567. Haplotype H5, with 33 specimens, was the most common among the four populations. Only haplotypes H5 and H7 were present in all four populations. The population from Doutor Camargo showed the highest genetic diversity, and only this population shared haplotypes with those from the other municipalities. The highest number of haplotypes was sheared with Lobato which also had the highest number of unique haplotypes. This probably occurred because of constant anthropic changes that happened in the environment during the first half of the twentieth century, mainly after 1998. There was no significant correlation between genetic and geographical distances regarding these populations. However, the highest genetic and geographical distances, and the lowest gene flow were observed between Japira and Porto Rico. Geographical distance is a possible barrier between these municipalities through the blocking of haplotype sharing.

ABSTRACT The authors report a case of disseminated cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis, in a 55 years old patient with 1,119 lesions distributed throughout the body. The patient resides in Sabáudia municipality, North of Paraná State, Southern Brazil, where there was no previous report of this form of leishmaniasis. Treatment with meglumine antimoniate was successful, although the diagnosis was made only five months later.

Resumo A febre maculosa brasileira (FMB) é uma zoonose fatal devido às dificuldades para diagnosticá-la e tratá-la precocemente. A ocorrência de casos de FMB no Estado do Paraná suscitou a investigação de áreas de risco desta rickettsiose nos municípios de Japira, Jaboti, Pinhalão e Tomazina, na mesorregião norte pioneiro do Paraná. Para determinar as áreas de risco foram analisadas amostras de soro de 592 cães e 230 equídeos submetidos à reação de imunofluorescência indireta para Rickettsia rickettsii e R. parkeri. Além disto, foram construídos mapas de probabilidade de risco pela técnica de krigagem indicatriz. Das amostras testadas 5,3% (43/822) continham anticorpos para pelo menos uma das duas rickettsias testadas. Os equídeos apresentaram uma positividade de 7,8% (18/230) e os cães de 4,2% (25/592). A análise geoestatística mostrou que a soropositividade média é de 5 a 6%. Embora as soropositividade médias de cães e equídeos constatadas tenham sido menores do que as relatadas em áreas endêmicas do território brasileiro, os componentes bióticos (agente etiológico, vetor e reservatórios) e ambientais da epidemiologia da FMB se fazem presentes nos municípios referidos.

Abstract Brazilian spotted fever (BSF) is a fatal zoonosis because of the difficulties in its early diagnosis and treatment. Occurrences of BSF in the northeast of the state of Paraná prompted investigation of areas at risk of this rickettsiosis in the municipalities of Japira, Jaboti, Pinhalão and Tomazina. To determine the areas at risk, 592 serum samples from dogs and 230 from equids were analyzed by means of the indirect immunofluorescence assay (IFA) for Rickettsia rickettsii and R. parkeri . In addition, risk probability maps were drawn up using the kriging indicator technique. Among the samples tested, 5.3% (43/822) indicated presence of antibodies reactive to at least one of the two Rickettsia species tested: 7.8% of the equids (18/230) and 4.2% of the dogs (25/592) were positive. Geostatistical analysis showed that the average seropositivity rate was 5 to 6%. Although the average seropositivity rates observed among these dogs and equids were lower than those reported from endemic areas of Brazil, the biotic components (etiological agent, vector and reservoirs) and environmental aspects of BSF epidemiology were present in these municipalities.

Flebotomíneos transmitem os patógenos das leishmanioses. Foi avaliada a infecção natural de flebotomíneos por Leishmania (Viannia) em municípios do Estado do Paraná, sul do Brasil. Os flebotomíneos foram coletados com armadilhas de Falcão e Shannon. Após dissecação para pesquisa de flagelados no tubo digestório e identificação das espécies, as fêmeas de flebotomíneos foram submetidas a Multiplex Reação em Cadeia da Polimerase (multiplex PCR) para a detecção do fragmento do kDNA de Leishmania (Viannia) e do fragmento do gene IVS6 da cacofonia de flebotomíneos. A análise foi realizada em pools contendo sete a 12 tubos digestórios de fêmeas da mesma espécie. Um total de 510 fêmeas foram analisadas, incluindo nove Migonemyia migonei, 17 Pintomyia fischeri, 216 Nyssomyia neivai e 268 Nyssomyia whitmani. Embora nenhuma fêmea tenha sido encontrada naturalmente infectada com flagelados pela dissecação, o fragmento de DNA de Leishmania (Viannia) foi mostrado por multiplex PCR em uma amostra de Ny. neivai (0,46%) e três amostras de Ny. whitmani (1,12%). Conclui-se que Ny. neivai e Ny. whitmani são suscetíveis à infecção por Leishmania, e que multiplex PCR, devido à sua sensibilidade, especificidade e viabilidade, pode ser utilizada em estudos epidemiológicos para a detecção da infecção natural do inseto vetor.

Sandflies transmit pathogens of leishmaniasis. The natural infection of sandflies by Leishmania (Viannia) was assessed in municipalities, in the state of Paraná, in Southern Brazil. Sandflies were collected with Falcão and Shannon traps. After dissection in search of flagellates in digestive tubes and identification of the species, female sandflies were submitted to the Multiplex Polymerase Chain Reaction (multiplex PCR) for detection of the fragment of the kDNA of Leishmania (Viannia) and the fragment from the IVS6 cacophony gene region of the phlebotomine insects. The analysis was performed in pools containing seven to 12 guts from females of the same species. A total of 510 female sandflies were analyzed, including nine Migonemyia migonei, 17 Pintomyia fischeri, 216 Nyssomyia neivai, and 268 Nyssomyia whitmani. Although none of the females was found naturally infected by flagellates through dissection, the fragment of DNA from Leishmania (Viannia) was shown by multiplex PCR in one sample of Ny. neivai (0.46%) and three samples of Ny. whitmani (1.12%). It was concluded that Ny. neivai and Ny. whitmani are susceptible to Leishmania infection, and that multiplex PCR can be used in epidemiological studies to detect the natural infection of the sandfly vector, because of its sensitivity, specificity and feasibility.

RESUMORelatam-se, neste trabalho, a fauna e frequência de flebotomíneos em abrigos de animais domésticos, residências e outros ecótopos em áreas rurais do município de Bandeirantes, Estado do Paraná. Os flebotomíneos foram coletados em oito bairros rurais, com armadilhas de Falcão, duas vezes em cada bairro, das 20 às 6 horas, em 2008. No conjunto dos bairros coletaram-se 4.790 flebotomíneos, representados por dez espécies, com predomínio de Nyssomyia neivai e Nyssomyia whitmani. Os abrigos dos animais domésticos são os ecótopos onde há maior frequência desses insetos. As localidades onde as coletas foram realizadas têm características ambientais que permitem a persistência da transmissão de parasitos da leishmaniose tegumentar americana. Apesar da fauna e do comportamento das espécies de flebotomíneos serem semelhantes nas diversas localidades, o método de controle desses insetos deve ser ajustado às características ambientais de cada uma das mais diversas áreas endêmicas de leishmaniose tegumentar americana, nos municípios do Paraná.

SUMMARYThis study reports the fauna and frequency of sandflies in domestic animal shelters, residences and other ecotopes in rural areas of the municipality of Bandeirantes, Paraná State. Sandflies were collected twice in eight rural villages by using Falcon traps from 8pm to 6am in 2008. In these localities 4,790 sandflies were collected, which were represented by ten sandfly species, prevailing of Nyssomyia neivai and Nyssomyia whitmani species. It was observed that animal shelters are the domestic ecotopes where there is the greatest frequency of these insects. The localities where the collections were made had the environmental characteristics that allow the persistence of transmission of parasites from the American tegumentary leishmaniasis. Although the fauna and the behavior of sandflies species are similar in different localities, the method of controlling these insects should be adjusted to the environmental characteristics of each one of the most diverse endemic areas of American tegumentary leishmaniasis in the municipalities of Paraná State.

INTRODUÇÃO: Relatam-se os resultados de coletas de flebotomíneos na Fazenda Santa Juliana, município de Sarandi, Estado do Paraná, Brasil, onde se verificou a fauna, a sazonalidade e a frequência desses insetos nos ambientes florestal e extraflorestal. MÉTODOS: O trabalho foi realizado nesta fazenda pela inexistência de registro de casos de LTA e por diferir de outras áreas onde foram realizadas pesquisas com flebotomíneos, no Paraná, e pela limpeza e organização do peridomicílio. As coletas foram realizadas com sete armadilhas luminosas de Falcão, quinzenalmente das 22 às 2 horas, de novembro de 2007 a novembro de 2008. RESULTADOS: Foram capturados 4.506 flebotomíneos de 13 espécies, com predomínio de Nyssomyia whitmani (71,8%). Coletou-se maior proporção de flebotomíneos no ambiente florestal (52,6%) do que no extraflorestal (residências e chiqueiro) (47,4%), entretanto a proporção de Ny. whitmani coletada foi maior no ambiente extraflorestal (38,3%) do que no florestal (33,5%). A maioria dos flebotomíneos foi coletada nos meses mais quentes e com quedas regulares de chuva. CONCLUSÕES: Os resultados sugerem que a limpeza e a organização do peridomicílio podem auxiliar a reduzir a população de flebotomíneos no domicílio e no peridomicílio, recomendando-se que a construção de abrigos de animais guarde a distância aproximada de 100m das residências, para evitar a invasão desses insetos, uma vez que nesta fazenda existe uma área de mata de preservação, com a presença de animais silvestres e flebotomíneos, que mantem o ciclo enzoótico de Leishmania.

INTRODUCTION: Sandflies caught in Santa Juliana Farm in Sarandi, State of Paraná, Brazil, were assessed in terms of their fauna, seasonality, and frequency in the homes and in shelters of domestic animals around the homes, as well as in the nearby forest. METHODS: In Santa Juliana Farm, there are no records of cases of ACL, differing from other relatively clean and organized areas where surveys of sandflies have been conducted in Paraná. Samples were collected with Falcão light traps, fortnightly from 22:00 to 02:00 hours, from November 2007 to November 2008. RESULTS: A total of 4,506 sandflies were captured, representing 13 species, predominantly Nyssomyia whitmani (71.8%). More sandflies were collected in the forest (52.6%) than outside the forest (residences and pigsty) (47.4%). However, Ny. whitmani was collected in greater numbers outside (38.3%) than inside the forest (33.5%). Most sandflies were collected in the warmer months and during periods with regular rainfall. CONCLUSIONS: The results suggest that cleaning and organization around the houses could reduce sandfly population in peridomicile. Constructing shelters for animal at a distance of approximately 100m from domiciles is recommended to prevent the invasion of sandflies, as this farm has an area of preserved forest, with wild animals and sandflies present to maintain the enzootic cycle of Leishmania.

Relatam-se os resultados de coletas de flebotomíneos em seis lotes na zona rural no Município de Japurá, Estado do Paraná, Brasil, mostrando a presença de flebotomíneos no domicílio, peridomicílio e em matas residuais. As coletas de flebotomíneos foram realizadas com armadilhas de Falcão, das 20:00h às 03:00h. Nos lotes 195, 223, 236 e 527 foram feitas três coletas em diferentes períodos, de dezembro de 2007 a janeiro de 2009. Nos lotes 175 e 218, as coletas foram feitas de janeiro a dezembro de 2008. Coletaram-se 8.453 flebotomíneos, com uma média horária (MH) de 155,40 exemplares. Nyssomyia neivai foi a espécie dominante. A maioria dos flebotomíneos foi coletada em abrigos de animais domésticos (MH = 75,91) e nas matas ciliares (MH = 38,45), nos meses mais quentes e chuvosos, num ambiente peridomiciliar com acúmulo de matéria orgânicas e descarte inadequado de águas de uso doméstico, o que mostra a necessidade da limpeza regular do peridomicílio e do afastamento dos abrigos de animais domésticos das residências.

This study reports the results from sandfly captures at six sites in a rural area of Japurá, Paraná State, Brazil, showing the vector's presence indoors, outdoors, and in residual forest. Sandfly captures were performed with Falcão traps from 8:00 AM to 3:00 PM. At sites 195, 223, 236, and 527, three captures were performed at different times from December 2007 to January 2009. At sites 175 and 218, captures were performed from January to December 2008. 8,453 sandflies were captured, with an average of 155.40 specimens per hour. Nyssomyia neivai was the predominant species. Most sandflies were captured in domestic animal shelters (75.91 per hour) and in ciliary forest (38.45 per hour) during the hottest and rainiest months, in the outdoor environment with accumulation of organic matter and inadequate disposal of household wastewater. The study emphasizes the need for regular outdoor cleaning around households and building domestic animal shelters far from residences.

Relatam-se os resultados de coletas de flebotomíneos em seis lotes na zona rural no Município de Japurá, Estado do Paraná, Brasil, mostrando a presença de flebotomíneos no domicílio, peridomicílio e em matas residuais. As coletas de flebotomíneos foram realizadas com armadilhas de Falcão, das 20:00h às 03:00h. Nos lotes 195, 223, 236 e 527 foram feitas três coletas em diferentes períodos, de dezembro de 2007 a janeiro de 2009. Nos lotes 175 e 218, as coletas foram feitas de janeiro a dezembro de 2008. Coletaram-se 8.453 flebotomíneos, com uma média horária (MH) de 155,40 exemplares. Nyssomyia neivai foi a espécie dominante. A maioria dos flebotomíneos foi coletada em abrigos de animais domésticos (MH = 75,91) e nas matas ciliares (MH = 38,45), nos meses mais quentes e chuvosos, num ambiente peridomiciliar com acúmulo de matéria orgânicas e descarte inadequado de águas de uso doméstico, o que mostra a necessidade da limpeza regular do peridomicílio e do afastamento dos abrigos de animais domésticos das residências.

This study reports the results from sandfly captures at six sites in a rural area of Japurá, Paraná State, Brazil, showing the vector's presence indoors, outdoors, and in residual forest. Sandfly captures were performed with Falcão traps from 8:00 AM to 3:00 PM. At sites 195, 223, 236, and 527, three captures were performed at different times from December 2007 to January 2009. At sites 175 and 218, captures were performed from January to December 2008. 8,453 sandflies were captured, with an average of 155.40 specimens per hour. Nyssomyia neivai was the predominant species. Most sandflies were captured in domestic animal shelters (75.91 per hour) and in ciliary forest (38.45 per hour) during the hottest and rainiest months, in the outdoor environment with accumulation of organic matter and inadequate disposal of household wastewater. The study emphasizes the need for regular outdoor cleaning around households and building domestic animal shelters far from residences.

OBJECTIVE: The objective of this study was to analyze different primers that are commonly used in epidemiological studies for the detection of Leishmania DNA by PCR, and to compare them to the conventional direct parasite search for American cutaneous leishmaniasis (ACL) diagnosis. MATERIAL AND METHODS: Five pairs of primers, four of them derived from Leishmania kDNA sequences (MP3H-MP1L; B1-B2; LBF1-LBR1; 13A-13B), and one derived from the SL RNA (mini-exon) gene repeat (LU5A-LB3C), reported previously, were used. RESULTS: The MP3H-MP1L primers were the best at amplifying the DNA, detecting 2 fg of Leishmania spp. DNA. The 13A-13B primers presented the worst performance, detecting 512 x 10³ fg of DNA. CONCLUSION: The wide variation in the analytical sensitivity of the primers used in the PCR, and the significant differences from the conventional method of ACL diagnosis found in this study, emphasize the importance of standardizing the PCR technique, analyzing sensitivity, and selecting suitable oligonucleotide primers.

A endemicidade da leishmaniose tegumentar americana (LTA) no município de Cianorte, PR, a ocorrência de casos humanos com provável local de infecção na área urbana, a presença de mata nativa modificada de preservação permanente no perímetro urbano e o desconhecimento da fauna de flebotomíneos no município motivaram a realização deste trabalho. Procurou-se conhecer a fauna, frequência e sazonalidade de flebotomíneos no peridomicílio e na floresta, na área urbana desse município. Os flebotomíneos foram coletados com armadilhas de Falcão instaladas no peridomicílio e na floresta, no período de julho de 2005 a junho de 2006. Foram coletados 755 flebotomíneos, com predomínio da espécie Nyssomyia whitmani (Antunes & Coutinho) (84,0%), seguida da espécie Nyssomyia neivai (Pinto) (12,7%). O número de flebotomíneos coletados foi maior no peridomicílio (P = 0.0068). O pequeno número de flebotomíneos coletados, principalmente na floresta, pode estar relacionado às alterações ambientais realizadas no entorno do Parque Cinturão Verde que circunda a área urbana do município. Cinco espécies de flebotomíneos foram assinaladas na área urbana do município de Cianorte, com maior frequência no peridomicílio, especialmente nos meses de novembro a abril. Os resultados indicam a necessidade de se manterem as medidas que contribuem para evitar o contato do homem com os flebotomíneos, diminuindo o risco de transmissão de LTA.

The endemicity of American cutaneous leishmaniasis (ACL) in the Cianorte municipality, Paraná State the occurrence of human cases with the probable infection locus in the urban area, the presence of a permanently preserved modified native forest in the urban perimeter, and the lack of knowledge of the fauna of sand flies in the municipality provided the impetus for this study. The objective of this study was to assess the fauna, frequency and seasonality of the sand flies in the peridomicile, forest and urban area of this municipality. Sand flies were collected using Falcão light traps installed in the peridomicile and forest, from July 2005 to June 2006. A total of 755 sand flies were collected; Nyssomyia whitmani (Antunes & Coutinho) (84.0%), followed by Nyssomyia neivai (Pinto) (12.7%) were the predominant species. The number of sand flies collected in the peridomicile was significantly higher than in the forest (P = 0.0068). The small number of sand flies collected, especially in the forest, may be related to the modifications to the environment on the edge of the Parque Cinturão Verde, which surrounds the urban area of the municipality. Five species of sand flies were distinguished in the urban area of Cianorte, with greater frequencies found in the peridomicile, especially from November to April. Our data illustrate the necessity of maintaining the measures that contributed to reduce human contact with sand flies, thereby reducing the transmission risk of ACL.

O objetivo deste estudo foi investigar a associação de algumas variáveis para a cicatrização de lesões em pacientes com leishmaniose tegumentar americana (LTA). Os pacientes com diagnóstico clínico e laboratorial foram acompanhados depois do tratamento por avaliação clínica e reação de imunofluorescência indireta (IFI), de setembro de 2000 a dezembro de 2003. Dos 163 pacientes 85,3% apresentaram cicatrização das lesões no último retorno para a avaliação clínica e 82,7% destes tiveram a IFI negativa indicando uma associação entre a cicatrização das lesões e a negativação da IFI (p=0,000). Nos pacientes acompanhados até 120 dias depois do tratamento houve associação significativa entre os resultados negativos da IFI e a cicatrização das lesões (p=0,0000). A análise pela regressão logística mostrou que quando a IFI do primeiro retorno após o tratamento foi negativa, o paciente tinha 2,175 mais chance de cicatrização (p=0,0001). Os resultados mostram associação entre a negativação da IFI e a cicatrização das lesões quando o primeiro retorno foi até 120 dias e que as chances de cicatrização são significativamente maiores nos pacientes que apresentaram IFI negativa no primeiro retorno depois do tratamento.

The purpose of this study was to investigate the relationship of several variables to the healing of lesions in patients with American cutaneous leishmaniasis (ACL). The patients with clinical and/or laboratorial diagnoses of the disease were followed up for varying periods after treatment by clinical evaluation and indirect immunofluorescence assay (IFA), from September 2000 to December 2003. The lesions of 85.3% of the 163 patients had healed by their last return for clinical evaluation, and of these, 82.7% had negative IFA results, indicating an association between the healing of lesions and IFA negativity (p=0.000). In patients evaluated up to 120 days after treatment, there was a significant association between negative IFA results and the healing of lesions (p=0.0000). Logistic regression analysis showed that negative IFA results on patients' first return after treatment predicted a 2.175 fold greater chance of lesion healing (p=0.0001). These results indicate an association between IFA negativity at the first return up to a period of 120 days, and the healing of lesions, and that the chances of healing are significantly higher in patients with negative IFA results at their first return after treatment.

São escassas as informações sobre o papel da mobilidade populacional na manutenção da leishmaniose tegumentar americana no estado do Paraná. Avalia-se a mobilidade populacional como fator de risco para esta endemia em três mesorregiões do Paraná, utilizando dados gerados na Universidade Estadual de Maringá, no período de 1987 a 2004. Foram notificados 1.933 casos, predominando os casos migrantes (54,4%). Os municípios com maior número de casos notificados foram Maringá (358), Doutor Camargo (108) e Terra Boa (105). Os casos rurais foram predominantemente autóctones (89,8%), enquanto os urbanos, na maioria (84,8%) migrantes (p<0,0001). Para os casos rurais autóctones, não houve predomínio entre os sexos (p=0,127); para os casos urbanos migrantes, prevaleceu o sexo masculino (p<0,0001). Os casos migrantes foram na maioria relacionados com a mobilidade intra e intermunicipal. A mobilidade populacional parece ser uma variável importante na epidemiologia desta doença no Estado do Paraná.

Information on the role of population mobility in maintaining American tegumentary leishmaniasis in the State of Paraná is scarce. Population mobility was evaluated as a risk factor for this endemic disease in three mesoregions of Paraná, using data built up at the State University of Maringá, covering 1987 to 2004. A total of 1,933 cases were notified, mostly among migrants (54.4%). The municipalities with the greatest numbers of cases notified were Maringá (358), Doutor Camargo (108) and Terra Boa (105). The rural cases were predominantly autochthonous (89.8%), while the urban cases were mostly among migrants (84.8%) (p < 0.0001). Among the rural autochthonous cases, there was no difference between the sexes (p = 0.127), whereas among the urban migrant cases, men predominated (p < 0.0001). The migrant cases were mostly related to mobility within and between municipalities. Population mobility seems to be an important variable in the epidemiology of this disease in the State of Paraná.