Leishmaniose en Equateur. 1. Incidence de la leishmaniose tégumentaire sur la façade pacifique.

A clinico-epidemiologic survey on cutaneous leishmaniasis, due to Leishmania panamensis, was carried out on 961 persons in two study areas of the Pacific coast of Ecuador, to estimate the prevalence and the incidence of the disease. In the preandean hills, at Paraiso Escondido, the 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 in 1991 was high: 147% in the first village, and 106% in the second. These data are far higher than the Health Ministry statistics. The cumulated prevalence, obtained by addition of the scars and active lesions of leishmaniasis, was as high as 66% at Paraiso Escondido, and 47% at La Tablada. Most of the patients (62%) had only one ulcer or scar. Most of the people are contaminated during the first five years they live in these endemic areas. Nevertheless, the incidence remains high in all the age groups, because large numbers of migrants coming from non endemic regions are continuously settling in these colonization areas. Interviews have shown that the contaminations had occurred in the dry season, between July and December. These findings were confirmed by passive case detection at the Hospital A. Egas of Santo Domingo which covered the region. Contamination 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.