Leishmaniasis: Historical configuration in Brazil with an emphasis on the visceral disease, from the 1930s to the 1960s

Abstract

The first cases of cutaneous and mucocutaneous leishmaniasis in the Americas were described in São Paulo in 1909; visceral leishmaniasis was only found in Brazil in 1934, by a Yellow Fever Service pathologist. The historical processes related to these forms of leishmaniasis gained institutional strength in the 1930s. While the Leishmaniasis Study Commission solidified the concept of American tegumentary leishmaniasis, the American Visceral Leishmaniasis Study Commission (headed by Evandro Chagas) gave rise to the Institute of Experimental Pathology for the North (1936) and the Large Endemic Disease Study Service (1938). Visceral leishmaniosis gained importance in northeastern Brazil in the 1950s, and control measures against its vectors using dichlorodiphenyltrichloroethane (DDT) followed in the wake of the malaria campaign. They also targeted dogs (which were killed en masse) and humans, who were treated with antimonial drugs. Large-scale undertakings in Brazil's hinterlands after the 1964 civilian-military coup transformed cutaneous and mucocutaneous leishmaniasis into a serious problem in Amazonia and other regions. Brazil and other countries saw a resurgence of all forms of leishmaniasis in rural and urban areas because of environmental changes, human migrations, chaotic urban growth, and other socioeconomic processes.