The Ecology of Cutaneous Leishmaniasis in the Republic of Panama1

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Abstract
Ecological studies on leishmaniasis at Gorgas Memorial Laboratory, Panama, over the past 4 decades are reviewed and supplemented with unpublished data relating to sand fly vectors, sylvatic reservoir hosts, parasites, and the clinical disease. The systematics, microhabitats, breeding sites, seasonality, flight activity, rearing, predators, host-feeding profiles, and vector competence of the Panamanian sand fly fauna are discussed. The reservoir hosts of the 3 indigenous species of Leishmania, Le. braziliensis panamensis, Le. mexicana aristedesi, and Le. hertigi hertigi, are detailed, as well as the disease manifestations within these hosts and experimental animals. Characterization of the indigenous Leishmania subspecies by isozyme electrophoretic patterns is described and compared with that of related taxa within their respective complexes. The prevalence, clinical findings, and characterization of various forms of human cutaneous leishmaniasis in Panama, as well as diagnostic methods and treatment regimens, are outlined.