Comprehensive review and current status in Tarija, Bolivia - border with Argentina

Introduction: In the department of Tarija in the Bolivian-Argentine border, human cases with ulcers on uncovered parts of the skin, plus clinical and epidemiological characteristics related to leishmaniasis were reported for the first time in 1997. Objective: To describe and to verify the presence Leishmaniasis in Tarija, sixth endemic department in Bolivia. Materials and methods: Both an outbreak study (November 1998 to December 2002), and a longitudinal study (1997 to 2018) in humans were conducted, in addition both Phlebotominae and potential reservoirs captures. Results: A total of 1,250 patients were registered; in the outbreaks 190 cases (1998) and 249 cases (2002) were reported, with inter-epidemic periods of 37 cases as an annual average. 68% of the were highlander migrants, who inhabited precarious housing near residual forest. The predominant patient sex was male (ratio 2:1). 363 cases (62%) were the most affected with the disease, belonging to the economically-active group (15 to 49 years-old). 124 cases (21%) were children under 15 years old, 33 cases of them were under 4 years old. 51 patients (8.7%) had mucosal lesions. Leishmania (V). braziliensis was isolated and characterized from mucous ulcers of sick dogs. Nyssomyia neivai (an abundant anthropophilic species) incriminated as probable vector, was captured. Conclusions: The initial 1997 leishmaniasis presence in the municipality of Bermejo has spread out to four municipalities in 2018 (Padcaya, Carapari, Entre Rios and Yacuiba) in northeast of the department of Tarija.