Transmission of cutaneous leishmaniasis associated with cacao (Theobroma cacao) plantations in Tabasco

INTRODUCTION: Tabasco is the Mexican state that reported the highest number (37.4%) of patients with leishmaniasis during 1990-2011. Close to 90% of these patients lived in Chontalpa, where the municipality of Cunduacan accounted for the majority of the cases. One of the characteristics of this region is that houses are located within cacao plantations. OBJECTIVE: To determine if cacao plantations are a risk factor for leishmaniasis transmission in locations of Cunduacan, Tabasco. MATERIAL AND METHODS: We performed an analytical and retrospective study of 115 locations in Cunduacan, analyzing the number of localities with or without patients with leishmaniasis registered between 2000-2011 and, additionally, if they had cacao plantations, using a map where different crops were georeferenced. We measured the magnitude of the association (odds ratio, 95% CI). RESULTS: During the period 2000-2011, cases of leishmaniasis were reported in 77 (67.0%) Cunduacan locations, of these, 55 (71.4%) had cocoa plantations, five (6.5%) of banana, five (6.5%) of cane, and 12 (15.6%) had no crops georeferenced. We found that cocoa crops are a risk factor for the transmission of leishmaniasis (OR: 3.438; 95% CI: 1,526-7,742). CONCLUSIONS: The probability of transmission of leishmaniasis in areas with cocoa crops is greater than in communities without this crop.