Avaliação da contribuição dos exames diretos para o diagnóstico das leishmanioses

The clinical diagnosis of leishmaniasis remains a daunting and challenging task. In addition, the direct parasitological examination prevails as the gold standard for diagnosis, due to its potential advantages including cost, availability and feasibility. Thus, the aim of the current thesis was to evaluate the contribution of microscopic examination for the diagnosis of Leishmaniasis through the: a) production of information material regarding morphology of the parasite; b) Description of the use of parasitological tests for the diagnosis of human and canine visceral leishmaniasis; c) Proposition of alternatives to clinical specimen concentration as cytocentrifugation and thick smear for the diagnosis of canine American tegumentary and visceral leishmainiasis. We enrolled consented patients with confirmed diagnosis of American tegumentary leishmaniasis (ATL) or visceral leishmaniasis (VL). Besides, euthanized seropositive dogs were also included. Our findings were published in 6 distinct papers. Papers I and II approaches aspects of the direct exam of ATL and papers III, IV, V and VI showed the dramatically changes observed in epidemiology of VL in the state of Rio de Janeiro, showing the importance of the direct exam. In addition, our work confirmed that Leishmania chagasi is the responsible agent for the cases of VL in Barra Mansa (RJ). Paper VI shows the use of the thick smear on parasitological confirmed sororeactors dogs. The direct examinations are neglected methods and our study aimed to highlights the value of hese tests, also contributing with alternatives for concentration of clinical material as thick smear, that showed excellent performance and sensitivity that will surely provide greater flexibility in processing steps and microscopic observation of these tests