Transmisión de leishmaniasis cutánea asociada con plantaciones de cacao (Theobroma cacao) en Tabasco

espanolIntroduccion: Tabasco es el estado de Mexico que reporto el mayor numero de pacientes con leishmaniasis (37.4%) durante el periodo 1990-2011. Alrededor del 90% de estos casos se presentaron en la Chontalpa, con el municipio de Cunduacan en primer lugar. Esta region se caracteriza por casas ubicadas dentro de plantaciones de cacao. Objetivo: Determinar si los cultivos de cacao representan un factor de riesgo para la transmision de leishmaniasis en esa zona. Materiales y metodos: Se realizo un estudio analitico retrospectivo en 115 localidades de Cunduacan; se analizaron las localidades con o sin casos de leishmaniasis registrados entre los anos 2000 y 2011, y si tenian cultivos de cacao, utilizando un mapa en que se encontraban georreferenciados diferentes cultivos. Se midio la magnitud de la asociacion (odds ratio [OR]; intervalo de confianza [IC] del 95%). Resultados: En 2000-2011, se reportaron casos de leishmaniasis en 77 (67.0%) localidades de Cunduacan, de las cuales 55 (71.4%) tenian cultivos de cacao, 5 (6.5%) de platano, 5 (6.5%) de cana y 12 (15.6%) no tenian cultivos georreferenciados. Encontramos que los cultivos de cacao son un factor de riesgo para la transmision de la leishmaniasis (OR: 3.438; IC 95%: 1.526-7.742). Conclusiones: La probabilidad de que la leishmaniasis se transmita en localidades con cultivos de cacao es mayor que en localidades sin este tipo de cultivos. EnglishIntroduction: 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. (Gac Med Mex. 2014;150:499-508) Corresponding author: Georgina del Carmen Carrada Figueroa, georginacarrada@hotmail.com