Diversity and bioecological characteristics of phlebotominae species (Diptera: Psychodidae) in endemic areas of visceral and cutaneous leishmaniasis-an update.

Phlebotomine sand flies are responsible for transmitting Leishmania (Ross, 1903) species, the etiological agents of leishmaniases, causing impacts on global public health, especially in northeastern Brazil. The state of Rio Grande do Norte has been recording cases of the disease compulsorily since the 1980s, and the last comprehensive and systematic survey of phlebotomine species was completed in 1997. Since then, new infected species have been identified in the country. Our objectives are to update the inventory of phlebotomine species in Rio Grande do Norte , analyze the natural infection by Leishmania, and detect spatial clusters of leishmaniasis incidence in Rio Grande do Norte . Systematic literature reviews and unpublished surveys were used; for spatial analysis, the calculation of the Local Index of Spatial Association and Moran's Local Index were employed; finally, quantitative PCR targeting the kDNA-7 gene with TaqMan system amplification was used to analyze natural infection. We recorded 30 phlebotomine species, 21 from the literature and 9 newly reported. Three species showed infection with Leishmania infantum (Nicolle, 1908), and we observed the formation of 4 high-incidence clusters of leishmaniases in Rio Grande do Norte . Over 20 yr, there was a significant increase in the number of species recorded in Rio Grande do Norte, since the last survey across the 8 geographic zones of Rio Grande do Norte; additionally, we recorded Psychodopygus wellcomei (Fraiha, Shaw & Lainson, 1971) and Evandromyia walkeri (Newstead, 1914) infected, the latter being the first report of infection with L. infantum. Finally, the cluster formation in the western region of Rio Grande do Norte may be related to local social and economic characteristics.