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<P>Dr. Shaw has called attention to the high lethality rate of VL in Minas
Gerais State, as it has appeared in Folha de São Paulo, one of the most
important Brazilian newspapers, two weeks ago. Although the fact has only
recently called the attention of the press (immediately after the death of a
physician), the lethality rate in the metropolitan region of Belo Horizonte
(population: 4.3 million) has ranged from 6.5 to 20% since the beginning of the
VL urbanization in 1989. </P>
<P>The rapid spread of the infection has surprised unprepared health services.
Up to 2001, 17 (47%) out of the 36 municipalities faced the infection. The
number of deaths occurring in HIV co-infected patients corresponds to a low
proportion of the reported deaths and does not justify the extremely high
lethality rate. Treatment with antimoniate is successful if promptly initiated.
</P>
<P>Due to the observation that patients were dying as consequence of diagnostics
delay, a "Program for Reduction of the Lethality Rate of Visceral Leishmaniasis"
has been launched last December by the Reference Center for Leishmaniasis of
"Centro de Pesquisas René Rachou-FIOCRUZ" and the Health Services of the
municipalities and State. This effort comprises information for population,
training and distribution of guidelines for physicians and rapid access to
diagnostics support.</P>
<P>Once more, infectious diseases are challenging us. </P>
<P>Ana Rabello and Zélia Profeta</P><FONT face="Comic Sans MS"
size=2></FONT></FONT>
<DL>
<DD>
<ADDRESS>Reference Center for Leishmaniasis </ADDRESS></DD>
<DD>
<ADDRESS>Centro de Pesquisas René Rachou - FIOCRUZ</ADDRESS></DD>
<DD>
<ADDRESS>Belo Horizonte, MG - Brazil</ADDRESS></DD></DL><FONT
face="Comic Sans MS" size=2>
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