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Leal JFDC, Barroso DH, Trindade NS, de Miranda VL, Gurgel-Gonçalves R. Automated Identification of Cutaneous Leishmaniasis Lesions Using Deep-Learning-Based Artificial Intelligence. Biomedicines 2023; 12:12. [PMID: 38275373 PMCID: PMC10813291 DOI: 10.3390/biomedicines12010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
The polymorphism of cutaneous leishmaniasis (CL) complicates diagnosis in health care services because lesions may be confused with other dermatoses such as sporotrichosis, paracocidiocomycosis, and venous insufficiency. Automated identification of skin diseases based on deep learning (DL) has been applied to assist diagnosis. In this study, we evaluated the performance of AlexNet, a DL algorithm, to identify pictures of CL lesions in patients from Midwest Brazil. We used a set of 2458 pictures (up to 10 of each lesion) obtained from patients treated between 2015 and 2022 in the Leishmaniasis Clinic at the University Hospital of Brasilia. We divided the picture database into training (80%), internal validation (10%), and testing sets (10%), and trained and tested AlexNet to identify pictures of CL lesions. We performed three simulations and trained AlexNet to differentiate CL from 26 other dermatoses (e.g., chromomycosis, ecthyma, venous insufficiency). We obtained an average accuracy of 95.04% (Confidence Interval 95%: 93.81-96.04), indicating an excellent performance of AlexNet in identifying pictures of CL lesions. We conclude that automated CL identification using AlexNet has the potential to assist clinicians in diagnosing skin lesions. These results contribute to the development of a mobile application to assist in the diagnosis of CL in health care services.
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Affiliation(s)
- José Fabrício de Carvalho Leal
- Graduate Program in Tropical Medicine, Center for Tropical Medicine, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil;
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
| | - Daniel Holanda Barroso
- Postgraduate Program in Medical Sciences, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil;
| | - Natália Santos Trindade
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
| | - Vinícius Lima de Miranda
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
| | - Rodrigo Gurgel-Gonçalves
- Graduate Program in Tropical Medicine, Center for Tropical Medicine, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil;
- Laboratory of Medical Parasitology and Vector Biology, Faculty of Medicine, University of Brasília–UnB, Brasília 70904-970, Brazil; (N.S.T.); (V.L.d.M.)
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Kariyawasam R, Valencia BM, Lau R, Shao E, Thompson CA, Stevens M, Kincaid L, Del Castillo ALQ, Cruz-Arzapalo LO, Llanos-Cuentas A, Boggild AK. Evaluation of a point-of-care molecular detection device for Leishmania spp. and intercurrent fungal and mycobacterial organisms in Peruvian patients with cutaneous ulcers. Infection 2021; 49:1203-1211. [PMID: 34368941 DOI: 10.1007/s15010-021-01673-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Overlapping clinical features of cutaneous leishmaniasis (CL) with ulcers caused by fungi and mycobacteria necessitate confirmatory diagnostic testing. We evaluated a handheld battery-operated device for detection of CL and common fungal and mycobacterial causes of ulcers. METHODS We validated Palm PCR™ for detection of common ulcerative skin pathogens using ATCC® reference and clinical strains of Leishmania, mycobacteria, and fungi in the lab and field. Amplified products were Sanger sequenced. Performance characteristics were calculated using conventional PCR as a reference standard. RESULTS Palm PCR™ detected 100% of ATCC® strains of Leishmania, fungi, and mycobacteria, with sensitivity and specificity of 90% and 91.7%, respectively. In the field, the sensitivity for detection of Leishmania in patients with suspected CL was 100%. In 61% of CL patients, co-colonization with genera such as Malassezia, Aspergillus, Candida, and Cladosporium was detected. In 50% of CL patients with an inflammatory (secondarily infected) phenotype, detected fungal species had known associations with human cutaneous disease. CONCLUSIONS Palm PCR™ performs comparably to conventional PCR for detection of Leishmania, fungi, and mycobacteria. This work has implications for the diagnostic approach to tropical ulcers, and has the potential to improve field detection of ulcerative pathogens in resource constrained areas.
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Affiliation(s)
| | - Braulio M Valencia
- Instituto de Medicina Tropical "Alexander Von Humboldt", Lima, Peru
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Rachel Lau
- Public Health Ontario Laboratory, Toronto, ON, Canada
| | - Eric Shao
- Department of Microbiology and Immunology, Western University, London, ON, Canada
| | - Courtney A Thompson
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, 13EN-218, Toronto, ON, M5G 2C4, Canada
- Markham-Stouffville Hospital, Markham, ON, Canada
| | - Michael Stevens
- Division of Clinical Dermatology and Cutaneous Science, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Leah Kincaid
- Alliance Dermatology Associates, Lawrenceville, NJ, USA
| | | | | | - Alejandro Llanos-Cuentas
- Instituto de Medicina Tropical "Alexander Von Humboldt", Lima, Peru
- Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andrea K Boggild
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
- Tropical Disease Unit, Toronto General Hospital, 200 Elizabeth Street, 13EN-218, Toronto, ON, M5G 2C4, Canada.
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Akuffo R, Sanchez C, Chicharro C, Carrillo E, Attram N, Mosore MT, Yeboah C, Kotey NK, Boakye D, Ruiz-Postigo JA, Moreno J, Wilson M, Sarfo B, Anto F. Detection of cutaneous leishmaniasis in three communities of Oti Region, Ghana. PLoS Negl Trop Dis 2021; 15:e0009416. [PMID: 34029326 PMCID: PMC8177633 DOI: 10.1371/journal.pntd.0009416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/04/2021] [Accepted: 04/27/2021] [Indexed: 11/19/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL) is the most common type of leishmaniasis, a neglected tropical disease caused by parasites of the genus Leishmania. In Ghana, some studies in the Volta region have detected Leishmania parasites among persons with skin ulcers. Methodology/Principal findings Using a cross-sectional study design, the prevalence of CL in three communities of the Oti Region of Ghana was investigated. Demographic and epidemiological data were obtained by a structured interviewer administered questionnaire. A total of 426 (12.4%) out of 3,440 participants screened had at least one skin ulcer. Of 595 skin ulcers sampled and tested by PCR for Leishmania infection, 150 (25.2%) ulcers from 136 individuals tested positive, accounting for an overall CL prevalence of 31.9% among persons with skin ulcers. Individual community CL prevalence of 23.2%, 29.8%, and 36.8% was observed in Ashiabre, Keri, and Sibi Hilltop respectively among persons with skin ulcers. Conclusions/Significance Confirmation of CL in the study area suggests an active cycle of transmission of Leishmania infection. The observation of skin ulcers which tested negative to Leishmania infection suggests a need to test for additional causes of skin ulcers such as Treponema pallidum pertenue and Mycobacterium ulcerans in the study area. Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by parasites of the genus Leishmania and is transmitted by various species of female sandflies. CL usually begins as painless nodules and is usually characterized by skin ulcers which may be single or multiple. Although ulcers due to CL are often self-healing, they may become painful and result in scarring after healing. Typically, CL occurs on exposed parts of the body such as the neck, limbs, and face, which may be easily accessible to sandflies. Although cases of CL had previously been reported in some parts of the Volta region of Ghana, no previous case of CL had been reported in the Oti region. This study was initiated following reports of skin ulcers which were suggestive of CL in some communities of the Oti region. This study confirmed Leishmania infection in 150(25.5%) out of 595 skin ulcer samples obtained from 426 study participants. Given that 445(74,8%) of the skin ulcers tested negative for Leishmania parasite suggests a need for investigation of additional causes of skin ulcers such as yaws and Buruli ulcer in the study area.
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Affiliation(s)
- Richard Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- School of Public Health, University of Ghana, Accra, Ghana
| | - Carmen Sanchez
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Chicharro
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Eugenia Carrillo
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Naiki Attram
- U.S. Naval Medical Research Unit No. 3, Ghana Detachment, Accra, Ghana
| | | | - Clara Yeboah
- U.S. Naval Medical Research Unit No. 3, Ghana Detachment, Accra, Ghana
| | | | - Daniel Boakye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Jose-Antonio Ruiz-Postigo
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Javier Moreno
- WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, Madrid, Spain
| | - Michael Wilson
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Bismark Sarfo
- School of Public Health, University of Ghana, Accra, Ghana
| | - Francis Anto
- School of Public Health, University of Ghana, Accra, Ghana
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Epidemiology, clinical pattern and impact of species-specific molecular diagnosis on management of leishmaniasis in Belgium, 2010-2018: A retrospective study. Travel Med Infect Dis 2020; 38:101885. [PMID: 32977026 DOI: 10.1016/j.tmaid.2020.101885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Species-directed therapy of leishmaniasis has been recommended for travelers since 2014, but little is known about species distribution and treatment practices in non-endemic countries. We aimed to describe leishmaniasis cases in Belgium since species typing became available and evaluate its impact on patient management. METHOD Retrospective analysis of all patients diagnosed by PCR at our national reference laboratory from 2010 to 2018. Species were typed by Hsp-70 sequencing. RESULTS We identified 18 visceral leishmaniasis (VL) and 147 (muco)cutaneous leishmaniasis ((M)CL) cases. VL was exclusively due to L. infantum and consistently treated with liposomal amphotericin B, with four observed failures. (M)CL was caused by ten different species. Of 62 cases diagnosed and species typed after 2014 with timing information, 28 (45.2%) were treated before the species result was available. Therapy was not species-directed in 10/32(28.1%) of those treated after species identification. Patients treated according to the guidelines tended to have a favorable outcome more often than those who were not (36/44, 81.8% versus 8/19, 57.9%; p = 0.045). CONCLUSIONS In contrast to VL, various species caused (M)CL in our setting and species result was often not considered for treatment. Outcome tended to be better however when therapy was species-directed.
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Abstract
Cutaneous leishmaniasis (CL) is called "the great imitator," because it can mimic almost all types of dermatoses. This similarity may sometimes lead to misdiagnosis, resulting in inappropriate treatment and morbidities. Atypical forms occur due to the interaction between parasitic factors and the host immune response. Secondary infection or mistreatment of CL can also alter the natural course, resulting in bizarre and misdiagnosed cases. Atypical leishmaniasis should be considered in longstanding and painless lesions that may simulate erysipelas, dermatitis, verruca, herpes zoster, paronychia, and sporotrichosis. Less commonly, sarcoidosis, deep mycosis, basal and squamous cell carcinoma, cutaneous lymphoma, or pseudolymphomalike lesions may need to be considered in the differential diagnosis. A high index of suspicion is required to consider a diagnosis of CL, especially in nonendemic or newly endemic regions. Smear, histopathologic examination, culture, and polymerase chain reaction serve as important tools to differentiate CL from its clinical and histologic look-alikes. CL is discussed from various perspectives, with emphasis on CL and its broad differential diagnosis.
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Moosazadeh M, Afshari M, Parsaee M, charkameh A, Nezammahalleh A, Abedi G, Fakhar M, Mahdavi SA, Shojaei J, Enayati AA. Clinico-epidemiological features of cutaneous leishmaniasis in Mazandaran Province, northern Iran. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Malli S, Pomel S, Ayadi Y, Deloménie C, Da Costa A, Loiseau PM, Bouchemal K. Topically Applied Chitosan-Coated Poly(isobutylcyanoacrylate) Nanoparticles Are Active Against Cutaneous Leishmaniasis by Accelerating Lesion Healing and Reducing the Parasitic Load. ACS APPLIED BIO MATERIALS 2019; 2:2573-2586. [DOI: 10.1021/acsabm.9b00263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Sophia Malli
- Institut Galien Paris Sud, UMR CNRS 8612, Univ. Paris-Sud, Université Paris-Saclay, Faculté de Pharmacie, 5, rue J.B. Clément, 92296 Cedex Châtenay-Malabry, France
- BioCIS Biomolécules: Conception, Isolement, Synthèse, Chimiothérapie Antiparasitaire, UMR CNRS 8076, Univ. Paris-Sud, Université Paris-Saclay, Faculté de Pharmacie, 5, rue J.B. Clément, 92296 Cedex Châtenay-Malabry, France
| | - Sebastien Pomel
- BioCIS Biomolécules: Conception, Isolement, Synthèse, Chimiothérapie Antiparasitaire, UMR CNRS 8076, Univ. Paris-Sud, Université Paris-Saclay, Faculté de Pharmacie, 5, rue J.B. Clément, 92296 Cedex Châtenay-Malabry, France
| | - Yasmine Ayadi
- Institut Galien Paris Sud, UMR CNRS 8612, Univ. Paris-Sud, Université Paris-Saclay, Faculté de Pharmacie, 5, rue J.B. Clément, 92296 Cedex Châtenay-Malabry, France
- BioCIS Biomolécules: Conception, Isolement, Synthèse, Chimiothérapie Antiparasitaire, UMR CNRS 8076, Univ. Paris-Sud, Université Paris-Saclay, Faculté de Pharmacie, 5, rue J.B. Clément, 92296 Cedex Châtenay-Malabry, France
| | - Claudine Deloménie
- Faculté de Pharmacie, Institut Paris Saclay d’Innovation Thérapeutique, UMS Inserm CNRS UPSud, Université Paris-Saclay, 92296 Cedex Châtenay-Malabry, France
| | - Antonio Da Costa
- Université d’Artois, CNRS, Centrale Lille, ENSCL, Université Lille, UMR 8181, Unité de Catalyse et de Chimie du Solide (UCCS), Faculté Jean-Perrin, Rue Jean Souvras − SP 18, 62307 Lens, France
| | - Philippe M. Loiseau
- BioCIS Biomolécules: Conception, Isolement, Synthèse, Chimiothérapie Antiparasitaire, UMR CNRS 8076, Univ. Paris-Sud, Université Paris-Saclay, Faculté de Pharmacie, 5, rue J.B. Clément, 92296 Cedex Châtenay-Malabry, France
| | - Kawthar Bouchemal
- Institut Galien Paris Sud, Junior Member of the Institut Universitaire de France, UMR CNRS 8612, Univ. Paris-Sud, Université Paris-Saclay, Faculté de Pharmacie, 5, rue J.B. Clément, 92296 Cedex Châtenay-Malabry, France
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Jorjani O, Mirkarimi K, Charkazi A, Shahamat YD, Mehrbakhsh Z, Bagheri A. The epidemiology of cutaneous leishmaniasis in Golestan Province, Iran: A cross-sectional study of 8-years. Parasite Epidemiol Control 2019; 5:e00099. [PMID: 30937404 PMCID: PMC6430073 DOI: 10.1016/j.parepi.2019.e00099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/23/2019] [Accepted: 02/23/2019] [Indexed: 01/06/2023] Open
Abstract
Background Leishmaniasis occurs with an incidence of 0.5-1.5 million new cases annually, and is also endemic in 88 countries across the world. Aim Presently, we aimed to investigate the status of Cutaneous Leishmaniasis (CL) in Golestan Province in North of Iran. Methods A retrospective survey was conducted on existed data of 6873 patients with CL who attended to Health Centers in Golestan Province during 2010 to 2017 years. Data were collected using patient sheets and online registry form of CL. Descriptive statistical methods such as mean and standard deviation, and Chi-square test were employed to report and analyze results. p-Value <0.05 was considered significant. Results CL cases were more common in men 3885 (56.7%) than women 2965 (43.3%) (p = 0.001). The most and least cases was reported in 2017 and 2104 as 18 and 3 CL cases, accordingly. CL was mainly happen in the November (3816 cases), December (2832 cases) months. Presently, CL gradually increases in the last three years from 2014 to 2017 years. Conclusion Decrease of exposurement, improve the nutrition and child's immunity can be more beneficial.
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Affiliation(s)
- Oghlniaz Jorjani
- Laboratory Science Research Center, Department of Medical Laboratory Science, Faculty of Paramedicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Kamal Mirkarimi
- Health Management and Social Development Research Center, Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdurrahman Charkazi
- Environmental Health Research Center, Department of Public Health, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Yousef Dadban Shahamat
- Environmental Health Research Center, Department of Environmental Health Engineering, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zahra Mehrbakhsh
- Department of Biostatistics, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ali Bagheri
- Communicable Disease Control of Health Center, Golestan University of Medical Sciences, Gorgan, Iran
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ÖZAVCI H, KAPLAN M. Cloning and molecular characterization of thiol-specific antioxidant gene of Leishmania tropica Turkey isolate. Turk J Med Sci 2019; 49:392-402. [PMID: 30761841 PMCID: PMC7350880 DOI: 10.3906/sag-1808-98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim Thiol-specific antioxidant (TSA) protein is one of the most promising molecules among candidates for vaccine against cutaneous leishmaniasis. It was found to be significantly protective against different Leishmania species. In this study, cloning and molecular characterization of thiol-specific antioxidant gene of L. tropica Turkey isolate (LtTSA) were aimed. Materials and methods LtTSA was amplified by PCR using the specific primers of TSA gene and cloned into the pcDNA3.1 vector. The cloning was confirmed by PCR screening, restriction enzyme reactions, and DNA sequence analysis. Finally, three-dimensional structure and antigenic properties of the protein encoded by the LtTSA were determined Results Six hundred base pair bands belonging to LtTSA were shown with electrophoresis. It was found that LtTSA and its encoded protein have high similarity with different Leishmania species. LtTSA protein consisting of 199 amino acids was found to have 7 different antigenic regions. Conclusion LtTSA and its encoded TSA protein were found to be highly immunogenic and similar to TSA proteins previously tested as a vaccine candidate.
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Affiliation(s)
- Hamza ÖZAVCI
- Department of Medical Parasitology, Faculty of Medicine, Fırat University, ElazığTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Mustafa KAPLAN
- Department of Medical Parasitology, Faculty of Medicine, Fırat University, ElazığTurkey
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Kuna A, Gajewski M, Bykowska M, Pietkiewicz H, Olszański R, Myjak P. Imported cutaneous leishmaniasis: a 13-year experience of a Polish tertiary center. Postepy Dermatol Alergol 2019; 36:104-111. [PMID: 30858788 PMCID: PMC6409886 DOI: 10.5114/ada.2019.82830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 06/30/2018] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Leishmaniasis is a vector-borne infection endemic in 98 countries. Its cutaneous form (CL) causes skin lesions on exposed parts of the body and may lead to scarring. The numbers of imported cases of CL are increasing in Europe but the incidence of CL importation in Poland is unknown. MATERIAL AND METHODS A list of all patients diagnosed with CL at the Department in the years 2005-2017 was obtained. The study presents their data including age, sex, areas visited, purpose of travel, time from the onset of symptoms to correct diagnosis, appearance of lesions, results of impression smears and PCR, and superinfection, if detected, as well as treatment methods and their outcomes. RESULTS Altogether, 14 cases of cutaneous leishmaniasis were identified. The study demonstrates an increase in the number of cases of imported CL at our center over the last 5 years. The time to correct diagnosis was long in spite of the fact that the lesions had usually an appearance typical of CL. CONCLUSIONS Intensified education of physicians and travelers, as well as improvement in the access to travel medicine services and to the diagnosis and treatment methods appropriate for CL, are needed in our country. In our opinion, surveillance of leishmaniasis should be introduced in Poland.
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Affiliation(s)
- Anna Kuna
- Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Michał Gajewski
- Department of Infectious Diseases, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Martyna Bykowska
- Department of Tropical and Parasitic Diseases, Institute of Maritime and Tropical Medicine in Gdynia, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Halina Pietkiewicz
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Romuald Olszański
- Department of Maritime and Hyperbaric Medicine in Gdynia, Military Institute of Medicine in Warsaw, Poland
| | - Przemysław Myjak
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
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Abstract
Leishmaniasis is a poverty-related disease with two main clinical forms: visceral leishmaniasis and cutaneous leishmaniasis. An estimated 0·7-1 million new cases of leishmaniasis per year are reported from nearly 100 endemic countries. The number of reported visceral leishmaniasis cases has decreased substantially in the past decade as a result of better access to diagnosis and treatment and more intense vector control within an elimination initiative in Asia, although natural cycles in transmission intensity might play a role. In east Africa however, the case numbers of this fatal disease continue to be sustained. Increased conflict in endemic areas of cutaneous leishmaniasis and forced displacement has resulted in a surge in these endemic areas as well as clinics across the world. WHO lists leishmaniasis as one of the neglected tropical diseases for which the development of new treatments is a priority. Major evidence gaps remain, and new tools are needed before leishmaniasis can be definitively controlled.
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Affiliation(s)
- Sakib Burza
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Médecins Sans Frontières, Delhi, India
| | - Simon L Croft
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
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Montalvo AM, Fraga J, Blanco O, González D, Monzote L, Soong L, Capó V. Imported leishmaniasis cases in Cuba (2006-2016): what have we learned. Trop Dis Travel Med Vaccines 2018; 4:7. [PMID: 30094054 PMCID: PMC6081946 DOI: 10.1186/s40794-018-0067-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 07/29/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Leishmaniasis is a neglected parasitic disease caused by Leishmania spp., which is not endemic in Cuba. However, several factors (such as human activities, climate changes, and tourism) have led to an increase in the number of leishmaniasis cases in all regions, raising diagnosis and surveillance issues. We aim to present the retrospective analysis of 16 human cases suspicious of leishmaniasis, which were received during 2006-2016 for diagnosis at the Department of Parasitology from the Institute of Tropical Medicine Pedro Kourí, Cuba. METHODS Clinical samples were collected and analyzed via different diagnostic assays, including direct smear, cultivation, histological analysis, and molecular analysis. Epidemiology and background of infection, clinical features, sex and age from each patient was recorded. RESULTS From the 16 suspicious cases, 5 cases were confirmed for Leishmania infection, based on at least two positive results using different methods: PCR-based diagnosis [18S rRNA (5/5), hsp20 gene (4/5), hsp70 gene (3/5)], histopathology evaluation (2/3), parasite cultivation (2/3), or direct smears (2/3). L. braziliensis and L. mexicana were identified as the involving species in two cases, according to hsp70 PCR-RFLP protocols. Demographic and clinical features, as well as treatment and follow up, are described for every case. CONCLUSIONS The combination of parasitological and molecular methods allowed proper diagnosis of imported leishmaniasis cases in Cuba. The utility and advantages of molecular diagnosis assays in non-endemic countries like Cuba are discussed.
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Affiliation(s)
- Ana M. Montalvo
- Institute of Tropical Medicine “Pedro Kourí”, Autopista Novia del Mediodía Km 6 y ½, Lisa, La Habana, Cuba
| | - Jorge Fraga
- Institute of Tropical Medicine “Pedro Kourí”, Autopista Novia del Mediodía Km 6 y ½, Lisa, La Habana, Cuba
| | - Orestes Blanco
- Institute of Tropical Medicine “Pedro Kourí”, Autopista Novia del Mediodía Km 6 y ½, Lisa, La Habana, Cuba
| | - Daniel González
- Institute of Tropical Medicine “Pedro Kourí”, Autopista Novia del Mediodía Km 6 y ½, Lisa, La Habana, Cuba
| | - Lianet Monzote
- Institute of Tropical Medicine “Pedro Kourí”, Autopista Novia del Mediodía Km 6 y ½, Lisa, La Habana, Cuba
| | - Lynn Soong
- Department of Microbiology and Immunology, Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, TX USA
| | - Virginia Capó
- Institute of Tropical Medicine “Pedro Kourí”, Autopista Novia del Mediodía Km 6 y ½, Lisa, La Habana, Cuba
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Challener D, Abu Saleh O. A Traveler's Unwanted Souvenir. Am J Med 2018; 131:e137-e138. [PMID: 29031592 DOI: 10.1016/j.amjmed.2017.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 09/29/2017] [Accepted: 09/29/2017] [Indexed: 11/27/2022]
Affiliation(s)
| | - Omar Abu Saleh
- Department of Infectious Diseases, Mayo Clinic, Rochester, Minn
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15
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Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method. ASIAN PAC J TROP MED 2017; 10:79-86. [DOI: 10.1016/j.apjtm.2016.12.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 11/16/2016] [Accepted: 12/15/2016] [Indexed: 11/18/2022] Open
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16
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Figliuolo VR, Chaves SP, Savio LEB, Thorstenberg MLP, Machado Salles É, Takiya CM, D'Império-Lima MR, de Matos Guedes HL, Rossi-Bergmann B, Coutinho-Silva R. The role of the P2X7 receptor in murine cutaneous leishmaniasis: aspects of inflammation and parasite control. Purinergic Signal 2016; 13:143-152. [PMID: 27866341 DOI: 10.1007/s11302-016-9544-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 10/25/2016] [Indexed: 11/28/2022] Open
Abstract
Leishmania amazonensis is the etiological agent of diffuse cutaneous leishmaniasis. The immunopathology of leishmaniasis caused by L. amazonensis infection is dependent on the pathogenic role of effector CD4+ T cells. Purinergic signalling has been implicated in resistance to infection by different intracellular parasites. In this study, we evaluated the role of the P2X7 receptor in modulating the immune response and susceptibility to infection by L. amazonensis. We found that P2X7-deficient mice are more susceptible to L. amazonensis infection than wild-type (WT) mice. P2X7 deletion resulted in increased lesion size and parasite load. Our histological analysis showed an increase in cell infiltration in infected footpads of P2X7-deficient mice. Analysis of the cytokine profile in footpad homogenates showed increased levels of IFN-γ and decreased TGF-β production in P2X7-deficient mice, suggesting an exaggerated pro-inflammatory response. In addition, we observed that CD4+ and CD8+ T cells from infected P2X7-deficient mice exhibit a higher proliferative capacity than infected WT mice. These data suggest that P2X7 receptor plays a key role in parasite control by regulating T effector cells and inflammation during L. amazonensis infection.
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Affiliation(s)
- Vanessa Ribeiro Figliuolo
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil.,National Institute of Science and Technology for Translational Research in Health and Environment in the Amazon Region (INPeTAm), Rio de Janeiro, Brazil
| | - Suzana Passos Chaves
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil.,National Institute of Science and Technology for Translational Research in Health and Environment in the Amazon Region (INPeTAm), Rio de Janeiro, Brazil
| | - Luiz Eduardo Baggio Savio
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil.,National Institute of Science and Technology for Translational Research in Health and Environment in the Amazon Region (INPeTAm), Rio de Janeiro, Brazil
| | - Maria Luiza Prates Thorstenberg
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil
| | | | - Christina Maeda Takiya
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil
| | | | - Herbert Leonel de Matos Guedes
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Bartira Rossi-Bergmann
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil.,National Institute of Science and Technology for Translational Research in Health and Environment in the Amazon Region (INPeTAm), Rio de Janeiro, Brazil
| | - Robson Coutinho-Silva
- Institute of Biophysics Carlos Chagas Filho, IBCCF/Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, 21941-902, Brazil. .,National Institute of Science and Technology for Translational Research in Health and Environment in the Amazon Region (INPeTAm), Rio de Janeiro, Brazil. .,Instituto de Biofísica Carlos Chagas Filho - UFRJ, Edifício do Centro de Ciências da Saúde, Bloco G. Av. Carlos Chagas Filho, 373. Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
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17
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Achtman JC, Ellis DL, Saylors B, Boh EE. Cutaneous leishmaniasis caused by Leishmania (Viannia) panamensis in 2 travelers. JAAD Case Rep 2016; 2:95-7. [PMID: 27051841 PMCID: PMC4810283 DOI: 10.1016/j.jdcr.2015.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jordan C. Achtman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Dana L. Ellis
- Department of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Bradley Saylors
- Department of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Erin E. Boh
- Department of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana
- Correspondence to: Erin E. Boh, MD, PhD, Department of Dermatology, 1430 Tulane Avenue, #8036, New Orleans, LA 70112.Department of Dermatology1430 Tulane Avenue#8036New OrleansLA70112
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