Geographic and ecological features of phlebotomine sand flies (Diptera: Psychodidae) as leishmaniasis in Central Iran

Population dynamics of phlebotomine sand flies (Diptera: Psychodidae) in cutaneous leishmaniasis endemic areas of Kurunegala District, Sri Lanka

Sand flies are the primary vectors of leishmaniasis. Disease management with effective vector control depends on the knowledge of vector population dynamics. In Sri Lanka, despite few isolated entomological collections, long-term studies are not reported to date. In the reported study, monthly entomological surveillance was conducted from May 2017 to December 2018 in Polpithigama, Maho, and Galgamuwa Medical Officer of Health (MOH) areas using standard entomological techniques. Climatic data were collected from the Department of Meteorology, Sri Lanka. Patient records were collected from each MOH office. A total of 38,339 sand flies were collected. The majority were Phlebotomus argentipes (99.50%, n = 38,147), while the rest was Sergentomyia punjabensis (0.50%, n = 192). Wind speed reduces sand fly abundance (r = -0.519, P < 0.05) evidently by limiting the movement. Rainfall increases sand fly abundance (r = 0.842, P <0.05, lag = 6 months) probably by improving favorable conditions in breeding sites. The actual effect of humidity is not conclusive without further research. The observed higher prevalence of leishmaniasis in the study sites could be due to the higher sand fly density in these areas. The number of patients shows a strong positive correlation (r = 0.516, P <0.05) to the sand fly abundance with a lag of 7 months. Systematic surveillance of sand flies as a part of general healthcare services is strongly recommended to identify and prevent possible outbreaks through timely planned vector control measures.

First molecular identification of Leishmania major in Phlebotomus papatasi in an outbreak cutaneous leishmaniasis area in Iraq

Cutaneous leishmaniasis (CL) is transmitted by Phlebotomine sand fly vectors, among which Phlebotomus papatasi is prevalent in Western Asia, Northern Africa and Southern Europe, and it is known as a vector for Leishmania major parasite in the world. However, in Iraq, morphological studies showed that P. papatasi is a predominant sand fly species and hypothesised to transmit CL causing Leishmania species including L. major and L. tropica. Few studies have found Leishmania species in sand flies in mixed pools of samples in this country. Accurate identification of sand flies as vectors of Leishmania species is required in Iraq. The current study aims to identify sand fly species, using both morphological and molecular phylogenetic analyses, in a region where CL tends to be endemic. Furthermore, molecular phylogenetic analysis has also used to confirm Leishmania species in the sand fly samples collected in 11 villages between Diyala and Sulaymaniyah Provinces. For the first time, we have found L. major in three individual sand flies, one engorged (with fresh blood meal) and two non-engorged (without visible fresh blood meal) P. papatasi females in an area of CL outbreaks since 2014-till now due to civil wars and internal conflicts happen in the region. Further study should be performed on sand fly population and Leishmania reservoirs in this region.

Treatment Failure in Cutaneous Leishmaniasis Patients Referred to the School of Public Health, Tehran University of Medical Sciences during 2008-2017

BACKGROUND

Cutaneous leishmaniasis (CL) is a vector borne disease predominantly found in tropical and subtropical countries, including Iran. For more than 6 decades, pentavalent antimonials have been used successfully worldwide for the treatment of leishmaniasis, but over the past few years, clinical resistance to these medications has increased. In this study, we evaluated CL patients who did not show any desirable responses to the anti-leishmanial treatment within a 10-year period (2008 to 2017).

METHODS

All patients from different parts of Iran suspected of having cutaneous leishmaniasis, who were referred to the laboratory of leishmaniosis in Tehran University of Medical Sciences from 2008-2017 were parasitological examined.

RESULTS

During this period, a total of 1480 suspected CL patients were referred to the laboratory of leishmaniosis. Samples from 655 patients (70.8%) suspected of having CL were positive microscopically. The failure rate in patients treated with anti-leishmaniasis medications for a minimum of three complete treatment periods was 1.83% (12 cases). There was no association between the number and size of skin lesions and patient characteristics. Also, the route of drug administration had no significant effect on the number and size of lesions.

CONCLUSION

In the present study, treatment failure was found in some confirmed CL patients treated with meglumine antimoniate. Over the past few years, it seems that had been increased in resistance to these medications. So, a review of the correct implementation of the treatment protocol and/or a combination therapy may be helpful in preventing an increase in the rate of treatment failure.