The cutaneous leishmaniasis vulnerability index (CLVI)

A conceptual model for understanding the zoonotic cutaneous leishmaniasis transmission risk in the Moroccan pre-Saharan area

Leishmanioses are of public health concern in Morocco, mainly the Zoonotic Cutaneous Leishmaniasis (ZCL) endemic in the Moroccan pre-Saharian area. Transmission of this disease depends on eco-epidemiological and socio-economic conditions. Therefore, a multivariable approach is required to delineate the risk and intensity of transmission. This will help outline main disease risk factors and understand interactions between all underlying factors acting on disease transmission at a local and regional scale. In this context, we propose a new conceptual model, the Biophysical-Drivers-Response-Zoonotic Cutaneous Leishmaniasis (BDRZCL), adapted to the Pre-Saharian area. The proposed model highlights how the physical and human drivers affect the environment and human health. The incidence of ZCL is linked to human activity and biophysical changes or by their interactions. The human response added to risk drivers are the main components that influence the biophysical part. This model improves our understanding of the cause-effect interactions and helps decision-makers and stakeholders react appropriately.

Eco-epidemiological aspects of Zoonotic cutaneous leishmaniasis in Ouarzazate Province, Morocco

Some epidemiological and ecological aspects of Zoonotic cutaneous leishmaniasis (ZCL) in Ouarzazate province, southern Morocco, were explored with the objective of analyzing ZCL distribution and associated ecological factors. Information on cutaneous leishmaniasis patients attending the local health centers of Ouarzazate during the period 2002-2009 was gathered and compiled. Urban, peri-urban, rural origin, precipitation, wind speed, temperature, water irrigation, dam volume, and altitude were studied. The findings show that the disease affected 5405 person during this period; the major part was found in the municipalities near both oases (desert oasis) and water resources, with a high concentration of cases in the peri-urban area. The highest percentage of cases was recorded mainly in September. Considerable associations were found between relative humidity and wind speed with ZCL occurrence. A large number of cases were recorded in areas with altitude ranging from 800 to 2000 m.a.s.l. and spatial precipitation from 15 to 150 mm. The statistical analysis showed a strong association between water storage volume and water irrigation with the annual ZCL occurrence recorded in the downstream area (Zagora province). The results will lead us to understand ZCL risk areas for effective control. Further work is needed mainly for gathering these variables in one single and simplest model.

American cutaneous leishmaniasis associated with degradation of native forest, regardless of economic, social and infrastructure vulnerability

American cutaneous leishmaniasis (ACL) is a notifiable dermatozoonosis with relevant morbidity. The present study aimed to evaluate the epidemiological aspects of cases of ACL reported in Northern Paraná (2007-2016), as well as to georeference and analyse the influence of economic, social and environmental variables. Data from ACL notification forms were obtained and the patients' houses were georeferenced. Descriptive statistics, calculations of disease incidence and proportion of vegetation cover by municipality, spatial analysis, multiple linear regression and vulnerability analysis by census sector (CS) were performed. One thousand four hundred fifty-one cases of ACL were reported in the 89 municipalities of four regional health (RH). The average incidence of cases per 10,000 inhabitants was as follows: 11.58, 8.79, 4.92 and 4.03 in 18thRH, 15thRH, 16thRH and 17thRH. Peaks of incident cases were observed in 2008, 2012 and 2015. There was a statistically significant difference between the HR when comparing the proportions of the variables gender, age, education level, area of residence, clinical form, diagnostic criteria, response to treatment and drug used in case of failure. It was observed that the lower the proportion of remaining Atlantic Forest, the greater the incidence of ACL in the municipality. With regard to clusters analysis, treatment abandonment clusters were observed in the 15thRH and mucous form clusters were observed in the 15thRH, 16thRH and 17thRH. The vulnerability analysis by CS allowed us to observe a statistically significant difference in all vulnerability indicators: economic and social in 15thRH and 17thRH; home infrastructure in 15thRH and 18thRH, urban infrastructure in 15thRH and 18thRH and compound vulnerability index in 15thRH and 18thRH. However, the most vulnerable areas did not always have the highest number of cases. The data presented demonstrate that preventive and health education measures must be mainly directed to areas of greater degradation of native forest; regardless of the vulnerability situation.

Spatial-Temporal Analysis of Lutzomyia trapidoi and Lutzomyia reburra (Diptera: Phlebotominae), in Rural Tourist Locations, Biosphere Reserve and Leishmaniasis Endemic Area, Ecuador

This research represents the first attempt to assess the spatial and temporal distribution based on micro-meso scales on two species with different host preference habits (anthropophilic vs zoophilic), in the major Leishmaniasis endemic area in Ecuador, tourist locations, and Biosphere reserve. Phlebotomine species, Lutzomyia trapidoi (Fairchild) and Lutzomyia reburra (Fairchild and Hertig), were analyzed by trap/habitat/month/locality/altitude, through the Poisson generalized regression model. Our data reveal a bimodal pattern for both species related with low precipitations and preference for forest habitat. Altitude, proximity to the forest, and the river were the variables that determine the hypervolume of the spatial distribution of relative abundance, where the overlap of these two species increases the risk of translocation and circulation of the etiological agent of leishmaniasis in sylvatic environments to rural-tourist-biosphere reserve areas and vice versa. The ecological characteristics of these two phlebotomines could explain the permanence of the major active and endemic focus of cutaneous leishmaniasis in the North-Western Ecuador a key aspect in tourism health-security in alternative tourism.

Seasonal Distribution of Phlebotomus papatasi, Vector of Zoonotic Cutaneous Leishmaniasis

PURPOSE

The activity of Phlebotomus papatasi Scopoli, a vector of cutaneous leishmaniasis, is known to be seasonal, but the information describing these patterns is sparse in time and space. The purpose of his paper is to conduct a meta-analysis to depict the seasonality of P. papatasi at the global scale.

METHODS

The current paper uses data from a collection of 1200 scientific papers, where 300 are about the vector and 36 include monthly data (of 61 sites) of the P. papatasi from 15 countries published from 1994 to 2017.

RESULTS

The activity peaked mainly in dry periods in all explored sites. A map of seasonal distribution depicted a peak activity in August, followed by September. Geographically (geographic preference), August and September at the latitude 33° showed the highest abundance at a global scale. Concerning the latitude P. papatasi distribution, the high number is localized between 27° and 35°. However, the high number of this species according to the longitude is localized between - 4° and 58°, which shows a high interval of activity. Locally, for the habitat preference, the findings show a preference of this vector to indoor than to outdoor.

CONCLUSIONS

All these results can be helpful in identifying the period and sites of a future potential risk of leishmaniasis. This is the first attempt at the update of the vector activity both at global and local scale.