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Ullah W, Khan A, Niaz S, Al-Garadi MA, Nasreen N, Swelum AA, Ben Said M. Epidemiological survey, molecular profiling and phylogenetic analysis of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan. Trans R Soc Trop Med Hyg 2024; 118:273-286. [PMID: 38055843 DOI: 10.1093/trstmh/trad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/22/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL), an emerging vector-borne ailment in Khyber Pakhtunkhwa (KPK), Pakistan, exhibits diverse spread patterns and outbreaks. METHODS To comprehend its epidemiology and identify parasite species, we conducted an active survey on suspected CL cases (n=8845) in KPK. RESULTS Microscopy and internal transcribed spacer-1 PCR-restriction fragment length polymorphism (RFLP) molecular techniques detected Leishmania spp. in blood samples. Phylogenetic analysis gauged genetic affinities with other areas. District Bannu displayed the highest CL impact (14.58%), while Swat had the lowest impact (4.33%) among cases. Annual blood examination rate, parasite incidence and slide positivity rate were 4.96 per 1000 people, 0.0233 and 0.047%, respectively. CL infections were prevalent in 1- to 20-y-olds, with males (57.17%) more vulnerable than females (42.82%). Single lesions occurred in 43.73% of patients, while 31.2% people had two lesions, 17.31% had three lesions and 7.74% had more than three lesions. Most had sand-fly exposure but lacked preventive measures like repellents and bed nets. Leishmania tropica was confirmed via RFLP analysis in amplified samples. Phylogenetic analysis unveiled genetic parallels between L. tropica of KPK and isolates from China, Iran, Afghanistan, India, Syria and Morocco. CONCLUSIONS Urgent comprehensive control measures are imperative. Early detection, targeted interventions and raising awareness of CL and sand-fly vectors are vital for reducing the disease's impact. International collaboration and monitoring are crucial to tackle Leishmania spp.'s genetic diversity and curtail its cross-border spread.
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Affiliation(s)
- Wasia Ullah
- Depart ment of Zoology, Abdul Wali Khan University, Khyber Pakhtunkhwa, Pakistan
| | - Adil Khan
- Department of Botany/Zoology, Bacha Khan University Charsadda, Khyber Pakhtunkhwa, Pakistan
- Department of Biology, Mountain Allison university, Sackville, new Brunswick, Canada
| | - Sadaf Niaz
- Depart ment of Zoology, Abdul Wali Khan University, Khyber Pakhtunkhwa, Pakistan
| | - Maged A Al-Garadi
- Department of Animal Production, College of Food and Agriculture Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Nasreen Nasreen
- Depart ment of Zoology, Abdul Wali Khan University, Khyber Pakhtunkhwa, Pakistan
| | - Ayman A Swelum
- Department of Animal Production, College of Food and Agriculture Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mourad Ben Said
- Laboratory of Microbiology, National School of Veterinary Medicine of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
- Department of Basic Sciences, Higher Institute of Biotechnology of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
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Khazal RM, Flaih MH, Kadhim MK, Hussein KR. Genetic Diversity of Leishmania major Isolated from Different Dermal Lesions Using ITS2 Region. Acta Parasitol 2024; 69:831-838. [PMID: 38436865 DOI: 10.1007/s11686-024-00817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/24/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND AND OBJECTIVE Cutaneous leishmaniasis (CL) is still considered to be an uncontrolled endemic disease that spreads in many countries. The current study aimed to determine intra-species relationships of L. major using ITS2 sequencing. METHODS The study was conducted from the beginning of March to the end of November 2022. All medical information regarding CL was collected from patients of Thi-Qar province who attended the Dermatology Department of Al-Hussein Teaching Hospital in Nasiriyah city. Seventy-three samples were selected for the molecular identification after confirming microscopy with Giemsa stain. In this study, the primers were designed using NCBI GenBank sequence database and Primer 3 plus primer design online software. RESULTS The results recorded 21 (28.77%) positive samples of L. major using the internal transcribed spacer 2 region (ITS2) in ribosomal RNA gene. The local L. major IQN.1-IQN.10 were submitted to NCBI GenBank database with accession numbers OM069357.1-OM069366.1, respectively. The phylogenetic analysis revealed that local isolates of L. major showed a close relationship with NCBI-BLAST L. major Iran isolate (KU680848.1). CONCLUSION ITS2-PCR is suitable for identifying Leishmania spp. and determining genetic diversity. A phylogenetic data analysis may provide an idea on the genetic homogeneity of local isolates and knowing the genetic origin of the dermal lesion. However, the local isolates showed genetic proximity to the KU680848.1 isolate. This signifies the possibility of infection prevalence from Iranian areas. In general, genetic variation of L. major isolates may give several clinical manifestations of the cutaneous lesion. Therefore, determination of the heterogeneity is important for detecting the infection origin, epidemiology, therapy, and control strategies.
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Affiliation(s)
- Ruaa M Khazal
- Department of Medical Laboratory Techniques, Nasiriyah Technical Institute, Southern Technical University, Nasiriyah, 64001, Iraq
| | - Mohammed H Flaih
- Department of Nursing Techniques, Nasiriyah Technical Institute, Southern Technical University, Nasiriyah, 64001, Iraq.
| | - Manar K Kadhim
- Education Directorate of Thi-Qar, Ministry of Education, Nasiriyah, 64001, Iraq
| | - Khwam R Hussein
- Department of Nursing Techniques, Nasiriyah Technical Institute, Southern Technical University, Nasiriyah, 64001, Iraq
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Ghatee MA, Sharifi I, Mohammadi N, Moghaddam BE, Kohansal MH. Geographical and climatic risk factors of cutaneous leishmaniasis in the hyper-endemic focus of Bam County in southeast Iran. Front Public Health 2023; 11:1236552. [PMID: 38026324 PMCID: PMC10680988 DOI: 10.3389/fpubh.2023.1236552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Cutaneous leishmaniasis (CL) is a prevalent debilitating disease in many countries, particularly in Iran, the Middle East, North Africa, and South America. Bam County is the most important highly endemic focus of anthropometric CL in Iran and has been under consideration by WHO. This study investigated the environmental and geographic factors affecting the occurrence and distribution of CL in this focus. Methods Demographic data and the home addresses of CL patients diagnosed from 2015 to 2020 were retrieved from the Leishmaniasis Center of Bam in southeast Iran. The effects of mean annual rainfall (MAR), mean annual humidity (MAH), mean annual temperature (MAT), maximum annual temperature (MaxMAT), minimum annual temperature (MinMAT), mean annual humidity (MAH), mean annual evaporation (MAE), mean annual frosty days (MAFD), mean annual snowy hours (MASH), elevation, and land cover on the distribution of CL were analyzed using geographical information systems (GIS) and univariate and multivariate regression models. Results Of 847 patients studied, 50.9% (n = 431) were female and 49.1% (n = 416) were male. The age classes 0-10 (n = 246) and 11-20 (n = 145) showed the highest frequency of patients, respectively. Leishmaniasis patients were reported from 66 villages/cities (11.8%) out of 561 residential areas in Bam County. Univariate analysis showed that urban settings (OR = 21.66), agriculture (OR = 5.73), orchards (OR = 5), salty land (OR = 1.05), and temperatures (OR = 2.37, 2.79 and 3.47) had positive effects on CL occurrence (p < 0.05), while altitude, precipitation, humidity, evaporation, and the number of frozen days had negative effects. Multivariate analysis identified urban settings (OR = 13.6), orchards (OR = 6.29), agriculture (OR = 5.82), and minimum temperature (OR = 2.38) as the most significant determinants of CL occurrence in this region. Conclusion Environmental and ecological factors play an important role in the distribution of CL in Bam County. The high-risk zones for CL are cities/large villages, agricultural and orchard areas in lower altitudes and with warmer climates and lower rainfall and humidity. This model can guide researchers and health managers to properly conduct CL control programs and allocate budgets.
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Affiliation(s)
- Mohammad Amin Ghatee
- Department of Medical Microbiology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Niloufar Mohammadi
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Mohammad Hasan Kohansal
- School of Medicine, Bam University of Medical Sciences, Bam, Iran
- Department of Parasitology and Mycology, Tabriz University of Medical Sciences, Tabriz, Iran
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Zakariaei Z, Fakhar M, Bari S, Derakhshani M, Banimostafavi ES, Soleymani M. Nasal Leishmaniasis Misdiagnosed With Intranasal Polyp in a Patient Candidate for Rhinoplasty. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2023; 16:11795476231186913. [PMID: 37799763 PMCID: PMC10548795 DOI: 10.1177/11795476231186913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 10/07/2023]
Abstract
Mucosal leishmaniasis (ML) is a chronic and rare form of leishmaniasis that causes malignant lesions in the mucosa of the nasal, pharyngeal, and laryngeal regions. We describe a 29-year-old woman who had been suffering from an intranasal polyp for 3 years. The polyp recurred annually after surgical removal, and was diagnosed as nasal leishmaniasis.
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Affiliation(s)
- Zakaria Zakariaei
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Toxicology and Forensic Medicine Division, Mazandaran Registry Center for Opioids Poisoning, Antimicrobial Resistance Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Simin Bari
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Derakhshani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elham Sadat Banimostafavi
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Radiology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mostafa Soleymani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
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Al-Jawabreh A, Ereqat S, Al-Jawabreh H, Dumaidi K, Nasereddin A. Genetic diversity and haplotype analysis of Leishmania tropica identified in sand fly vectors of the genera Phlebotomus and Sergentomyia using next-generation sequencing technology. Parasitol Res 2023; 122:1351-1360. [PMID: 37036520 DOI: 10.1007/s00436-023-07835-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/30/2023] [Indexed: 04/11/2023]
Abstract
Next-generation sequencing (NGS) was used to investigate the genetic diversity of Leishmania tropica in the sand fly vector, targeting the internal transcribed spacer 1 (ITS1) of the genus Leishmania. Bioinformatics analyses were conducted using Galaxy, MEGA version X, DnaSP ver. 6.12.03, and PopART 1.7 software for NGS analysis, phylogenetic tree, genetic diversity, and haplotype networking, respectively. A total of 307 engorged sand flies were trapped, with an overall Leishmania infection rate of 9.4 (29/307) and 6.8% by NGS and ITS1-PCR, respectively. Two Leishmania-infected sand fly genera were identified: Phlebotomus (10.2%, 26/254) and Sergentomyia (5.7% (3/53). The phylogenetic tree showed two clusters, cluster I included the four study sequences along with 25 GenBank-retrieved DNA sequences. Cluster II consisted of three sequences from Iran and Pakistan. The genetic diversity analysis for the 29 L. tropica sequences showed high haplotype (gene) diversity index (Hd) (0.62 ± 0.07) but low nucleotide diversity index (π) (0.04 ± 0.01). Tajima's D, a neutrality test, is more negative in cluster I (D = - 2.0) than in total population (D = - 1.83), but both are equally significant (P < 0.001), indicating that observed variation in cluster I and whole population is less frequent than expected. The median-joining haplotype network produced a total of 11 active haplotypes. In conclusion, L. tropica from sand flies in Palestine is monophyletic that assembled in one main phylogroup and one haplotype.
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Affiliation(s)
- Amer Al-Jawabreh
- Arab American University, Jenin, Palestine
- Leishmaniases Research Unit-Jericho, Jericho, Palestine
| | - Suheir Ereqat
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, East Jerusalem, Palestine.
| | - Hanan Al-Jawabreh
- Leishmaniases Research Unit-Jericho, Jericho, Palestine
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, East Jerusalem, Palestine
| | | | - Abedelmajeed Nasereddin
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, East Jerusalem, Palestine
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Awada B, Hamie M, El Hajj R, Derbaj G, Najm R, Makhoul P, Ali DH, Abou Fayad AG, El Hajj H. HAS 1: A natural product from soil-isolated Streptomyces species with potent activity against cutaneous leishmaniasis caused by Leishmania tropica. Front Pharmacol 2022; 13:1023114. [PMID: 36299890 PMCID: PMC9589300 DOI: 10.3389/fphar.2022.1023114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/26/2022] [Indexed: 01/19/2023] Open
Abstract
Cutaneous Leishmaniasis (CL) is a neglected tropical disease, classified by the World Health Organization (WHO) as one of the most unrestrained diseases. The Syrian war and the significant displacement of refugees aggravated the spread of this ailment into several neighboring countries in the Eastern Mediterranean Region (EMR). In Syria, Leishmania tropica is identified as one of the most aggressive and endemic identified species, causing localized or generalized lesions, often chronic or relapsing. Pentavalent antimonial drugs are currently used as first line treatment against CL. Nonetheless, these drugs exhibit several limitations, including the repetitive painful injections, high cost, poor availability, and mainly systemic toxicity. Besides, the emergence of acquired parasitic resistance hinders their potency, stressing the need for new therapies to combat CL. Natural products (NPs) epitomize a valuable source in drug discovery. NPs are secondary metabolites (SMs) produced by plants, sponges, or a wide variety of organisms, including environmental microorganisms. The EMR is characterized by its immense biodiversity, yet it remains a relatively untapped area in drug discovery. NPs of the region were explored over the last 2 decades, but their discoveries lack biogeographical diversity and are limited to the Red Sea. Here, we isolated previously uncultured environmental soil-dwelling Streptomyces sp. HAS1, from Hasbaya region in southeast Lebanon. When fermented in one of our production media named INA, HAS1 produced a crude extract with significant potency against a clinical Leishmania tropica isolate. Using bio-guided fractionation, the bioactive compound was purified and the structure was elucidated by NMR and LC-HRMS. Our findings establish NPs as strong candidates for treating Leishmania tropica and further dwells on the importance of these natural sources to combat microbial infections.
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Affiliation(s)
- Bassel Awada
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Drug Discovery, American University of Beirut, Beirut, Lebanon
| | - Maguy Hamie
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Drug Discovery, American University of Beirut, Beirut, Lebanon
| | - Rana El Hajj
- Department of Biological Sciences, Beirut Arab University, Beirut, Lebanon
| | - Ghada Derbaj
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Drug Discovery, American University of Beirut, Beirut, Lebanon
| | - Rania Najm
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Perla Makhoul
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Drug Discovery, American University of Beirut, Beirut, Lebanon
| | - Dima Hajj Ali
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Antoine G. Abou Fayad
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Drug Discovery, American University of Beirut, Beirut, Lebanon
- *Correspondence: Antoine G. Abou Fayad, ; Hiba El Hajj,
| | - Hiba El Hajj
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Drug Discovery, American University of Beirut, Beirut, Lebanon
- *Correspondence: Antoine G. Abou Fayad, ; Hiba El Hajj,
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Daoui O, Bennaid H, Kbaich MA, Mhaidi I, Aderdour N, Rhinane H, Bouhout S, Akarid K, Lemrani M. Environmental, Climatic, and Parasite Molecular Factors Impacting the Incidence of Cutaneous Leishmaniasis Due to Leishmania tropica in Three Moroccan Foci. Microorganisms 2022; 10:microorganisms10091712. [PMID: 36144314 PMCID: PMC9506065 DOI: 10.3390/microorganisms10091712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Cutaneous leishmaniasis (CL) occurring due to Leishmania tropica is a public health problem in Morocco. The distribution and incidence of this form of leishmaniasis have increased in an unusual way in the last decade, and the control measures put in place are struggling to slow down the epidemic. This study was designed to assess the impact of climatic and environmental factors on CL in L. tropica foci. The data collected included CL incidence and climatic and environmental factors across three Moroccan foci (Foum Jemaa, Imintanout, and Ouazzane) from 2000 to 2019. Statistical analyses were performed using the linear regression model. An association was found between the occurrence of CL in Imintanout and temperature and humidity (r2 = 0.6076, df = (1.18), p-value = 3.09 × 10−5; r2 = 0.6306, df = (1.18), p-value = 1.77 × 10−5). As a second objective of our study, we investigated the population structure of L.tropica in these three foci, using the nuclear marker internal transcribed spacer 1 (ITS1). Our results showed a low-to-medium level of geographic differentiation among the L.tropica populations using pairwise differentiation. Molecular diversity indices showed a high genetic diversity in Foum Jemaa and Imintanout; indeed, 29 polymorphic sites were identified, leading to the definition of 13 haplotypes. Tajima’s D and Fu’s F test statistics in all populations were not statistically significant, and consistent with a population at drift–mutation equilibrium. Further analysis, including additional DNA markers and a larger sample size, could provide a more complete perspective of L. tropica’s population structure in these three regions. In addition, further research is needed to better understand the impact of climatic conditions on the transmission cycle of Leishmania, allowing both for the development of effective control measures, and for the development of a predictive model for this parasitosis.
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Affiliation(s)
- Othmane Daoui
- Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca 20250, Morocco
- Molecular Genetics and Immunophysiopathology Research Team, Health and Environment Laboratory, Aïn Chock Faculty of Sciences, Hassan II University of Casablanca, Casablanca 20000, Morocco
| | - Hamza Bennaid
- Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca 20250, Morocco
- Information Retrieval and Data Analytics Laboratory, National School of Computer Science and System Analysis (Ensias), Rabat 10112, Morocco
| | - Mouad Ait Kbaich
- Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca 20250, Morocco
| | - Idris Mhaidi
- Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca 20250, Morocco
| | - Nacer Aderdour
- Geosciences Laboratory, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca 20000, Morocco
| | - Hassan Rhinane
- Geosciences Laboratory, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca 20000, Morocco
| | - Souad Bouhout
- Directorate of Epidemiology, Division of Infectious Diseases, Service of Parasitic Diseases, Ministry of Health of Morocco, Rabat 10020, Morocco
| | - Khadija Akarid
- Molecular Genetics and Immunophysiopathology Research Team, Health and Environment Laboratory, Aïn Chock Faculty of Sciences, Hassan II University of Casablanca, Casablanca 20000, Morocco
| | - Meryem Lemrani
- Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca 20250, Morocco
- Correspondence:
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Al-Rashed AS, Al Jindan R, Al Jaroodi S, Al Mohanna A, Abdelhady A, El-Badry AA. Genotypic and phylogenic analyses of cutaneous leishmaniasis in Al Ahsa, Eastern Saudi Arabia during the coronavirus disease 2019 pandemic: First cases of Leishmania tropica with the predominance of Leishmania major. Sci Rep 2022; 12:10753. [PMID: 35750705 PMCID: PMC9232512 DOI: 10.1038/s41598-022-14702-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/10/2022] [Indexed: 01/19/2023] Open
Abstract
During the coronavirus disease 2019 lockdown period, a surge in sandflies and cutaneous leishmaniasis (CL) cases was observed in Al-Ahsa, Saudi Arabia. Skin punch biopsies were obtained from 100 patients clinically diagnosed with CL in Al-Ahsa who had no travel history in the last 6 months. Impression smears were used following a three-step polymerase chain reaction (PCR) protocol using genus-specific primers targeting kDNA and ITS1. Leishmania speciation was determined by ITS1 PCR/nested PCR-restriction fragment length polymorphism and sequencing. A phylogenetic tree was constructed. The associated patient characteristics were analyzed. Using internal transcribed spacer one (ITS1)-PCR/nested PCR, 98 cases were considered true-positive CL. Leishmania major was the predominant species, and Leishmania tropica was identified in three cases. Microscopy had poor sensitivity and perfect specificity. Direct ITS1-PCR missed nine cases. Sex, residence, and treatment outcome were significantly associated with the occurrence of Leishmania; distribution of skin lesion(s) and treatment outcome were significantly associated with Leishmania genotype. This is the first time that L. tropica was identified as a cause of CL in human in Al-Ahsa, in addition to the predominant zoonotic species, L. major. We recommend using ITS1-nested PCR for negative cases by ITS1-PCR. Further exploration of Leishmania transmission dynamics in vectors and reservoir animals is essential for designing effective preventive measures.
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Affiliation(s)
- Abdullatif S Al-Rashed
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem Al Jindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Salma Al Jaroodi
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Al Mohanna
- Vector Borne and Diseases Prevention Center, Al Ahsa, Saudi Arabia
| | | | - Ayman A El-Badry
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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Fakhar M, Rasooli SA, Banimostafavi ES, Soleymani M. Atypical manifestations of cutaneous leishmaniasis in a boy from Afghanistan. Clin Case Rep 2022; 10:e05738. [PMID: 35441027 PMCID: PMC9012161 DOI: 10.1002/ccr3.5738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
Cutaneous leishmaniasis is one of the most common forms of leishmaniasis in Afghanistan, which is caused by different Leishmania species that are transmitted to humans by sandflies. Its clinical manifestations are very diverse and depend on a variety of parasite and host factors.
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Affiliation(s)
- Mahdi Fakhar
- Toxoplasmosis Research Center Communicable Diseases Institute Iranian National Registry Center for Lophomoniasis (INRCL) Mazandaran University of Medical Sciences Sari Iran
| | - Seyed Abobaker Rasooli
- National Health Coordinator (NHC) and Head of Herat WHO Sub‐office Herat Province Afghanistan
| | - Elham Sadat Banimostafavi
- Toxoplasmosis Research Center Communicable Diseases Institute Iranian National Registry Center for Lophomoniasis (INRCL) Mazandaran University of Medical Sciences Sari Iran
| | - Mostafa Soleymani
- Toxoplasmosis Research Center Communicable Diseases Institute Iranian National Registry Center for Lophomoniasis (INRCL) Mazandaran University of Medical Sciences Sari Iran
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Taxonomy, Population Structure and Genetic Diversity of Iranian Leishmania Strains of Cutaneous and Visceral Leishmaniasis. Acta Parasitol 2021; 66:1274-1284. [PMID: 33942225 DOI: 10.1007/s11686-021-00377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Despite the broad distribution of leishmaniasis in Iran, there is a little genetic information about the causative agents and epidemiological status of the disease. Genetic diversity of the parasite is suggested to be one of the factors, which influences the clinical manifestations of the disease. In this study, we investigated the genetic variations, population structure, and evolutionary history of Leishmania species from endemic foci of Iran. METHODS Fifty-two isolates from humans, canines, and rodents from different endemic foci of Iran were used to sequence the N-acetyl glucosamine-1-phosphate transferase (Nagt) gene. Phylogenetic and structure analyses were performed to investigate inter- and intra-species diversity of the Leishmania isolates. RESULTS In total, 10 haplotypes including L. major (n = 6), L. tropica (n = 2), L. infantum (n = 1) and L. turanica (n = 1) were identified across 52 isolates. Haplotype diversity (Hd) ranged from zero for L. infantum and L. turanica to 0.78 ± 0.136 for L. major. This study identified population structure of Leishmania isolates from different geographical regions of Iran. The results of the phylogenetic tree showed 4 distinct clades for each species of Leishmania. In addition, the highest intraspecies diversity was observed among L. major isolates. No correlation was observed between species and geographic distribution of haplotypes. CONCLUSIONS Leishmania isolates were identified at the species level using the Nagt gene, low variation within species indicates conservation of this gene in Leishmania. The results provide knowledge into the evolutionary history of Iranian Leishmania isolates.
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Shaheen N, Verma C, Pacheco-Fernandez T, Volpedo G, Hamid A, Zeb I, Shah SAA, Fahad S, Iqbal A, Ashraf A, Khan A, Gul M, Khan MI, Fatima H, Afzal M, Satoskar AR, Qureshi NA. Molecular characterization and genetic diversity of cutaneous leishmaniasis from North Eastern Pakistan. Acta Trop 2021; 221:105964. [PMID: 34023304 DOI: 10.1016/j.actatropica.2021.105964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/28/2021] [Accepted: 05/11/2021] [Indexed: 11/17/2022]
Abstract
The genetic diversity of Leishmania spp. in North Eastern Pakistan remains undetermined despite increased cases of cutaneous leishmaniasis (CL). This study was designed to decipher the molecular characterization and genetic diversity of Leishmania spp. in North Eastern Pakistan. Out of 13761 CL suspected cases, 567 cases were microscopically positive and confirmed as Leishmania spp. by internal transcribed spacer (ITS) gene amplification through the PCR- RFLP technique. Further, isolates were directly sequenced to conduct phylogenetic analysis for genetic diversity. Among suspected CL cases, Mirpur showed the highest proportion of CL infection with 4.85% (118/2431) of the cases, while the Neelum district showed the lowest percentage at 3.29% (9/273). The slide positivity rate, annual blood examination rate, and annual parasite incidence rate were 3.84, 0.27, and 0.01% respectively, and the incidence of CL in the age group 1-20 years old was higher in males (50.92%) than females (25.75%). The RFLP analysis and sequencing confirmed the occurrence of Leishmania tropica, Leishmania major, and Leishmania infantum. Leishmania tropica (p = 0.02) confirmed significantly higher nucleotides variation than L. major (p = 0.05). Current findings confirmed the prior assumption that anthroponotic CL is the primary CL form present in North Eastern Pakistan. Moreover, this is the first report based on molecular identification of L. major, and L. infantum from North Eastern Pakistan. This remarkable heterogeneity in the Leishmania spp. is the leading cause of treatment failure and emergence of new haplotypes. Therefore more extensive investigations are recommended from all geographical regions of North Eastern Pakistan, especially those using a large sample size.
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Affiliation(s)
- Nargis Shaheen
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan; Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Chaitenya Verma
- Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Thalia Pacheco-Fernandez
- Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Greta Volpedo
- Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Aneeqa Hamid
- Department of Pharmacy, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Ismail Zeb
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Syed Aizaz Ali Shah
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Shah Fahad
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Attiya Iqbal
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Asma Ashraf
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Amjad Khan
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan; Departement of Zoology, Faculty of Science,University of lakki marwat 28420, Khyber Pakhtunkhwa, Pakistan
| | - Misbah Gul
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Muhammad Ilyas Khan
- Department of Zoology, Kohat University of Science and Technology Khyber Pakhtunkhwa Islamabad, Pakistan
| | - Huma Fatima
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Muhammad Afzal
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan
| | - Abhay R Satoskar
- Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, United States
| | - Naveeda Akhter Qureshi
- Department of Zoology, Faculty of Biological Science, Quaid-i-Azam University Islamabad 45320, Pakistan.
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12
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Al-Ghabban MJS, Al-Bayati NY, Al-Mayah QS, Al-Matubsi HY. The role of cytotoxic T-Lymphocyte antigen-4+49A/G gene polymorphism in cutaneous leishmaniasis. Microb Pathog 2021; 158:105073. [PMID: 34182077 DOI: 10.1016/j.micpath.2021.105073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cutaneous Leishmaniasis (CL) is a parasitic disease caused by intracellular protozoa belonging to the Leishmania genus. In endemic areas, only a proportion of exposed subjects develop the disease under almost similar circumstances, reflecting the role of genetic inheritance in resistance and susceptibility to infection. This study aimed To evaluate the association of cytotoxic T-lymphocyte antigen-4 (CTLA-4)+49G/A single nucleotide polymorphism (SNP) with incidence and severity of CL. METHODS This cross-sectional study includes 110 patients with confirmed CL (60 newly diagnosed and 50 patients undergoing treatment) and 60 healthy subjects of similar age and sex. The CTLA-4 gene fragment corresponding to CTLA-4+49G/A polymorphism was amplified and genotyped using tetra primer amplification refractory mutation- polymerase chain reaction system (TARMS-PCR) methods. Soluble CTLA-4 (sCTLA-4) was estimated in the serum using an enzyme-linked immunosorbent assay (ELISA). RESULTS The GG genotype of CTLA-4+49G/A polymorphism was significantly more common in controls than in patients (OR = 0.11, 95% CI = 0.02-0.58, p = 0.009). At allelic level, G allele was much more common in controls than in patients (30.83% vs. 17.73%) with a significant difference (OR = 2.07, 95% CI = 1.23-3.48, p = 0.006). However, there was no significant difference in the frequency of genotypes and alleles between newly diagnosed and treated patients. Median serum concentration of sCTLA-4 in newly diagnosed patients was 72.6 pg/ml (range 15.6-127 pg/ml) which was higher than either controls (median = 16.3 pg/ml, range 0.8-48.5 pg/ml) or treated patients (median = 17.9 pg/ml, range 2.9-74.7 pg/ml) with highly significant differences, while there was no significant difference between controls and treated patients. The median sCTLA-4 level was comparable across genotypes of the CTLA-4+49G/A polymorphism, with no significant difference. CONCLUSIONS Collectively, these results show the protective role of allele G of the SNP CTLA-4+49G/A against CL and increased serum sCTLA-4 in newly diagnosed CL patients, which may be used as an additional diagnostic tool. Different genotypes of the CTLA-4+49G/A polymorphism have no effect on sCLTA-4 serum levels.
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Affiliation(s)
| | - Nagham Y Al-Bayati
- Department of Microbiology, College of Medicine, University of Diyala, Iraq.
| | - Qasim S Al-Mayah
- Medical Research Unit, College of Medicine, Al-Nahrain University, Iraq.
| | - Hisham Y Al-Matubsi
- Department of Pharmacology and Medical Sciences, University of Petra, Amman, Jordan.
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13
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Genetic diversity of Leishmania tropica: Unexpectedly complex distribution pattern. Acta Trop 2021; 218:105888. [PMID: 33713626 DOI: 10.1016/j.actatropica.2021.105888] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022]
Abstract
In this study, we characterized a collection of clinical samples obtained from Syrian and Turkish patients with cutaneous leishmaniasis using internal transcribed spacer 1 (ITS1) sequences. All obtained sequences belonged to Leishmania tropica. Combining them with those available from GenBank allowed us performing a broad-scale analysis of genetic diversity for this species. We demonstrated that L. tropica has a complex phylogeographic pattern with some haplotypes being widespread across endemic countries and others restricted to particular regions. We hypothesize that at least some of them may be associated with alternative vectors or animal reservoirs.
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14
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Ziaei Hezarjaribi H, Karamian M, Geran Orimi T, Pagheh AS, Emadi SN, Fakhar M, Derakhshani-Niya M. Phylogenetic position of Leishmania tropica isolates from an old endemic focus in south-eastern Iran; relying on atypical cutaneous leishmaniasis. Transbound Emerg Dis 2020; 68:1493-1503. [PMID: 32881318 DOI: 10.1111/tbed.13818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/23/2020] [Accepted: 08/28/2020] [Indexed: 02/07/2023]
Abstract
Cutaneous leishmaniasis (CL) is a major health problem in Iran, with a heavy burden on human health and society. There is little knowledge about the molecular epidemiology of the disease, as well as phylogenetic relationship of causative agents in south-eastern Iran. The aim of the present study was to investigate the molecular aspects of CL, especially atypical CL in the Bam district, Kerman province, south-eastern Iran, as an endemic region of CL in Iran. The smears were collected from lesion samples of 353 patients clinically suspected to CL, who attended local health centres in the Bam district during 2016-2017. Direct smears were examined for Leishmania parasites using the Giemsa staining technique. Amplification of kinetoplast DNA (kDNA) and the ribosomal internal transcribed spacer 1(ITS-1) gene were carried out using polymerase chain reaction (PCR). Then, the ITS1-PCR products were sequenced for phylogenetic analysis. Overall, 278 cases were confirmed as CL by microscopic examination of Giemsa-stained slides. Clinical presentation of the lesions was basically of two types: (a) typical lesions and (b) atypical including lupoid ulcers, sporotrichoid, nodular and exudative lesions. The PCR assay on all specimens of skin lesions proved L. tropica as the main pathogenic agent. Phylogenic analysis revealed high similarity among isolates from the Bam district in the south-east with isolates from Birjand in eastern Iran, as well as with isolates from Herat province in western Afghanistan. The study provided valuable information concerning the genetic diversity of the parasite as one of the factors influencing the clinical manifestations in CL in south-eastern Iran, which could be the basis for planning future control strategies.
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Affiliation(s)
- Hajar Ziaei Hezarjaribi
- Molecular and Cell Biology Research Center, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis (INRCL) and Toxoplasmosis (INRCT), Department of Parasitolgy, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Karamian
- Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Tahmineh Geran Orimi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis (INRCL) and Toxoplasmosis (INRCT), Department of Parasitolgy, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdol Sattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyed Naser Emadi
- Skin Research Center, Razi and Imam Khomeini Hospitals, Department of Dermatology, Faculty of Medicine, Tehran University of Medical Sciences, and Iranian Red Crescent, Tehran, Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis (INRCL) and Toxoplasmosis (INRCT), Department of Parasitolgy, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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15
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Nazar E, Yazdani Charati J, Pazoki H, Saki A, Fakhar M, Boroumand F, Rasooli SA. Modelling the number of dermal lesions in anthroponotic cutaneous leishmaniasis and its associated factors in Herat province, western Afghanistan, during 2012-2013. Transbound Emerg Dis 2020; 67:2692-2701. [PMID: 32403184 DOI: 10.1111/tbed.13623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/28/2022]
Abstract
Cutaneous leishmaniasis (CL), caused by Leishmania tropica, is the main causative agent of CL in the Herat province, western Afghanistan. In CL patients, one of the most important indicators for reducing the amount of body damage and the choice of treatment is the number of dermal lesions, but there is no strong evidence in this regard. Therefore, using count regression models, the main objective of this historical cohort study was to identify the distribution of the number of dermal lesions and determine the associated factors among CL patients referring to leishmaniasis reference laboratory in Herat province, from January 2012 to December 2013. In a total of 4,127 clinically suspected CL cases, 50.20% were female and 49.80% male. Based on the results of ZINB model, which is the best model suggested by goodness-of-fit criteria, age variables (IRR = 1.007), duration of lesion (6-12 weeks compared to < 6 weeks with IRR = 1.36 and >12 weeks with IRR = 1.39 compared to <6 weeks), type of lesion(both nodule and ulcer compared to papule with IRR = 2.03), location of lesion (trunk with IRR = 1.90, upper with IRR = 1.66, lower with IRR = 1.61 and mix with IRR = 10.35 compared to head/neck/ears) and type of lesion (ulcer compared to papule with IRR = 0.50, nodule and lupoid, respectively, as IRR = 0.72 and IRR = 0.51 compared to papule) had a significant effect on the mean number of dermal lesions (p < .05). Also, our results showed that among four models used, the ZINB model represented a better performance to determine the associated probable factors about the number of dermal lesions in ACL patients. Moreover, there was a direct association between age and number of dermal lesions; in addition, duration of lesion, type of lesion and location of lesion had a significant effect on the number of dermal lesions. Therefore, a comprehensive planning is necessary for controlling and reducing the number of dermal lesions.
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Affiliation(s)
- Eisa Nazar
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Pazoki
- Student Research Committee, Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Saki
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.,Social Determinants of Health Research Centre, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Fakhar
- Department of Parasitology, School of Medicine, Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farzaneh Boroumand
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayed Abobakar Rasooli
- National Health Coordinator (NHC) and Head of Herat WHO Sub-office, Herat Province, Afghanistan
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16
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Ghatee MA, Taylor WR, Karamian M. The Geographical Distribution of Cutaneous Leishmaniasis Causative Agents in Iran and Its Neighboring Countries, A Review. Front Public Health 2020; 8:11. [PMID: 32133334 PMCID: PMC7039857 DOI: 10.3389/fpubh.2020.00011] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/14/2020] [Indexed: 12/15/2022] Open
Abstract
Leishmania tropica and Leishmania major are both the main cause of anthroponotic (ACL) and zoonotic cutaneous leishmaniasis (ZCL), respectively, in the Old World. Leishmania infantum and Leishmania donovani, which are important causes of visceral leishmaniasis, have also occasionally been reported in CL patients. The present study investigates the current distribution of causative species of CL in Iran and neighboring countries in the Middle East. There has been expansion of L. tropica into new urban and rural foci in Iran, with well-documented cases of visceralization, a substantial increase of CL in Syria, and the emergence of new foci and outbreaks in Turkey and Iraq, especially due to L. major. Civil war in Syria and Iraq, population movement, poverty, and climatic change play important roles in the changing CL distribution in this region. Control programs should adopt a multidisciplinary approach based on active surveillance and case finding, especially in vulnerable refugee populations, determination of hazard maps for CL hot points using GIS and other advanced technology, the free distribution of drugs, rodent control, and greater community engagement in poor and marginalized populations. Comprehensive molecular studies that could show the species and strains of Leishmania in different areas of each country can give a better view from the distribution of CL in this region.
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Affiliation(s)
- Mohammad Amin Ghatee
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.,Department of Parasitology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Walter R Taylor
- Clinical Therapeutics Unit, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mehdi Karamian
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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17
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Razavinasab SZ, Sharifi I, Aflatoonian MR, Babaei Z, Mohammadi MA, Salarkia E, Sharifi F, Aghaei Afshar A, Bamorovat M. Expansion of urban cutaneous leishmaniasis into rural areas of southeastern Iran: Clinical, epidemiological and phylogenetic profiles explored using 7SL high resolution melting-PCR analysis. Transbound Emerg Dis 2019; 66:1602-1610. [PMID: 30912874 DOI: 10.1111/tbed.13186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/20/2019] [Accepted: 03/01/2019] [Indexed: 11/29/2022]
Abstract
Cutaneous leishmaniasis (CL) has increased remarkably in Iran and has expanded into new areas. The present study aimed to assess the emerging CL outbreak in southeastern Iran using high resolution melting-polymerase chain reaction (HRM-PCR) and phylogenetic analysis using the 7SL RNA gene marker. A cross-sectional and analytical survey was conducted during a house-to-house census of 11,021 inhabitants in Narmashir County in southeastern Iran in 2016. The cases were detected by direct smear microscopic examination and sequencing and were characterized using the 7SL RNA gene. All age groups and sexes were equally affected. Most were single lesions (70.7%). The hands (55.2%) and face (37.9%) were the main sites of involvement. The disease was more common among illiterate persons. Sequencing and HRM-PCR revealed that Leishmania tropica (accession no. MH632168 Qale-Shahid) was the principal causative agent of anthroponotic CL (ACL) in new areas of expansion. This is the first emergence of ACL in rural areas of Narmashir County. Based on the molecular data, the causative parasite species confirmed to be L. tropica. Sequencing and phylogenetic analysis indicated that a single clone of the organism derived from a single source has spread into the affected villages. Construction of a main road, population movement and recent urbanization in the area are likely the major factors associated with the establishment of this new outbreak. This study was essential to enable the planning of effective therapeutic and prophylactic measures to control the disease.
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Affiliation(s)
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Aflatoonian
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Babaei
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Department of Parasitology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Mohammadi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Salarkia
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sharifi
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Aghaei Afshar
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
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18
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Mohammadpour I, Hatam GR, Handjani F, Bozorg-Ghalati F, PourKamal D, Motazedian MH. Leishmania cytochrome b gene sequence polymorphisms in southern Iran: relationships with different cutaneous clinical manifestations. BMC Infect Dis 2019; 19:98. [PMID: 30696426 PMCID: PMC6352432 DOI: 10.1186/s12879-018-3667-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/28/2018] [Indexed: 01/04/2023] Open
Abstract
Background Cutaneous leishmaniasis (CL) caused by Leishmania species, is a geographically extensive disease that infects humans and animals. CL is endemic in half of the 31 provinces of Iran, with 29,201 incidence cases reported in Fars province from 2010 to 2015. CL is polymorphic and may result in lesions characterized by different clinical features. Parasite genetic diversity is proposed to be one of the factors affecting the clinical outcome and lesion characteristics in CL patients. However, there is still very limited data regarding the genetic variation of Leishmania spp. based on the sequencing of Cytochrome b (Cyt b) gene. Methods All patients originated from endemic regions in Fars province. The amplification of the Cyt b gene from isolates of 100 patients with disparate clinical forms of CL was accomplished using Nested-PCR. Sequence analysis of the amplified Cyt b was used to scrutinize the genetic variations among Leishmania isolates and connect the results with clinical pictures. The clinical demonstrations were basically of two types, typical and atypical lesions. Molecular phylogenetic tree was constructed using the Neighbor-Joining method, with species/strains from this study compared to species/strains from other geographical regions. Results Leishmania major was identified as the predominant infecting Leishmania spp. (86% of cases), with the remainder of cases being infected by Leishmania tropica. Clinical examination of patients revealed 12 different clinical CL forms. Among Leishmania samples analyzed, five distinct haplotypes were recognized: three in L. major and two in L. tropica. We found a correlation between clinical outcomes and Cyt b sequence variation of Leishmania spp. involved. Moreover, we observed a higher presence of polymorphisms in L. major compared with L. tropica. This difference may be due to the different eco-epidemiologies of both species, with L. tropica being an anthroponosis compared to L. major, which is a zoonosis. Conclusions The sequence analysis of Cyt b gene from 25 L. major and L. tropica strains demonstrated genetic variability of L. major and L. tropica causing CL in southern Iran, and a feasible connection amid the genetic heterogeneity of the parasite, geographical source and clinical appearance of the disease in human was detected.
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Affiliation(s)
- Iraj Mohammadpour
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Gholam Reza Hatam
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Handjani
- Molecular Dermatology Research Center, Department of Dermatology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Bozorg-Ghalati
- Department of Molecular Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Daniel PourKamal
- Fajr Health Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Motazedian
- Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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19
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Ghatee MA, Mirhendi H, Karamian M, Taylor WR, Sharifi I, Hosseinzadeh M, Kanannejad Z. Population structures of Leishmania infantum and Leishmania tropica the causative agents of kala-azar in Southwest Iran. Parasitol Res 2018; 117:3447-3458. [PMID: 30105405 DOI: 10.1007/s00436-018-6041-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 08/02/2018] [Indexed: 10/28/2022]
Abstract
Visceral leishmaniasis (VL) is endemic in Iran and is caused predominantly by Leishmania infantum, but L. tropica is emerging as an important cause. We studied the intra-species population structure of Leishmania spp. causing VL in southwest Iran by sequence analysis of the internal transcribed spacer (ITS) 1 of DNA samples from 29 bone marrow aspiration smears. L. infantum (n = 25) and L. tropica (n = 4) were identified, consisting of 10 and three ITS1 sequence types (STs), respectively. Compared to GenBank ITS1 STs, our L. infantum parasites displayed high heterogeneity but less heterogeneity compared than northwest Iranian isolates. VL affects mostly nomadic populations in southwest Iran, and their mobility may explain partly the L. infantum heterogeneity. The VL causing L. tropica was also genetically heterogeneous but genetically indistinguishable from L. tropica strains causing anthroponotic cutaneous leishmaniasis from southwest Iran.
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Affiliation(s)
- Mohammad Amin Ghatee
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. .,Department of Parasitology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
| | - Hossein Mirhendi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Karamian
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran.,Infectious Diseases Research Centre, Birjand University of Medical Sciences, Birjand, Iran
| | - Walter R Taylor
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Massood Hosseinzadeh
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kanannejad
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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20
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Population Structure of Leishmania tropica Causing Anthroponotic Cutaneous Leishmaniasis in Southern Iran by PCR-RFLP of Kinetoplastid DNA. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6049198. [PMID: 29984240 PMCID: PMC6011176 DOI: 10.1155/2018/6049198] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/13/2018] [Indexed: 12/22/2022]
Abstract
Iran is one of the six countries with the most cutaneous leishmaniasis (CL) patients. Understanding better the genotypes of the parasite population in relation to geography and climate is critical to achieving better CL control. We aimed to characterise the population structure of Leishmania tropica, the cause of anthroponotic cutaneous leishmaniasis (ACL), from important foci in southeast (Bam and Kerman) and southwest (Shiraz) Iran. A total of 39 L. tropica isolates from ACL patients from southeast (Bam 14, Kerman 12) and southwest (Shiraz 13) Iran were analysed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) of the kinetoplast DNA (kDNA) using restriction enzymes MspI (HpaII) and ClaI. 37 genotypes were identified among south Iran L. tropica isolates. The unweighted pair group method with arithmetic mean (UPGMA) tree obtained from the banding patterns of ClaI digested kDNA RFLP distinguished southeast from and southwest L. tropica isolates with some subclustering but the MspI derived tree showed greater discrimination with greater subclustering and divergence of the two foci of southeast region but with some overlapping. Although a monophyletic structure has been defined for southeast L. tropica, isolates from two foci of southeast Iran were partly discriminated in the current study.
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Ghatee MA, Haghdoost AA, Kooreshnia F, Kanannejad Z, Parisaie Z, Karamian M, Moshfe A. Role of environmental, climatic risk factors and livestock animals on the occurrence of cutaneous leishmaniasis in newly emerging focus in Iran. J Infect Public Health 2017; 11:425-433. [PMID: 29287805 DOI: 10.1016/j.jiph.2017.12.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 10/27/2017] [Accepted: 12/06/2017] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Occurrence of leishmaniasis is affected by various biological and environmental factors. Kohgiluye and Boyerahmad (K-B) province is an emerging focus of cutaneous leishmaniasis (CL) in Southwest Iran. SUBJECTS AND METHODS To elucidate some angles of occurrence of CL in this province, climatic and environmental factors and close proximity to livestock were studied by univariate and two multivariate logistic regression models. The dwelling addresses of 275 CL patients were obtained from Health Centers records for a 5 years period. The effect of mean annual temperature, minimum mean annual temperature, maximum mean annual temperature, mean annual rainfall, slope, elevation, land covers and close proximity to cattle and sheep/goat sheds on the occurrence of CL were analysed using geographical information systems (GIS) approach. RESULTS CL occurred in all counties with the most cases in Northwest, West and South semi-arid and warm regions. Land cover, slope, elevation and close proximity to cattle sheds, were the most effective factors. Urban, dry farm and thin rangeland were found as the most important land covers. Slope and elevation decreased the probability of disease. Close proximity to cattle sheds notably increased the chance of CL. The importance of other factors such as rainfall, temperature and close proximity to sheep/goat sheds only were shown when their effects were evaluated independently from other factors. So regions with urban, dry farm and thin rangeland covers with lower slope and altitude where in close proximity of cattle sheds seems to be potentially most high risk areas. CONCLUSION Distribution of CL cases is influenced by combination of environmental, ecological factors and close proximity to livestock sheds but control programs should be focused on cities and villages in the above-mentioned most high risk regions.
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Affiliation(s)
- Mohammad A Ghatee
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran; Department of Medical Parasitology and Mycology, School of Medicine, University of Medical Sciences, Yasuj, Iran.
| | - Ali A Haghdoost
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Fatemeh Kooreshnia
- Department of Medical Parasitology and Mycology, School of Medicine, University of Medical Sciences, Yasuj, Iran
| | - Zahra Kanannejad
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zafar Parisaie
- Province Health Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mehdi Karamian
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
| | - Abdolali Moshfe
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
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Fakhar M, Karamian M, Ghatee MA, Taylor WR, Pazoki Ghohe H, Rasooli SA. Distribution pattern of anthroponotic cutaneous leishmaniasis caused by Leishmania tropica in Western Afghanistan during 2013-2014. Acta Trop 2017; 176:22-28. [PMID: 28754249 DOI: 10.1016/j.actatropica.2017.07.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 07/24/2017] [Accepted: 07/24/2017] [Indexed: 11/17/2022]
Abstract
Anthroponotic cutaneous leishmaniasis (ACL), caused by Leishmania tropica, is the main cause of cutaneous leishmaniasis (CL) in the Herat province, Western Afghanistan. We investigated the role of environmental factors on ACL distribution in Herat. Epidemiological data from 2457 patients were retrieved from the local WHO sub-office. Shapefile layers of districts, cities, villages, land cover, soil type and digital elevation model (DEM) of the Herat province were used to assess, by logistic regression modelling, the effects of land cover, soil types, elevation, and proximity to the Harirud river on the distribution of ACL. The key determinants of distribution were: (i) close proximity to the Harirud river, (ii) elevation between 700 and 1200m, (iii) intensive and intermittent irrigated cultivated land, and (iv) Haplocalcids with Torriorthents and Torrifluvents soil types. No ACL cases were found below 700m, and a few cases were present at >1200m in irrigated areas around the Harirud river. These findings suggest that moist soil and the humidity from irrigated areas found between 700 and 1200m provide suitable breeding sites of Phlebotomus sergenti, the main sandfly vector of L. tropica in Afghanistan. The effect of elevation also explains the predominance of ACL over ZCL in this region. The present study showed that distribution of ACL is strongly associated with environmental factors in West Afghanistan where the political and socio-economic conditions may also affect the epidemiology of CL.
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Affiliation(s)
- Mahdi Fakhar
- Molecular and Cell Biology Research Center, Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Karamian
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Amin Ghatee
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran; Parasitology Department, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
| | - Walter Robert Taylor
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand; Oxford Centre for Tropical Medicine and Global Health, University of Oxford, UK
| | - Hossein Pazoki Ghohe
- Student Research Committee, Molecular and Cell Biology Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sayed Abobakar Rasooli
- National Health Coordinator (NHC) and Head of Herat WHO Sub-office, Herat Province, Afghanistan
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Heterogenity of Echinococcus canadensis genotype 6 − the main causative agent of cystic echinococcosis in Birjand, Eastern Iran. Vet Parasitol 2017; 245:78-85. [DOI: 10.1016/j.vetpar.2017.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/23/2017] [Accepted: 08/26/2017] [Indexed: 01/06/2023]
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Abstract
Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide, 1.5 to 2 million new cases occur each year, 350 million are at risk of acquiring the disease, and leishmaniasis causes 70,000 deaths per year. Clinical features depend on the species of
Leishmania involved and the immune response of the host. Manifestations range from the localized cutaneous to the visceral form with potentially fatal outcomes. Many drugs are used in its treatment, but the only effective treatment is achieved with current pentavalent antimonials.
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Affiliation(s)
- Edoardo Torres-Guerrero
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
| | | | - Julieta Ruiz-Esmenjaud
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
| | - Roberto Arenas
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
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