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Yizengaw E, Gashaw B, Yimer M, Takele Y, Nibret E, Yismaw G, Cruz Cervera E, Ejigu K, Tamiru D, Munshea A, Müller I, Weller R, Cotton JA, Chapman LAC, Kropf P. Demographic characteristics and clinical features of patients presenting with different forms of cutaneous leishmaniasis, in Lay Gayint, Northern Ethiopia. PLoS Negl Trop Dis 2024; 18:e0012409. [PMID: 39146362 PMCID: PMC11349221 DOI: 10.1371/journal.pntd.0012409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 08/27/2024] [Accepted: 07/26/2024] [Indexed: 08/17/2024] Open
Abstract
Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by Leishmania parasites, that can cause long-term chronic disabilities. The clinical presentation of CL varies in both type and severity. CL presents as three main clinical forms: localised lesions (localised cutaneous leishmaniasis, LCL); mucocutaneous leishmaniasis (MCL) that affects the mucosa of the nose or the mouth; or as disseminated not ulcerating nodules (diffuse cutaneous leishmaniasis, DCL). Here we recruited a cohort of CL patients in a newly established leishmaniasis treatment centre (LTC) in Lay Gayint, Northwest Ethiopia, and collected detailed demographic and clinical data. The results of our study show that more males than females present to the LTC to seek diagnosis and treatment. 70.2% of CL patients presented with LCL and 20.8% with MCL. A small number of patients presented with DCL, recidivans CL (a rare form of CL where new lesions appear on the edges of CL scars) or with a combination of different clinical presentations. The duration of illness varied from 1 month to 180 months. Over a third of CL patients had additional suspected CL cases in their household. Despite the majority of CL patients having heard about CL, only a minority knew about its transmission or that it could be treated. Most CL patients lived in areas where environmental factors known to be associated with the transmission of CL were present. This work highlights that CL is an important public health problem in Lay Gayint and emphasises the urgent need for more CL awareness campaigns, better health education and better disease management practices.
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Affiliation(s)
- Endalew Yizengaw
- Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
- Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Bizuayehu Gashaw
- Amhara Public Health Institute, Bahir Dar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulat Yimer
- Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Yegnasew Takele
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Endalkachew Nibret
- Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Edward Cruz Cervera
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Kefale Ejigu
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | | | - Abaineh Munshea
- Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ingrid Müller
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Richard Weller
- Department of Dermatology, University of Edinburgh, Edinburgh, United Kingdom
| | - James A. Cotton
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Lloyd A. C. Chapman
- Department of Mathematics and Statistics, Lancaster University, Lancaster, United Kingdom
| | - Pascale Kropf
- Department of Infectious Disease, Imperial College London, London, United Kingdom
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Amare GA, Mekonnen GG, Kassa M, Addisu A, Kendie DA, Tegegne B, Abera A, Tadesse D, Getahun S, Wondmagegn YM, Merdekios B, Asres MS, van Griensven J, Van der Auwera G, van Henten S, Pareyn M. First report of cutaneous leishmaniasis caused by Leishmania donovani in Ethiopia. Parasit Vectors 2023; 16:457. [PMID: 38104111 PMCID: PMC10725588 DOI: 10.1186/s13071-023-06057-9] [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: 07/19/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Leishmaniasis is a common neglected tropical disease in Ethiopia. Visceral leishmaniasis (VL) caused by Leishmania donovani presents in the lowlands, while cutaneous leishmaniasis (CL) affects people living in the highlands. Although CL is described as being caused by Leishmania aethiopica, there is also evidence of L. tropica and L. major isolated from a patient, sand flies and potential reservoirs. Information on species causing CL in Ethiopia is patchy, and no nation-wide study has ever been done. Understanding which species are causing CL in Ethiopia can have important implications for patient management and disease prevention. METHODS We analyzed stored routine samples and biobanked DNA isolates from previously conducted studies of CL patients from different centers in the north, center and south of Ethiopia. Species typing was performed using ITS-1 PCR with high-resolution melt (HRM) analysis, followed by HSP70 amplicon sequencing on a selection of the samples. Additionally, sociodemographic, clinical and laboratory data of patients were analyzed. RESULTS Of the 226 CL samples collected, the Leishmania species could be determined for 105 (45.5%). Leishmania aethiopica was identified in 101 (96.2%) samples from across the country. In four samples originating from Amhara region, northwestern Ethiopia, L. donovani was identified by ITS-1 HRM PCR, of which two were confirmed with HSP70 sequences. While none of these four patients had symptoms of VL, two originated from known VL endemic areas. CONCLUSIONS The majority of CL was caused by L. aethiopica, but CL due to L. tropica and L. major cannot be ruled out. Our study is the first to our knowledge to demonstrate CL patients caused by L. donovani in Ethiopia. This should spark future research to investigate where, how and to which extent such transmission takes place, how it differs genetically from L. donovani causing VL and whether such patients can be diagnosed and treated successfully with the currently available tools and drugs.
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Affiliation(s)
| | | | | | | | | | | | - Adugna Abera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | | | | | | | | | | | - Myrthe Pareyn
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
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Yizengaw E, Nibret E, Yismaw G, Gashaw B, Tamiru D, Munshea A, Takele Y, Müller I, Chapman L, Weller R, Cotton JA, Kropf P. Cutaneous leishmaniasis in a newly established treatment centre in the Lay Gayint district, Northwest Ethiopia. SKIN HEALTH AND DISEASE 2023; 3:e229. [PMID: 37538321 PMCID: PMC10395643 DOI: 10.1002/ski2.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/02/2023] [Accepted: 03/02/2023] [Indexed: 08/05/2023]
Abstract
Background Cutaneous leishmaniasis (CL) is a neglected tropical disease that primarily affects the most vulnerable populations. In Ethiopia, where this study took place, CL is an important health problem, however, the incidence of CL is poorly monitored. Objectives This study took place in a recently established CL treatment centre, at Nefas Mewcha Hospital, Lay Gayint. This area was considered to be endemic for CL, however, no cases of CL from Lay Gayint had previously been officially reported to the Amhara Regional Health Bureau. Methods Following a CL awareness campaign, a retrospective data review was performed of patients presenting to this centre between July 2019 and March 2021. Basic demographic and clinical data were collected by a nurse and recorded in the logbook of the CL treatment centre. Results Two hundred and one patients presented for diagnosis and treatment. The age of the patients ranged from 2 to 75 years and 63.2% were males. Most patients were between 10- and 19-years-old. The majority (79.1%) of the patients presented with localised cutaneous leishmaniasis and 20.9% with mucocutaneous leishmaniasis. 98% of the patients tested positive for Leishmania parasites by microscopy. Conclusions This work underpinned how CL is a major public health problem in the Lay Gayint district. It also shows that raising awareness about CL in the community and providing diagnosis and treatment encouraged patients to travel to seek diagnosis and treatment.
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Affiliation(s)
- Endalew Yizengaw
- Department of Medical Laboratory ScienceCollege of Medicine and Health ScienceBahir Dar UniversityBahir DarEthiopia
- Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Amhara Public Health InstituteBahir DarEthiopia
| | - Endalkachew Nibret
- Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyCollege of ScienceBahir Dar UniversityBahir DarEthiopia
| | | | - Bizuayehu Gashaw
- Amhara Public Health InstituteBahir DarEthiopia
- Department of BiologyCollege of ScienceBahir Dar UniversityBahir DarEthiopia
| | | | - Abaineh Munshea
- Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyCollege of ScienceBahir Dar UniversityBahir DarEthiopia
| | - Yegnasew Takele
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Ingrid Müller
- Department of Infectious DiseaseImperial College LondonLondonUK
| | - Lloyd Chapman
- Department of DermatologyUniversity of EdinburghEdinburghUK
| | - Richard Weller
- Department of Infectious Disease and EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - James A. Cotton
- School of BiodiversityOne Health and Veterinary MedicineWellcome Centre for Integrative ParasitologyCollege of MedicalVeterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Pascale Kropf
- Department of Infectious DiseaseImperial College LondonLondonUK
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Berhanu A, Dugassa S, Maru M, Animut A, Erko B, Hailu A, Gebresilassie A. Cutaneous leishmaniasis in Kutaber District, Ethiopia: Prevalence, sand fly fauna and community knowledge, attitude and practices. Heliyon 2023; 9:e18286. [PMID: 37520994 PMCID: PMC10382297 DOI: 10.1016/j.heliyon.2023.e18286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
Background Cutaneous leishmaniasis (CL) affects 25% of the population living in the highlands of Ethiopia. CL intervention has not decreased the number of leishmaniasis patients. A cross-sectional study was conducted to determine CL prevalence, community's knowledge, attitude and practices (KAP), and the sand fly fauna in Kutaber district, northeast Ethiopia. Methods A retrospective, community-based cross-sectional study was conducted in Boru Meda Hospital from December 2014-March 2021 to study CL prevalence of Kutaber district. A Pre-tested, well-structured questionnaire was used to collect data on the participants' socio-demographic characteristics, KAP towards CL and knowledge about sand fly vectors. Chi-square test and logistic regression analysis were used in the study, and data were analyzed using SPSS version 23 (p < 0.05). Results A total of 10,002 (14.02%), of which 71,325 samples were confirmed as positive for CL. The infection rate of CL in females (7.1%) was a little bit higher than males (7.0%). More cases were recorded among 15-29 age category. The study also revealed that 77.1% of the respondents had poor knowledge about CL treatment, prevention, clinical presentation and disease transmission. Farmers tended to have poorer knowledge about sand flies than non-workers and students (32.7 vs. 35 and 44.1%; P = 0.049). Housewives had poorer knowledge about sand flies than farmers and workers (22.2 vs. 32.7 and 33.3%; P = 0.023). Phlebotomus longipes comprised the highest composition (80%) of the sand fly species identified in Kutaber district. Conclusions The data showed that the community had poor knowledge about CL, vector, and transmission mode. CL preventive measures were prevalent, implying the need to raise CL awareness. Phlebotomus longipes was identified as the most dominant sand fly species which accounted for CL. The findings can be used in developing an effective control strategy to reduce CL transmission in the study area and elsewhere in Ethiopia.
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Affiliation(s)
- Abib Berhanu
- Addis Ababa University, College of Natural and Computational Sciences, Department of Zoological Sciences, Insect Science Stream, Addis Ababa, Ethiopia
| | - Sisay Dugassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Minwuyelet Maru
- Health Research and Technology Transfer Directorate, Amhara Public Health Institute, Dessie Branch, Ethiopia
| | - Abebe Animut
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Asrat Hailu
- College of Health Sciences, Addis Ababa University, Ethiopia
| | - Araya Gebresilassie
- Addis Ababa University, College of Natural and Computational Sciences, Department of Zoological Sciences, Insect Science Stream, Addis Ababa, Ethiopia
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Melkie I, Yimer M, Alemu G, Tegegne B. Asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia: a cross- sectional study. Arch Public Health 2023; 81:62. [PMID: 37085820 PMCID: PMC10120276 DOI: 10.1186/s13690-023-01082-7] [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: 12/12/2022] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Ethiopia is one of the top 10 countries in the world where 90% visceral leishmaniasis cases are reported. Metema-Humera lowlands are the most important foci in Ethiopia. Blood transfusion in visceral leishmaniasis endemic foci in Ethiopia does not consider screening of visceral leishmaniasis during blood donation. The aim of this study is therefore, was to assess asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia. METHODS A Health facility based cross-sectional study was conducted at Metema Blood Bank from February to March 2020. A total of 205 blood donors were eligible and participated in this study. Structured questionnaire were used to collect data on socio-demographic characteristics and perceived risk factors associated with asymptomatic visceral leishmaniasis among blood donors. Blood donors were screened using both rK39 and direct agglutination tests based on the manufactures' instructions. Data were analyzed using SPSS version 20.0. Chi-square test was used to assess associations of Leishmania donovani infection with predisposing factors. Associations were considered statstically significant on P-value < 0.05 at 95% confidence level. RESULTS Of the total 205 participants, 32(15.6%) were positive for asymptomatic Leishmania donovani infection at least by one of the diagnostic tests used. Eight (3.9%) and 30(14.6%) of the participants` were positive by the rK39 and direct agglutination tests, respectively. Six (2.9%) donors were tested positive by both diagnostic tests. Family history of visceral leishmaniasis (X²=11.334, P = 0.003) and having neighbors with history of visceral leishmaniasis (X²=5.923, P = 0.015) were significantly associated with asymptomatic Leishmania donovani infection among blood donors. CONCLUSIONS The prevalence of asymptomatic Leishmania donovani infection was 15.6%. Asymptomatic visceral leishmaniasis was significantly associated with donors' family and neighbors' history of infection. Therefore, laboratory screening of blood donors for visceral leishmaniasis in endemic areas will be mandatory. Moreover, this study will give base line information for future study in the country.
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Affiliation(s)
- Iyasu Melkie
- Bahir Dar city administration Blood Bank, Bahir Dar city, Ethiopia
| | - Mulat Yimer
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar city, Ethiopia.
| | - Getaneh Alemu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar city, Ethiopia
| | - Banchamlak Tegegne
- Medical Parasitology Department, Amhara Public Health Institute, Bahir Dar city, Ethiopia
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Aklilu E, Yared S, Gebresilassie A, Legesse B, Hailu A. Phlebotomine sandflies (Diptera: Psychodidae) of Ethiopia. Heliyon 2023; 9:e14344. [PMID: 36925525 PMCID: PMC10011004 DOI: 10.1016/j.heliyon.2023.e14344] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/17/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023] Open
Abstract
Phlebotomine sandflies have a long history of association with humans, which makes them the only proven natural vectors of Leishmania species, the parasitic protozoans that cause leishmaniases in humans and animals. In Ethiopia, the three forms of leishmaniases, viz., visceral, dermal and mucocutaneous are endemic in different parts of the country. Since the first report of phlebotomine sandflies in Ethiopia in 1936, the distribution of different species and their role in the transmission of leishmaniases have been extensively studied. The objective of this review was to summarize the patchy information and give an updated list of phlebotomine sandfly species in Ethiopia and their known geographical distribution in the country. Peer-reviewed literature search was conducted using online databases. All articles published which focus on distribution and medical importance of Phlebotomus and Sergentomyia species of Ethiopia starting from 1936 up to 2022 were reviewed. Until July 2022, 65 phlebotomine sandfly species have been reported, belonging to the genus Phlebotomus and Sergentomyia. The genus Phlebotomus in Ethiopia is represented by six subgenera such as Adlerius, Anaphlebotomus, Larroussius, Paraphlebotomus Phlebotomus and Synphlebotomus, whereas the genus Sergentomyia is represented by six subgenera, namely Grassomyia, Parrotomyia, Parvidens, Rondanomyia, Sergentomyia, and Sintonius.
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Affiliation(s)
- Esayas Aklilu
- Vector Biology and Control Unit, Aklilu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Yared
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia
| | - Araya Gebresilassie
- Department of Zoological Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Behailu Legesse
- Department of Geography, Madda Walabu University, Bale-Robe, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology and Parasitology, Faculty of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Alemayehu B, Kelbore AG, Alemayehu M, Adugna C, Bibo T, Megaze A, Leirs H. Knowledge, attitude, and practice of the rural community about cutaneous leishmaniasis in Wolaita zone, southern Ethiopia. PLoS One 2023; 18:e0283582. [PMID: 36976758 PMCID: PMC10047512 DOI: 10.1371/journal.pone.0283582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a neglected tropical disease that is caused by a Leishmania parasite and transmitted by the bite of infected female sandflies. Community awareness is an essential component of disease control and prevention. Therefore, this study aimed to assess the community's knowledge, attitude, and practice toward CL in Wolaita zone, southern Ethiopia. METHODS A community-based cross-sectional study design was employed to include 422 study subjects selected using a systematic sampling technique from two districts, Kindo Didaye and Sodo Zuria. A pretested structured questionnaire was used to collect data from the household heads. Bivariate and multivariate logistic regression analyses were performed to determine the relationship between the participants' knowledge about CL and socio-demographic characteristics. RESULTS Out of the 422 study participants, only 19% had good knowledge of CL in general. Most (67.1%) of the respondents knew CL by its local name ("bolbo" or "moora") though this knowledge varied highly over the study districts. The majority (86.3%) of respondents did not know how CL is acquired, though they considered CL a health problem. Most (62.8%) respondents believed that CL was an untreatable disease. Most (77%) participants responded that CL patients preferred to go to traditional healers for treatment. Herbal treatment was the most (50.2%) used to treat CL. Knowledge about CL was significantly associated with sex, age, and study districts. CONCLUSION The overall knowledge, attitude, and practice about CL and its prevention in the study area were low. This emphasizes the need to implement health education and awareness campaign to reduce the risk of CL infection. Policymakers and stakeholders should also give due attention to the prevention and treatment of CL in the study area.
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Affiliation(s)
- Bereket Alemayehu
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Abraham Getachew Kelbore
- Department of Dermatology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Mihiretu Alemayehu
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Chimdesa Adugna
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tessema Bibo
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Aberham Megaze
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Herwig Leirs
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
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Eight-Year Trend Analysis of Cutaneous Leishmaniasis Cases in West Amhara Region Referred to Amhara Public Health Institute Northwest, Ethiopia: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6562092. [PMID: 36046459 PMCID: PMC9423996 DOI: 10.1155/2022/6562092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
Cutaneous leishmaniasis is a continually spreading health problem in Amhara Region, Ethiopia. Despite this, up- to-date information on referral laboratory facility has been not yet reported. Therefore, this study was aimed at reporting up-to-date information about eight year’s cutaneous leishmaniasis trend status. Data on referred cases from 2013 to 2020 were collected at Amhara Public Health Institute Parasitology department by reviewing log book. Of the 243 suspected cases, 114 (46.9%) were positive (confirmed) with microscope and cultured results showed that most of them were negatives. Most of the suspected cases were from 16 to 30 years and males by age and sex, respectively. Trend status by year depicted that largest numbers of suspected and confirmed cases were reported in 2013, 2015, and 2019 years. Finally, the trend status by zone showed that most cases were reported from South Gondar and Awi zones, respectively.
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Shita EY, Nibret E, Munshea A, Gashaw B. Burden and risk factors of cutaneous leishmaniasis in Ethiopia: a systematic review and meta‐analysis. Int J Dermatol 2022; 61:1336-1345. [DOI: 10.1111/ijd.16265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/13/2022] [Accepted: 04/23/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Endalew Yizengaw Shita
- Department of Medical Laboratory Science, College of Medicine and Health science Bahir Dar University Bahir Dar Ethiopia
- Institute of Biotechnology Bahir Dar University Bahir Dar Ethiopia
| | - Endalkachew Nibret
- Institute of Biotechnology Bahir Dar University Bahir Dar Ethiopia
- Department of Biology, College of Science Bahir Dar University Bahir Dar Ethiopia
| | - Abaineh Munshea
- Institute of Biotechnology Bahir Dar University Bahir Dar Ethiopia
- Department of Biology, College of Science Bahir Dar University Bahir Dar Ethiopia
| | - Bizuayehu Gashaw
- Department of Biology, College of Science Bahir Dar University Bahir Dar Ethiopia
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Tegegne B, Yimer M, G/Eyesus T, Ayal A, Yimer M. Short reports on cutaneous leishmaniasis outbreak investigation in Ankesha-Guagsa district, Amhara region, Northwest Ethiopia. Trop Doct 2021; 52:131-133. [PMID: 34894873 DOI: 10.1177/00494755211055252] [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] [Indexed: 11/17/2022]
Abstract
Cutaneous leishmaniasis is spreading in Ethiopia and outbreaks have been recorded at new foci. In the Ankesha-Guagsa district, from September 24 to 28, 2020, 39 suspected cases were screened, and amastigote stages were identified in lesion samples of 34 (87.2%) cases.
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Affiliation(s)
| | - Mekonnen Yimer
- 247366Amhara Public Health Institute, Bahir Dar, Ethiopia
| | | | - Alie Ayal
- 247366Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Mulat Yimer
- Department of Medical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, 128158Bahir Dar University, Bahir Dar, Ethiopia
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11
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Jones CM, Welburn SC. Leishmaniasis Beyond East Africa. Front Vet Sci 2021; 8:618766. [PMID: 33732738 PMCID: PMC7959848 DOI: 10.3389/fvets.2021.618766] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/15/2021] [Indexed: 01/25/2023] Open
Abstract
Climate change is having a substantial impact on our environment and ecosystems and has altered the way humans live, access, and utilize resources with increased risk of zoonotic infectious disease encounters. As global temperatures continue to increase, they impact on public health, migration, food security and land conflict, and as new environments become favorable, exposure to disease carrying vectors. Increased forests or natural habitat clearance for land repurposing, urbanization, road building, and water management are related to an increase in emerging vector borne parasitic diseases. The East African region remains one of the most impacted regions globally for leishmaniasis, a vector borne disease that impacts significantly on the health, wellbeing and livelihoods of affected communities and for which a lack of reporting and control interventions hinder progress toward elimination of this neglected tropical disease. As our world continues to transform, both politically and climatically, it is essential that measures are put in place to improve surveillance and disease management with implementation of control measures, including vector control, especially in low- and middle-income countries that are expected to be most impacted by changes in climate. Only through effective management, now, can we be sufficiently resilient to preventing the inevitable spread of vectors into suitable habitat and expansion of the geographical range of leishmaniasis. This review offers a current perspective on Leishmaniasis as an endemic disease in East Africa and examines the potential of the recent emergence of Leishmania infection in hitherto unaffected regions to become a public health concern if no disease management is achieved.
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Affiliation(s)
- Caitlin M Jones
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, International Campus, Zhejiang University, Haining, China.,Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Susan C Welburn
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, International Campus, Zhejiang University, Haining, China.,Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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An integrative approach to identify sand fly vectors of leishmaniasis in Ethiopia by morphological and molecular techniques. Parasit Vectors 2020; 13:580. [PMID: 33203446 PMCID: PMC7672994 DOI: 10.1186/s13071-020-04450-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/30/2020] [Indexed: 12/17/2022] Open
Abstract
Background Ethiopia is affected by human leishmaniasis caused by several Leishmania species and transmitted by a variety of sand fly vectors of the genus Phlebotomus. The sand fly fauna in Ethiopia is highly diverse and some species are closely related and similar in morphology, resulting in difficulties with species identification that requires deployment of molecular techniques. DNA barcoding entails high costs, requires time and lacks reference sequences for many Ethiopian species. Yet, proper species identification is pivotal for epidemiological surveillance as species differ in their actual involvement in transmission cycles. Recently, protein profiling using MALDI-TOF mass spectrometry has been introduced as a promising technique for sand fly identification. Methods In our study, we used an integrative taxonomic approach to identify most of the important sand fly vectors of leishmaniasis in Ethiopia, applying three complementary methods: morphological assessment, sequencing analysis of two genetic markers, and MALDI-TOF MS protein profiling. Results Although morphological assessment resulted in some inconclusive identifications, both DNA- and protein-based techniques performed well, providing a similar hierarchical clustering pattern for the analyzed species. Both methods generated species-specific sequences or protein patterns for all species except for Phlebotomus pedifer and P. longipes, the two presumed vectors of Leishmania aethiopica, suggesting that they may represent a single species, P. longipes Parrot & Martin. All three approaches also revealed that the collected specimens of Adlerius sp. differ from P. (Adlerius) arabicus, the only species of Adlerius currently reported in Ethiopia, and molecular comparisons indicate that it may represent a yet undescribed new species. Conclusions Our study uses three complementary taxonomical methods for species identification of taxonomically challenging and yet medically import Ethiopian sand flies. The generated MALDI-TOF MS protein profiles resulted in unambiguous identifications, hence showing suitability of this technique for sand fly species identification. Furthermore, our results contribute to the still inadequate knowledge of the sand fly fauna of Ethiopia, a country severely burdened with human leishmaniasis.![]()
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Eshetu B, Mamo H. Cutaneous leishmaniasis in north-central Ethiopia: trend, clinical forms, geographic distribution, and determinants. Trop Med Health 2020; 48:39. [PMID: 32518497 PMCID: PMC7271444 DOI: 10.1186/s41182-020-00231-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/25/2020] [Indexed: 12/17/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL), being among the neglected tropical diseases, catches little attention despite its considerable influence. This study aimed at estimating the prevalence and associated factors of CL in Boru Meda Hospital, Dessie town, north-central Ethiopia. Methods Medical records of patients who attended the Dermatology Department of the Hospital in 2012-May 2018 were assessed. In addition, dermatological patients who were visiting the hospital during the data collection period (November 2017-May 2018) were interviewed to capture socio-demographic, environmental variables, and related factors. The source population was individuals who visited the hospital for skin problems in the stated years and CL positives were the targets. The association between CL and its determinants was tested by logistic regression. Results CL prevalence was 1.5% showing increasing trend with the year of examination. Localized, diffused, and mucosal CL was evident across the years. Dessie town had the highest prevalence, 291 (32.8%) patients out of 888 cases. The number of examined (29,701) and positives (543, 1.8%) for males was comparable with females, 28,459 and 345 (1.2%), respectively, increasing with age but without significant difference. Dessie town residence (adjusted odds ratio (AOR) 12.2, 95% confidence interval (CI) 2.2-18.6, p = 0.01), no bed net (AOR 9.9, 95% CI 2.7-16.7, p < 0.01), nearby irrigation (AOR 8.1, 95% CI 1.9-12.4, p < 0.01), and travel to CL endemic areas (AOR 13.9, 95% CI 4.4-14.3, p < 0.01) were significantly associated with CL. Conclusion CL is a growing health problem in Dessie and its surroundings. Known risk factors prevail. Comprehensive parasitological, entomological, and social studies are warranted to better manage the disease.
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Affiliation(s)
- Belayneh Eshetu
- Department of Zoological Sciences, College of Natural and Computational Sciences, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia
| | - Hassen Mamo
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia
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Ecology and seasonality of sandflies and potential reservoirs of cutaneous leishmaniasis in Ochollo, a hotspot in southern Ethiopia. PLoS Negl Trop Dis 2019; 13:e0007667. [PMID: 31425506 PMCID: PMC6715250 DOI: 10.1371/journal.pntd.0007667] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 08/29/2019] [Accepted: 07/27/2019] [Indexed: 12/29/2022] Open
Abstract
Background Ochollo is a village in southern Ethiopia burdened with cutaneous leishmaniasis (CL), where Phlebotomus pedifer is the only vector for Leishmania aethiopica and hyraxes are confirmed reservoir hosts. A detailed description of the different players of transmission, and the ecology and seasonality of the vector needs to be established in order to accomplish efficient control programs. Methods and findings Between March 2017 and February 2018, a monthly sandfly collection was carried out in different habitats and records of temperature and humidity were taken. Rodents and hyraxes were trapped in the dry and wet season. All samples were screened for Leishmania kinetoplast DNA (kDNA). Positive samples were further processed for determination of the Leishmania species and the species of the sandfly/small mammal that was found infected. Additionally, the species of 400 sandfly specimens from different habitats and seasons was identified. 17,190 Sergentomyia and Phlebotomus sandflies were caught and showed an overall kDNA prevalence of 2.6%, all were L. aethiopica infections only found in P. pedifer. The overall sandfly and P. pedifer abundance peaked in the dry season and was negatively correlated with the %RH. The kDNA prevalence varied over the months and was negatively correlated with the temperature. Total sandfly abundance did not differ between the sampled habitats, but P. pedifer was the distinct predominant species only in caves. Moreover, significantly more infected sandflies were found in caves. Only 1/192 rodents were kDNA positive, while 20.0% (5/25) of Heterohyrax brucei were found infected. Conclusions This study suggests that caves may be a source of multiplication of the infection. If an outdoor control program would be considered, it would be useful to focus on caves in the wet season, when the sandfly abundance is lowest. The captured rodent species appear not important for transmission and the contribution of hyraxes in transmission should be further investigated. Zoonotic cutaneous leishmaniasis poses a considerable health problem in Ethiopia. Efficient disease control can only be accomplished when all players of transmission are well understood and taken into account. The aim of our study was to investigate in a village in the south, called Ochollo, whether rodents also harbor the parasite and to assess the different potential vector species (sandflies) and their spatial and seasonal distribution. We established that the rodent species we captured are probably no hosts for Leishmania aethiopica, but confirmed that hyraxes are abundant and that a high percentage of them is positive for L. aethiopica. Based on a very large sample size, we found that Phlebotomus pedifer is the only vector in the area. We discovered that the general sandfly and specific P. pedifer abundance are lowest in the wet season and negatively correlated with humidity. We also demonstrated that the sandfly abundance is equally distributed among different habitats, but P. pedifer and infected sandflies mainly reside in caves. Altogether, we suggest that if outdoor sandfly control methods would be considered, it would be useful to carry it out in the wet season in or around caves. The role of hyraxes in disease transmission should be further investigated.
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Alebie G, Worku A, Yohannes S, Urga B, Hailu A, Tadesse D. Epidemiology of visceral leishmaniasis in Shebelle Zone of Somali Region, eastern Ethiopia. Parasit Vectors 2019; 12:209. [PMID: 31060585 PMCID: PMC6503444 DOI: 10.1186/s13071-019-3452-5] [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: 11/23/2018] [Accepted: 04/20/2019] [Indexed: 12/15/2022] Open
Abstract
Background Visceral leishmaniasis (VL), a vector-borne disease caused by species of the L.donovani complex, has (re)-emerged in Ethiopia during the last two decades and is currently of increasing public health concern. However, very little is known about VL epidemiology in the Somali Region of Ethiopia. The aim of this study was to provide detailed epidemiological information on seroprevalence, associated factors and incriminated vectors of VL in Shebelle Zone and Ethiopian Somali Region in general. Methods A cross-sectional epidemiological study was conducted between March and May 2016 in Gode and Adadle districts of Shebelle Zone, Ethiopian Somali Region. Two-stage semi-random sampling was applied for selecting study participants for the field survey. The study included structured questionnaire interviews, serological assays (rK39-immunochromatographic test), ELISA and entomological surveys. Results From a total of 361 participants, 57 (15.8%) were seropositive for VL including 46 (12.7%) rK39 positive and 11 (3.0%) positive by both rK39 and ELISA. VL seroprevalence was higher (P < 0.001) in Adadle (31.1%) compared to Gode (12.7%) district. The VL seroprevalence rate was higher in females than in males [rK39 (17.2 vs 14.0%) and ELISA (3.4 vs 2.5%)]. Children under the 15 years of age were the most highly affected group [rK39 (20.4%) and ELISA (4.4%)]. Increased VL risk was associated with presence of termite hills, study district, outdoor sleeping, Acacia trees and domestic animals [odds ratio (95% confidence interval): 12.58 (5.911–26.763), 5.40 (2.90–10.07), 5.31 (2.283–12.364), 2.37 (1.1190–4.728) and 0.199 (0.097–0.410), respectively]. The entomological survey identified 74 Phlebotomus [P. (Larroussius) orientalis (52/74), P. (Anaphlebotomus) rodhaini (14/74), P. (Paraphlebotomus) sergenti (8/74)] and 11 Sergentomyia sand flies. The average frequency of P. orientalis (3.06 ± 0.66) collected by all traps per night was higher than that of other species. The average frequency of total and specific (P. orientalis) female sand flies was higher in Adadle (1.89 ± 0.423 vs 1.11 ± 0.309) than in Gode (0.62 ± 0.324 vs 0.38 ± 0.183) district. The highest mean numbers of total (8 ± 1.5) and P. orientalis (6 ± 0.913) sand flies were collected in termite hills. Conclusions The present findings revealed potential new VL-transmission foci in the study districts. Therefore, the need for parasitological and molecular characterization of the parasite in humans and vector sand flies is of paramount importance to confirm transmission. Electronic supplementary material The online version of this article (10.1186/s13071-019-3452-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Getachew Alebie
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia.
| | - Amha Worku
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia
| | - Siele Yohannes
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia
| | - Befikadu Urga
- College of Veterinary Medicine, Jigjiga University, Jigjiga, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dagimawie Tadesse
- Department of Medical Microbiology, DNDi Leishmaniasis Research and Treatment Center, Arbaminch Hospital, Arbaminch, Ethiopia
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van Henten S, Adriaensen W, Fikre H, Akuffo H, Diro E, Hailu A, Van der Auwera G, van Griensven J. Cutaneous Leishmaniasis Due to Leishmania aethiopica. EClinicalMedicine 2018; 6:69-81. [PMID: 31193672 PMCID: PMC6537575 DOI: 10.1016/j.eclinm.2018.12.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/21/2018] [Accepted: 12/24/2018] [Indexed: 01/06/2023] Open
Abstract
Leishmania aethiopica is the main causative species for cutaneous leishmaniasis (CL) in Ethiopia. Despite its considerable burden, L. aethiopica has been one of the most neglected Leishmania species. In this review, published evidence on L. aethiopica history, geography, vector, reservoir, epidemiology, parasitology, and immunology is discussed and knowledge gaps are outlined. L. aethiopica endemic regions are limited to the highland areas, although nationwide studies on CL prevalence are lacking. Phlebotomus pedifer and P. longipes are the sandfly vectors and hyraxes are considered to be the main reservoir, but the role of other sandfly species and other potential reservoirs requires further investigation. Where and how transmission occurs exactly are also still unknown. Most CL patients in Ethiopia are children and young adults. Lesions are most commonly on the face, in contrast to CL caused by other Leishmania species which may more frequently affect other body parts. CL lesions caused by L. aethiopica seem atypical and more severe in their presentation as compared to other Leishmania species. Mucocutaneous leishmaniasis and diffuse cutaneous leishmaniasis are relatively common, and healing of lesions caused by L. aethiopica seems to take longer than that of other species. A thorough documentation of the natural evolution of L. aethiopica as well as in depth studies into the immunological and parasitological characteristics that underpin the atypical and severe clinical presentation are needed. Better understanding of CL caused by this parasite species will contribute to interventions related to transmission, prevention, and treatment.
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Affiliation(s)
- Saskia van Henten
- Unit of HIV and Neglected Tropical Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Wim Adriaensen
- Unit of HIV and Neglected Tropical Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Helina Fikre
- Leishmania Research and Treatment Center, University of Gondar Hospital, Gondar, Ethiopia
| | - Hannah Akuffo
- Swedish International Development Agency (Sida) and Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Solna, Sweden
| | - Ermias Diro
- Leishmania Research and Treatment Center, University of Gondar Hospital, Gondar, Ethiopia
| | - Asrat Hailu
- Addis Ababa University School of Medicine, Ethiopia
| | - Gert Van der Auwera
- Unit of Molecular Parasitology, Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
| | - Johan van Griensven
- Unit of HIV and Neglected Tropical Diseases, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Exploratory, Phase II Controlled Trial of Shiunko Ointment Local Application Twice a Day for 4 Weeks in Ethiopian Patients with Localized Cutaneous Leishmaniasis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:5984709. [PMID: 27195014 PMCID: PMC4853951 DOI: 10.1155/2016/5984709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/09/2016] [Accepted: 03/22/2016] [Indexed: 11/30/2022]
Abstract
The clinical efficacy and safety of Shiunko ointment (phase II clinical trial) was investigated in 40 Ethiopian patients with cutaneous leishmaniasis. Patients were randomized to receive treatment with Shiunko ointment or placebo (n = 20, each), applied on the lesion twice a day for 4 weeks. Clinicoparasitological assessments were performed before treatment, weekly for 4 weeks, and then 4, 8, and 12 weeks after the end of treatment. A marked reduction in lesion size was observed on week 16 of treatment in the Shiunko compared with placebo group (69% and 22% reduction, resp.). The overall rate of lesion reduction during the four weeks of treatment was significantly faster in the Shiunko group. Shiunko provided significant effect on wound closure in patients with ulcerated lesion. The clinical efficacy and tolerability of Shiunko were comparable to placebo with regard to its clinicoparasitological response (cure rate and parasitological clearance). Results of this preliminary study may suggest that Shiunko could be useful as adjuvant or as complementary treatment, not as alternatives to current treatment. Its attractive action includes fast lesion healing with a significantly smaller lesion at week 16 of treatment compared with placebo. In addition, its action was promoted in ulcerative lesions.
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Kassahun A, Sadlova J, Benda P, Kostalova T, Warburg A, Hailu A, Baneth G, Volf P, Votypka J. Natural infection of bats with Leishmania in Ethiopia. Acta Trop 2015; 150:166-70. [PMID: 26232657 DOI: 10.1016/j.actatropica.2015.07.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/24/2015] [Accepted: 07/27/2015] [Indexed: 10/23/2022]
Abstract
The leishmaniases, a group of diseases with a worldwide-distribution, are caused by different species of Leishmania parasites. Both cutaneous and visceral leishmaniasis remain important public health problems in Ethiopia. Epidemiological cycles of these protozoans involve various sand fly (Diptera: Psychodidae) vectors and mammalian hosts, including humans. In recent years, Leishmania infections in bats have been reported in the New World countries endemic to leishmaniasis. The aim of this study was to survey natural Leishmania infection in bats collected from various regions of Ethiopia. Total DNA was isolated from spleens of 163 bats belonging to 23 species and 18 genera. Leishmania infection was detected by real-time (RT) PCR targeting a kinetoplast (k) DNA and internal transcribed spacer one (ITS1) gene of the parasite. Detection was confirmed by sequencing of the PCR products. Leishmania kDNA was detected in eight (4.9%) bats; four of them had been captured in the Aba-Roba and Awash-Methara regions that are endemic for leishmaniasis, while the other four specimens originated from non-endemic localities of Metu, Bedele and Masha. Leishmania isolates from two bats were confirmed by ITS1 PCR to be Leishmania tropica and Leishmania major, isolated from two individual bats, Cardioderma cor and Nycteris hispida, respectively. These results represent the first confirmed observation of natural infection of bats with the Old World Leishmania. Hence, bats should be considered putative hosts of Leishmania spp. affecting humans with a significant role in the transmission.
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Kassahun A, Sadlova J, Dvorak V, Kostalova T, Rohousova I, Frynta D, Aghova T, Yasur-Landau D, Lemma W, Hailu A, Baneth G, Warburg A, Volf P, Votypka J. Detection of Leishmania donovani and L. tropica in Ethiopian wild rodents. Acta Trop 2015; 145:39-44. [PMID: 25700710 DOI: 10.1016/j.actatropica.2015.02.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/03/2015] [Accepted: 02/07/2015] [Indexed: 11/29/2022]
Abstract
Human visceral (VL, also known as Kala-azar) and cutaneous (CL) leishmaniasis are important infectious diseases affecting countries in East Africa that remain endemic in several regions of Ethiopia. The transmission and epidemiology of the disease is complicated due to the complex life cycle of the parasites and the involvement of various Leishmania spp., sand fly vectors, and reservoir animals besides human hosts. Particularly in East Africa, the role of animals as reservoirs for human VL remains unclear. Isolation of Leishmania donovani parasites from naturally infected rodents has been reported in several endemic countries; however, the status of rodents as reservoirs in Ethiopia remains unclear. Here, we demonstrated natural Leishmania infections in rodents. Animals were trapped in 41 localities of endemic and non-endemic areas in eight geographical regions of Ethiopia and DNA was isolated from spleens of 586 rodents belonging to 21 genera and 38 species. Leishmania infection was evaluated by real-time PCR of kinetoplast (k)DNA and confirmed by sequencing of the PCR products. Subsequently, parasite species identification was confirmed by PCR and DNA sequencing of the 18S ribosomal RNA internal transcribed spacer one (ITS1) gene. Out of fifty (8.2%) rodent specimens positive for Leishmania kDNA-PCR and sequencing, 10 were subsequently identified by sequencing of the ITS1 showing that five belonged to the L. donovani complex and five to L. tropica. Forty nine kDNA-positive rodents were found in the endemic localities of southern and eastern Ethiopia while only one was identified from northwestern Ethiopia. Moreover, all the ten ITS1-positive rodents were captured in areas where human leishmaniasis cases have been reported and potential sand fly vectors occur. Our findings suggest the eco-epidemiological importance of rodents in these foci of leishmaniasis and indicate that rodents are likely to play a role in the transmission of leishmaniasis in Ethiopia, possibly as reservoir hosts.
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Affiliation(s)
- Aysheshm Kassahun
- Department of Parasitology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
| | - Jovana Sadlova
- Department of Parasitology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
| | - Vit Dvorak
- Department of Parasitology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
| | - Tatiana Kostalova
- Department of Parasitology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
| | - Iva Rohousova
- Department of Parasitology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
| | - Daniel Frynta
- Department of Zoology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
| | - Tatiana Aghova
- Institute of Vertebrate Biology, Academy of Sciences of the Czech Republic, 675 02 Studenec 122, Czech Republic.
| | - Daniel Yasur-Landau
- School of Veterinary Medicine, Hebrew University, P.O. Box 12, Rehovot 76100, Israel.
| | - Wessenseged Lemma
- Department of Zoological Science, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Asrat Hailu
- Department of Microbiology, Immunology & Parasitology, Faculty of Medicine, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia.
| | - Gad Baneth
- School of Veterinary Medicine, Hebrew University, P.O. Box 12, Rehovot 76100, Israel.
| | - Alon Warburg
- Department of Microbiology and Molecular Genetics, The Institute for Medical Research Israel-Canada, The Kuvin Centre for the Study of Infectious and Tropical Diseases, The Hebrew University Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem 91120, Israel.
| | - Petr Volf
- Department of Parasitology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
| | - Jan Votypka
- Department of Parasitology, Faculty of Science, Charles University in Prague, Vinicna 7, 128 44 Prague 2, Czech Republic.
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Bsrat A, Berhe N, Balkew M, Yohannes M, Teklu T, Gadisa E, Medhin G, Abera A. Epidemiological study of cutaneous leishmaniasis in Saesie Tsaeda-emba district, eastern Tigray, northern Ethiopia. Parasit Vectors 2015; 8:149. [PMID: 25889827 PMCID: PMC4359476 DOI: 10.1186/s13071-015-0758-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 02/20/2015] [Indexed: 11/10/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL) is one of the endemic and neglected diseases known to exist in Ethiopian highlands. However, little is known about its epidemiological characteristics. Hence, this study was initiated and conducted from November 2011 to April 2012 to assess the epidemiological situation of CL in Saesie Tsaeda-emba District. Methods A cross sectional design was employed in six randomly selected Peasant associations and a house to house survey was carried out in the District. Detailed clinical assessment, and smear and culture for Leishmania parasite detection were done to confirm clinical suspension. Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) analysis of the ribosomal DNA Internal Transcribed Spacer (ITS-1) sequences was used to type isolates. Sandfly collection was also conducted in possible micro-habitats of the target areas. Results The overall prevalence of CL in the District was 14.0% (6.7% for active lesion and 7.3% for scar) with the highest prevalence amongst the age group of 10–19 years. Field isolates typed were L. aethiopica. Environmental and host risk factors significantly associated with CL distribution were age, study Peasant associations, presence of cave/gorge, walls with cracks and/or holes, presence of hyrax, animal burrow, animal dung and farm land near to residents’ houses. Five phlebotomine sandflies, Phlebotomus longipes, Sergentomyia bedfordi, S.africana, S.schwetzi and S.antenata were captured. Conclusion All the precipitating factors in the area are indicative of the public health importance of CL although there has been little attention given. The present study is a starter for wider investigation into the mode of its transmission, incrimination of sandfly vectors and possible animal reservoirs. Detailed information will be the basis to launch effective control of CL in the area. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-0758-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abrha Bsrat
- College of Veterinary Medicine, Mekelle University, P O Box 231, Mekelle, Ethiopia.
| | - Nega Berhe
- Aklilu Lemma Institution of Pathobiology, Addis Ababa University College of Health Sciences, P O Box 1176, Addis Ababa, Ethiopia.
| | - Meshesha Balkew
- Aklilu Lemma Institution of Pathobiology, Addis Ababa University College of Health Sciences, P O Box 1176, Addis Ababa, Ethiopia.
| | - Mekonnen Yohannes
- Mekelle University College of Health Sciences, P O Box 231, Mekelle, Ethiopia.
| | - Tsigemariam Teklu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia. .,Tigray Regional Health Bureau, Mekelle, Ethiopia.
| | | | - Girmay Medhin
- Aklilu Lemma Institution of Pathobiology, Addis Ababa University College of Health Sciences, P O Box 1176, Addis Ababa, Ethiopia.
| | - Adugna Abera
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
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Maroli M, Feliciangeli MD, Bichaud L, Charrel RN, Gradoni L. Phlebotomine sandflies and the spreading of leishmaniases and other diseases of public health concern. MEDICAL AND VETERINARY ENTOMOLOGY 2013; 27:123-47. [PMID: 22924419 DOI: 10.1111/j.1365-2915.2012.01034.x] [Citation(s) in RCA: 483] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Phlebotomine sandflies transmit pathogens that affect humans and animals worldwide. We review the roles of phlebotomines in the spreading of leishmaniases, sandfly fever, summer meningitis, vesicular stomatitis, Chandipura virus encephalitis and Carrión's disease. Among over 800 species of sandfly recorded, 98 are proven or suspected vectors of human leishmaniases; these include 42 Phlebotomus species in the Old World and 56 Lutzomyia species in the New World (all: Diptera: Psychodidae). Based on incrimination criteria, we provide an updated list of proven or suspected vector species by endemic country where data are available. Increases in sandfly diffusion and density resulting from increases in breeding sites and blood sources, and the interruption of vector control activities contribute to the spreading of leishmaniasis in the settings of human migration, deforestation, urbanization and conflict. In addition, climatic changes can be expected to affect the density and dispersion of sandflies. Phlebovirus infections and diseases are present in large areas of the Old World, especially in the Mediterranean subregion, in which virus diversity has proven to be higher than initially suspected. Vesiculovirus diseases are important to livestock and humans in the southeastern U.S.A. and Latin America, and represent emerging human threats in parts of India. Carrión's disease, formerly restricted to regions of elevated altitude in Peru, Ecuador and Colombia, has shown recent expansion to non-endemic areas of the Amazon basin.
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Affiliation(s)
- M Maroli
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
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Susceptibility of clinical isolates of Leishmania aethiopica to miltefosine, paromomycin, amphotericin B and sodium stibogluconate using amastigote-macrophage in vitro model. Exp Parasitol 2013; 134:68-75. [DOI: 10.1016/j.exppara.2013.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 01/14/2013] [Accepted: 01/30/2013] [Indexed: 11/21/2022]
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Treatment response of cutaneous leishmaniasis due to Leishmania aethiopica to cryotherapy and generic sodium stibogluconate from patients in Silti, Ethiopia. Trans R Soc Trop Med Hyg 2012; 106:496-503. [DOI: 10.1016/j.trstmh.2012.02.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 02/27/2012] [Accepted: 02/27/2012] [Indexed: 11/23/2022] Open
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Morrone A, Pitidis A, Pajno MC, Dassoni F, Latini O, Barnabas GA, Padovese V. Epidemiological and geographical aspects of leishmaniasis in Tigray, northern Ethiopia: a retrospective analysis of medical records, 2005-2008. Trans R Soc Trop Med Hyg 2011; 105:273-80. [PMID: 21439603 DOI: 10.1016/j.trstmh.2011.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 02/16/2011] [Accepted: 02/16/2011] [Indexed: 11/26/2022] Open
Abstract
Leishmaniasis is one of the most neglected tropical diseases and epidemic outbreaks often occur worldwide. This paper reports some epidemiological features of the disease in Tigray, northern Ethiopia, with the aim of studying the disease distribution and the environmental factors that may have influenced it. Medical records from patients with Leishmania attending the Italian Dermatological Centre of Mekele in the period 2005-2008 were retrospectively reviewed. Age and gender distribution, clinical types, occupation, co-morbidity, urban/rural origin, altitude and rainfall were investigated. The result was 471 patients affected and the prevalent clinical form was cutaneous leishmaniasis (86%). Five main risk areas were identified in the Tigray highlands and only isolated cases were reported at altitudes below 1700m. The variables related to a higher risk of catching leishmaniasis were male gender, age over-14, poor education, outdoor activities and living at high altitudes. Climatic and environmental changes occurring in this region and land degradation are discussed as factors influencing leishmaniasis distribution. Further research including field missions and geomapping is needed to quantify the actual disease burden in the region.
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Affiliation(s)
- Aldo Morrone
- National Institute for Health, Migration and Poverty, via di San Gallicano 25/A, 00153 Rome, Italy
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Lemma W, Erenso G, Gadisa E, Balkew M, Gebre-Michael T, Hailu A. A zoonotic focus of cutaneous leishmaniasis in Addis Ababa, Ethiopia. Parasit Vectors 2009; 2:60. [PMID: 19954530 PMCID: PMC2794267 DOI: 10.1186/1756-3305-2-60] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Accepted: 12/02/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is endemic in the highlands of Ethiopia, and almost always caused by Leishmania aethiopica. Hitherto, Addis Ababa (the capital city of Ethiopia) was not considered endemic for CL, mainly due to absence of epidemiological and field ecological studies. This report summarizes the preliminary epidemiological investigation that proved the existence of active transmission in southeastern Addis Ababa. RESULTS Active case finding surveys were conducted in 3 localities, Saris, Kality, and Akaki, which are found in and around Bulbula-Akaki river gorges. During the surveys conducted in January 2005 - May 2006, a total of 35 cases with 9 active and 26 healed skin lesions were identified. Eighteen of the cases (51.4%) were found in Saris; while 10 (28.6%) and 7 (20%) cases were from Kality and Akaki respectively.Ten colonies of rock hyraxes (Heterohyrax brucei) were identified in the vicinities of the 3 localities. Three of the 48 hyraxes (6.3%) trapped from the surroundings harbored natural infections of Leishmania aethiopica. Confirmation of the Leishmania species of the 3 isolates was achieved by PCR amplification and RFLP analysis of the ribosomal DNA internal transcribed spacer (ITS) sequences. Based on sandfly species composition and proximity of resting sites to human settlements, Phlebotomus longipes is circumstantially proven to be the vector of CL in south east Addis Ababa. CONCLUSION The study proves the existence of isolated zoonotic foci of CL in south eastern Addis Ababa, with P. longipes as the likely vector and H. brucei as the natural reservoir host.
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Affiliation(s)
- Wossenseged Lemma
- College of Medicine and Health Sciences, Department of Medical Laboratory Technology, Gondar University, PO Box 196, Gondar, Ethiopia.
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Pratlong F, Dereure J, Ravel C, Lami P, Balard Y, Serres G, Lanotte G, Rioux JA, Dedet JP. Geographical distribution and epidemiological features of Old World cutaneous leishmaniasis foci, based on the isoenzyme analysis of 1048 strains. Trop Med Int Health 2009; 14:1071-85. [PMID: 19624480 DOI: 10.1111/j.1365-3156.2009.02336.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Francine Pratlong
- Université Montpellier 1, Centre National de Référence des Leishmania, Génétique et Evolution des Maladies Infectieuses, Laboratoire de Parasitologie-Mycologie, CHU de Montpellier, France
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Negera E, Gadisa E, Yamuah L, Engers H, Hussein J, Kuru T, Hailu A, Gedamu L, Aseffa A. Outbreak of cutaneous leishmaniasis in Silti woreda, Ethiopia: risk factor assessment and causative agent identification. Trans R Soc Trop Med Hyg 2008; 102:883-90. [DOI: 10.1016/j.trstmh.2008.03.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2007] [Revised: 03/27/2008] [Accepted: 03/27/2008] [Indexed: 11/30/2022] Open
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Gadisa E, Genetu A, Kuru T, Jirata D, Dagne K, Aseffa A, Gedamu L. Leishmania (Kinetoplastida): Species typing with isoenzyme and PCR–RFLP from cutaneous leishmaniasis patients in Ethiopia. Exp Parasitol 2007; 115:339-43. [PMID: 17083934 DOI: 10.1016/j.exppara.2006.09.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Revised: 09/13/2006] [Accepted: 09/21/2006] [Indexed: 10/24/2022]
Abstract
Cutaneous leishmaniasis (CL) is an increasing public health problem in Ethiopia. There is a concern that it is spreading with increased incidence. In this study, we used isoenzyme electrophoresis and internal transcribed spacer one (ITS1) PCR-RFLP techniques to identify Leishmania species from CL patients in Ethiopia. We obtained isolates from 55 localized cutaneous leishmaniasis (LCL), 3 diffused cutaneous leishmaniasis (DCL) and 36 biopsy samples from 34 LCL and 2 DCL cases from All Africa Leprosy and Tuberculosis Rehabilitation and Training Center (ALERT) and clinically diagnosed CL cases from Ochollo village. Both isoenzyme and ITS1 PCR-RFLP techniques showed that Leishmania aethiopica (L. aethiopica) was the aetiologic agent in all cases. Our study also showed that ITS1 PCR-RFLP could identify Leishmania species from biopsy samples and suggests the method could be used for epidemiological surveillance of leishmaniasis in Ethiopia and for species-specific diagnosis.
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Affiliation(s)
- E Gadisa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
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