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Giunti G, Becker N, Benelli G. Invasive mosquito vectors in Europe: From bioecology to surveillance and management. Acta Trop 2023; 239:106832. [PMID: 36642256 DOI: 10.1016/j.actatropica.2023.106832] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
Invasive mosquitoes (Diptera: Culicidae) play a key role in the spread of a number of mosquito-borne diseases worldwide. Anthropogenic changes play a significant role in affecting their distribution. Invasive mosquitoes usually take advantage from biotic homogenization and biodiversity reduction, therefore expanding in their distribution range and abundance. In Europe, climate warming and increasing urbanization are boosting the spread of several mosquito species of high public health importance. The present article contains a literature review focused on the biology and ecology of Aedes albopictus, Ae. aegypti, Ae. japonicus japonicus, Ae. koreicus, Ae. atropalpus and Ae. triseriatus, outlining their distribution and public health relevance in Europe. Bioecology insights were tightly connected with vector surveillance and control programs targeting these species. In the final section, a research agenda aiming for the effective and sustainable monitoring and control of invasive mosquitoes in the framework of Integrated Vector Management and One Health is presented. The WHO Vector Control Advisory Group recommends priority should be given to vector control tools with proven epidemiological impact.
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Affiliation(s)
- Giulia Giunti
- Department of Pharmacy, University of Salerno, via Giovanni Paolo II 132, Fisciano, SA 84084, Italy
| | - Norbert Becker
- Faculty of Biosciences, University of Heidelberg, Im Neuenheimer Feld 230, Heidelberg 69120, Germany; Institute of Dipterology (IfD), Georg-Peter-Süß-Str. 3, Speyer 67346, Germany; IcyBac-Biologische Stechmückenbekämpfung GmbH (ICYBAC), Georg-Peter-Süß-Str. 1, Speyer 67346, Germany
| | - Giovanni Benelli
- Department of Agriculture, Food and Environment, University of Pisa, via del Borghetto 80, Pisa 56124, Italy.
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2
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Bertola M, Mazzucato M, Pombi M, Montarsi F. Updated occurrence and bionomics of potential malaria vectors in Europe: a systematic review (2000-2021). Parasit Vectors 2022; 15:88. [PMID: 35292106 PMCID: PMC8922938 DOI: 10.1186/s13071-022-05204-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/14/2022] [Indexed: 01/09/2023] Open
Abstract
Despite the eradication of malaria across most European countries in the 1960s and 1970s, the anopheline vectors are still present. Most of the malaria cases that have been reported in Europe up to the present time have been infections acquired in endemic areas by travelers. However, the possibility of acquiring malaria by locally infected mosquitoes has been poorly investigated in Europe, despite autochthonous malaria cases having been occasionally reported in several European countries. Here we present an update on the occurrence of potential malaria vector species in Europe. Adopting a systematic review approach, we selected 288 papers published between 2000 and 2021 for inclusion in the review based on retrieval of accurate information on the following Anopheles species: An. atroparvus, An. hyrcanus sensu lato (s.l.), An. labranchiae, An. maculipennis sensu stricto (s.s.), An. messeae/daciae, An. sacharovi, An. superpictus and An. plumbeus. The distribution of these potential vector species across Europe is critically reviewed in relation to areas of major presence and principal bionomic features, including vector competence to Plasmodium. Additional information, such as geographical details, sampling approaches and species identification methods, are also reported. We compare the information on each species extracted from the most recent studies to comparable information reported from studies published in the early 2000s, with particular reference to the role of each species in malaria transmission before eradication. The picture that emerges from this review is that potential vector species are still widespread in Europe, with the largest diversity in the Mediterranean area, Italy in particular. Despite information on their vectorial capacity being fragmentary, the information retrieved suggests a re-definition of the relative importance of potential vector species, indicating An. hyrcanus s.l., An. labranchiae, An. plumbeus and An. sacharovi as potential vectors of higher importance, while An. messeae/daciae and An. maculipennis s.s. can be considered to be moderately important species. In contrast, An. atroparvus and An. superpictus should be considered as vectors of lower importance, particularly in relation to their low anthropophily. The presence of gaps in current knowledge of vectorial systems in Europe becomes evident in this review, not only in terms of vector competence but also in the definition of sampling approaches, highlighting the need for further research to adopt the appropriate surveillance system for each species.
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Affiliation(s)
- Michela Bertola
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
| | - Matteo Mazzucato
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy
| | - Marco Pombi
- Dipartimento di Sanità Pubblica e Malattie Infettive, Università di Roma "Sapienza", P.le Aldo Moro 5, 00185, Roma, Italy.
| | - Fabrizio Montarsi
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Italy.,Dipartimento di Sanità Pubblica e Malattie Infettive, Università di Roma "Sapienza", P.le Aldo Moro 5, 00185, Roma, Italy
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3
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Ali N, Noreen S, Khan K, Wahid S. Population dynamics of mosquitoes and malaria vector incrimination in district Charsadda, Khyber Pakhtunkhwa (KP) Pakistan. Acta Trop 2015; 141:25-31. [PMID: 25255965 DOI: 10.1016/j.actatropica.2014.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 11/26/2022]
Abstract
This study aimed to obtain updated information on mosquito diversity and malaria vector incrimination in Charsadda Khyber Pakhtunkhwa to help in devising effective control and preventive measures in the area. Monthly survey of indoor mosquitoes for one year was carried out in three villages, Dhaki Totaqi and Mathra. Female Anopheline were used to detect Circumsporozoites protein (CSP) using Enzyme Linked Immunosorbent Assay. Among 17 mosquito species, Culex quinquefasciatus, Anopheles splendidus, Anopheles stephensi, Anopheles fluviatilus, Anopheles culicifacies and Culex tritaeniorhynchus were predominant. Dhaki village had the highest mosquito species diversity (1.015) and similar species richness (0.7) and evenness (0.5) with village Mathra. Slide positivity rate (SPR) shows that the rate of malaria transmission increases with mosquito population. Four anopheline species i.e. A. stephensi, A. fluviatilis, A. splendidus, and A. culicifacies were CSP positive. The CSP rate was 0.8%, where two specimens of A. splendidus and one of A. fluviatilus were positive for Plasmodium falciparum, Plasmodium vivax was represented by two variants 210 and 247. Among the 20 CSP positive specimens, variant 210 was found in 12 (one belonging to A. culicifacies, two each of A. stephensi and A. fluviatilus, seven specimens of A. splendidus) and 247 in 8 specimens (two of A. stephensi, three each of A. fluviatilus and A. splendidus). The number of infected mosquitoes collected from animal sheds was higher (15) though non-significant (P>0.05) than that from bedrooms (8).
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4
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Stiller CA, Trama A, Brewster DH, Verne J, Bouchardy C, Navarro C, Chirlaque MD, Marcos-Gragera R, Visser O, Serraino D, Weiderpass E, Dei Tos AP, Ascoli V. Descriptive epidemiology of Kaposi sarcoma in Europe. Report from the RARECARE project. Cancer Epidemiol 2014; 38:670-8. [PMID: 25454979 DOI: 10.1016/j.canep.2014.09.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 08/06/2014] [Accepted: 09/26/2014] [Indexed: 11/18/2022]
Abstract
Kaposi sarcoma (KS) is a virus-related malignancy which most frequently arises in skin, though visceral sites can also be involved. Infection with Kaposi sarcoma herpes virus (KSHV or HHV-8) is required for development of KS. Nowadays, most cases worldwide occur in persons who are immunosuppressed, usually because of HIV infection or as a result of therapy to combat rejection of a transplanted organ, but classic Kaposi sarcoma is predominantly a disease of the elderly without apparent immunosuppression. We analyzed 2667 KS incident cases diagnosed during 1995-2002 and registered by 75 population-based European cancer registries contributing to the RARECARE project. Total crude and age-standardized incidence rate was 0.3 per 100,000 per year with an estimated 1642 new cases per year in the EU27 countries. Age-standardized incidence rate was 0.8 per 100,000 in Southern Europe but below 0.3 per 100,000 in all other regions. The elevated rate in southern Europe was attributable to a combination of classic Kaposi sarcoma in some Mediterranean countries and the relatively high incidence of AIDS in several countries. Five-year relative survival for 2000-2002 by the period method was 75%. More than 10,000 persons were estimated to be alive in Europe at the beginning of 2008 with a past diagnosis of KS. The aetiological link with suppressed immunity means that many people alive following diagnosis of KS suffer comorbidity from a pre-existing condition. While KS is a rare cancer, it has a relatively good prognosis and so the number of people affected by it is quite large. Thus it provides a notable example of the importance of networking in diagnosis, therapy and research for rare cancers.
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Affiliation(s)
- C A Stiller
- Childhood Cancer Research Group, Department of Paediatrics, University of Oxford, Oxford, UK.
| | - A Trama
- Department of Preventive and Predictive Medicine, Fondazione IRCSS, Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - D H Brewster
- Scottish Cancer Registry, Information Services Division, National Services Scotland Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, Scotland, UK
| | - J Verne
- Public Health England Knowledge & Intelligence Team (South West), Grosvenor House, 149 Whiteladies Road, Bristol BS8 2RA, UK
| | - C Bouchardy
- Geneva Cancer Registry, IMSP - University of Geneva 55, Bd de la Cluse, CH-1205 Geneva, Switzerland
| | - C Navarro
- Department of Epidemiology, Murcia Regional Health Authority, Ronda de Levante 11, 30008 Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - M D Chirlaque
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - R Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia and Descriptive Epidemiology, Genetics and Cancer Prevention Group [Girona Biomedical Research Institute (IdIBGi)], Catalan Institute of Oncology, Carrer del Sol, 15, 17004 Girona, Spain
| | - O Visser
- Comprehensive Cancer Centre the Netherlands, Registration & Research, PO Box 19.079, 3501 DB Utrecht, The Netherlands
| | - D Serraino
- SOC Epidemiologia e Biostatistica, Friuli Venezia Giulia Cancer Registry, IRCCS Centro di Riferimento Oncologico, Aviano, Italy
| | - E Weiderpass
- Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Samfundet Folkhälsan, Helsinki, Finland
| | - A P Dei Tos
- Department of Oncology and Anatomic Pathology and General Hospital of Treviso, Piazza Ospedale 1, Treviso, Italy
| | - V Ascoli
- Dipartimento di Scienze Radiologiche, Oncologiche ed Anatomopatologiche, Università Sapienza, Viale Regina Elena 324, 00161 Roma, Italy
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Wakeham K, Webb EL, Sebina I, Nalwoga A, Muhangi L, Miley W, Johnston WT, Ndibazza J, Whitby D, Newton R, Elliott AM. Risk factors for seropositivity to Kaposi sarcoma-associated herpesvirus among children in Uganda. J Acquir Immune Defic Syndr 2013; 63:228-33. [PMID: 23403859 PMCID: PMC3707567 DOI: 10.1097/qai.0b013e31828a7056] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 01/18/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND Determinants of Kaposi sarcoma-associated herpesvirus (KSHV) seropositivity among children living in sub-Saharan African populations where infection is endemic are not well understood. Local environmental factors, including other infectious agents, may be key. METHODS Within the context of a well-characterized birth cohort, we examined associations between various factors and antibodies against KSHV, measured in stored plasma samples from 1823 mother-child pairs in Entebbe, Uganda. RESULTS Seroprevalence increased with increasing age of the child (P = 0.0003) and was higher among those with KSHV seropositive mothers than in those without (12% vs 9%; odds ratio: 1.4, 95% confidence interval: 1.1 to 2.0). It was also higher among children with HIV infection (29% vs 10%; odds ratio: 3.1, 95% confidence interval: 1.2 to 8.3) or malaria parasitemia (30% vs 10%; odds ratio: 4.1, 95% confidence interval: 2.4 to 7.0) than in children without. These associations were not explained by socioeconomic status. CONCLUSIONS The finding that KSHV serostatus is associated with malaria parasitemia in children is novel. In a country endemic for KSHV, malaria may be a cofactor for KSHV infection or reactivation among children.
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Affiliation(s)
- Katie Wakeham
- Medical Research Council, Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, Uganda.
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Conant KL, Kaleeba JAR. Dangerous liaisons: molecular basis for a syndemic relationship between Kaposi's sarcoma and P. falciparum malaria. Front Microbiol 2013; 4:35. [PMID: 23487416 PMCID: PMC3594938 DOI: 10.3389/fmicb.2013.00035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 02/07/2013] [Indexed: 11/13/2022] Open
Abstract
The most severe manifestations of malaria (caused by Plasmodium falciparum) occur as a direct result of parasitemia following invasion of erythrocytes by post-liver blood-stage merozoites, and during subsequent cyto-adherence of infected erythrocytes to the vascular endothelium. However, the disproportionate epidemiologic clustering of severe malaria with aggressive forms of endemic diseases such as Kaposi's sarcoma (KS), a neoplasm that is etiologically linked to infection with KS-associated herpesvirus (KSHV), underscores the significance of previously unexplored co-pathogenetic interactions that have the potential to modify the overall disease burden in co-infected individuals. Based on recent studies of the mechanisms that P. falciparum and KSHV have evolved to interact with their mutual human host, several new perspectives are emerging that highlight a surprising convergence of biological themes potentially underlying their associated co-morbidities. Against this background, ongoing studies are rapidly constructing a fascinating new paradigm in which the major host receptors that control parasite invasion (Basigin/CD147) and cyto-adherence (CD36) are, surprisingly, also important targets for exploitation by KSHV. In this article, we consider the major pathobiological implications of the co-option of Basigin/CD147 and CD36 signaling pathways by both P. falciparum and KSHV, not only as essential host factors for parasite persistence but also as important mediators of the pro-angiogenic phenotype within the virus-infected endothelial microenvironment. Consequently, the triangulation of interactions between P. falciparum, KSHV, and their mutual human host articulates a syndemic relationship that points to a conceptual framework for prevalence of aggressive forms of KS in malaria-endemic areas, with implications for the possibility of dual-use therapies against these debilitating infections in resource-limited parts of the world.
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Affiliation(s)
| | - Johnan A. R. Kaleeba
- Department of Microbiology and Immunology, Uniformed Services University of the Health SciencesBethesda, MD, USA
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7
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Wakeham K, Webb EL, Sebina I, Muhangi L, Miley W, Johnson WT, Ndibazza J, Elliott AM, Whitby D, Newton R. Parasite infection is associated with Kaposi's sarcoma associated herpesvirus (KSHV) in Ugandan women. Infect Agent Cancer 2011; 6:15. [PMID: 21962023 PMCID: PMC3197512 DOI: 10.1186/1750-9378-6-15] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 09/30/2011] [Indexed: 12/20/2022] Open
Abstract
Background Immune modulation by parasites may influence susceptibility to bacteria and viruses. We examined the association between current parasite infections, HIV and syphilis (measured in blood or stool samples using standard methods) and antibodies against Kaposi's sarcoma herpesvirus (KSHV), measured by ELISA, in 1915 stored plasma samples from pregnant women in Entebbe, Uganda. Results Seroprevalence of KSHV was higher in women with malaria parasitaemia (73% vs 60% p = 0.01), hookworm (67% vs 56% p = 0.001) and Mansonella perstans (69% vs 59% p = 0.05); seroprevalence increased with increasing intensity of hookworm infection (p < 0.001[trend]). No associations were found for HIV, five other parasites or active syphilis. These effects were not explained by socioeconomic status or education. Conclusions Specific parasite infections are associated with presence of antibodies against KSHV, perhaps mediated via their effect on immune function.
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Affiliation(s)
- Katie Wakeham
- Co-infections Studies Programme, Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, PO Box 49, Entebbe, Uganda.,Epidemiology and Genetics Unit, Department of Health Sciences, Area 3 Seebohm Rowntree Building, University of York, York, YO10 5DD, UK
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppal Street, London, WC1E 7HT, UK
| | - Ismail Sebina
- Co-infections Studies Programme, Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, PO Box 49, Entebbe, Uganda
| | - Lawrence Muhangi
- Co-infections Studies Programme, Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, PO Box 49, Entebbe, Uganda
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC_Frederick, National Cancer Institute, PO Box B, Frederick, MD 21702, USA
| | - W Thomas Johnson
- Epidemiology and Genetics Unit, Department of Health Sciences, Area 3 Seebohm Rowntree Building, University of York, York, YO10 5DD, UK
| | - Juliet Ndibazza
- Co-infections Studies Programme, Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, PO Box 49, Entebbe, Uganda
| | - Alison M Elliott
- Co-infections Studies Programme, Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, PO Box 49, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppal Street, London, WC1E 7HT, UK
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC_Frederick, National Cancer Institute, PO Box B, Frederick, MD 21702, USA
| | - Robert Newton
- Epidemiology and Genetics Unit, Department of Health Sciences, Area 3 Seebohm Rowntree Building, University of York, York, YO10 5DD, UK.,Hull York Medical School, University of York, Heslington, YO10 5DD, UK
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Amodio E, Valentini M, Gori-Savellini G, Valenti RM, Romano N, Goedert JJ, Cusi MG. Prevalence of toscana and sicilian phlebovirus antibodies in classic Kaposi sarcoma case patients and control subjects in sicily. J Infect Dis 2011; 204:1423-6. [PMID: 21900487 DOI: 10.1093/infdis/jir546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To assess whether arthropod bites promote Kaposi sarcoma (KS), we determined the seroprevalence of Sicilian (SFSV) and Toscana (TOSV) phlebovirus antibodies in 30 patients with classic KS and 100 controls in Sicily. Nine (6.9%) subjects, all controls, were positive for SFSV, whereas 41 (31.5%) were positive for TOSV. Seroprevalence with immunoglobulin (Ig) M or IgG against either virus was significantly higher in controls (43% vs 13.3% in case patients; P < .01). Adjusted for age, IgG seroprevalence was significantly lower in KS patients compared to controls (adjusted odds ratio, 0.22; 95% confidence interval, .07-.72). Low phlebovirus seroprevalence in patients with KS may reflect incapacity to produce robust, persistent antibody responses, and suggests that arthropod bites do not promote KS.
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Affiliation(s)
- Emanuele Amodio
- Department of Sciences for Health Promotion G. D'Alessandro, University of Palermo, Italy
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Ascoli V, Senis G, Zucchetto A, Valerio L, Facchinelli L, Budroni M, Dal Maso L, Coluzzi M. Distribution of 'promoter' sandflies associated with incidence of classic Kaposi's sarcoma. MEDICAL AND VETERINARY ENTOMOLOGY 2009; 23:217-225. [PMID: 19712152 DOI: 10.1111/j.1365-2915.2009.00811.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The patchy geographical distributions of classic Kaposi's sarcoma (KS) and human herpesvirus type 8 (HHV-8), better known as Kaposi's sarcoma-associated herpesvirus (KSHV) remain unexplained. It has been proposed that certain species of bloodsucking insects ('promoter arthropods') promote the reactivation of HHV-8/KSHV and facilitate both HHV-8/KSHV transmission and KS development. This hypothesis was tested by sampling the presence and density of human-biting Diptera with CDC light traps in two areas of Sardinia with contrasting incidence rates of classic KS. In total, 11,030 specimens (99.9% sandflies and 0.1% mosquitoes) belonging to 10 species were collected from 40 rural sites. Five of these species are considered to be possible promoter arthropods because of the irritation their bites cause: Phlebotomus perniciosus Newstead; Phlebotomus perfiliewi Parrot (Diptera: Psychodidae); Aedes berlandi Seguy; Culiseta annulata (Schrank) and Culex theileri Theobald (Diptera: Culicidae). Five species are probable 'non-promoters' because their bites are not particularly irritating: Culiseta longiareolata (Macquart); Culex pipiens s.l.; Anopheles algeriensis Theobald; Anopheles maculipennis s.l., and Anopheles plumbeus Stephens. A significant correlation was found between the geographical distribution of promoter arthropods and incidence rates of KS (Spearman's r = 0.59,P < 0.01). Promoter arthropods were more likely to be caught in areas with cutaneous leishmaniasis and a past high prevalence of malaria, and in areas of limestone, acid volcanic soil and cereal cultivation. The study supports the association between promoter arthropods and classic KS, which may explain the geographic variability of KS and HHV-8/KSHV, and highlights the links with a number of variables previously associated with the incidence of KS.
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Affiliation(s)
- V Ascoli
- Anatomia Patologica, Dipartimento di Medicina Sperimentale, Università La Sapienza, Rome, Italy.
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10
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Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995-2002). Br J Cancer 2009; 101:1085-90. [PMID: 19707194 PMCID: PMC2768094 DOI: 10.1038/sj.bjc.6605265] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Little information is available on the causes of death among persons with classic Kaposi's sarcoma (CKS). Methods: We conducted a population-based study in Italy to identify deceased persons with CKS and the underlying causes of death among them, by reviewing multiple-causes-of-death records. Standardised mortality ratios (SMRs) and 95% confidence intervals were calculated to compare the distribution of causes to that among the same-age general population of deceased persons. The geographical distribution was also evaluated. Results: Of the 946 deaths among persons with CKS, 65.9% were attributable to non-neoplastic conditions and 21.9% to malignancies. For 12.2%, no lethal pathology was identified and CKS was considered as the underlying cause. In 90% of these cases, there was visceral/nodal involvement, therapy-related complications, or neoplastic cachexia. Among persons with CKS who died of other causes, an excess for lymphoid malignancies emerged (SMR=4.40) (chronic lymphocytic leukaemia (11.03), non-Hodgkin's lymphoma (4.22), Hodgkin's lymphoma (11.80), and multiple myeloma (2.3)), balanced by a deficit for all solid cancers (0.56), with a marked deficit for lung cancer (0.41). We found an excess for respiratory diseases (chronic obstructive pulmonary disease (1.86)) and genitourinary diseases (chronic renal failure (6.47)). There was marked geographical heterogeneity in the distribution of deaths. Conclusions: Though referring specifically to Italy, the results are informative for other countries and populations and all cases of CKS in general.
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Schwartz RA, Micali G, Nasca MR, Scuderi L. Kaposi sarcoma: a continuing conundrum. J Am Acad Dermatol 2008; 59:179-206; quiz 207-8. [PMID: 18638627 DOI: 10.1016/j.jaad.2008.05.001] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 04/20/2008] [Accepted: 05/05/2008] [Indexed: 12/11/2022]
Abstract
UNLABELLED Kaposi sarcoma (KS) remains a challenge. Its classic or Mediterranean form tends to be benign. In transplant recipients it may be less so. As part of the AIDS pandemic, of which it was an original defining component, it may be life-threatening. It is due to human herpesvirus-8, which is necessary but not sufficient to produce the disease. KS has a low prevalence in the general population of the United States and United Kingdom, with an intermediate rate in Italy and Greece, and a high one in parts of Africa. In Italy, hot spots include its southern regions, the Po River Valley, and Sardinia, possibly related to a high density of blood-sucking insects. An important challenge is to treat KS patients without immunocompromising them. The potential of effective anti-herpes virus therapy and the use of sirolimus in transplantation recipients have added new opportunities for KS prevention. LEARNING OBJECTIVES At the conclusion of this learning activity, participants should be able to provide the most recent information about Kaposi sarcoma in the context in which it occurs. Its classic or Mediterranean form, its pattern in transplant recipients and others iatrogenically immunosuppressed, and its occurrence as a potentially life-threatening part of the AIDS pandemic will be stressed. Its etiology and transmission will be discussed in detail to facilitate understanding of Kaposi sarcoma and of human herpesvirus-8 infection in the general population of the United States and United Kingdom, in Italy and Greece, and in certain parts of Africa. Its therapy, including the concept of doing it without immunocompromising the patient, will be stressed. New opportunities for Kaposi sarcoma prevention will also be discussed.
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Affiliation(s)
- Robert A Schwartz
- Department of Dermatology, New Jersey Medical School, Newark, New Jersey 07103-2714, USA.
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12
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Ascoli V, Facchinelli L, Valerio L, Manno D, Coluzzi M. Kaposi's sarcoma, human herpesvirus 8 infection and the potential role of promoter-arthropod bites in northern Sweden. J Med Virol 2006; 78:1452-5. [PMID: 16998892 DOI: 10.1002/jmv.20718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Valeria Ascoli
- Dipartimento di Medicina Sperimentale e Patologia, Università La Sapienza, Roma, Italy.
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