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Kashif M, Waseem M, Subbarao N. In silico prediction of CD8 + and CD4 + T cell epitopes in Leishmania major proteome: Using immunoinformatics. J Mol Graph Model 2024; 129:108759. [PMID: 38492406 DOI: 10.1016/j.jmgm.2024.108759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/12/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
The leishmaniases are NDTs (neglected tropical diseases) that affect people all over the world. They are brought on by protozoans from the genus Leishmania and disseminated by phlebotomine flies that are afflicted with the disease. The best option to manage and lower the incidence of these diseases has been thought by the creation of a safe and effective vaccination. This research used an in silico based mining approach to look for high potential epitopes that might bind to MHC Class I and MHC Class II molecules (mainly; HLA-A*02:01 & HLA-DRB1*03:01) from human population in order to promote vaccine development. Based on the presence of signal peptides, GPI anchors, antigenicity predictions, and a subtractive proteomic technique, we have screened 17 putative antigenic proteins from the 8083 total proteins of L. major. After that thorough immunogenic epitope prediction were done using IEDB-AR tools. We isolated five immunogenic epitopes (three 9-mer & two 15-mer) from five antigenic proteins through docking and MD simulation analysis. Finally, these five anticipated epitopes, viz., TLPEIPVNV, ELMAPVFGL, TLAAAVALL, NSINIRLDGVTSAGF and NVPLVVDASSLFRVA have considerably stronger binding potential with their respective alleles and may trigger immunological responses. The goal of this work was to identify MHC restricted epitopes for CD8+ and CD4+ T cells activation using immunoinformatics in order to identify potential vaccine candidates against L. major parasites.
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Affiliation(s)
- Mohammad Kashif
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, 110067, India.
| | - Mohd Waseem
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - Naidu Subbarao
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
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Ocampo CB, Guzmán-Rodríguez L, Moreno M, Castro MDM, Valderrama-Ardila C, Alexander N. Integration of phlebotomine ecological niche modelling, and mapping of cutaneous leishmaniasis surveillance data, to identify areas at risk of under-estimation. Acta Trop 2021; 224:106122. [PMID: 34480871 PMCID: PMC9017289 DOI: 10.1016/j.actatropica.2021.106122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/13/2021] [Accepted: 08/25/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Passive surveillance systems are thought to under-estimate the true incidence of American cutaneous leishmaniasis (ACL) by two- to five-fold. Ecological niche models based on remotely sensed data can identify environmental factors which favor phlebotomine vectors. Here we report an integrated approach to identifying areas at risk of cutaneous leishmaniasis by applying spatial analysis methods to niche model results, and local surveillance data, in two locations in Colombia with differing vector ecology. The objective was to identify townships in which later phases of the project could implement community-based surveillance to obtain direct estimates of under-reporting. MATERIALS AND METHODS The study was carried out in one municipality in each of two departments of the Andean region of Colombia: Pueblo Rico in Risaralda, and Rovira in Tolima. Niche mapping by maximum entropy, based on published and unpublished existing locations of Pintomyia (Pifanomyia) longiflocosa and Psychodopygus panamensis, and using variables on land cover, climate and elevation. Field catches were done in each municipality to test predictions of high relative probability of presence. The niche model results were included as a predictor in a conditional autoregressive spatial model, in which the outcome variable was the number of cases by township, as detected by passive surveillance. RESULTS Having rarefied 173 geolocated records, 46 of Pi. longiflocosa and 57 of Ps. panamensis were used for the niche modelling. At the national level, both species had high relative probability of presence on parts of the slopes of the three Andean cordilleras. Pi. longiflocosa also has a high relative probability of presence in the higher parts of the Magdalena valley, as does Ps. panamensis in some areas close to the Caribbean coast. At the local level, field catches confirmed that Pi. longiflocosa was the most abundant species in Rovira, and likewise Ps. panamensis in Pueblo Rico. The spatial regression showed that the incidence of ACL, according to surveillance, was positively, but not statistically significantly, associated with the relative probability of presence from the risk model. CONCLUSIONS These niche maps bring together published and unpublished results on phlebotomine species which are important vectors in Colombia. Maps of the fitted values of incidence were used to guide the selection of townships in which further phases of the study will attempt to quantify the extent of under-estimation of ACL incidence.
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Affiliation(s)
- Clara B Ocampo
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia; Universidad Icesi., Cali, Colombia; Ministerio de Ciencia Tecnología e Innovación (Minciencias), Bogotá, Colombia
| | - Lina Guzmán-Rodríguez
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia
| | - Mabel Moreno
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia
| | - María Del Mar Castro
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia; Universidad Icesi., Cali, Colombia
| | | | - Neal Alexander
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia; Universidad Icesi., Cali, Colombia.
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Han S, Chen SB, Yang ZH, Feng Y, Wu WP. Epidemiology of Leishmania Carriers in Tan Chang County, Gansu Province, China. Front Cell Infect Microbiol 2021; 11:645944. [PMID: 33842392 PMCID: PMC8029648 DOI: 10.3389/fcimb.2021.645944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/10/2021] [Indexed: 11/27/2022] Open
Abstract
Background Leishmaniasis is a regional infectious disease caused by the bite of Leishmania-carrying sandflies. The clinical symptoms include prolonged fever, spleen enlargement, anemia, emaciation, leukopenia, and increased serum globulin levels. If not appropriately treated, patients may die of complications caused by leishmaniasis within 1–2 years after the onset of the illness. Therefore, further investigation of the mechanisms of infection by this pathogen is required. Here, an epidemiological study of Leishmania carriers was conducted. The potential mechanism of infection through domestic animals as carriers of the parasite was investigated to identify potential reservoir hosts for Leishmania. Methods The rK-39 strip test was performed on blood samples from previously infected patients. Blood samples were collected from the patients and their families. The blood, liver, spleen, and diaphragm muscle samples were collected from livestock. To perform nested polymerase chain reaction (PCR), DNA was extracted and the internal transcribed spacer sequence was used. The amplified products were then subjected to restriction fragment length polymorphism and phylogenetic analyses. Results Among previously infected patients, 40% (12/30) showed positive results in the rK-39 strip test. The nested PCR positive rates for previously infected patients/relatives and livestock samples were 86% (77/90) and 80% (8/10), respectively. Moreover, the phylogenetic analysis showed that the pathogen was Leishmania infantum. Dogs, patients, and domesticated animals carrying Leishmania were found to be a potential source of infection for leishmaniasis. Conclusions The results of this study provide a basis for developing disease prevention and control strategies for leishmaniasis.
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Affiliation(s)
- Shuai Han
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.,Chinese Center for Tropical Diseases Research, Shanghai, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
| | - Sheng-Bang Chen
- Gansu Province Center for Disease Control and Prevention, Lanzhou, China
| | - Zhang-Hong Yang
- Tan Chang County Center for Disease Control and Prevention, Longnan, China
| | - Yu Feng
- Gansu Province Center for Disease Control and Prevention, Lanzhou, China
| | - Wei-Ping Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.,Chinese Center for Tropical Diseases Research, Shanghai, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.,WHO Collaborating Centre for Tropical Diseases, Shanghai, China.,National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
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Takahashi EA, Masoud L, Mukbel R, Guitian J, Stevens KB. Modelling habitat suitability in Jordan for the cutaneous leishmaniasis vector (Phlebotomus papatasi) using multicriteria decision analysis. PLoS Negl Trop Dis 2020; 14:e0008852. [PMID: 33226979 PMCID: PMC7721129 DOI: 10.1371/journal.pntd.0008852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/07/2020] [Accepted: 10/05/2020] [Indexed: 11/30/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a zoonotic vector-borne neglected tropical disease transmitted by female Phlebotomine sand flies. It is distributed globally but a large proportion of cases (70–75%) are found in just ten countries. CL is endemic in Jordan yet there is a lack of robust entomological data and true reporting status is unknown. This study aimed to map habitat suitability of the main CL vector, Phlebotomus papatasi, in Jordan as a proxy for CL risk distribution to (i) identify areas potentially at risk of CL and (ii) estimate the human population at risk of CL. A literature review identified potential environmental determinants for P. papatasi occurrence including temperature, humidity, precipitation, vegetation, wind speed, presence of human households and presence of the fat sand rat. Each predictor variable was (a) mapped; (b) standardized to a common size, resolution and scale using fuzzy membership functions; (c) assigned a weight using the analytical hierarchy process (AHP); and (d) included within a multicriteria decision analysis (MCDA) model to produce monthly maps illustrating the predicted habitat suitability (between 0 and 1) for P. papatasi in Jordan. Suitability increased over the summer months and was generally highest in the north-western regions of the country and along the Jordan Valley, areas which largely coincided with highly populated parts of the country, including areas where Syrian refugee camps are located. Habitat suitability in Jordan for the main CL vector—P. papatasi—was heterogeneous over both space and time. Suitable areas for P. papatasi coincided with highly populated areas of Jordan which suggests that the targeted implementation of control and surveillance strategies in defined areas such as those with very high CL vector suitability (>0.9 suitability) would focus only on 3.42% of the country’s total geographic area, whilst still including a substantial proportion of the population at risk: estimates range from 72% (European Commission’s Global Human Settlement population grid) to 89% (Gridded Population of the World) depending on the human population density data used. Therefore, high impact public health interventions could be achieved within a reduced spatial target, thus maximizing the efficient use of resources. Cutaneous leishmaniasis (CL) is a globally distributed zoonotic vector-borne neglected tropical disease transmitted by female sandflies. The aim of this study was to estimate habitat suitability of the CL-transmitting sandfly in Jordan using spatial data on variables that influence the sandflies’ presence and survival including temperature, humidity, precipitation, vegetation, wind speed, presence of human households and presence of the fat sand rat. Once high-risk areas were identified, the number of people at risk of infection could be estimated. Sandfly habitat suitability increased over the summer months and was generally highest in the north-western parts of the country and along the Jordan Valley, coinciding with highly populated regions, including areas containing Syrian refugee camps. These results suggest the need for targeted surveillance and disease control efforts.
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Affiliation(s)
- Emi A. Takahashi
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
- * E-mail: (ET); (KS)
| | - Lina Masoud
- Department of Basic Medical Veterinary Science, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rami Mukbel
- Department of Basic Medical Veterinary Science, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Javier Guitian
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - Kim B. Stevens
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
- * E-mail: (ET); (KS)
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Ghatee MA, Taylor WR, Karamian M. The Geographical Distribution of Cutaneous Leishmaniasis Causative Agents in Iran and Its Neighboring Countries, A Review. Front Public Health 2020; 8:11. [PMID: 32133334 PMCID: PMC7039857 DOI: 10.3389/fpubh.2020.00011] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/14/2020] [Indexed: 12/15/2022] Open
Abstract
Leishmania tropica and Leishmania major are both the main cause of anthroponotic (ACL) and zoonotic cutaneous leishmaniasis (ZCL), respectively, in the Old World. Leishmania infantum and Leishmania donovani, which are important causes of visceral leishmaniasis, have also occasionally been reported in CL patients. The present study investigates the current distribution of causative species of CL in Iran and neighboring countries in the Middle East. There has been expansion of L. tropica into new urban and rural foci in Iran, with well-documented cases of visceralization, a substantial increase of CL in Syria, and the emergence of new foci and outbreaks in Turkey and Iraq, especially due to L. major. Civil war in Syria and Iraq, population movement, poverty, and climatic change play important roles in the changing CL distribution in this region. Control programs should adopt a multidisciplinary approach based on active surveillance and case finding, especially in vulnerable refugee populations, determination of hazard maps for CL hot points using GIS and other advanced technology, the free distribution of drugs, rodent control, and greater community engagement in poor and marginalized populations. Comprehensive molecular studies that could show the species and strains of Leishmania in different areas of each country can give a better view from the distribution of CL in this region.
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Affiliation(s)
- Mohammad Amin Ghatee
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.,Department of Parasitology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Walter R Taylor
- Clinical Therapeutics Unit, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mehdi Karamian
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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El Safadi D, Merhabi S, Rafei R, Mallat H, Hamze M, Acosta-Serrano A. Cutaneous leishmaniasis in north Lebanon: re-emergence of an important neglected tropical disease. Trans R Soc Trop Med Hyg 2019; 113:471-476. [DOI: 10.1093/trstmh/trz030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/28/2019] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
Cutaneous leishmaniasis (CL) is the most prevalent neglected tropical disease among externally displaced people in the Middle East. In recent years, the Lebanese population has increased >30%, mainly due to a mass influx of Syrian migrants, thousands of them carrying CL, among other infectious diseases. Here we revisit the current CL prevalence among refugees in northern Lebanon.
Methods
This cohort study was conducted at the Al Bashaer Medical Center in north Lebanon between January and June 2017. A total of 48 randomly selected suspected CL patients were clinically diagnosed by dermatologists and samples were obtained for microscopic examination and molecular identification by polymerase chain reaction restriction fragment length polymorphism. The treatment response to antimonials was assessed each week and was followed for up 6 months.
Results
Leishmania tropica was the predominant species (91.7%) followed by Leishmania major (8.3%). Confirmed cases were treated with one to two courses of antimonials and healing was usually achieved after receiving a second course of treatment. Importantly, we show evidence of possible local CL transmission by indigenous sandflies in three separate patients who had no history of recent travel to Syria.
Conclusions
This highlights the urgent necessity to implement preventive disease strategies to avoid further dispersion of L. tropica CL in north Lebanon.
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Affiliation(s)
- Dima El Safadi
- Health and Environment Microbiology Laboratory, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Sabah Merhabi
- Health and Environment Microbiology Laboratory, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Rayane Rafei
- Health and Environment Microbiology Laboratory, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Hassan Mallat
- Health and Environment Microbiology Laboratory, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- Health and Environment Microbiology Laboratory, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Alvaro Acosta-Serrano
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, England, UK
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Abstract
Background Cutaneous and visceral forms of leishmaniasis are the most important protozoan infection in the Middle East and North Africa (MENA). Objectives Review the current knowledge on leishmaniasis in the MENA. Methods The data presented in this review are gathered primarily from WHO reports and from an extensive literature search on PubMed. Results There are four cycles of transmission of leishmaniasis: zoonotic cutaneous leishmaniasis (ZCL), induce by Leishmania (L.) major, transmitted by Phlebotomus (P.) papatasi, with rodent species of Psammomys obesus, Meriones libycus, Nesokia indica, and Rhombomys opimus are considered as host reservoirs. Zoonotic visceral leishmaniasis (ZVL) is inducing by L. infantum, transmitted by several Phlebotomus spp. of the sub-genus Larroussius and mainly P. perniciosus in more than one-half of the MENA countries and the dog species of Canis familiaris are considered as the main reservoirs. Anthroponotic cutaneous leishmaniasis (ACL), induce by L. tropica and transmitted by P. sergenti, without any non-human reservoir in most cases. Anthroponotic visceral leishmaniasis (AVL) induces by L. donovani spreads through P. alexandri, circulates exclusively in humans. Conclusion There are many challenges facing the successful control of leishmaniasis. However, there is continuing research into the treatment of leishmaniasis and potentially vaccinations for the disease.
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Affiliation(s)
- Ahmed Tabbabi
- Department of Hygiene and Environmental Protection, Ministry of Public Health, Tunis, Tunisia
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Prevalence of Cutaneous Leishmaniasis in Western Highlands in Yemen. J Trop Med 2019; 2019:8248916. [PMID: 30941183 PMCID: PMC6421047 DOI: 10.1155/2019/8248916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/24/2018] [Accepted: 01/17/2019] [Indexed: 11/27/2022] Open
Abstract
Leishmaniasis in Yemen is still not fully investigated nor well studied. Recently, outbreaks of cutaneous leishmaniasis (CL) in western highland were declared. However, there are no reports concerning the disease and the circulating species in the region. The aim of this study was to determine the prevalence of cutaneous leishmaniasis in Utmah district located in Western Highlands in Yemen. A cross-sectional survey was carried out at those highlands. For the survey, 1165 participants were subjected to Leishmanin Skin Test (LST) accompanied with direct interviews and physical examination. The overall prevalence of cutaneous leishmaniasis in the district was 18.5% and the cutaneous leishmaniasis (CL) was more frequent in the escarpments with a prevalence of 37%, including 5.5% for active lesion and 31.5% for scar of healed lesions. Children under the age of 16 years old comprised most of the CL cases (76.3%). The escarpments of western highlands in Yemen were hyperendemic areas for CL and the infection was more prevalent in children.
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Hijawi KJF, Hijjawi NS, Ibbini JH. Detection, genotyping, and phylogenetic analysis of Leishmania isolates collected from infected Jordanian residents and Syrian refugees who suffered from cutaneous leishmaniasis. Parasitol Res 2019; 118:793-805. [PMID: 30729301 DOI: 10.1007/s00436-019-06222-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 01/17/2019] [Indexed: 12/21/2022]
Abstract
Leishmania is a parasitic protozoan which is transmitted to humans through the bite of an infected female Phlebotomus and Lutzomyia sand flies. Cutaneous leishmaniasis (CL), caused by Leishmania major and L. tropica, is an endemic disease in many areas of Jordan and considered as a major public health problem. The political instability in the Syrian Arab Republic has resulted in the immigration of large number of refugees into Jordan where most of them resided in camps near the Syrian borders. Therefore, the main objective of the present study was to inspect Leishmania species/genotypes which are responsible for CL infections among Syrian refugees and compare them with the recovered species/genotypes isolated from Jordanian patients. Three molecular-based assays (ITS1-PCR-RFLP, Nested ITS1-5.8S rDNA PCR, and Kinetoplast DNA PCR) followed by sequencing and phylogenetic analysis were undertaken and compared for their efficiency to confirm CL diagnosis and genotype the infecting Leishmania species. Thereafter, the evolutionary relationships among various Leishmania isolates from Syrian and Jordanian CL patients were elucidated. Results from the present study indicated that 20 and 9 out of the inspected 66 patients (39 Jordanian and 27 Syrian) were infected with L. major and L. tropica respectively. ITS1-PCR RFLP typing proved to be more sensitive in the detection of Leishmania species (positive in 44% of the isolates) compared to both ITS1-5.8S rDNA gene and Kinetoplast DNA PCR which were successful in identifying Leishmania species only in 23% and 33% of the isolates respectively. Sequencing and phylogenetic analysis of ITS1 and ITS1-5.8S rDNA genes revealed high levels of heterogeneity among the sequenced isolates. One sample typed as L. tropica from Jordanian patient showed high similarity with L. tropica sample isolated from a Syrian patient in a Lebanon refugee camp; therefore, the need for comprehensive studies to confirm if any new L. tropica strains might be introduced to Jordan by Syrian refugees is urgently indicated. These observations highlighted the need for further studies to clarify the risk status of species and strains which might be introduced from Syria to Jordan.
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Affiliation(s)
- Kamal J F Hijawi
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, PO Box 150459, Zarqa, 13115, Jordan.
| | - Nawal S Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, PO Box 150459, Zarqa, 13115, Jordan
| | - Jwan H Ibbini
- Department of Land Management and Environment, Faculty of Natural Resources and Environment, Hashemite University, Zarqa, 13115, Jordan
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Han S, Wu WP, Chen K, Osman I, Kiyim K, Zhao J, Hou YY, Wang Y, Wang LY, Zheng CJ. Epidemiological survey of sheep as potential hosts for Leishmania in China. BMC Vet Res 2018; 14:378. [PMID: 30509251 PMCID: PMC6276147 DOI: 10.1186/s12917-018-1701-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/20/2018] [Indexed: 11/18/2022] Open
Abstract
Background Leishmania parasites cause visceral leishmaniasis (VL), an important infectious disease that is endemic to large parts of the world and often leads to epidemics. Sand flies are the primary transmission vector for the parasite in endemic regions. We hypothesized that sheep might serve as an overlooked reservoir for Leishmania transmission to humans due to the asymptomatic nature of infection in many species. As a preliminary test of this hypothesis, the aim of the present study was to investigate sheep in an area of China that is endemic for the desert sub-type of zoonotic VL and establish if they are potential carriers of Leishmania. Results Sheep tissue samples were collected from abattoirs in VL endemic areas of Jiashi County, China during the non-transmission season. rK39 immunochromatographic tests were performed to detect the presence of the parasite in blood samples. In addition, DNA was extracted from the blood, and used for detection of the Leishmania-specific internal transcribed spacer-1 (ITS-1) genomic region using a nested polymerase chain reaction (PCR) approach. PCR products were further analyzed to identify restriction fragment-length polymorphism patterns and representative sequences of each pattern were selected for phylogenetic analysis. The rK-39 and nested PCR data indicated positive detection rates for Leishmania in sheep of 26.32 and 54.39%, respectively. The phylogenetic analysis revealed that all of the samples belonged to the species L. infantum and were closely related to strains isolated from human infections in the same area. Conclusions Sheep could be a potential host for Leishmania in VL endemic areas in China and may be an overlooked reservoir of human VL transmission in this region. To further confirm livestock as a potential host, further verification is required using a sand fly biting experiment.
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Affiliation(s)
- Shuai Han
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China
| | - Wei-Ping Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China.
| | - Kai Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China
| | - Israyil Osman
- Xinjiang Uygur Autonomous Regional Center for Disease Control and Prevention, Urumqi, China
| | - Kaisar Kiyim
- Kashgar Prefectural Center for Disease Control and Prevention, Kashgar, China
| | - Jun Zhao
- Xinjiang Uygur Autonomous Regional Center for Disease Control and Prevention, Urumqi, China
| | - Yan-Yan Hou
- Xinjiang Uygur Autonomous Regional Center for Disease Control and Prevention, Urumqi, China
| | - Ying Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China
| | - Li-Ying Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Tropical Diseases, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, 200025, China
| | - Can-Jun Zheng
- Chinese Center for Disease Control and Prevention, Beijing, China
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Mosleh IM, Schönian G, Kanani K, Shadfan B. Leishmania major cutaneous leishmaniasis outbreak in the Jordanian side of the Northern Jordan Valley. Pathog Glob Health 2018; 112:22-28. [PMID: 29392995 DOI: 10.1080/20477724.2018.1431191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is endemic in many foci of Jordan and the Jordanian Mid Jordan Valley (JMJV) is the most affected and the incidence is quite high. The situation in the northern part of the Jordanian side of the Jordan Valley (NJJV) was different; before 2008, CL has rarely been reported from this area. From April 2008 to May 2009, passive detection followed by active detection was used to trace cases of CL from the NJJV. DNA was extracted from seven clinical isolates of Leishmania promastigotes and lesion scrapings spotted on filter papers obtained from 51 suspected CL patients living in the NJJV. The identity of the causative species of CL in the NJJV was investigated using ITS1-PCR followed by RFLP. In 2008/2009, 183 cases were clinically diagnosed of having CL in the NJJV. The parasites in five of the isolates and in 48 PCR-positive scrapings were classified as Leishmania major. In two isolates and in one PCR-positive scraping Leishmania tropica was identified. Investigations on the origin of CL cases revealed that the L. tropica cases were residents of two towns outside the NJJV. Herein, we report the clinical features, parasitological diagnosis, etiology, and the geographical distribution of CL cases from NJJV with the aim of documenting, for the first time, an outbreak in this area.
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Affiliation(s)
- Ibrahim M Mosleh
- a Faculty of Science, Department of Medical Laboratory Sciences , University of Jordan , Amman , Jordan
| | - Gabrielle Schönian
- b Institute of Microbiology and Hygiene , Charité University of Medicine , Berlin , Germany
| | - Khalil Kanani
- c Department of Zoonotic and Parasitic Diseases, Communicable Disease Directorate , Ministry of Health , Amman , Jordan
| | - Bassam Shadfan
- c Department of Zoonotic and Parasitic Diseases, Communicable Disease Directorate , Ministry of Health , Amman , Jordan
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Obwaller AG, Köhsler M, Poeppl W, Herkner H, Mooseder G, Aspöck H, Walochnik J. Leishmania infections in Austrian soldiers returning from military missions abroad: a cross-sectional study. Clin Microbiol Infect 2018; 24:1100.e1-1100.e6. [PMID: 29339223 DOI: 10.1016/j.cmi.2018.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The incidence of leishmaniasis is known to increase in conflict areas. The aims of this study were to determine the exposure to Leishmania species in Austrian soldiers returning from missions abroad and to assess possible risk factors. METHODS A retrospective explorative cross-sectional serologic study was conducted in 225 healthy Austrian soldiers returning from UN or EU peacekeeping missions in Syria, Lebanon and Bosnia and Herzegovina (BIH). Sera were tested for anti-Leishmania antibodies using a commercial enzyme-linked immunosorbent assay. All positive individuals were screened for Leishmania DNA by PCR targeting the ITS1 region using EDTA blood samples. RESULTS In total, 13.3% (30/225) of the individuals tested were either positive (8%, 18/225) or borderline (5.3%, 12/225) in the enzyme-linked immunosorbent assay, with the highest seroprevalence in soldiers returning from Syria (17.8%, 18/101; 12 positive, six borderline), second from Lebanon (11.1%, 7/63; four positive, three borderline) and lowest from BIH (8.2%, 5/61; two positive, three borderline). Ten soldiers returning from Syria and one from BIH were also positive for Leishmania DNA. Six of these were identified as Leishmania donovani/infantum complex, two as L. tropica and another three as mixed infections by DNA sequencing. Epidemiologic data were collected via a questionnaire, and seropositivity was correlated with a history of insect bites that took a long time to heal (odds ratio, 5.33; 95% confidence interval, 1.23-23.04; p 0.025). CONCLUSIONS Although pretravel serologic data were not available in this study, the exposure of soldiers to Leishmania spp. during their missions can be assumed to be considerable. Because even asymptomatic infections may resurge in case of emerging immunodeficiencies, adequate prevention measures seem important.
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Affiliation(s)
- A G Obwaller
- Federal Ministry of Defence, Division of Science, Research and Development, Vienna, Austria; Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Infectiology and Immunology, Vienna, Austria
| | - M Köhsler
- Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Infectiology and Immunology, Vienna, Austria
| | - W Poeppl
- Department of Infectious Diseases and Tropical Medicine, Vienna, Austria; Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, Vienna, Austria
| | - H Herkner
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - G Mooseder
- Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, Vienna, Austria
| | - H Aspöck
- Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Infectiology and Immunology, Vienna, Austria
| | - J Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Infectiology and Immunology, Vienna, Austria.
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Eid D, Guzman-Rivero M, Rojas E, Goicolea I, Hurtig AK, Illanes D, San Sebastian M. Assessment of a Leishmaniasis Reporting System in Tropical Bolivia Using the Capture-Recapture Method. Am J Trop Med Hyg 2018; 98:134-138. [PMID: 29141751 DOI: 10.4269/ajtmh.17-0308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This study evaluates the level of underreporting of the National Program of Leishmaniasis Control (NPLC) in two communities of Cochabamba, Bolivia during the period 2013-2014. Montenegro skin test-confirmed cases of cutaneous leishmaniasis (CL) were identified through active surveillance during medical campaigns. These cases were compared with those registered in the NPLC by passive surveillance. After matching and cleaning data from the two sources, the total number of cases and the level of underreporting of the National Program were calculated using the capture-recapture analysis. This estimated that 86 cases of CL (95% confidence interval [CI]: 62.1-110.8) occurred in the study period in both communities. The level of underreporting of the NPLC in these communities was very high: 73.4% (95% CI: 63.1-81.5%). These results can be explained by the inaccessibility of health services and centralization of the NPLC activities. This information is important to establish priorities among policy-makers and funding organizations as well as implementing adequate intervention plans.
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Affiliation(s)
- Daniel Eid
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden.,Department of Biomedical Sciences Research, Faculty of Medicine, San Simon University, Cochabamba, Bolivia
| | - Miguel Guzman-Rivero
- Department of Biomedical Sciences Research, Faculty of Medicine, San Simon University, Cochabamba, Bolivia
| | - Ernesto Rojas
- Department of Biomedical Sciences Research, Faculty of Medicine, San Simon University, Cochabamba, Bolivia
| | - Isabel Goicolea
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Anna-Karin Hurtig
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Daniel Illanes
- Department of Biomedical Sciences Research, Faculty of Medicine, San Simon University, Cochabamba, Bolivia
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umea, Sweden
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Abuzaid AA, Abdoon AM, Aldahan MA, Alzahrani AG, Alhakeem RF, Asiri AM, Alzahrani MH, Memish ZA. Cutaneous Leishmaniasis in Saudi Arabia: A Comprehensive Overview. Vector Borne Zoonotic Dis 2017; 17:673-684. [PMID: 28806141 PMCID: PMC5649416 DOI: 10.1089/vbz.2017.2119] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite the great efforts by health authorities in Kingdom of Saudi Arabia (KSA), Cutaneous leishmaniasis (CL) continues to be a major public health problem in the country. Many risk factors make KSA prone to outbreaks and epidemics; among these, rapid urbanization and the huge population movement are the most important. The disease is endemic in many parts of KSA, with the majority of cases concentrated in six regions, including Al-Qaseem, Riyadh, Al-Hassa, Aseer, Ha'il, and Al-Madinah. Leishmania major (L. major) and Leishmania tropica (L. tropica) are the main dermotropic species, and Phlebotomus papatasi (vector of L. major) and Phlebotomus sergenti (vector of L. tropica) are the proved vectors of the disease. Psammomys obesus and Meriones libycus have been defined as the principal reservoir hosts of zoonotic CL in Al-Hassa oasis, Al-Madinah, and Al-Qaseem provinces. Clinically, males are affected more than females, and there is no variation between the Saudis and expatriates in terms of number of reported cases, but the disease tends to run a more severe course among non-Saudis. Face is the most commonly affected site, and ulcerative pattern accounts for 90% of lesions. Despite local and international recommendations of using laboratory diagnostics to confirm CL cases, most cases in KSA are diagnosed and treated on clinical grounds and local epidemiology. However, systemic parenteral sodium stibogluconate (SSG) is the first line of therapy and used to treat all CL patients irrespective of their clinical presentation or the incriminated species. In brief, more efforts are needed to combat this disease. Several aspects of the disease require more evaluation through encouragement of national and regional studies. Development of evidence based national diagnostic and management guidelines, as well as algorithms, is urgently needed to improve the practice of diagnosing and treating CL in KSA.
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Affiliation(s)
- Abuzaid A Abuzaid
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia
| | - Abdalmohsin M Abdoon
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia
| | - Mohamed A Aldahan
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia
| | - Abdullah G Alzahrani
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia
| | - Raaft F Alhakeem
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia
| | - Abdullah M Asiri
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia
| | - Mohamed H Alzahrani
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia
| | - Ziad A Memish
- 1 Infectious Diseases Control Directorate, Ministry of Health , Riyadh, Kingdom of Saudi Arabia .,2 College of Medicine, Alfaisal University , Riyadh, Kingdom of Saudi Arabia .,3 Hubert Department of Global Health, Rollins School of Public health, Emory University , Atlanta, Georgia
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Gignoux E, Idowu R, Bawo L, Hurum L, Sprecher A, Bastard M, Porten K. Use of Capture-Recapture to Estimate Underreporting of Ebola Virus Disease, Montserrado County, Liberia. Emerg Infect Dis 2016; 21:2265-7. [PMID: 26583831 PMCID: PMC4672419 DOI: 10.3201/eid2112.150756] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Molecular Diagnosis and Identification of Leishmania Species in Jordan from Saved Dry Samples. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6871739. [PMID: 27403435 PMCID: PMC4926024 DOI: 10.1155/2016/6871739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/11/2016] [Accepted: 04/13/2016] [Indexed: 11/26/2022]
Abstract
Diagnosis of the endemic cutaneous leishmaniasis (CL) in Jordan relies on patient clinical presentation and microscopic identification. Studies toward improved identification of the causative Leishmania species, especially in regions where multiple species exist, and the introduction of these techniques into medical diagnosis is paramount. This study looked at the current epidemiology of CL in Jordan. Clinically diagnosed 41 patients with CL were tested for the presence of Leishmania parasite using both Giemsa staining from skin scraps on glass slides and ITS1-PCR from samples blotted onto storage cards (NucleoCards®). Microscopically, 28 out of the 41 (68.3%) collected samples were positive for amastigotes, whereas the molecular ITS1-PCR amplification successfully identified 30 of the 41 samples (73.2%). Furthermore, PCR-RFLP analysis allowed species identification which is impossible microscopically. Of the 30 PCR positive samples, 28 were Leishmania major positive and the other two samples were Leishmania tropica. This indicates that L. major is the most prevalent species in Jordan and the two L. tropica cases originated from Syria indicating possible future L. tropica outbreaks. Diagnosis of CL based on clinical presentation only may falsely increase its prevalence. Although PCR is more sensitive, it is still not available in our medical laboratories in Jordan.
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Mukbel RM, Khasharmeh RH, Hijjawi NS, Khalifeh MS, Hatmal MM, McDowell MA. Human immune response to salivary proteins of wild-caught Phlebotomus papatasi. Parasitol Res 2016; 115:3345-55. [PMID: 27160331 DOI: 10.1007/s00436-016-5094-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/26/2016] [Indexed: 12/15/2022]
Abstract
Phlebotomine sand flies are the known vectors of Leishmania parasites. New approaches in vaccination against Leishmania have investigated the possibility of integrating Phlebotomus papatasi salivary proteins to enhance the immune response and protect against the transmission of the infection. The aim of the present study was to screen human immune responses to wild sand fly saliva and evaluate immunogenic salivary proteins. Blood samples were collected from donors in control and sand fly infested areas. Antibodies specific for sand fly antigens in donor plasma were probed using immunoblotting. In addition, recall proliferation capability of peripheral blood mononuclear cells (PBMC) was tested after sand fly salivary homogenates stimulation. The significant immunogenic salivary proteins (SPs) identified by immunoblotting were SP28, SP32, and SP36. A specific proliferative response of PBMC after stimulation with sand fly salivary homogenates was evident in donors that have antibody responses against sand fly salivary proteins. Individuals with antibody recognition to a higher number of salivary proteins (i.e., 3 or more SP bands) showed lower PBMC proliferative responses after in vitro stimulation with salivary gland homogenates (SGH) only in the sand fly infested, leishmaniasis free area. Interestingly, the presence of a humoral immune response to many SP antigens inversely correlates with a strong cell-mediated immune response (CMI). It was also noticed that some other heavily expressed antigens, in sand fly salivary homogenate, lack or have weak humoral immune reactivity in exposed individuals. Therefore, considering these antigens alone as CMI activators, without including the immunodominant humoral immune response proteins, needs future investigation.
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Affiliation(s)
- Rami M Mukbel
- Department of Basic Veterinary Medical Science, Faculty of Veterinary Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan.
| | - Rehab H Khasharmeh
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University, PO Box 150459, Zarqa, 13115, Jordan
| | - Nawal S Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University, PO Box 150459, Zarqa, 13115, Jordan
| | - Mohammed S Khalifeh
- Department of Basic Veterinary Medical Science, Faculty of Veterinary Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Ma'mon M Hatmal
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University, PO Box 150459, Zarqa, 13115, Jordan
| | - Mary Ann McDowell
- Eck Institute for Global Health, Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA
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18
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Haouas N. Estimations of cutaneous leishmaniasis burden: a constant challenge. THE LANCET. INFECTIOUS DISEASES 2016; 16:515-516. [PMID: 26879177 DOI: 10.1016/s1473-3099(16)00058-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Najoua Haouas
- College of Applied Medical Sciences, Clinical Laboratory Sciences Department, University of Hail, Saudi Arabia; Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie, Université de Monastir, Tunisia.
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20
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Gandacu D, Glazer Y, Anis E, Karakis I, Warshavsky B, Slater P, Grotto I. Resurgence of cutaneous leishmaniasis in Israel, 2001-2012. Emerg Infect Dis 2015; 20:1605-11. [PMID: 25271882 PMCID: PMC4193169 DOI: 10.3201/eid2010.140182] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Cutaneous leishmaniasis has long been endemic in Israel. After a 15-year period of moderate illness rates, reported incidence increased from 0.4 cases per 100,000 population in 2001 to 4.4 cases per 100,000 population in 2012, and the disease emerged in areas where its presence had previously been minimal. We analyzed all cases reported to the national surveillance system and found that outbreak patterns revealed an expansion of Leishmania major infections over large areas in the southern part of the country and the occurrence of spatially focused L. tropica outbreaks in the northern part of the country. Outbreaks often followed new construction in populated areas. Further study of factors affecting the transmission of cutaneous leishmaniasis is needed in Israel, as well as the development of effective methods to control the disease, an increase in awareness among health care professionals, and intensive public education regarding control measures in areas of known leishmaniasis foci.
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21
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Mosleh IM, Shönian G, Geith E, Al-Jawabreh A, Natsheh L. The Jordanian Mid Jordan Valley is a classic focus of Leishmania major as revealed by RFLP of 56 isolates and 173 ITS-1-PCR-positive clinical samples. Exp Parasitol 2014; 148:81-5. [PMID: 25450773 DOI: 10.1016/j.exppara.2014.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 11/10/2014] [Accepted: 11/18/2014] [Indexed: 11/24/2022]
Abstract
The identity of the causative species of cutaneous leishmaniasis (CL) in the endemic Jordanian Mid Jordan Valley (JMidJV) was investigated using the polymerase chain reaction (PCR) amplifying the ribosomal internal transcribed spacer 1 (ITS-1) followed by the restriction fragment length polymorphism (RFLP). The geographical distribution of CL and the usefulness of ITS1 PCR in diagnosis of suspected CL in the study area were also addressed. Over the period from 2004 to 2009, 56 clinical isolates of Leishmania promastigotes and 185 lesion scrapings spotted on filter papers were obtained from suspected CL patients living in the JMidJV, which is divided into northern and southern districts. The majority (67.1%) of patients occurred in the populated eastern part of the southern district. Of the 185 suspected CL patients, 173 (93.5%) were confirmed positive using PCR. Leishmanial DNA was detected in 27 (90%) of 30 patients having clinically atypical lesions of CL and in 60 (92%) of 65 smear- and culture-negative cases having typical lesions of CL. The parasites in all of the 56 isolates and the 173 PCR-positive scrapings were classified as Leishmania major. In conclusion, PCR is useful in diagnosis of CL especially when smear and culture are negative. It is also recommended as a differential diagnostic tool of atypical lesions when CL is endemic. The identification of L. major as the causative species in such a considerable number of CL cases, representative of all mini foci of CL in the study area, shows that the JMidJV is a classic focus of L. major.
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Affiliation(s)
- Ibrahim M Mosleh
- Department of Biological Sciences, Faculty of Science, University of Jordan, Amman, Jordan.
| | - Gabriele Shönian
- Institute of Microbiology and Hygiene, Charité University of Medicine, Dorotheenstr. 96, D-10098 Berlin, Germany
| | - Eid Geith
- South Shuneh Hospital, Ministry of Health, South Shuneh, Jordan
| | | | - Lina Natsheh
- Department of Biological Sciences, Faculty of Science, University of Jordan, Amman, Jordan
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22
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Jabbour MN, Issa G, Charafeddine K, Simaan Y, Karam M, Khalifeh H, Habib R, Khalifeh I. The immune microenvironment in cutaneous leishmaniasis. J Eur Acad Dermatol Venereol 2014; 29:1170-9. [PMID: 25351105 DOI: 10.1111/jdv.12781] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 09/19/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Cutaneous leishmaniasis is an infection that has spread to non-endemic regions, stimulating recent interest for the enhanced understanding of this disease. Downregulation of the CD1a receptor on Langerhans cells has been described in various cutaneous infections. OBJECTIVE In this study, the immune response across different Ridley patterns and parasitic indices is outlined in a case series of cutaneous leishmaniasis. METHODS Skin punch biopsies from the interface of normal and lesional cutaneous leishmaniasis were collected from 33 patients with molecularly confirmed Leishmania tropica or L. major infection. Ridley patterns (2-5) were assessed for various clinicopathological features including age, gender, disease duration, parasitic index and constituents of the inflammatory infiltrate. CD1a, CD68, CD3, CD4, CD8, CD20 and CD138 stains were performed on normal skin tissue, cutaneous leishmaniasis biopsies and cytospin/cell block cytology preparations of cultured leishmania promastigotes. CD1a was quantified per mm2 in the epidermis and dermis. The remaining stains were graded according to a 4-tiered grading system [0 (0-4%); 1 (5-24%); 2 (25-49%); 3 (50-74%) and 4 (75-100%). RESULTS Total CD1a expression significantly decreased (14-fold) from parasitic indices (0-2) to (5-6); (ρ < 0.001). CD1a expression in the epidermis was at least 5-fold lower than normal skin (58 vs. 400 cells/mm2), inversely correlating with the parasitic index. There was an increase in dermal CD1a Langerhans cells (33 vs. 0 cells/mm² in the dermis). CD1a and CD68 staining of amastigotes was strong and diffuse, whereas promastigotes were negative. The major inflammatory infiltrate, in all Ridley patterns, consisted of macrophages and double-negative CD3(+) CD4(-) CD8(-) T lymphocytes. The double-negative CD3 T cells formed a ring around the parasitic laden macrophages. Apart from CD1a, there was no significant difference in inflammatory markers between the various Ridley patterns and parasitic indices. Disease duration did not correlate with Ridley pattern. CONCLUSION The significant decrease in CD1a expression is postulated by two mechanisms; either via direct CD1a receptor uptake by leishmania amastigotes and/or negative feedback inhibition of CD1a Langerhans cells by double-negative CD3 T-regulatory cells. Modulation of the immune microenvironment in cutaneous leishmaniasis represents a potential therapeutic and prophylactic target.
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Affiliation(s)
- M N Jabbour
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - G Issa
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - K Charafeddine
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Y Simaan
- Department of Biology, University of Balamand, Tripoli, Lebanon
| | - M Karam
- Department of Biology, University of Balamand, Tripoli, Lebanon
| | - H Khalifeh
- Children's Cancer Center Lebanon, American University of Beirut Medical Center, Beirut, Lebanon
| | - R Habib
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - I Khalifeh
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Abstract
Leishmaniasis is a major health problem worldwide, with several countries reporting cases of leishmaniasis resulting in loss of human life or a lifelong stigma because of bodily scars. The Middle East is endemic for cutaneous leishmaniasis, with countries like Syria reporting very high incidence of the disease. Despite several countries establishing national control programs for containing the sandfly vector and treatment of infection, the disease continues to spread. In addition to the endemicity of the region for leishmaniasis, the Middle East has seen a great deal of human migration either for earning of livelihood or due to political upheaval in the region. These factors contribute to the spread and proliferation of the causative species Leishmania and its sandfly host. This review discusses the current epidemiological scenario in Iraq, Syria, Saudi Arabia, and Jordan, emphasizing the number of cases reported, vector species, Leishmania species, and treatment available. The data is primarily from WHO reports for each country and current and old literature.
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Affiliation(s)
- Nasir Salam
- Department of Biochemistry, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
- * E-mail:
| | - Waleed Mohammed Al-Shaqha
- Department of Pharmacology, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Arezki Azzi
- Department of Pharmacology, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
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Hussain H, Al-Harrasi A, Al-Rawahi A, Green IR, Gibbons S. Fruitful decade for antileishmanial compounds from 2002 to late 2011. Chem Rev 2014; 114:10369-428. [PMID: 25253511 DOI: 10.1021/cr400552x] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Hidayat Hussain
- UoN Chair of Oman's Medicinal Plants and Marine Natural Products, University of Nizwa , P.O. Box 33, Birkat Al Mauz, Nizwa 616, Sultanate of Oman
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Fu Q, Li SZ, Wu WP, Hou YY, Zhang S, Feng Y, Zhang LP, Tang LH. Endemic characteristics of infantile visceral leishmaniasis in the People's Republic of China. Parasit Vectors 2013; 6:143. [PMID: 23680411 PMCID: PMC3669108 DOI: 10.1186/1756-3305-6-143] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 05/12/2013] [Indexed: 11/18/2022] Open
Abstract
Background Visceral leishmaniasis (VL) was once a severe parasitic disease in China. Thanks to the great efforts of integrated control, VL was eliminated in most epidemic areas, except for certain western provinces (autonomous region) at the end of 1950s. From then on, VL gained less attention and has seemed to spread, especially in the last 15 years. Infants are the most important population threatened by VL. However, there have been few studies on the endemic characteristics of infantile VL in China. Methods Infantile VL cases were collected from the online National Infectious Diseases Reporting System (NIDRS). Statistical description and inference was used to reveal the endemic characteristics in gender, age group, time and regionalism. Spatial analysis was carried out to explore the high risk area for infantile VL in China. Results A total of 1093 infantile VL cases were reported from 2006 to 2012. There was no statistically significant difference in gender over time. The minimum, maximum and mean age of these cases was 1.1, 35.9 and 13.8 months, respectively. Among them 86.92% were under 2 years of age, and there was a statistically significant difference among age groups over time. An incidence peak appeared in 2008-2009, most cases were distributed in the months September to December, and there was a tail-raising effect in the coming two months of the next year. More than 98% of cases were reported in Xinjiang Uygur Autonomous Region, Gansu Province and Sichuan Province, accounting for 61.02%, 32.75% and 4.57%, respectively. A total of 56 counties reported infantile VL cases, with the cumulative incidence ranging from 0.02 to 24.57%. There were two main zones of high endemicity for infantile VL in China. The monthly incidence clearly coincides with the number of towns where infantile VL cases were reported. Three fatalities were reported during the study period, the case fatality rate was 2.75‰. Conclusions The endemic situation of infantile VL is serious, and there are several active foci of infantile VL prevalence in China. VL has emerged as a severe threat to infants of endemic regions in China.
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Affiliation(s)
- Qing Fu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, People's Republic of China
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Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: 10.1371/journal.pone.0035671 order by 1-- gadu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: 10.1371/journal.pone.0035671 order by 8029-- awyx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: 10.1371/journal.pone.0035671 order by 1-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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29
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Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, Boer MD. Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: '10.1371/journal.pone.0035671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 countries and three territories (see ‘Leishmaniasis Country Profiles Text S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11, S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S25, S26, S27, S28, S29, S30, S31, S32, S33, S34, S35, S36, S37, S38, S39, S40, S41, S42, S43, S44, S45, S46, S47, S48, S49, S50, S51, S52, S53, S54, S55, S56, S57, S58, S59, S60, S61, S62, S63, S64, S65, S66, S67, S68, S69, S70, S71, S72, S73, S74, S75, S76, S77, S78, S79, S80, S81, S82, S83, S84, S85, S86, S87, S88, S89, S90, S91, S92, S93, S94, S95, S96, S97, S98, S99, S100, S101’). Additional information was collated during meetings conducted at WHO regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru, together account for 70 to 75% of global estimated CL incidence. Mortality data were extremely sparse and generally represent hospital-based deaths only. Using an overall case-fatality rate of 10%, we reach a tentative estimate of 20,000 to 40,000 leishmaniasis deaths per year. Although the information is very poor in a number of countries, this is the first in-depth exercise to better estimate the real impact of leishmaniasis. These data should help to define control strategies and reinforce leishmaniasis advocacy.
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Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: 10.1371/journal.pone.0035671 and 1880=1880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: 10.1371/journal.pone.0035671 order by 8029-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: 10.1371/journal.pone.0035671 order by 1-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One 2012. [DOI: 10.1371/journal.pone.0035671 order by 8029-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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35
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Leishmaniasis: new insights from an old and neglected disease. Eur J Clin Microbiol Infect Dis 2011; 31:109-18. [PMID: 21533874 DOI: 10.1007/s10096-011-1276-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 04/12/2011] [Indexed: 02/06/2023]
Abstract
Leishmaniases are a clinically heterogeneous group of diseases caused by protozoa of the genus Leishmania. There is growing evidence that the true incidence of the disease is underestimated, especially in hyperendemic regions. Moreover, climate changes together with the increasing movement of humans and animals raise concerns about the possible introduction of Leishmania infection in previously spared areas. The disease is emerging in immunocompromised patients undergoing bone marrow or solid organ transplantation or treatment with biologic drugs. Furthermore, the deployment of military troops and travel to endemic areas are associated with the observation of a growing number of patients with cutaneous disease. Improvement in diagnostic methods, both in the field and in specialized laboratories, has been obtained through the implementation of molecular amplification methods and using the rK39 antigen as the substrate. Finally, new therapeutic approaches are gaining attention, such as the use of miltefosine for cutaneous leishmaniasis and paromomycin for visceral leishmaniasis, as well as the use of various antileishmanial drugs in combination.
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Jacobson RL. Leishmaniasis in an era of conflict in the Middle East. Vector Borne Zoonotic Dis 2010; 11:247-58. [PMID: 20846030 DOI: 10.1089/vbz.2010.0068] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Leishmaniasis is endemic in the Middle East, and both cutaneous and visceral forms are reported from the region ranging from the Levant to Afghanistan. The potential and proven phlebotomine sand fly vectors and reservoir hosts of the Leishmaniases species in Afghanistan, Iran, Iraq, Israel, Jordan, Lebanon, Saudi Arabia, Syria, Turkey, and Yemen are described. This region has seen a movement of populations across the area, due to both military and civilian strife. Refugees, armed forces, and multi-national contractors are particularly at risk to acquire this disease. There has been an upsurge in Leishmaniasis research, especially as new foci are exposed and the need to protect the naïve populations moving into endemic areas becomes a public health priority. New sand fly vectors and animal reservoirs have been discovered while novel control methods are being evaluated. Modern molecular techniques are now being used more routinely and revealing some unusual findings. The aim of this review is to collate the most recent data on the burden of the disease, diagnostic applications, eco-epidemiology of vectors, and reservoir hosts, and how the control projects have been developing in the Middle East.
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Affiliation(s)
- Raymond L Jacobson
- Department of Molecular Genetics and Microbiology, The Hebrew University-Hadassah Medical School, The Institute of Medical Research Canada-Israel, Jerusalem, Israel.
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Abstract
Leishmaniasis represents a major public health problem in the Eastern Mediterranean Region (EMR) of the World Health Organization (WHO). Cutaneous and visceral leishmaniasis are mainly seen in 14 of the 22 countries of the region. In several of these countries outbreaks have an apparent tendency to occur at around 10-year intervals. In 2008, some 100000 new cases of cutaneous leishmaniasis were reported. Foci of zoonotic cutaneous leishmaniasis, caused by Leishmania major, occur in Afghanistan, Egypt, Iran, Iraq, Jordan, Libya, Morocco, Palestine, Pakistan, Saudi Arabia, Sudan, Syria, Tunisia and Yemen. Anthroponotic cutaneous leishmaniasis, caused by L. tropica, occurs in Afghanistan, Iran, Iraq, Morocco, Pakistan, Saudi Arabia, Syria and Yemen. Anthroponotic visceral leishmaniasis, caused by L. donovani, occurs mainly in Sudan and Somalia. Zoonotic visceral leishmaniasis, caused by L. infantum, occurs in most countries of the region. In order to address the problem of leishmaniasis in the EMR, WHO is supporting ministries of health through a strategic plan focusing on (a) training programme managers and health workers on diagnosis and case management; (b) establishing a harmonized regional surveillance system; (c) creating a regional network of experts; (d) promoting political commitment of national governments.
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Affiliation(s)
- Jose A Ruiz Postigo
- World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt.
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Mosleh IM, Geith E, Schönian G, Kanani KA. Two recent but temporally distinct outbreaks of cutaneous leishmaniasis among foreign workers in the Dead-Sea area of Jordan. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2010; 103:393-400. [PMID: 19583910 DOI: 10.1179/136485909x451735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Two temporally distinct outbreaks of human cutaneous leishmaniasis (CL), as well as scattered cases of the disease, have recently been observed close to the Dead Sea, in Jordan. Each of the two outbreaks, which occurred in 2004/2005 and 2007/2008, involved a group of foreign workers who were deployed within otherwise uninhabited locations. During each outbreak, about 20% of the workers were found infected with the causative parasite. In the earlier outbreak, 61 workers were found to have skin lesions like those of CL and all but three were confirmed by culture and/or the examination of smears (40 cases) or, in the case of 18 (86%) of the 21 suspected cases found smear- and culture-negative, by PCR. In the second outbreak, the cases were only identified from their clinical manifestations and their response to antileishmanial treatment (cryotherapy). Leishmania major was identified as the cause of the 2004/2005 outbreak and some sporadic cases that occurred, in 2004, along the shores of the Dead Sea. The burrows of potential reservoir hosts were found close to the outbreak locations, frequently under the chenopod Seidlitzia rosmarinus. The two outbreaks emphasise the continuing problem posed by the CL focus in the Mid Jordan Valley and its impact on humans who move into the area. Curiously, an investigation on the socio-economic conditions of the workers during the outbreaks identified a group of 48 workers who were living in air-conditioned rooms during the 2007/2008 outbreak, among whom no CL cases were found. In contrast, 26 of a neighbouring group of 124 workers, who were all living in non-air-conditioned rooms, developed CL lesions. The role of air conditioning, and of other factors and measures, in the prevention of the transmission of the causative parasites of CL merits further investigation and the attention of the local health authorities.
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Affiliation(s)
- I M Mosleh
- Department of Biological Sciences, Faculty of Science, University of Jordan, Amman, Jordan.
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