1
|
Msellemu D, Tanner M, Yadav R, Moore SJ. Occupational exposure to malaria, leishmaniasis and arbovirus vectors in endemic regions: A systematic review. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2024; 6:100185. [PMID: 39027087 PMCID: PMC11252614 DOI: 10.1016/j.crpvbd.2024.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/26/2024] [Accepted: 06/01/2024] [Indexed: 07/20/2024]
Abstract
Vector-borne diseases, including dengue, leishmaniasis and malaria, may be more common among individuals whose occupations or behaviours bring them into frequent contact with these disease vectors outside of their homes. A systematic review was conducted to ascertain at-risk occupations and situations that put individuals at increased risk of exposure to these disease vectors in endemic regions and identify the most suitable interventions for each exposure. The review was conducted in accordance with PRISMA guidelines on articles published between 1945 and October 2021, searched in 16 online databases. The primary outcome was incidence or prevalence of dengue, leishmaniasis or malaria. The review excluded ecological and qualitative studies, abstracts only, letters, commentaries, reviews, and studies of laboratory-acquired infections. Studies were appraised, data extracted, and a descriptive analysis conducted. Bite interventions for each risk group were assessed. A total of 1170 articles were screened and 99 included. Malaria, leishmaniasis and dengue were presented in 47, 41 and 24 articles, respectively; some articles presented multiple conditions. The most represented populations were soldiers, 38% (43 of 112 studies); refugees and travellers, 15% (17) each; migrant workers, 12.5% (14); miners, 9% (10); farmers, 5% (6); rubber tappers and missionaries, 1.8% (2) each; and forest workers, 0.9% (1). Risk of exposure was categorised into round-the-clock or specific times of day/night dependent on occupation. Exposure to these vectors presents a critical and understudied concern for outdoor workers and mobile populations. When devising interventions to provide round-the-clock vector bite protection, two populations are considered. First, mobile populations, characterized by their high mobility, may find potential benefits in insecticide-treated clothing, though more research and optimization are essential. Treated clothing offers personal vector protection and holds promise for economically disadvantaged individuals, especially when enabling them to self-treat their clothing to repel vectors. Secondly, semi-permanent and permanent settlement populations can receive a combination of interventions that offer both personal and community protection, including spatial repellents, suitable for extended stays. Existing research is heavily biased towards tourism and the military, diverting attention and resources from vulnerable populations where these interventions are most required like refugee populations as well as those residing in sub-Saharan Africa.
Collapse
Affiliation(s)
- Daniel Msellemu
- Vector Control Product Testing Unit, Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Tanzania
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Rajpal Yadav
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
- Academy of Public Health Entomology, Udaipur, 313 002, India
| | - Sarah J. Moore
- Vector Control Product Testing Unit, Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Tanzania
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
- The Nelson Mandela African Institution of Science and Technology (NM-AIST), P.O. Box 447, Tengeru, Arusha, Tanzania
| |
Collapse
|
2
|
Non-Endemic Leishmaniases Reported Globally in Humans between 2000 and 2021—A Comprehensive Review. Pathogens 2022; 11:pathogens11080921. [PMID: 36015042 PMCID: PMC9415673 DOI: 10.3390/pathogens11080921] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Leishmaniases are human and animal parasitic diseases transmitted by phlebotomine sand flies. Globalization is an important driver of the burden and in the current dynamics of these diseases. A systematic review of articles published between 2000 and 2021 was conducted using the PubMed search engine to identify the epidemiology and clinical management of imported human leishmaniases as a fundamental step to better manage individual cases and traveler and migrant health from a global perspective. A total of 275 articles were selected, representing 10,341 human imported cases. Identified drivers of changing patterns in epidemiology include conflict and war, as well as host factors, such as immunosuppression, natural and iatrogenic. Leishmania species diversity associated with different clinical presentations implies diagnostic and treatment strategies often complex to select and apply, especially in non-endemic settings. Thus, diagnostic and management algorithms for medical clinical decision support are proposed. Increased surveillance of non-endemic cases, whether in vulnerable populations such as refugees/migrants and immunocompromised individuals or travelers, could improve individual health and mitigate the public health risk of introducing Leishmania species into new areas.
Collapse
|
3
|
Bastos DSS, Silva AC, Novaes RD, Souza ACF, Santos EC, Gonçalves RV, Marques-Da-Silva EA. Could combination chemotherapy be more effective than monotherapy in the treatment of visceral leishmaniasis? A systematic review of preclinical evidence. Parasitology 2022; 149:1-14. [PMID: 35346411 DOI: 10.1017/s0031182022000142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
From a systematic review framework, we assessed the preclinical evidence on the effectiveness of drug combinations for visceral leishmaniasis (VL) treatment. Research protocol was based on the PRISMA guideline. Research records were identified from Medline, Scopus and Web of Science. Animal models, infection and treatment protocols, parasitological and immunological outcomes were analysed. The SYRCLE's (SYstematic Review Center for Laboratory Animal Experimentation) toll was used to evaluate the risk of bias in all studies reviewed. Fourteen papers using mice, hamster and dogs were identified. Leishmania donovani was frequently used to induce VL, which was treated with 23 drugs in 40 different combinations. Most combinations allowed to reduce the effective dose, cost and time of treatment, in addition to improving the parasitological control of Leishmania spp. The benefits achieved from drug combinations were associated with an increased drug's half-life, direct parasitic toxicity and improved immune defences in infected hosts. Selection, performance and detection bias were the main limitations identified. Current evidence indicates that combination chemotherapy, especially those based on classical drugs (miltefosine, amphotericin B antimony-based compounds) and new drugs (CAL-101, PAM3Cys, tufisin and DB766), develops additive or synergistic interactions, which trigger trypanocidal and immunomodulatory effects associated with reduced parasite load, organ damage and better cure rates in VL.
Collapse
Affiliation(s)
- Daniel S S Bastos
- Department of General Biology, Federal University of Viçosa, Viçosa, 36570-000, Minas Gerais, Brazil
| | - Adriana C Silva
- Department of General Biology, Federal University of Viçosa, Viçosa, 36570-000, Minas Gerais, Brazil
| | - Rômulo D Novaes
- Department of Structural Biology, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil
| | - Ana Claudia F Souza
- Department of Animal Biology, Federal Rural University of Rio de Janeiro, Seropédica, 23897-000, Rio de Janeiro, Brazil
| | - Eliziária C Santos
- School of Medicine, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina39100-00, Minas Gerais, Brazil
| | - Reggiani V Gonçalves
- Department of Animal Biology, Federal University of Viçosa, Viçosa, 36570-000, Minas Gerais, Brazil
| | | |
Collapse
|
4
|
Silgado A, Armas M, Sánchez-Montalvá A, Goterris L, Ubals M, Temprana-Salvador J, Aparicio G, Chicharro C, Serre-Delcor N, Ferrer B, Molina I, García-Patos V, Pumarola T, Sulleiro E. Changes in the microbiological diagnosis and epidemiology of cutaneous leishmaniasis in real-time PCR era: A six-year experience in a referral center in Barcelona. PLoS Negl Trop Dis 2021; 15:e0009884. [PMID: 34758023 PMCID: PMC8580242 DOI: 10.1371/journal.pntd.0009884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Leishmaniasis is a neglected disease caused by different species of the protozoa Leishmania spp. Cutaneous lesions are the most common clinical manifestation. This disease is prevalent in tropical and subtropical areas, including the Mediterranean basin. In Spain, Leishmania (L.) infantum is the only endemic species, but imported cases are often diagnosed. Different classical parasitological methods can be performed for cutaneous leishmaniasis (CL) diagnosis; but currently molecular techniques serve as a relevant tool for the detection and characterization of Leishmania parasites. We aimed to evaluate clinical and epidemiological characteristics of CL diagnosed patients by real-time PCR in a tertiary hospital over a six-year period. METHODOLOGY/PRINCIPAL FINDINGS Clinical, epidemiological and microbiological data were retrospectively collected and analyzed. In our study, CL was confirmed in 59 (31.4%) out of 188 patients by real-time PCR, showing an increase over recent years: 11 cases of CL between 2014 and 2016 and 48 between 2017 and 2019. Real-time PCR was performed on skin swabs and/or biopsies samples, with a positivity of 38.5% and 26.5%, respectively. Results were 100% concordant when biopsy and skin swab were performed simultaneously. L. (L.) infantum was the most frequent species detected (50%), followed by L. (L.) major (45%) and Viannia subgenus (5%), which were detected only in imported cases. L. (L.) major was almost entirely detected in travelers/migrants from Morocco. Multiple and atypical skin lesions were more common in imported cases than in autochthonous cases (44.4% vs. 21.8%). CONCLUSIONS/SIGNIFICANCE An increase in both autochthonous and imported CL cases has been observed in past years in our hospital. Molecular techniques assist in improving CL diagnosis and characterization of the Leishmania species, mainly in imported cases.
Collapse
Affiliation(s)
- Aroa Silgado
- Department of Microbiology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Mayuli Armas
- Department of Microbiology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases-Drassanes, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Lidia Goterris
- Department of Microbiology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Maria Ubals
- Department of Dermatology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Temprana-Salvador
- Department of Pathology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gloria Aparicio
- Department of Dermatology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Núria Serre-Delcor
- Department of Infectious Diseases-Drassanes, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Berta Ferrer
- Department of Pathology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases-Drassanes, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Vicenç García-Patos
- Department of Dermatology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tomas Pumarola
- Department of Microbiology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| |
Collapse
|
5
|
Behniafar H, Vaziri VM, Tabaei SJS, Taghipour N. Comparison of Three Commonly Used Genetic Markers for Detection of Leishmania Major: An Experimental Study. Ethiop J Health Sci 2021; 31:725-730. [PMID: 34703171 PMCID: PMC8512936 DOI: 10.4314/ejhs.v31i4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 11/28/2022] Open
Abstract
Background Leishmaniasis is a vector-borne disease caused by an intracellular protozoan parasite called Leishmania spp. Different species produce different clinical outcomes; the majority of cases are cutaneous forms. Leishmania major is one of the main causative agents of cutaneous leishmaniasis (CL). Various methods are being using to diagnose CL, including microscopic examination, culture, and molecular detection of the parasite genome. Method In the current study, we tried to compare three common molecular markers, including Kinetoplast DNA (kDNA), Cytochrome b (Cyt b), and Internal transcribed space 1 (ITS1), for the detection of Leishmania major. After cultivation of standard strain of L. major MHOM/IR/75/ER in RPMI 1640, certain number of promastigotes was subjected to DNA extraction and different PCR reactions. Results The lowest number of the parasite (5 promastigotes) can be detected by kDNA-PCR, followed by Cyt b-PCR (10 promastigotes), and ITS1-PCR (50 promastigotes). Conclusion In conclusion, kDNA-PCR was the most sensitive marker and may provide more reliable data in the initial screening, especially in false-negative results provided by parasitological methods due to the low number of parasites.
Collapse
Affiliation(s)
- Hamed Behniafar
- Department of Medical Parasitology, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Vahideh Moin Vaziri
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyyed Javad Seyyed Tabaei
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Taghipour
- Department of Tissue engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Davies-Bolorunduro O, Osuolale O, Saibu S, Adeleye I, Aminah N. Bioprospecting marine actinomycetes for antileishmanial drugs: current perspectives and future prospects. Heliyon 2021; 7:e07710. [PMID: 34409179 PMCID: PMC8361068 DOI: 10.1016/j.heliyon.2021.e07710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/25/2021] [Accepted: 07/30/2021] [Indexed: 01/01/2023] Open
Abstract
Revived analysis interests in natural products in the hope of discovering new and novel antileishmanial drug leads have been driven partially by the increasing incidence of drug resistance. However, the search for novel chemotherapeutics to combat drug resistance had previously concentrated on the terrestrial environment. As a result, the marine environment was often overlooked. For example, actinomycetes are an immensely important group of bacteria for antibiotic production, producing two-thirds of the known antibiotics. However, these bacteria have been isolated primarily from terrestrial sources. Consequently, there have been revived efforts to discover new compounds from uncharted or uncommon environments like the marine ecosystem. Isolation, purification and structure elucidation of target compounds from complex metabolic extract are major challenges in natural products chemistry. As a result, marine-derived natural products from actinomycetes that have antileishmanial bioactivity potentials have been understudied. This review highlights metagenomic and bioassay approaches which could help streamline the drug discovery process thereby greatly reducing time and cost of dereplication to identify suitable antileishmanial drug candidates.
Collapse
Affiliation(s)
- O.F. Davies-Bolorunduro
- Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Postdoc Fellow Department of Chemistry, Faculty of Science and Technology, Universitas Airlangga, Komplek Kampus C, Jl. Mulyorejo, Surabaya, 60115, Indonesia
| | - O. Osuolale
- Applied Environmental Metagenomics and Infectious Diseases Research Group (AEMIDR), Department of Biological Sciences, Elizade University, Ilara Mokin, Nigeria
| | - S. Saibu
- Department of Microbiology, University of Lagos, Akoka, Lagos, Nigeria
| | - I.A. Adeleye
- Department of Microbiology, University of Lagos, Akoka, Lagos, Nigeria
| | - N.S. Aminah
- Department of Chemistry, Faculty of Science and Technology, Universitas Airlangga, Komplek Kampus C UNAIR, Jl. Mulyorejo, Surabaya, 60115, Indonesia
- Biotechnology of Tropical Medicinal Plants Research Group, Universitas Airlangga, Indonesia
| |
Collapse
|
7
|
Fernández-Arévalo A, Ballart C, Muñoz-Basagoiti J, Basarte L, Lobato G, Arnau A, Abras A, Tebar S, Llovet T, Lami P, Pratlong F, Alsina M, Roe E, Puig L, Muñoz C, Gállego M. Autochthonous and imported tegumentary leishmaniasis in Catalonia (Spain): Aetiological evolution in the last four decades and usefulness of different typing approaches based on biochemical, molecular and proteomic markers. Transbound Emerg Dis 2021; 69:1404-1418. [PMID: 33864706 DOI: 10.1111/tbed.14107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/22/2021] [Accepted: 04/11/2021] [Indexed: 02/07/2023]
Abstract
Leishmaniasis is a transmissible disease caused by Leishmania protozoa. Spain is endemic for both visceral and cutaneous leishmaniasis, the autochthonous aetiological agent being Leishmania infantum. Around the world, the L. donovani complex is associated with visceral symptoms, while any species of the Leishmania or Viannia subgenera affecting human can produce tegumentary forms. In a context of growing numbers of imported cases, associated with globalisation, the aim of this study was to analyse the aetiological evolution of human tegumentary leishmaniasis in a region of Spain (Catalonia). Fifty-six Leishmania strains, isolated from 1981 to 2018, were analysed using MLEE, gene sequencing (hsp70, rpoIILS, fh and ITS2) and MALDI-TOF. The utility of these different analytical methods was compared. The results showed an increase in leishmaniasis over the two last decades, particularly imported cases, which represented 39% of all cases studied. Leishmania infantum, L. major, L. tropica, L. braziliensis, L. guyanensis and L. panamensis were identified. The combination of molecular and enzymatic methods allowed the identification of 29 different strain types (A to AC). Strain diversity was higher in L. (Viannia), whilst the different L. major types were relatable with geo-temporal data. Among the autochthonous cases, type C prevailed throughout the studied period (39%). Minor types generally appeared within a short time interval. While all the techniques provided identical identification at the species complex level, MALDI-TOF and rpoIILS or fh sequencing would be the most suitable identification tools for clinical practice, and the tandem hsp70-ITS2 could substitute MLEE in the epidemiological field.
Collapse
Affiliation(s)
- Anna Fernández-Arévalo
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Cristina Ballart
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Jordana Muñoz-Basagoiti
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Leire Basarte
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Gonzalo Lobato
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Albert Arnau
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Alba Abras
- Laboratori d'Ictiologia Genètica, Departament de Biologia, Universitat de Girona, Girona, Spain
| | - Silvia Tebar
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
| | - Teresa Llovet
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Patrick Lami
- National Reference Centre for Leishmaniasis, University Hospital Centre of Montpellier, University of Montpellier, Montpellier, France
| | - Francine Pratlong
- National Reference Centre for Leishmaniasis, University Hospital Centre of Montpellier, University of Montpellier, Montpellier, France
| | - Mercè Alsina
- Servei de Dermatologia, Hospital Clínic de Barcelona & Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Esther Roe
- Servei de Dermatologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lluís Puig
- Servei de Dermatologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carme Muñoz
- Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Montserrat Gállego
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
8
|
Performance of a universal PCR assay to identify different Leishmania species causative of Old World cutaneous leishmaniasis. Parasit Vectors 2020; 13:431. [PMID: 32854753 PMCID: PMC7450935 DOI: 10.1186/s13071-020-04261-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The characterization of Leishmania species is important for clinical management of the diseases and the epidemiological control of the parasite distribution. Most of the published polymerase chain reaction (PCR) amplification methods lack the ability to identify all species complexes, have low performance and usually need post-PCR procedures. There is a need for improving the diagnosis of CL by development of an accurate affordable PCR method to identify all Leishmania species in clinical specimens. METHODS We designed an optimized a PCR amplifying the internal transcribed spacer 2 sequence of the ribosomal RNA gene (ITS2) aligned from different strains of CL-causing Leishmania species in the Old World. The performance of the method was evaluated on lesion samples from several CL suspected patients and the limit of detection (LOD) was determined on DNA of promastigotes from reference strains. RESULTS The universal PCR enabled simultaneous discrimination of L. major, L. tropica and L. infantum using one primer pair in one reaction. Stained smear microscopy and Novy-MacNeal-Nicolle (NNN) medium culture alone detected 77.27% (17/22) and 72.73% (16/22) of the positive CL samples, respectively. The PCR assay showed 100% sensitivity (22/22) (95% CI: 84.56-100%) and 100% specificity (3/3) (95% CI: 29.24-100%) for species identification on isolates from lesion scraping/exudate and 100% sensitivity (13/13) (95% CI: 75.29-100%) and 100% specificity (11/11) (95% CI: 71.51-100%) for species identification on biopsy samples of CL patients, while being capable to successfully amplify as little as 0.01-0.1 pg of Leishmania DNA from cultured promastigotes. CONCLUSIONS We present a validated easy-to-use affordable universal PCR assay to identify the most common Old World Leishmania species causing CL. This PCR assay could be used as a sensitive/specific technique to diagnose CL-causing Leishmania species in clinical samples with high accuracy.
Collapse
|
9
|
Gianchecchi E, Montomoli E. The enemy at home: leishmaniasis in the Mediterranean basin, Italy on the focus. Expert Rev Anti Infect Ther 2020; 18:563-577. [DOI: 10.1080/14787210.2020.1751611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
| | - Emanuele Montomoli
- VisMederi S.r.l, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| |
Collapse
|
10
|
Montalvo AM, Alba A, Fraga J, Marzoa A, Torres C, Muskus C. Improving the sensitivity of an hsp20-based PCR for genus detection of Leishmania parasites in cutaneous clinical samples: a proof of concept. Parasitol Res 2019; 119:345-349. [PMID: 31776667 DOI: 10.1007/s00436-019-06520-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 10/23/2019] [Indexed: 12/14/2022]
Abstract
Leishmaniasis is a parasitic disease of medical importance widely distributed around the world. Several methods are available for diagnosis but molecular approaches are highly recommended. To improve the sensitivity of an existing hsp20 gene based-PCR protocol to detect Leishmania parasites, primers were redesigned to amplify a shorter fragment using a new PCR variant (PCR-hsp20S). In this study, we aimed at characterizing the performance of the new method on cutaneous clinical samples and compare it with the former PCR-hsp20. The analytical sensitivity of the PCR-hsp20S was evaluated using DNA dilutions (100-0.1 pg) from Leishmania donovani and resulted in the detection of 10 fg of parasitic DNA, the equivalent to 0.05 parasite genome. For the diagnostic evaluation, a panel of 127 human clinical samples was used to calculate the parameters of sensitivity, specificity, accuracy, and positive and negative predictive values of the PCR-hsp20S. Diagnostic sensitivity was 94% (CI, 89.1-99.7%) and the specificity of 100% (CI, 98.6-100%). The same panel was also evaluated with the PCR-hsp20 to calculate the agreement between both molecular assays and to compare their performances. While both hsp20-based PCRs showed a good agreement coefficient (kappa index = 0.6), the performance of the novel variant, PCR-hsp20S, was significantly higher in terms of sensitivity (P = 0.0001) allowing the accurate detection of a higher number of Leishmania-positive clinical samples. We endorse the use of the PCR-hsp20S over the former protocol for the detection of Leishmania parasites from cutaneous clinical samples. In addition, as an improved sensitivity was achieved with the new method merely through the amplification of a shorter gene fragment, this investigation constitutes an experimental proof of this concept.
Collapse
Affiliation(s)
- Ana M Montalvo
- Department of Parasitology, Institute of Tropical Medicine Pedro Kourí (IPK), Havana, Cuba.
| | - Annia Alba
- Department of Parasitology, Institute of Tropical Medicine Pedro Kourí (IPK), Havana, Cuba
| | - Jorge Fraga
- Department of Science and Innovation, IPK, Havana, Cuba
| | | | - Cecia Torres
- Department of Parasitology, Institute of Tropical Medicine Pedro Kourí (IPK), Havana, Cuba
| | - Carlos Muskus
- PECET (Program of Study and Control of Tropical Diseases), University of Antioquia, Medellín, Colombia
| |
Collapse
|
11
|
Liposomal amphotericin B treatment of Old World cutaneous and mucosal leishmaniasis: A literature review. Acta Trop 2018; 182:246-250. [PMID: 29550282 DOI: 10.1016/j.actatropica.2018.03.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 02/20/2018] [Accepted: 03/10/2018] [Indexed: 11/22/2022]
Abstract
Old World cutaneous and mucosal leishmaniasis is a potentially serious disease. Systemic treatment approaches with pentavalent antimonials, liposomal amphotericin B, fluconazole and miltefosine are increasingly used despite the absence of supportive evidence - to date, no prospective clinical trials have been conducted for systemic treatment of these diseases. We performed a literature search to delineate the contemporary evidence for the use of liposomal amphotericin B, and found that although cure rates of 17/20 (85%) were achieved in immune competent patients with Old World cutaneous leishmaniasis and cure rates of 10/13 (77%) for Old World mucosal leishmaniasis due to L. infantum, the available data is highly limited with high variation in total treatment dosages. The presented findings reflect a lack of consensus on the optimal treatment dosage and on the schedule of application.
Collapse
|
12
|
Merino-Espinosa G, Rodríguez-Granger J, Morillas-Márquez F, Tercedor J, Corpas-López V, Chiheb S, Alcalde-Alonso M, Azaña-Defez JM, Riyad M, Díaz-Sáez V, Martín-Sánchez J. Comparison of PCR-based methods for the diagnosis of cutaneous leishmaniasis in two different epidemiological scenarios: Spain and Morocco. J Eur Acad Dermatol Venereol 2018; 32:1999-2003. [PMID: 29704265 DOI: 10.1111/jdv.15034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/04/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a disfiguring and stigmatising disease occurring in more than 70 countries across the world including Spain and Morocco. The use of sensitive tests that can differentiate Leishmania species is advised. OBJECTIVE To evaluate the influence of the epidemiological scenario on the reliability of the PCR techniques and contribute to the selection of the most efficient one for CL diagnosis. METHODS The sensitivities of parasitological methods and four PCRs were compared in cutaneous samples from 77 patients from Spanish (PSH) and Moroccan hospitals (PMH). Exudates and fresh or paraffin-embedded tissue biopsies were used. RESULTS None of the PCRs used in this study allowed the diagnosis of all CL cases, showing also some drawbacks. Lmj4/Uni21-PCR displayed the best sensitivity with PMH, but it did not provide positive results in PSH with CL confirmed by other PCRs. Conversely, JW13/JW14-PCR and L. infantum-PCR-ELISA displayed good sensitivities with PSH that were not achieved with PMH. Nested-ITS-1-PCR did not show enough sensitivity with paraffin-embedded tissue biopsies. False-negative results were obtained in 19% of PSH due to unspecific hybridizations of ITS-1 primers with human chromosome1. CONCLUSIONS PCR should be routinely used in patients with cutaneous lesions compatible with CL and furthermore, the combination of two PCR techniques is advisable. The selection of these PCRs will be influenced by the epidemiological scenario: In areas where L. infantum is endemic, the use of the PCR-ELISA joint with JW13/JW14-PCR seems an appropriate choice, whereas in areas such as Morocco, Lmj4/Uni21 and ITS-1 provide satisfactory results.
Collapse
Affiliation(s)
- G Merino-Espinosa
- Faculty of Pharmacy, Department of Parasitology, University of Granada, Granada, Spain
| | - J Rodríguez-Granger
- Department of Microbiology, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - F Morillas-Márquez
- Faculty of Pharmacy, Department of Parasitology, University of Granada, Granada, Spain
| | - J Tercedor
- Microbiology, Internal Medicine and Dermatology Services, Virgen de las Nieves Hospital, Granada, Spain
| | - V Corpas-López
- Faculty of Pharmacy, Department of Parasitology, University of Granada, Granada, Spain
| | - S Chiheb
- Department of Dermatology, University Hospital Ibn Rochd and Faculty of Medicine and Pharmacy, University Hassan II of Casablanca, Casablanca, Morocco.,Faculty of Medicine and Pharmacy, Research team on Immunopathology of Infectious and Systemic Diseases, University Hassan II of Casablanca, Casablanca, Morocco
| | - M Alcalde-Alonso
- Department of Dermatology and Venereology, Torrecardenas Hospital, Almeria, Spain
| | - J M Azaña-Defez
- Department of Dermatology, Complejo Hospitalario Universitario, Albacete, Spain
| | - M Riyad
- Faculty of Medicine and Pharmacy, Research team on Immunopathology of Infectious and Systemic Diseases, University Hassan II of Casablanca, Casablanca, Morocco.,Laboratory of Parasitology-Mycology, Faculty of Medicine and Pharmacy, University Hassan II of Casablanca, Casablanca, Morocco
| | - V Díaz-Sáez
- Faculty of Pharmacy, Department of Parasitology, University of Granada, Granada, Spain
| | - J Martín-Sánchez
- Faculty of Pharmacy, Department of Parasitology, University of Granada, Granada, Spain
| |
Collapse
|
13
|
Merino-Espinosa G, Corpas-López V, Díaz-Sáez V, Morillas-Márquez F, Tercedor-Sánchez J, Azaña-Defez J, López-Hidalgo J, Aneiros-Fernández J, Martín-Sánchez J. Cutaneous leishmaniasis byLeishmania infantum:behind granulomatous lesions of unknown aetiology. J Eur Acad Dermatol Venereol 2017; 32:117-124. [DOI: 10.1111/jdv.14506] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/25/2017] [Indexed: 01/19/2023]
Affiliation(s)
- G. Merino-Espinosa
- Department of Parasitology; Faculty of Pharmacy; University of Granada; Granada Spain
| | - V. Corpas-López
- Department of Parasitology; Faculty of Pharmacy; University of Granada; Granada Spain
| | - V. Díaz-Sáez
- Department of Parasitology; Faculty of Pharmacy; University of Granada; Granada Spain
| | - F. Morillas-Márquez
- Department of Parasitology; Faculty of Pharmacy; University of Granada; Granada Spain
| | - J. Tercedor-Sánchez
- Department of Dermatology; Complejo Hospitalario Universitario; Granada Spain
| | - J.M. Azaña-Defez
- Department of Dermatology; Complejo Hospitalario Universitario; Albacete Spain
| | - J. López-Hidalgo
- Department of Pathology; Complejo Hospitalario Universitario; Granada Spain
| | | | - J. Martín-Sánchez
- Department of Parasitology; Faculty of Pharmacy; University of Granada; Granada Spain
| |
Collapse
|
14
|
Detection and identification of Leishmania spp.: application of two hsp70-based PCR-RFLP protocols to clinical samples from the New World. Parasitol Res 2017; 116:1843-1848. [DOI: 10.1007/s00436-017-5454-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/20/2017] [Indexed: 10/19/2022]
|
15
|
Aronson N, Herwaldt BL, Libman M, Pearson R, Lopez-Velez R, Weina P, Carvalho EM, Ephros M, Jeronimo S, Magill A. Diagnosis and Treatment of Leishmaniasis: Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016; 63:e202-e264. [PMID: 27941151 DOI: 10.1093/cid/ciw670] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/22/2016] [Indexed: 12/25/2022] Open
Abstract
It is important to realize that leishmaniasis guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. The IDSA and ASTMH consider adherence to these guidelines to be voluntary, with the ultimate determinations regarding their application to be made by the physician in the light of each patient's individual circumstances.
Collapse
Affiliation(s)
- Naomi Aronson
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Michael Libman
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Peter Weina
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | | | | | - Selma Jeronimo
- Federal University of Rio Grande do Norte, Natal, Brazil
| | - Alan Magill
- Bill and Melinda Gates Foundation, Seattle, Washington
| |
Collapse
|
16
|
Nath-Chowdhury M, Sangaralingam M, Bastien P, Ravel C, Pratlong F, Mendez J, Libman M, Ndao M. Real-time PCR using FRET technology for Old World cutaneous leishmaniasis species differentiation. Parasit Vectors 2016; 9:255. [PMID: 27141967 PMCID: PMC4855858 DOI: 10.1186/s13071-016-1531-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/24/2016] [Indexed: 02/06/2023] Open
Abstract
Background Recently, there has been a re-emergence of cutaneous leishmaniasis in endemic countries and an increase in imported cases in non-endemic countries by travelers, workers, expatriates, immigrants, and military force personnel. Old World cutaneous leishmaniasis is caused primarily by Leishmania major, L. tropica and L. aethiopica. Despite their low sensitivity, diagnosis traditionally includes microscopic and histopathological examinations, and in vitro cultivation. Several conventional PCR techniques have been developed for species identification, which are time-consuming and labour-intensive. Real-time PCR using SYBR green dye, although provides rapid detection, may generate false positive signals. Therefore, a rapid and easy method such as a FRET-based real-time PCR would improve not only the turn-around time of diagnosing Old World cutaneous Leishmania species but will also increase its specificity and sensitivity. Methods A FRET-based real-time PCR assay which amplifies the cathepsin L-like cysteine protease B gene encoding a major Leishmania antigen was developed to differentiate L. major, L. tropica, and L. aethiopica in one single step using one set of primers and probes. Assay performance was tested on cutaneous and visceral strains of Leishmania parasite cultures and isolates of other protozoan parasites as well as human biopsy specimen. Results The assay readily differentiates between the three Old World cutaneous leishmaniasis species based on their melting curve characteristics. A single Tm at 55.2 ± 0.5 °C for L. aethiopica strains was distinguished from a single Tm at 57.4 ± 0.2 °C for L. major strains. A double curve with melting peaks at 66.6 ± 0.1 °C and 48.1 ± 0.5 °C or 55.8 ± 0.6 °C was observed for all L. tropica strains. The assay was further tested on biopsy specimens, which showed 100 % agreement with results obtained from isoenzyme electrophoresis and Sanger sequencing. Conclusion Currently, there are no published data on real-time PCR using FRET technology to differentiate between Old World cutaneous Leishmania species. In summary, our assay based on specific hybridization addresses the limitations of previous PCR technology and provides a single step, reliable method of species identification and rapid diagnostic applications.
Collapse
Affiliation(s)
- Milli Nath-Chowdhury
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Mugundhine Sangaralingam
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Patrick Bastien
- Department of Parasitology-Mycology, Centre National de Référence des Leishmanioses, Centre Hospitalier Régional Universitaire of Montpellier and University Montpellier I (Faculty of Medicine), UMR CNRS 5290-IRD 224- UM1 et 2 "MIVEGEC", Montpellier, France
| | - Christophe Ravel
- Department of Parasitology-Mycology, Centre National de Référence des Leishmanioses, Centre Hospitalier Régional Universitaire of Montpellier and University Montpellier I (Faculty of Medicine), UMR CNRS 5290-IRD 224- UM1 et 2 "MIVEGEC", Montpellier, France
| | - Francine Pratlong
- Department of Parasitology-Mycology, Centre National de Référence des Leishmanioses, Centre Hospitalier Régional Universitaire of Montpellier and University Montpellier I (Faculty of Medicine), UMR CNRS 5290-IRD 224- UM1 et 2 "MIVEGEC", Montpellier, France
| | - Juan Mendez
- Division of Experimental Therapeutics, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Michael Libman
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,J.D. MacLean Centre for Tropical Diseases at McGill University, Montreal, QC, Canada
| | - Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada. .,J.D. MacLean Centre for Tropical Diseases at McGill University, Montreal, QC, Canada.
| |
Collapse
|
17
|
Handler MZ, Patel PA, Kapila R, Al-Qubati Y, Schwartz RA. Cutaneous and mucocutaneous leishmaniasis: Differential diagnosis, diagnosis, histopathology, and management. J Am Acad Dermatol 2016; 73:911-26; 927-8. [PMID: 26568336 DOI: 10.1016/j.jaad.2014.09.014] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 09/03/2014] [Accepted: 09/05/2014] [Indexed: 12/25/2022]
Abstract
The diagnosis of leishmaniasis can be challenging because it mimics both infectious and malignant conditions. A misdiagnosis may lead to an unfavorable outcome. Using culture, histologic, and/or polymerase chain reaction study results, a diagnosis of leishmaniasis can be established and treatment initiated. Appropriate management requires an accurate diagnosis, which often includes identification of the specific etiologic species. Different endemic areas have varying sensitivities to the same medication, even within individual species. Species identification may be of practical value, because infections with select species have a substantial risk of visceral involvement. In addition, HIV and otherwise immunocompromised patients with leishmaniasis have a propensity for diffuse cutaneous leishmaniasis. For most New World Leishmania species, parenteral antimonial drugs remain the first line of therapy, while Old World species are easily treated with physical modalities. Historically, live organism vaccination has been used and is effective in preventing leishmaniasis, but results in an inoculation scar and an incubation period that may last for years. A more effective method of vaccination would be welcome.
Collapse
Affiliation(s)
- Marc Z Handler
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Parimal A Patel
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Rajendra Kapila
- Infectious Diseases, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Robert A Schwartz
- Dermatology, Rutgers New Jersey Medical School, Newark, New Jersey; Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey; Rutgers School of Public Affairs and Administration, Newark, New Jersey.
| |
Collapse
|
18
|
Molecular identification of Leishmania spp. clinical isolates from Colombia based on hsp70 gene. BIOMEDICA 2016; 36:37-44. [PMID: 27622623 DOI: 10.7705/biomedica.v36i2.2688] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 06/04/2015] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Leishmaniasis is highly prevalent in Colombia, where at least six different species can cause disease of varying clinical presentations in humans. The identification of the infecting species is quite important for prognosis, therapeutics and epidemiology. Different techniques with variable discriminatory power have been used for the identification. OBJECTIVE To carry out the molecular identification of Leishmania species through the amplification of a fragment of the hsp70 gene. MATERIALS AND METHODS Molecular amplification of the hsp70 gene fragment (PCR-hsp70) followed by restriction fragment length polymorphism analysis (RFLP) was done for identification purposes using DNA from 81 clinical isolates of Leishmania. RESULTS A single amplicon was obtained for all samples analyzed. The enzymatic restrictions of the 81 PCR products identified 70 with a banding pattern corresponding to L. braziliensis with two different patterns (62 and eight isolates, respectively), nine isolates compatible with L. panamensis and two with L. guyanensis. The geographical origin of the isolates is consistent with previous reports about the distribution of the corresponding species in Colombia. CONCLUSIONS The PCR-hsp70/RFLP technique used is a valid tool for the identification of Leishmania species isolated from clinical samples of patients in Colombia, which may also be applicable to the study of strains obtained from vectors and reservoirs with epidemiological significance.
Collapse
|
19
|
|
20
|
Di Muccio T, Scalone A, Bruno A, Marangi M, Grande R, Armignacco O, Gradoni L, Gramiccia M. Epidemiology of Imported Leishmaniasis in Italy: Implications for a European Endemic Country. PLoS One 2015; 10:e0129418. [PMID: 26114938 PMCID: PMC4482607 DOI: 10.1371/journal.pone.0129418] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/09/2015] [Indexed: 02/06/2023] Open
Abstract
In the past decade, the number of imported leishmaniasis cases has increased in countries of Western Europe. The trend is associated with increasing travels, ecotourism activity, military operations and immigration. While in endemic countries leishmaniasis is usually well diagnosed, accurate patient history and parasite identification are necessary to distinguish between autochthonous and imported cases. This is particularly important, as new Leishmania species/genotypes may be introduced and transmitted by local phlebotomine vectors without appropriate surveillance, with unpredictable consequences. We report on the surveillance of imported leishmaniasis performed by the Leishmania Identification Reference Centre of Rome from 1986 through 2012, involving health care centres from 16/20 Italian regions. Suspected imported cases were analyzed and conclusions were based on clinical, epidemiological and diagnostic findings. Over the years, different parasite identification methods were employed, including MultiLocus Enzyme Electrophoresis and molecular techniques combining disease diagnosis (SSU rDNA nested-PCR) and Leishmania typing (nuclear repetitive sequence and ITS-1 PCR-RFLPs). A total of 105 imported cases were recorded (annual range: 0-20) of which 36 were visceral (VL) (16 HIV-coinfections) and 69 cutaneous (CL) cases; 85 cases (52 CL) were from the Old World and 20 (17 CL) from the New World. Eight Leishmania species were identified, of which 7 were exotic to Italy. VL importation until 1995 was associated with the spread of Mediterranean Leishmania-HIV co-infections in early 1990s. Following the introduction of HAART treatment, such cases became occasional in Italians but relatively frequent among immigrants. In contrast, a steady increase of CL cases was observed from different areas of the Old and New Worlds, that in recent years included mainly immigrants ‘visiting friends and relatives’ and Italian tourists. This positive trend likely depends on better diagnosis and reporting; however, we suspect that many CL cases remained unrecognized. Given the relatively low incidence of leishmaniasis importation, the risk of introduction of exotic parasites appears limited, although the detection of anthroponotic species requires attention.
Collapse
Affiliation(s)
- Trentina Di Muccio
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
| | - Aldo Scalone
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
| | - Antonella Bruno
- Laboratory of Parasitology, Unit of Microbiology and Virology, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimo Marangi
- Unit of Infectious Diseases, Department of Medical Sciences, Sant’Andrea Hospital, Rome, Italy
| | - Romualdo Grande
- Unit of Clinical Microbiology Virology and Bioemergencies Diagnosis, Luigi Sacco University Hospital, Milan, Italy
| | | | - Luigi Gradoni
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Gramiccia
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
- * E-mail:
| |
Collapse
|
21
|
Yesilova Y, Surucu HA, Ardic N, Aksoy M, Yesilova A, Oghumu S, Satoskar AR. Meglumine antimoniate is more effective than sodium stibogluconate in the treatment of cutaneous leishmaniasis. J DERMATOL TREAT 2015; 27:83-7. [PMID: 26105204 DOI: 10.3109/09546634.2015.1054778] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Sodium stibogluconate (SSG, Pentostam) and meglumine antimoniate (MA, Glucantime) are two antimonials that are widely used to treat cutaneous leishmaniasis (CL), but the relative efficacies of these treatments are not clear. The aim of this study is to compare the efficacy of intralesional SSG with intralesional MA therapy in the treatment of CL. One month after completion of the therapy, 1431 of 1728 patients (82%) who received intralesional MA showed complete clinical cure compared to 1157 of 1728 patients (67%) in the SSG group. Patients who did not respond to the first round of therapy were re-administered the same treatment but with twice weekly injections. Following completion of the second course of therapy, 237 of 297 patients (80%) in the MA group and 407 of 561 patients (72%) in the SSG group healed their lesions by 1-month post-treatment. At both times, the differences in cure rates between MA and SSG groups were statistically significant (p < 0.05). Cure rates in the MA group were always significantly higher than SSG groups irrespective of other parameters including age, gender, lesion site and type of lesion. Intralesional MA is more effective than intralesional SSG in the treatment of CL.
Collapse
Affiliation(s)
- Yavuz Yesilova
- a Dermatology Clinic, Special Lokman Physician Van Hospital , Van , Turkey
| | - Hacer Altın Surucu
- b Department of Dermatology , Harran University School of Medicine , Şanlıurfa , Turkey
| | - Nurittin Ardic
- c Division of Basic Immunology, Department of Medical Microbiology , Gulhane Military Medical Academy , Ankara , Turkey
| | - Mustafa Aksoy
- b Department of Dermatology , Harran University School of Medicine , Şanlıurfa , Turkey
| | - Abdullah Yesilova
- d Department of Biostatistics , School of Medicine, YuzuncuYıl University , Van , Turkey , and
| | - Steve Oghumu
- e Department of Microbiology , The Ohio State University Medical Center , Columbus , OH , USA
| | - Abhay R Satoskar
- e Department of Microbiology , The Ohio State University Medical Center , Columbus , OH , USA
| |
Collapse
|
22
|
Montalvo AM, De Armas Y, Fraga J, Blanco O, Menéndez R, Montoto V, Capó de Paz V. Molecular and histological tools to diagnose an imported case of American cutaneous leishmaniasis in Cuba. Int J Dermatol 2015; 54:1175-9. [DOI: 10.1111/ijd.12915] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/29/2014] [Accepted: 11/23/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Ana M. Montalvo
- Department of Parasitology; Pedro Kourí Institute for Tropical Medicine; Havana Cuba
| | - Yaxsier De Armas
- Department of Epidemiology; Pedro Kourí Institute for Tropical Medicine; Havana Cuba
| | - Jorge Fraga
- Department of Parasitology; Pedro Kourí Institute for Tropical Medicine; Havana Cuba
| | - Orestes Blanco
- Hospital of the Pedro Kourí Institute for Tropical Medicine; Havana Cuba
| | - Reinaldo Menéndez
- Hospital of the Pedro Kourí Institute for Tropical Medicine; Havana Cuba
| | - Vicente Montoto
- Provincial Center for Hygiene, Epidemiology and Microbiology; Santiago de Cuba Cuba
| | - Virginia Capó de Paz
- Department of Pathology; Pedro Kourí Institute for Tropical Medicine; Havana Cuba
| |
Collapse
|
23
|
Cutaneous Leishmaniasis: 20 Years’ Experience in a Spanish Tertiary Care Hospital. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
24
|
Giavedoni P, Iranzo P, Fuertes I, Estrach T, Alsina Gibert M. Leishmaniasis cutánea. Experiencia de 20 años en un hospital español de tercer nivel. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:310-6. [DOI: 10.1016/j.ad.2014.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/16/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022] Open
|
25
|
Norman FF, Monge-Maillo B, Martínez-Pérez Á, Perez-Molina JA, López-Vélez R. Parasitic infections in travelers and immigrants: part I protozoa. Future Microbiol 2015; 10:69-86. [DOI: 10.2217/fmb.14.105] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
ABSTRACT The growth in international commerce, travel and migration contribute to the global emergence of certain parasitic infections. Importation of vectors and food products may contribute to the emergence of protozoan infections in nonendemic countries. Infections such as malaria are potentially fatal, especially in nonimmune patients, and outcome depends largely on timely diagnosis and treatment. Diagnosis/management of imported parasitic infections may be complex especially as some patients may have underlying immunosuppressive conditions such as HIV infection. Major challenges concern the development of improved diagnostic techniques, safer/more effective drug therapies and identification of biological markers of progression and response to treatment. Imported parasitic diseases which may be transmitted vertically or through blood transfusion/organ donation could become a public health priority in the near future. Climate change may affect arthropod distribution and facilitate the spread of protozoan vector-borne diseases. The first part of this review focuses on protozoan infections in travelers and immigrants.
Collapse
Affiliation(s)
- Francesca F Norman
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Begoña Monge-Maillo
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Ángela Martínez-Pérez
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Jose A Perez-Molina
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| | - Rogelio López-Vélez
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Ctra. De Colmenar, Km 9.1, 28034 Madrid, Spain
| |
Collapse
|
26
|
Mansueto P, Seidita A, Vitale G, Cascio A. Leishmaniasis in travelers: a literature review. Travel Med Infect Dis 2014; 12:563-81. [PMID: 25287721 DOI: 10.1016/j.tmaid.2014.09.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 05/17/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum ranges from asymptomatic infection to fatal visceral leishmaniasis. Over the last decades, an increase in imported leishmaniasis cases in developed, non-endemic countries, have been pointed-out from a review of the international literature. Among the possible causes are increasing international tourism, influx of immigrants from endemic regions and military operations. The main area for the acquisition of cutaneous leishmaniasis, especially for adventure travelers on long-term trips in highly-endemic forested areas, is represented from South America, whereas popular Mediterranean destinations are emerging as the main areas to acquire visceral variant. Leishmaniasis should be considered in the diagnostic assessment of patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years before. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas, should receive counseling regarding leishmaniasis and appropriate protective measures.
Collapse
Affiliation(s)
- Pasquale Mansueto
- Department of Internal Medicine and Biomedicine, University of Palermo, Italy.
| | - Aurelio Seidita
- Department of Internal Medicine and Biomedicine, University of Palermo, Italy
| | - Giustina Vitale
- Department of Internal Medicine and Biomedicine, University of Palermo, Italy
| | - Antonio Cascio
- Department of Human Pathology, University of Messina, Italy
| |
Collapse
|
27
|
Nadler C, Enk CD, Leon GT, Samuni Y, Maly A, Czerninski R. Diagnosis and Management of Oral Leishmaniasis—Case Series and Literature Review. J Oral Maxillofac Surg 2014; 72:927-34. [DOI: 10.1016/j.joms.2013.10.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 10/31/2013] [Accepted: 10/31/2013] [Indexed: 11/16/2022]
|
28
|
van Griensven J, Carrillo E, López-Vélez R, Lynen L, Moreno J. Leishmaniasis in immunosuppressed individuals. Clin Microbiol Infect 2014; 20:286-99. [DOI: 10.1111/1469-0691.12556] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
29
|
Bottieau E, Vekemans M, Van Gompel A. Therapy of vector-borne protozoan infections in nonendemic settings. Expert Rev Anti Infect Ther 2014; 9:583-608. [DOI: 10.1586/eri.11.32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
30
|
Blum J, Lockwood DNJ, Visser L, Harms G, Bailey MS, Caumes E, Clerinx J, van Thiel PPAM, Morizot G, Hatz C, Buffet P. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis. Int Health 2013; 4:153-63. [PMID: 24029394 DOI: 10.1016/j.inhe.2012.06.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML after the initial infection has been the main argument for systemic treatment. However, this statement needs re-evaluation and consideration of all the available data. The putative benefit of preventing ML should outweigh the toxicity of systemic antileishmanial therapy. To assess the need for and risk of systemic treatment the following factors were reviewed: the incidence and prevalence of ML in endemic populations and in travellers; the severity of mucosal lesions; the efficacy of current options to treat ML; the toxicity and, to a lesser extent, the costs of systemic treatment; the risk of developing ML after local treatment; and the strengths and limitations of current estimates of the risk of developing ML in different situations. Local treatment might be considered as a valuable treatment option for travellers suffering from New World CL, provided that there are no risk factors for developing ML such as multiple lesions, big lesions (>4 cm(2)), localisation of the lesion on the head or neck, immunosuppression or acquisition of infection in the high Andean countries, notably Bolivia.
Collapse
Affiliation(s)
- Johannes Blum
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Nadal-Nadal A, Nadal-Lladó C, Terrasa-Sagristà F, Díaz-Antolín MP. [Pain and inflammation of the pinna]. Enferm Infecc Microbiol Clin 2013; 32:125-6. [PMID: 23972568 DOI: 10.1016/j.eimc.2013.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 05/23/2013] [Accepted: 05/24/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Antoni Nadal-Nadal
- Servicio de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España.
| | | | | | | |
Collapse
|
32
|
Wu X, Tian H, Zhou S, Chen L, Xu B. Impact of global change on transmission of human infectious diseases. SCIENCE CHINA. EARTH SCIENCES 2013; 57:189-203. [PMID: 32288763 PMCID: PMC7104601 DOI: 10.1007/s11430-013-4635-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/19/2013] [Indexed: 05/19/2023]
Abstract
Global change, which refers to large-scale changes in the earth system and human society, has been changing the outbreak and transmission mode of many infectious diseases. Climate change affects infectious diseases directly and indirectly. Meteorological factors including temperature, precipitation, humidity and radiation influence infectious disease by modulating pathogen, host and transmission pathways. Meteorological disasters such as droughts and floods directly impact the outbreak and transmission of infectious diseases. Climate change indirectly impacts infectious diseases by altering the ecological system, including its underlying surface and vegetation distribution. In addition, anthropogenic activities are a driving force for climate change and an indirect forcing of infectious disease transmission. International travel and rural-urban migration are a root cause of infectious disease transmission. Rapid urbanization along with poor infrastructure and high disease risk in the rural-urban fringe has been changing the pattern of disease outbreaks and mortality. Land use changes, such as agricultural expansion and deforestation, have already changed the transmission of infectious disease. Accelerated air, road and rail transportation development may not only increase the transmission speed of outbreaks, but also enlarge the scope of transmission area. In addition, more frequent trade and other economic activities will also increase the potential risks of disease outbreaks and facilitate the spread of infectious diseases.
Collapse
Affiliation(s)
- XiaoXu Wu
- College of Global Change and Earth System Science, Beijing Normal University, Beijing, 100875 China
| | - HuaiYu Tian
- College of Global Change and Earth System Science, Beijing Normal University, Beijing, 100875 China
| | - Sen Zhou
- School of Environment, Tsinghua University, Beijing, 100084 China
| | - LiFan Chen
- College of Global Change and Earth System Science, Beijing Normal University, Beijing, 100875 China
| | - Bing Xu
- College of Global Change and Earth System Science, Beijing Normal University, Beijing, 100875 China
- School of Environment, Tsinghua University, Beijing, 100084 China
| |
Collapse
|
33
|
Clinical findings and management of imported cutaneous leishmaniasis: report of 14 cases from Austria. Travel Med Infect Dis 2013; 11:90-4. [PMID: 23522841 DOI: 10.1016/j.tmaid.2013.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/26/2013] [Accepted: 03/01/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND The management of cutaneous leishmaniasis in non-endemic countries is challenging due to the wide variety of clinical manifestations and little information available on treatment modalities for travellers. METHODS Retrospective analysis and follow-up investigation in patients with imported cutaneous leishmaniasis managed at the General Hospital Vienna from 2004 to 2010. RESULTS In total, 14 patients with cutaneous leishmaniasis were analyzed. The time to diagnosis ranged between weeks and several months and up to four consultations were necessary before diagnosis was accomplished. Histological investigations performed in all patients were diagnostic for CL in 8 (57%) patients. PCR analyses were performed in 12 patients and were positive in 10 (83%) patients. All six patients with negative histological results for CL tested positive in the PCR analysis. Treatment regimens applied included systemic therapy with liposomal amphotericin B, miltefosine, or fluconazole, and local therapy with cryotherapy, paromomycin ointment, photodynamic therapy, surgery, and various combinations. CONCLUSIONS The present analysis strongly suggests that awareness of CL among physicians and travellers remains low and highlights the need to harmonize diagnostic and treatment guidelines for cutaneous and mucosal leishmaniasis in European travellers. Diagnostic outcome can be improved by combining histology and PCR in patients with suspected cutaneous leishmaniasis.
Collapse
|
34
|
Liposomal amphotericin B in comparison to sodium stibogluconate for Leishmania braziliensis cutaneous leishmaniasis in travelers. J Am Acad Dermatol 2013; 68:284-9. [DOI: 10.1016/j.jaad.2012.06.014] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 06/05/2012] [Accepted: 06/07/2012] [Indexed: 11/18/2022]
|
35
|
Candidate gene case-control and functional study shows macrophage inhibitory factor (MIF) polymorphism is associated with cutaneous leishmaniasis. Cytokine 2013; 61:168-72. [DOI: 10.1016/j.cyto.2012.09.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 08/23/2012] [Accepted: 09/18/2012] [Indexed: 11/22/2022]
|
36
|
Masood S, Naveed S, Alvi RU. Infiltrated leishmaniasis recidivans cutis on the face: a rare clinical presentation. Trop Doct 2012; 42:120-1. [PMID: 22337728 DOI: 10.1258/td.2011.110396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cutaneous leishmaniasis is a protozoan disease caused by Leishmania and transmitted by the bite of some species of sand flies. Usually it presents with variety of clinical manifestations depending on both the infecting species of Leishmania and the immune response of the host. Leishmaniasis recidivans cutis (LRC) is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and its chronic relapsing nature. It is an evolving form of cutaneous leishmaniasis which clinically presents as a spreading of the initial nodule, leading to a plaque formation simulating discoid lupus erythematosus. A clinical course of leishmania recidivans is probably related to changes in cell-mediated immunity leading to localized or diffuse lesions. We report a case that presented with infiltrated, atrophic plaque on a patient's face. Clinically, the lesion resembled the lesion of discoid lupus erythematosus and lupus vulgaris but the cutaneous biopsy proved the diagnosis to be LRC.
Collapse
Affiliation(s)
- Sadia Masood
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
| | | | | |
Collapse
|
37
|
Old world Leishmania infantum cutaneous leishmaniasis unresponsive to liposomal amphotericin B treated with topical imiquimod. Pediatr Infect Dis J 2012; 31:97-100. [PMID: 21829140 DOI: 10.1097/inf.0b013e31822dfbf7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We present a case of a child with Leishmania infantum cutaneous leishmaniasis unresponsive to 2 courses of intravenous liposomal amphotericin B, a treatment failure that has not been reported in this Leishmania species. The patient responded to topical imiquimod and had no relapse. We review the literature on the treatment failure of liposomal amphotericin B for cutaneous leishmaniasis.
Collapse
|
38
|
Mohammadpour G, Marzony ET, Farahmand M. Evaluation of the Anti- Leishmania Major Activity of Satureja Bakhtiarica Essential Oil in Vitro. Nat Prod Commun 2012. [DOI: 10.1177/1934578x1200700142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leishmaniasis is a painless chronic skin disease that is caused by the protozoan parasite Leishmania. Due to the importance of this disease and the side effects of chemical drugs, use of drugs of plant origin to treat Leishmaniasis is very important. In the present study, the chemical composition and the anti- Leishmania major activity of the essential oils obtained from Satureja bakhtiarica were evaluated in vitro. The oils were extracted using a Clevenger apparatus and then the chemical composition was analyzed by GC-MS. Promastigotes of L. major were cultured in both N.N.N and RPMI1640 media. GC-MS analysis showed 13 compounds, in which the major components were the phenolic (37.4%) compounds, thymol (22.6%) and p-cymene (19.3%). The essential oil of S. bakhtiarica showed higher activity against L. major than the standard anti-Leishmania drug, glucantime,. Perhaps because of the high concentration of phenolic compounds in the essential oil, all the parasites were killed after 24 hours. The essential oil from S. bakhtiarica is a potential plant drug against leishmaniasis. Further studies are necessary to evaluate this oil in animal models ( in vivo) for future drug applications.
Collapse
Affiliation(s)
| | | | - Mahin Farahmand
- Department of Parasitology, Pasteur Institute of Iran, Tehran-Iran
| |
Collapse
|
39
|
Ono M, Takahashi K, Taira K, Uezato H, Takamura S, Izaki S. Cutaneous leishmaniasis in a Japanese returnee from West Africa successfully treated with liposomal amphotericin B. J Dermatol 2011; 38:1062-1065. [PMID: 21950705 DOI: 10.1111/j.1346-8138.2011.01270.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Leishmaniasis has been occasionally reported in returnees from endemic areas. Here, we report a case of cutaneous leishmaniasis in a 33-year-old Japanese man who presented with a skin nodule after returning from an 8-year stay in West Africa including Burkina Faso. He was successfully treated with liposomal amphotericin B with no significant adverse effects. This is the first Japanese case of cutaneous leishmaniasis treated successfully with liposomal amphotericin B.
Collapse
Affiliation(s)
- Misaki Ono
- Department of Dermatology, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
| | | | | | | | | | | |
Collapse
|
40
|
Cannella AP, Nguyen BM, Piggott CD, Lee RA, Vinetz JM, Mehta SR. A cluster of cutaneous leishmaniasis associated with human smuggling. Am J Trop Med Hyg 2011; 84:847-50. [PMID: 21633017 DOI: 10.4269/ajtmh.2011.10-0693] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is rarely seen in the United States, and the social and geographic context of the infection can be a key to its diagnosis and management. Four Somali and one Ethiopian, in U.S. Border Patrol custody, came to the United States by the same human trafficking route: Djibouti to Dubai to Moscow to Havana to Quito; and then by ground by Columbia/Panama to the United States-Mexico border where they were detained. Although traveling at different times, all five patients simultaneously presented to our institution with chronic ulcerative skin lesions at different sites and stages of evolution. Culture of biopsy specimens grew Leishmania panamensis. Soon thereafter, three individuals from East Africa traveling the identical route presented with L. panamensis CL to physicians in Tacoma, WA. We document here the association of a human trafficking route and new world CL. Clinicians and public health officials should be aware of this emerging infectious disease risk.
Collapse
Affiliation(s)
- Anthony P Cannella
- Division of Infectious Diseases and Division of Dermatology, Department of Medicine, University of California-San Diego, La Jolla, CA 92093, USA
| | | | | | | | | | | |
Collapse
|
41
|
Pavli A, Maltezou HC. Leishmaniasis, an emerging infection in travelers. Int J Infect Dis 2010; 14:e1032-9. [DOI: 10.1016/j.ijid.2010.06.019] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 04/30/2010] [Accepted: 06/16/2010] [Indexed: 02/06/2023] Open
|
42
|
Wortmann G, Zapor M, Ressner R, Fraser S, Hartzell J, Pierson J, Weintrob A, Magill A. Lipsosomal amphotericin B for treatment of cutaneous leishmaniasis. Am J Trop Med Hyg 2010; 83:1028-33. [PMID: 21036832 DOI: 10.4269/ajtmh.2010.10-0171] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Treatment options for cutaneous leishmaniasis in the United States are problematic because the available products are either investigational, toxic, and/or of questionable effectiveness. A retrospective review of patients receiving liposomal amphotericin B through the Walter Reed Army Medical Center for the treatment of cutaneous leishmaniasis during 2007-2009 was conducted. Twenty patients who acquired disease in five countries and with five different strains of Leishmania were treated, of whom 19 received a full course of treatment. Sixteen (84%) of 19 experienced a cure with the initial treatment regimen. Three patients did not fully heal after an initial treatment course, but were cured with additional dosing. Acute infusion-related reactions occurred in 25% and mild renal toxicity occurred in 45% of patients. Although the optimum dosing regimen is undefined and the cost and toxicity may limit widespread use, liposomal amphotericin B is a viable treatment alternative for cutaneous leishmaniasis.
Collapse
Affiliation(s)
- Glenn Wortmann
- Infectious Diseases Service, Walter Reed Army Medical Center, Washington, District of Columbia 20307, USA.
| | | | | | | | | | | | | | | |
Collapse
|