Studies on the Feeding Habits of Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) Populations from Endemic Areas of American Visceral Leishmaniasis in Northeastern Brazil

Identification of Lutzomyia longipalpis' using MALDI-TOF peptide/protein profiles

Sand flies are vectors of great public health importance, since they constitute a group of hematophagous insects responsible for etiological agents transmission of zoonotic diseases such a visceral leishmaniasis. In face of the expansion of these diseases, efficient control strategies are needed which depend on comprehending the sand fly eco-epidemiology. In this regard, MALDI-TOF mass spectrometry has been used for bacteria, fungi and yeast detection studies through peptide/protein profiles. However, little is known about interference of biological factors associated with vector ecology, such as blood meal preferences and even sand fly age on the peptide/protein profiles. Thus, the present study aimed to evaluate the differences in peptide/protein profiles of the sand fly Lutzomyia longipalpis, by means of MALDI-TOF, due to the sand fly's age, sex, blood meal source and Leishmania infantum infection. Sample preparation was made removing both head and last abdomen segments keeping the thorax, its appendices and the rest of the abdomen. Five specimens per pool were used to obtain peptide/protein extract of which 1 μL solution was deposited over 1 μL MALDI matrix dried. Characteristic spectra were analyzed using principal coordinate analysis as well as indicator species analysis to discriminate differences in sand flies's peptide/protein profile by sex, age, blood meal source and L. infantum infection. The results show that the evaluated variables produced distinct peptide/protein profiles, demonstrated by the identification of specific diagnostic ions. It was found that the interference of biological factors should be taken into account when using the MALDI-TOF analysis of sand fly species identification and eco-epidemiological applications in field studies. Based on our results, we believe that it is possible to identify infected specimens and the source of blood meal in a collection of wild sand flies, serving to measure infectivity and understand the dynamics of the vector's transmission chain. Our results may be useful for epidemiological studies that look at the ecology of sand flies and leishmaniasis, as well as for raising awareness of biological characteristics' impact on peptide/protein profiles in sand fly species identification.

You are what you eat: a systematic review exploring the interaction between Brazilian sand flies and their vertebrate food sources

Sand flies play a crucial role as vectors of bacteria, viruses, and protists, with Leishmania being the most notable among them, transmitted to vertebrate hosts during blood feeding. Understanding the feeding behaviours of sand flies is imperative for gaining insights into their eco-epidemiological roles in the transmission of these infectious agents. This systematic review aimed to answer the question 'What are the blood-feeding sources identified in Brazilian sand flies?' to provide an analysis of their blood-feeding habits. The diverse range of at least 16 vertebrate orders identified as blood sources for 54 sand fly species across different geographic regions was summarised, and the factors potentially associated with the risk of bias in the included studies were analysed. The findings broaden the discussion concerning methods used to identify blood meal sources and shed light on the implications of sand fly feeding behaviours for the transmission dynamics of Leishmania.

Environmental and socioeconomic risk factors for visceral and cutaneous leishmaniasis in São Paulo, Brazil

Leishmaniasis is a vector-borne disease caused by the protozoan Leishmania spp. mainly affecting individuals of low socioeconomic status. In tropical regions the transmission risk to humans depends not only on environmental factors, such as vegetation cover and climate, but also on the socioeconomic characteristics of human populations. However, the relative contribution of these factors to disease risk and incidence is not well understood. Yet this information is critical for the development of epidemiological surveillance schemes and control practices. Leishmaniasis cases have increased in São Paulo state, Brazil over recent years but the underlying risk factors for transmission remain understudied. Here, we use generalized linear mixed models to quantify the association between occurrence and incidence (number of cases) of cutaneous (CL) and visceral (VL) leishmaniasis from 1998 to 2015, and landscape (native vegetation cover), climate (seasonal and interannual variation in precipitation and temperature) and socioeconomic factors (population, number of cattle heads, Human Development Index - HDI, Gini inequality index and income per capita) across the 645 municipalities of São Paulo state, Brazil. For CL, probability of occurrence was greater in municipalities with high native vegetation cover and economic inequality and in years with greater average winter precipitation. For VL, probability of occurrence was greater in years with high minimum spring precipitation and maximum annual temperatures, and in municipalities with larger HDI values and a greater number of cattle heads. The number of VL cases increased during years with high mean fall precipitation and, for both CL and VL the number of cases was greater in years of high annual mean temperature. Understanding how these risk factors influence spatial and temporal variation in the risk and incidence of leishmaniasis can contribute to the development of effective public health policies and interventions.

Lutzomyia longipalpis, Gone with the Wind and Other Variables

Lutzomyia longipalpis (Lutz & Neiva) is the main vector of Leishmania infantum (Nicolle) in America, associated in turn with the current spread and urbanization of American visceral leishmaniasis (AVL). The vector distribution in AVL foci shows a spatial-temporal clustering despite the different epidemiological contexts. The factors associated with the macroscale distribution of Lu. longipalpis as a landscape stratification are discussed in the framework of the process of their adaptation to anthropized environments. On the other hand, the fact that Lu. longipalpis is clustered in only a few hot spots or critical sites suggests that microscale approaches that describe the trap surrounding environment and the availability of refuges and food sources are better at explaining the uneven distribution of this vector, and should contribute, together with macroscale variables, to design operational control strategies. With regard to temporal distribution and climatic or vegetation data obtained by remote sensing as variables to explain and forecast the abundance of Lu. longipalpis, it is necessary to take into account the time lags in relation to the life cycle of the vector, the difference between the level of daily activity and actual abundance, and the differences in critical variables and thresholds according to the region or season. In conclusion, this review shows that it is feasible to characterize the distribution of Lu. longipalpis at focus level and within it to identify the main critical sites, proposing a sequential cost-effectivity strategy for urban AVL surveillance and control.

Community deployment of a synthetic pheromone of the sand fly Lutzomyia longipalpis co-located with insecticide reduces vector abundance in treated and neighbouring untreated houses: Implications for control of Leishmania infantum

Background

The rising incidence of visceral leishmaniasis due to Leishmania infantum requires novel methods to control transmission by the sand fly vector. Indoor residual spraying of insecticide (IRS) against these largely exophilic / exophagic vectors may not be the most effective method. A synthetic copy of the male sex-aggregation pheromone of the key vector species Lutzomyia longipalpis in the Americas, was co-located with residual pyrethroid insecticide, and tested for its effects on vector abundance, hence potential transmission, in a Brazilian community study.

Methods

Houses within eight defined semi-urban blocks in an endemic municipality in Brazil were randomised to synthetic pheromone + insecticide or to placebo treatments. A similar number of houses located >100m from each block were placebo treated and considered as “True Controls” (thus, analysed as three trial arms). Insecticide was sprayed on a 2.6m² surface area of the property boundary or outbuilding wall, co-located within one metre of 50mg synthetic pheromone in controlled-release dispensers. Vector numbers captured in nearby CDC light traps were recorded at monthly intervals over 3 months post intervention. Recruited sentinel houses under True Control and pheromone + insecticide treatments were similarly monitored at 7–9 day intervals. The intervention effects were estimated by mixed effects negative binomial models compared to the True Control group.

Results

Dose-response field assays using 50mg of the synthetic pheromone captured a mean 4.8 (95% C.L.: 3.91, 5.80) to 6.3 (95% C.L.: 3.24, 12.11) times more vectors (female Lu. longipalpis) than using 10mg of synthetic pheromone. The intervention reduced household female vector abundance by 59% (C.L.: 48.7, 66.7%) (IRR = 0.41) estimated by the cross-sectional community study, and by 70% (C.L.: 56.7%, 78.8%) estimated by the longitudinal sentinel study. Similar reductions in male Lu. longipalpis were observed. Beneficial spill-over intervention effects were also observed at nearby untreated households with a mean reduction of 24% (95% C.L.: 0.050%, 39.8%) in female vectors. The spill-over effect in untreated houses was 44% (95% C.L.: 29.7%, 56.1%) as effective as the intervention in pheromone-treated houses. Ownership of chickens increased the intervention effects in both treated and untreated houses, attributed to the suspected synergistic attraction of the synthetic pheromone and chicken kairomones. The variation in IRR between study blocks was not associated with inter-household distances, household densities, or coverage (proportion of total households treated).

Conclusions

The study confirms the entomological efficacy of the lure-and-kill method to reduce the abundance of this important sand fly vector in treated and untreated homesteads. The outcomes were achieved by low coverage and using only 1–2% of the quantity of insecticide as normally required for IRS, indicating the potential cost-effectiveness of this method. Implications for programmatic deployment of this vector control method are discussed.

The predominant sand fly vector of the intracellular parasite Leishmania infantum, that causes human and canine visceral leishmaniasis in the Americas, is Lutzomyia longipalpis. Vector control tools to reduce transmission are needed. A sex-aggregation pheromone released by male Lu. longipalpis attracts female conspecifics which facilitates blood-feeding and transmission. This study, conducted in Brazil, quantifies the effects of community deployment of a synthetic version of the sex-aggregation pheromone, in a controlled-release dispenser, and co-located with lethal insecticide applied to a small area of the household compound or outbuilding wall. 50mg synthetic pheromone dispensers were used since they attracted substantially more vectors than 10mg dispensers. Deploying this novel lure-and-kill method to houses in eight replicate study blocks in two suburban endemic areas, demonstrated that it reduces vector numbers at both pheromone + insecticide treated houses, and neighbouring untreated houses. The presence of chickens (a known additional attraction to blood-seeking female Lu. longipalpis) increased the beneficial effects of the intervention. The method used only 1–2% of the quantity of insecticide necessary for IRS for an average sized house. The results demonstrate the efficacy and potential cost-effectiveness of this novel lure-and-kill control method.

Leishmania infantum Seroprevalence in Cats From Touristic Areas of Italy and Greece

Leishmaniosis by Leishmania infantum is a major zoonotic Vector-Borne Disease (VBD) in terms of geographic distribution, pathogenicity and zoonotic potential. While dogs are the main reservoir of L. infantum, the infection in cats is poorly understood although increasingly reported from enzootic and non-enzootic areas. The Mediterranean basin is a key area for leishmaniosis and includes touristic spots that require continuous surveillance for VBDs in consideration of the growing tendency of tourists to travel with their pets. This study evaluated L. infantum seroprevalence in cats living in selected touristic localities of Italy and Greece. A total of 269 cat serum samples from three Sites i.e., 76, 40, and 153 from Adriatic Coast of Abruzzo, Italy (Site A), Giglio Island, Tuscany, Italy (Site B), and Mykonos Island, Greece (Site C), respectively, were included in the survey. Sera samples were subjected to an indirect immunofluorescence antibody assay for the detection of anti-L. infantum specific IgG. Associations between possible risk factors and seropositivity to L. infantum were statistically evaluated. Antibodies against L. infantum were detected in eight out of 269 (3.0%) cats tested i.e., 4/76 (5.3%), 1/40 (2.5%), and 3/153 (2.0%), from sites A, B, and C, respectively. A statistical association between anti-L. infantum antibodies and cohabitation with dogs was shown. This study indicates that feline populations living in the examined Italian and Greek touristic areas are exposed to L. infantum and that they may contribute to the circulation of L. infantum, enhancing the risk of infection for dogs and humans.

Landscape effects on the abundance of Lutzomyia longipalpis and Migonemyia migonei (Diptera: Psychodidae: Phlebotominae) in Corrientes city, northern Argentina

We analyses the relationship between landscape and environmental variables estimated from high-resolution satellite images with the temporal variation of the abundance of Lutzomyia longipalpis and Migonemyia migonei, vectors of leishmaniasis, in Corrientes city. At 8 collection sites, 14 samples were conducted between March 2012 to February 2014. Proportion of land cover classes derived from high resolution satellite images as: water, bare soil, urban areas, low vegetation and high vegetation, as well as average, maximum and minimum values of Normalized Difference Vegetation Index and Normalized Difference Water Index) in buffer areas of 50 m, 100 m and 150 m were used to characterize and identify suitable environmental conditions for the development of sand flies through Generalized Linear Mixed Models. The most frequently collected species during the sampling period was Lu. longipalpis and followed by Mg. migonei. The models showed that high Lu. longipalpis abundance were related to low proportion of high vegetation coverage, while a negative association was among Mg. migonei abundance and with values of Normalized Difference Water Index and with the interaction between urban areas and minimum values of Normalized Difference Water Index, and a positive association with the interaction between low vegetation and average values of Normalized Difference Water Index.

Fast multiplex real-time PCR assay for simultaneous detection of dog and human blood and Leishmania parasites in sand flies

Background

The blood-feeding behaviour of female sand flies may increase their likelihood of acquiring and transmitting Leishmania parasites. Studies on the host usage by these insects may thus improve our understanding of the Leishmania transmission risk in leishmaniasis-endemic areas. Here, we developed a fast multiplex real-time PCR assay for simultaneous detection of dog, human and Leishmania DNA in sand flies.

Methods

Primers and TaqMan probes targeting the mitochondrial cytochrome c oxidase subunit 1 and cytochrome b genes of dog and human, respectively, were combined in a multiplex assay, which also includes primers and a TaqMan probe targeting the Leishmania minicircle kinetoplast DNA.

Results

The multiplex assay was 100% specific, with analytical sensitivities of 10³ fg/reaction for dog and human and 1 fg for Leishmania. By testing field-collected engorged female sand flies (95 Migonemyia migonei and two Nyssomyia intermedia), 50 M. migonei were positive for one or two targets (positivity rates: 45.4% for human, 4.1% for dog and 12.4% for Leishmania DNA).

Conclusions

This multiplex real-time PCR assay represents a novel fast assay for detecting dog, human and Leishmania DNA in female sand flies and therefore a tool for assessing the risk of Leishmania transmission to these hosts in areas of active transmission.

Latest trends in L. infantum infection in dogs in Spain, Part II: current clinical management and control according to a national survey of veterinary practitioners

Background

Canine leishmaniosis (CanL) is a parasitic zoonotic disease, endemic in the Mediterranean basin including Spain. While knowledge about CanL, its management, treatment, prevention and control mounts, it remains unclear whether all clinical veterinarians follow the same international recommendations, such as those of the LeishVet group. This study was thus designed to assess recent trends in the clinical management of CanL in veterinary clinics across Spain through a questionnaire-based survey. Results were compared with those of a prior national multicenter questionnaire administered by our research team in 2005.

Methods

A questionnaire consisting of 28 questions about CanL was developed using Google Forms and distributed by email to 1428 veterinary clinics in Spain. Questions were designed to obtain data on common clinical signs, techniques and complementary exams used to diagnose the disease, and on its monitoring, treatment and control measures. Data were collected in a database for statistical analysis.

Results

Completed questionnaires were returned by 295 clinics. Compared to the situation in 2005, responses indicate that clinical signs of CanL have not changed significantly, cutaneous lesions being still the most prevalent sign observed by practitioners. Quantitative serological techniques are considered an adequate approach to diagnosis, provided their results are supported by the findings of a thorough physical exam, as well as complementary tests (complete blood count, biochemical profile, plasma protein electrophoretogram and complete urinalysis). Treatment protocols and check-ups follow international recommendations. Finally, a multimodal approach is being endorsed to adequately control CanL including preventive measures such as annual serological check-ups and the combination of repellents and vaccines. Additionally, owners are being better informed about CanL by veterinarians, which translates to the improved control of this zoonosis.

Conclusions

The clinical management of CanL has recently undergone significant changes owing to improvements in clinical knowledge of the disease, more unified international criteria, improved diagnostic techniques and their adequate interpretation, as well as a greater awareness of the disease transmitted to owners.

Leishmania spp. Infection Rate and Feeding Patterns of Sand Flies (Diptera: Psychodidae) from a Hyperendemic Cutaneous Leishmaniasis Community in Panamá

American cutaneous leishmaniasis (ACL) is a common and important vector-borne parasitic zoonosis in Panamá. Here, we study Leishmania spp. infection rates and blood-feeding patterns among common sand flies in Trinidad de Las Minas, a rural community with hyperendemic ACL transmission, and where a deltamethrin fogging trial was performed. Sand flies were collected from April 2010 to June 2011 with light traps installed inside and in the peridomicile of 24 houses. We restricted our analysis to the most abundant species at the study site: Lutzomyia trapidoi, Lutzomyia gomezi, Lutzomyia panamensis, Lutzomyia triramula, and Lutzomyia dysponeta. We detected Leishmania spp. infection in sand flies by polymerase chain reaction (PCR) amplification of the internal transcribed spacer region 1 (ITS-1) in pooled females (1-10 females per pool). Host species of engorged sand flies were identified using a cytochrome b PCR. From 455 sand fly pools analyzed, 255 pools were positive for Leishmania spp., with an estimated infection rate (confidence interval) of 0.096 [0.080-0.115] before the deltamethrin fogging which slightly, but not significantly (P > 0.05), increased to 0.116 [0.098-0.136] after the deltamethrin fogging. Blood meal analysis suggested that pigs, goats, and birds were the most common sand fly blood sources, followed by humans and domestic dogs. DNA sequencing from a subsample of ITS-1 positive pools suggests that Leishmania panamensis, Leishmania naiffi, and other Leishmania spp. were the parasite species infecting the most common vectors at the study site. Our data confirm an association between sand fly species, humans, domestic dogs, and pigs and Leishmania spp. parasites in rural Panamá.

Leishmaniosis

Leishmania spp. affecting cats include L. infantum, L. mexicana, L. venezuelensis, L. amazonensis, and L. braziliensis. Leishmania infantum is the species most frequently reported in cats and causes feline leishmaniosis (FeL). Cats exposed to L. infantum are able to mount a cell-mediated immune response that does not parallel antibody production. Cats with L. infantum-associated clinical disease have positive blood PCR and low to very high antibody levels. About half of the clinical cases of FeL are diagnosed in cats with impaired immunocompetence. Skin or mucocutaneous lesions are the most common clinical findings; however, FeL is a systemic disease. Skin or mucocutaneous lesions and lymph node enlargement are seen in at least half of cases, ocular or oral lesions and some aspecific signs (weight loss, anorexia, lethargy) in about 20–30% of cases, and many other clinical signs (e.g., respiratory, gastrointestinal) are sporadically observed. Ulcerative and nodular lesions due to diffuse granulomatous dermatitis are the most frequent skin manifestations, mainly distributed on the head or symmetrically on the distal limbs. Diagnosis can be obtained by cytology and histology, and immunohistochemistry is useful to confirm the causative role of Leishmania infection in the dermopathological manifestations; however, other skin diseases may coexist with FeL. Polymerase chain reaction is used in case of suggestive lesions with lack of parasites and for Leishmania speciation. Comorbidities, coinfections, and chronic renal disease influence the prognosis and should be investigated. Treatment is currently based on the same drugs used for canine leishmaniosis, and generally clinical cure is obtained; however recurrence is possible.

Nutrition, malnutrition, and leishmaniasis

Leishmaniasis is a vector-borne infectious disease with a long history of infecting humans and other animals. It is a known emerging or resurging disease. The host nutritional state has an indispensable role in defense against pathogens. The host defense system disorganization as a result of undernutrition is responsible for asymptomatic infections and even severe diseases. Host susceptibility and pathophysiologic severity to infection can be aggravated owing to undernourishment in a number of pathways, and infection also may aggravate preexisting poor nutrition or further increase host susceptibility. This study suggests that there may be some relationship between malnutrition and the endemicity of the parasite. The susceptibility to and severity of leishmanial infection can be altered by the body weight and serum levels of micronutrients. Nutrition not only affects the vulnerability of the host but also may affect the desire of sandfly to bite a specific host. Apart from host defense mechanism, nutritional stress also greatly influences vector competence and host-seeking behavior, especially during larvae development. The host and sandfly vector nutritional states could also influence the evolution of the parasite. It is essential to elucidate the roles that diets and nutrition play in the leishmanial life cycle. The aim of this article is to review the influences of nutrition and diets on the host susceptibility and severity of infection, preemptive and therapeutic strategy feedback, parasite evolution, and vector competence.

Data scarcity and ecological complexity: the cutaneous leishmaniasis dynamics in Ecuador

Cutaneous leishmaniasis (CL) is a neglected tropical disease transmitted by species of Phlebotominae sand flies. CL is responsible for more than 1000 reported cases per year in Ecuador. Vector collection studies in Ecuador suggest that there is a strong association between the ecological diversity of an ecosystem, the presence of potential alternative or reservoir hosts and the abundance of sand fly species. Data collected from a coastal community in Ecuador showed that Leishmania parasites may be circulating in diverse hosts, including mammalian and potentially avian species, and these hosts may serve as potential hosts for the parasite. There has been limited reporting of CL cases in Ecuador because the disease is non-fatal and its surveillance system is passive. Hence, the actual incidence of CL is unknown. In this study, an epidemic model was developed and analysed to understand the complexity of CL transmission dynamics with potential non-human hosts in the coastal ecosystem and to estimate critical epidemiological quantities for Ecuador. The model is fitted to the 2010 CL outbreak in the town of Valle Hermoso in the Santo Domingo de los Tsachilas province of Ecuador and parameters such as CL transmission rates in different types of hosts (primary and alternative), and levels of case reporting in the town are estimated. The results suggest that the current surveillance in this region fails to capture 38% (with 95% CI (29%, 47%)) of the actual number of cases under the assumption that alternative hosts are dead-end hosts and that the mean CL reproduction number in the town is 3.9. This means that on the average 3.9 new human CL cases were generated by a single infectious human in the town during the initial period of the 2010 outbreak. Moreover, major outbreaks of CL in Ecuador in coastal settings are unavoidable until reporting through the surveillance system is improved and alternative hosts are managed properly. The estimated infection transmission probabilities from alternative hosts to sand flies, and sand flies to alternative hosts are 27% and 32%, respectively. The analysis highlights that vector control and alternative host management are two effective programmes for Ecuador but need to be implemented concurrently to avoid future major outbreaks.

Ecological aspects of Phlebotomines (Diptera: Psychodidae) and the transmission of American cutaneous leishmaniasis agents in an Amazonian/ Guianan bordering area

BACKGROUND

An entomological study was conducted in the municipality of Oiapoque (lower Oyapock River Basin) in the Brazilian side bordering French Guiana to gain information on the transmission pattern of American cutaneous leishmaniasis (ACL) in that region, presumed to reflect the classical Amazonian/Guianan enzootic scenario.

METHODS

Three ecologically isolated forested areas near urban environments were surveyed during the rainy and dry seasons of 2015 and 2016, using a multi-trapping approach comprising ground-level and canopy light traps, black and white colored cloth Shannon traps and manual aspiration on tree bases. Female phlebotomines were dissected to find infections and isolate flagellates from Leishmania spp. The strains were characterized by restriction fragment length polymorphism analysis and compared with those of local ACL cases and World Health Organization reference strains.

RESULTS

Nyssomyia umbratilis, Trichopygomyia trichopyga and Evandromyia infraspinosa were the most frequently found species. Findings on relative abundance, spatiotemporal vector/ACL congruence, natural infections and anthropophilic insights strengthened the Guianan classical transmission of Leishmania (Viannia) guyanensis by Ny. umbratilis and suggested further investigations for Ev. infraspinosa. Nyssomyia umbratilis showed an eclectic feeding habit, including bird blood. Ecological data and literature reports also included Psychodopygus squamiventris maripaensis and Bichromomyia flaviscutellata on the list of suspected vectors.

CONCLUSIONS

These findings contributed to understanding ACL ecoepidemiology in the Amazonian/Guianan scenario. Local studies are required to better comprehend the Leishmania spp. enzootic mosaic in specific ecotopes.

Variables associated with the prevalence of anti-Leishmania spp. antibodies in dogs on the tri-border of Foz do Iguaçu, Paraná, Brazil

The aim of this study was to investigate the occurrence of anti-Leishmania spp. antibodies in dogs from localities in the city of Foz do Iguaçu, Paraná state, Brazil, on the border with Argentina and Paraguay. Blood samples dogs were collected to perform the following serologic tests: immunochromatographic DPP® rapid test, indirect immunoenzymatic assay (ELISA) and indirect immunofluorescence assay (IFA). In 2012, 285 dogs were analyzed on Argentina border, and in 2013, serum samples from 396 dogs on the border of Paraguay were collected. Using ELISA for screening and IFA for the confirmatory test, the results showed that the antibody prevalence was 1.8% (5/285) on the border of Argentina and 3.0% (12/396) on Paraguay border. When using the DPP® for screening and ELISA as a confirmatory analysis, we observed a seroreagent prevalence in dogs of 2.5% (7/285) on Argentina border and 5.1% (20/396) on Paraguay border. The non-public collection of domestic waste (p= 0.0004) was shown to be associated with leishmaniasis. This study shows the presence of leishmaniasis and suggest the emergence of canine visceral leishmaniasis in state of Paraná due to the confirmed occurrence of seroreactive dogs on Argentina and Paraguay border, which has environmental and geographical characteristics that favor the spread of the parasite.

Leishmania, microbiota and sand fly immunity

In this review, we explore the state-of-the-art of sand fly relationships with microbiota, viruses and Leishmania, with particular emphasis on the vector immune responses. Insect-borne diseases are a major public health problem in the world. Phlebotomine sand flies are proven vectors of several aetiological agents including viruses, bacteria and the trypanosomatid Leishmania, which are responsible for diseases such as viral encephalitis, bartonellosis and leishmaniasis, respectively. All metazoans in nature coexist intimately with a community of commensal microorganisms known as microbiota. The microbiota has a fundamental role in the induction, maturation and function of the host immune system, which can modulate host protection from pathogens and infectious diseases. We briefly review viruses of public health importance present in sand flies and revisit studies done on bacterial and fungal gut contents of these vectors. We bring this information into the context of sand fly development and immune responses. We highlight the immunity mechanisms that the insect utilizes to survive the potential threats involved in these interactions and discuss the recently discovered complex interactions among microbiota, sand fly, Leishmania and virus. Additionally, some of the alternative control strategies that could benefit from the current knowledge are considered.

Co-occurrence and seasonal and environmental distributions of the sandflies Lutzomyia longipalpis and Nyssomyia whitmani in the city of Puerto Iguazú, northeastern Argentina

The aim of this work was to study the distribution of Phlebotominae (Diptera: Psycodidade) abundance in time and space in an area in northeastern Argentina with vector transmission of visceral and tegumentary leishmaniasis. For this, 51 households were selected using a 'worst scenario' criterion where one light trap was set during two consecutive nights in peridomiciles in the transitions between the four seasons, and the environment was surveyed simultaneously. The relationships of phlebotomine assemblage structure and the most abundant species with seasonality and environmental variables were evaluated using a canonical correspondence analysis and generalized linear mixed models, respectively. A total of 5110 individuals were captured. Lutzomyia longipalpis (Lutz & Neiva, 1912) and Nyssomyia whitmani (Antunes & Coutinho, 1939) were the most abundant species captured in all samplings (98.3% of the total capture). The period of highest abundance of Lu. longipalpis was early autumn, and it was distributed in the most urbanized areas. Nyssomyia whitmani occupied mainly the less urbanized areas, showing peaks of abundance in early spring and summer. Other species were captured in low numbers and showed seasonal-spatial variations similar to those of Ny. whitmani. We confirmed Leishmania spp. vector persistence throughout the year in spatial patches of high abundance even during the less favorable season.

Molecular and serological detection of Leishmania spp. in horses from an endemic area for canine visceral leishmaniasis in southeastern Brazil

ABSTRACT: This study aimed to verify the occurrence of Leishmania spp. and Leishmania (Leishmania) infantum in horses from a visceral leishmaniasis endemic area in Brazil. DNA samples from blood and conjunctival swab (CS) were tested by PCR and Indirect Immunofluorescence Antibody Test (IFAT). Although none of the horses was clinically sick, animals infected by Leishmania spp. were found and some could be characterized as infected by L. (L.) infantum. From 40 horses, 100% of the animals were positive by blood PCR, 90% (36/40) by CS PCR, and 2.5% (01/40) in serodiagnosis, by IFAT. Six from these 40 horses were L. (L.) infantum positive by blood PCR. Direct sequencing and analysis of amplicons resulted in a sequence to evolutionary analysis. Results indicate the presence of Leishmania spp. and L. (L.) infantum infecting healthy horses in Brazil. The presence of Leishmania spp. and L. (L.) infantum DNA in asymptomatic horses suggests that they can be important reservoirs of these parasites, a highly relevant finding for the epidemiological surveillance of the diseases they cause.

Effectiveness of dog collars impregnated with 4% deltamethrin in controlling visceral leishmaniasis in Lutzomyia longipalpis (Diptera: Psychodidade: Phlebotominae) populations

BACKGROUND

There is little information on the effect of using deltamethrin-impregnated dog collars for the control of canine visceral leishmaniasis.

OBJECTIVES

The objective of this study was to evaluate the effectiveness of the use of 4% deltamethrin-impregnated collars (Scalibor®) in controlling visceral leishmaniasis in Lutzomyia longipalpis by comparing populations in intervention and non-intervention areas.

METHODS

Phlebotomine flies were captured over 30 months in four neighbourhoods with intense visceral leishmaniasis transmission in Fortaleza and Montes Claros. We calculated the rates of domicile infestation, relative abundance of Lu. longipalpis, and Lu. longipalpis distribution in each site, capture location (intra- and peridomestic locations) and area (intervention and non-intervention areas).

FINDINGS

In the control area in Fortaleza, the relative abundance of Lu. longipalpis was 415 specimens at each capture site, whereas in the intervention area it was 159.25; in Montes Claros, the relative abundance was 5,660 specimens per capture site in the control area, whereas in the intervention area it was 2,499.4. The use of dog collars was associated with a reduction in captured insects of 15% (p = 0.004) and 60% (p < 0.001) in Montes Claros and Fortaleza, respectively.

MAIN CONCLUSIONS

We observed a lower vector abundance in the intervention areas, suggesting an effect of the insecticide-impregnated collars.

More than the eyes can see: The worrying scenario of canine leishmaniasis in the Brazilian side of the triple border

A cross-sectional epidemiological study in the extreme-west of the state of Paraná was carried out to access the prevalence, distribution, and risk variables of canine Visceral Leishmaniases (cVL). This study was conducted in three areas, two cities of far west of Parana state: Foz do Iguaçu (FI) and Santa Terezinha de Itaipu (STI), and along two transects between these two municipalities. To sample the entire urban area, the cities (FI and STI) were divided into a grid of squares of 400 m2 (patch). Among the 526 patches, 123 in FI, 40 in the transects and 33 in STI were selected according to the 'worst scenario' criterion. In the transect areas, in each 0.86 km five dogs from houses were surveyed to leishmaniasis. In each patch, blood of five dogs from houses (and from neighborhood when necessary) in the areas that seemed to be the most appropriate for the proliferation of vector were surveyed. The infection of the dogs by cVL were assessed using two serological tests were used (cELISA and TR-DPP®), and, for those seropositive for both methods, the PCR method were used. Moreover, dogs presenting clinical signs or cutaneous lesions were sampled to PCR. The identification of Leishmania species was confirmed using PCR-RFLP followed by DNA sequencing. Micro, meso and macro scale environmental variables were also surveyed and statistically analyzed. The prevalence rate Leishmania infantum was 23.8% in FI, 4.7% in STI and 9.1% in the transects areas. Among the extrinsic variables analysed, the number of vectors and the presence of infected dogs in neighbouring were positively correlated with the occurrence of infected dogs. Dog size was positively correlated with cVL infection, while the quality of the dog's nutrition affected cVL negatively. As for cutaneous leishmaniasis (CL), the first registry of dogs infected with L. braziliensis in the region shows that there is potential for transmission in peri-urban areas, since environmental conditions allow the proliferation of vectors capable of transmitting this species of parasite. cVL is widely spread in FI, with high prevalence. This supports the hypothesis that the parasite has been present in the region for longer than previously believed, despite the fact that the presence of leishmaniais in the region has only been recognized recently. It is important to control the population of dogs infected with L. infantum (parasite and non-antibodies) to prevent the spread of the disease to other dogs and also to people in the region.

A new whole mitochondrial genome qPCR (WMG-qPCR) with SYBR Green® to identify phlebotomine sand fly blood meals

Phlebotomine sand flies are blood-feeding insects of marked medical and veterinary significance. Investigations on the biology of these insects hold great importance for both ecological and epidemiological purposes. The present work describes a new approach for real-time PCR (qPCR) with SYBR Green^®, named WMG-qPCR, to identify phlebotomine blood meals. The novelty of the assay was to design primers based on the Whole Mitochondrial Genome (WMG) of the potential hosts (human, dog, cat, brown rat and chicken) aiming to amplify through qPCR the regions of mitochondrial DNA (mtDNA) which are less conserved among all species. Initially, the best method for mtDNA extraction to be applied in WMG-qPCR was determined. Afterwards, amplification specificities were accessed by cross-reaction assays with mtDNA samples from all animal species, besides phlebotomine DNA. Finally, the selected primers were also tested for their limit of DNA detection through standard curves constructed by serial dilution of blood DNA obtained for each target animal species. The WMG-qPCR was able to detect as low as 10pL of blood, equivalent to 26, 84, 130, and 320fg DNA of cat, human, dog and rat, respectively. The assay was also capable to amplify as low as 5pL of chicken blood (5pg DNA). In conclusion, WMG-qPCR seems to be a promising tool to identify phlebotomine blood meals, with high species-specificity and sensitivity. Furthermore, as no supplementary techniques are required, this new approach presents minimized costs and simplified technical-training requirements for execution.

SAND FLIES (DIPTERA: PSYCHODIDAE) IN AN ENDEMIC AREA OF LEISHMANIASIS IN AQUIDAUANA MUNICIPALITY, PANTANAL OF MATO GROSSO DO SUL , BRAZIL

The Aquidauana municipality is considered an endemic area of leishmaniasis and an important tourist site in Mato Grosso do Sul State. The aim of this study was to investigate the sand fly fauna in the city of Aquidauana. Captures were carried out twice a month, from April 2012 to March 2014 with automatic light traps and active aspiration, in the peridomicile and domicile of six residences. A total of 9,338 specimens were collected, 3,179 and 6,159 using light traps and active aspiration, respectively. The fauna consisted of: Brumptomyia brumpti, Evandromyia aldafalcaoae, Ev. evandroi, Ev. lenti, Ev. orcyi, Ev. sallesi, Ev. termitophila, Ev. walkeri, Lutzomyia longipalpis and Psathyromyia bigeniculata. The most abundant species captured was Lutzomyia longipalpis, present in all the ecotopes, predominantly in peridomicile areas, and mainly males. Leishmania DNA was not detected in the insects. It was observed the abundance of the sand fly fauna in the region, as well as the high frequency of Lu. longipalpis, the main vector of L. infantum. The results of this study show the need to increase the monitoring and more effective control measures. It is noteworthy that the studied region presents several activities related to tourism and recreation, increasing the risk of transmission of leishmaniasis to this particular human population.

IDENTIFICATION OF SANDFLIES (Diptera: Psychodidae: Phlebotominae) BLOOD MEALS IN AN ENDEMIC LEISHMANIASIS AREA IN BRAZIL

The aim of this study was to identify blood meals of female sandflies captured in the municipality of Governador Valadares, an endemic area of visceral and cutaneous leishmaniasis, in the State of Minas Gerais, Brazil. From May 2011 to January 2012, captures were performed using HP light traps in four districts. There were 2,614 specimens (2,090 males and 524 females) captured; 97 engorged females were identified belonging to the species Lutzomyia longipalpis (82.1%) and Lutzomyia cortelezzii (17.9%). Considering simple and mixed feeding, the enzyme-linked immunosorbent assay revealed a predominance of chicken blood (43.6%) in Lutzomyia longipalpis, showing the important role that chickens exert around the residential areas of Governador Valadares. This finding increases the chances of sandflies contact with other vertebrates and consequently the risk of leishmaniasis transmission.

Feeding Patterns and Xenomonitoring of Trypanosomes among Tsetse Flies around the Gashaka-Gumti National Park in Nigeria

In order to understand the epidemiology of trypanosomoses in Gashaka-Gumti National Park, Nigeria, we determined the density, infection rates, and feeding patterns of tsetse flies using biconical traps, ITS, and mitochondrial cytochrome b PCRs. A total of 631 tsetse flies were captured, of which 531 (84.2%) and 100 (15.8%) were analyzed for trypanosomes and blood meals, respectively. Tsetse distribution varied significantly (p < 0.05) across study sites with average trap and daily catches of 4.39 and 26.34, respectively. Overall tsetse infection rate was 5.08% and ranged between 3.03% and 6.84% across study sites. We identified 10 T. brucei, 3 T. congolense savannah, 2 T. congolense forest, and 2 mixed infections among the 13 pools made from the 27 flies positive for trypanosomes with light microscopy. The distribution of vertebrate blood meals in tsetse flies varied significantly (p < 0.05) and ranged between 6.0% and 45% across hosts. We also observed dual feeding patterns involving at least 2 hosts in 24% and multiple feeding involving at least 3 hosts in 17% of the flies. We observed predominance of G. palpalis which also recorded higher infection rate. T. brucei was more prevalent among tsetse flies. Tsetse flies fed predominantly on cattle and less frequently on humans and also showed mixed feeding habits.

Blood-meal identification in phlebotomine sand flies (Diptera: Psychodidae) from Valle Hermoso, a high prevalence zone for cutaneous leishmaniasis in Ecuador

Cutaneous leishmaniasis is a neglected tropical disease transmitted by phlebotomine sand flies of the genus Lutzomyia. In South America, cutaneous leishmaniasis is endemic in the majority of countries. There are no previous reports of phlebotomine sand fly host feeding sources in Ecuador. We identified blood meal sources for phlebotomine sand fly species in Valle Hermoso, a hyper endemic area for leishmaniasis in Ecuador. Phlebotomine sand fly collections were carried out during the dry and rainy seasons. PCR and multiplex PCR were performed from DNA extracted from the abdomens of blood-fed females to specifically identify the avian and mammalian blood meal sources. Avian-blood (77%), mammalian-blood (16%) and mixed avian-mammalian blood (7%) were found in the samples. At the species level, blood from chickens (35.5%), humans (2.8%), cows (2.8%) and dogs (1.9%) was specifically detected. Nyssomyia trapidoi was the most common species of Lutzomyia found that fed on birds. The present results may aid the development of effective strategies to control leishmaniasis in Ecuador.

Lutzomyia longipalpis urbanisation and control

Since the description of Lutzomyia longipalpis by Lutz and Neiva more than 100 years ago, much has been written in the scientific literature about this phlebotomine species. Soares and Turco (2003) and Lainson and Rangel (2005) have written extensive reviews focused on vector-host-parasite interactions and American visceral leishmaniasis ecology. However, during the last two decades, the success of Lu. longipalpis in colonising urban environments and its simultaneous geographical spreading have led to new theoretical and operational questions. Therefore, this review updates the general information about this species and notes the more challenging topics regarding the new scenario of urbanisation-spreading and its control in America. Here, we summarise the literature on these issues and the remaining unsolved questions, which pose recommendations for operational research.

LeishVet update and recommendations on feline leishmaniosis

Limited data is available on feline leishmaniosis (FeL) caused by Leishmania infantum worldwide. The LeishVet group presents in this report a review of the current knowledge on FeL, the epidemiological role of the cat in L. infantum infection, clinical manifestations, and recommendations on diagnosis, treatment and monitoring, prognosis and prevention of infection, in order to standardize the management of this disease in cats. The consensus of opinions and recommendations was formulated by combining a comprehensive review of evidence-based studies and case reports, clinical experience and critical consensus discussions. While subclinical feline infections are common in areas endemic for canine leishmaniosis, clinical illness due to L. infantum in cats is rare. The prevalence rates of feline infection with L. infantum in serological or molecular-based surveys range from 0% to more than 60%. Cats are able to infect sand flies and, therefore, they may act as a secondary reservoir, with dogs being the primary natural reservoir. The most common clinical signs and clinicopathological abnormalities compatible with FeL include lymph node enlargement and skin lesions such as ulcerative, exfoliative, crusting or nodular dermatitis (mainly on the head or distal limbs), ocular lesions (mainly uveitis), feline chronic gingivostomatitis syndrome, mucocutaneous ulcerative or nodular lesions, hypergammaglobulinaemia and mild normocytic normochromic anaemia. Clinical illness is frequently associated with impaired immunocompetence, as in case of retroviral coinfections or immunosuppressive therapy. Diagnosis is based on serology, polymerase chain reaction (PCR), cytology, histology, immunohistochemistry (IHC) or culture. If serological testing is negative or low positive in a cat with clinical signs compatible with FeL, the diagnosis of leishmaniosis should not be excluded and additional diagnostic methods (cytology, histology with IHC, PCR, culture) should be employed. The most common treatment used is allopurinol. Meglumine antimoniate has been administered in very few reported cases. Both drugs are administered alone and most cats recover clinically after therapy. Follow-up of treated cats with routine laboratory tests, serology and PCR is essential for prevention of clinical relapses. Specific preventative measures for this infection in cats are currently not available.

Identification of phlebotomine sand fly blood meals by real-time PCR

Background

Phlebotomine sand flies are blood-feeding insects of great medical and veterinary significance acting as vectors of Leishmania parasites. Studying the blood-feeding pattern of these insects may help in the understanding of their interactions with potential reservoir hosts of Leishmania parasites. In this study, we developed real time PCR assays for the identification of sand fly blood meal.

Methods

Six pairs of primers were designed based on cytochrome b gene sequences available in GenBank of the following potential hosts: dog, cat, horse, chicken, black rat, and human. Firstly, SYBR Green-based real time PCR assays were conducted using a standard curve with eight different concentrations (i.e., 10 ng, 1 ng, 100 pg, 10 pg, 1 pg, 100 fg, 10 fg and 1 fg per 2 μl) of DNA samples extracted from EDTA blood samples from each target animal. Then, DNA samples extracted from field-collected engorged female sand flies belonging to three species (i.e., Lutzomyia longipalpis, L. migonei and L. lenti) were tested by the protocols standardized herein. Additionally, female sand flies were experimentally fed on a black rat (Rattus rattus) and used for evaluating the time course of the detection of the protocol targeting this species.

Results

The protocols performed well with detection limits of 10 pg to 100 fg. Field-collected female sand flies were fed on blood from humans (73%), chickens (23%), dogs (22%), horses (15%), black rats (11%) and cats (2%). Interestingly, 76.1% of the L. longipalpis females were positive for human blood. In total, 48% of the tested females were fed on single sources, 31% on two and 12% on three. The analysis of the time course showed that the real time PCR protocol targeting the black rat DNA was able to detect small amounts of the host DNA up to 5 days after the blood meal.

Conclusions

The real time PCR assays standardized herein successfully detected small amounts of host DNA in female sand flies fed on different vertebrate species and, specifically for the black rats, up to 5 days after the blood meal. These assays represent promising tools for the identification of blood meal in field-collected female sand flies.

Knowledge of the population about visceral leishmaniasis transmission in endemic areas near the banks of the Mossoró River in northeastern Brazil

Visceral leishmaniasis (VL) is an anthropozoonosis with high prevalence and incidence in the Northeastern region of Brazil. This study aimed to determine whether people living near the Mossoró River in the city of Mossoró, Rio Grande do Norte, have knowledge of VL and to characterize the environmental properties of this region. Questionnaires were administered to 478 residents in three neighborhoods near the Mossoró River, addressing the population's knowledge about VL and environmental characteristics. Most survey participants were female, with ages between 18 and 40 years, 53.8% had completed primary education, and 61.5% owned pet dogs (p<0.05). The majority (95.9%) showed little knowledge about the characteristics inherent to sandflies, and 85.3% were unaware of the environments preferred by this vector (p<0.05). Sewage from the homes of respondents was mainly dumped into the river (44.6%), and 76.6% of the respondents complained about the accumulation of garbage in the streets (p<0.05). The association between education and knowledge about the transmission of VL and preferred vector locations was statistically significant (p<0.05). The lack of knowledge in the population about VL and the residential environment indicates a risk of maintaining sand fly habitats and hence disease transmission.

Leishmaniosis of companion animals in Europe: an update

Leishmaniosis caused by Leishmania infantum is a vector-borne zoonotic disease endemic in southern Europe, but which is spreading northwards. Millions of dogs, cats and other non-conventional companion animals susceptible to L. infantum, living in European households, may develop a severe disease and contribute to the spread of leishmaniosis because of travelling or re-homing. Dogs are the main reservoir but other new reservoirs have recently been incriminated. Sand flies remain the sole proven vector and non-vectorial transmission has been reported at individual level and in areas where the vector is absent. Clinical disease affects only a proportion of infected dogs and a complex genetic background of immune response is responsible for this susceptibility. There is a wide range of serological and parasitological diagnostic tools available whose cost-effective use depends on a reasoned approach. Clinical response to treatment of sick dogs is variable. Clinical cure is often obtained but clinical recurrence can occur and post-therapy follow up should be maintained life-long. In Europe, vaccination can be combined with individual protection with pyrethroids as part of an integrated approach to prevention. L. infantum is the only species isolated from cats in Europe and xenodiagnosis substantiated that infected cats are infectious for sand flies. Feline infection may be frequent in endemic areas, but prevalence is generally lower than in dogs. When cats are tested by both serological and molecular techniques discordant results are often observed. Feline cases have been reported from endemic areas in Italy, France, Spain and Portugal, but four cases were also diagnosed in Switzerland in cats that had travelled to or been imported from Spain. Half of the cases were diagnosed in cats with impaired immune responses. Clinical manifestations compatible with feline leishmaniosis include lymph node enlargement, skin and mucocutaneous lesions, ocular lesions, chronic gingivostomatitis, hypergammaglobulinemia, and normocytic normochromic anemia. Cats have been empirically treated with some drugs used in dogs. Due to polymorphic clinical picture and the insidious progressive course, leishmaniosis can persist for a long time before dogs or cats are brought to a veterinarian and so diagnosis can be delayed. Exotic or new Leishmania spp. have been reported in humans, animals and vectors in Europe. This changing situation requires attention in Europe for designing epidemiological studies and control measures.

Phlebotomine fauna, natural infection rate and feeding habits of Lutzomyia cruzi in Jaciara, state of Mato Grosso, Brazil

Visceral leishmaniasis (VL) in Brazil is transmitted by the phlebotomine Lutzomyia longipalpis and in some midwestern regions by Lutzomyia cruzi. Studies of the phlebotomine fauna, feeding habits and natural infection rate by Leishmania contribute to increased understanding of the epidemiological chain of leishmaniases and their vectorial capacity. Collections were performed in Jaciara, state of Mato Grosso from 2010-2013, during which time 2,011 phlebotomines (23 species) were captured (68.70% Lu. cruzi and 20.52% Lutzomyia whitmani). Lu. cruzi females were identified by observing the shapes of the cibarium (a portion of the mouthpart) and spermatheca, from which samples were obtained for polymerase chain reaction to determine the rates of natural infection. Engorged phlebotomines were assessed to identify the blood-meal host by ELISA. A moderate correlation was discovered between the number of Lu. cruzi and the temperature and the minimum rate of infection was 6.10%. Twenty-two females were reactive to the antisera of bird (28%), dog (3.30%) and skunk (1.60%). We conclude that Lu. cruzi and Lu. whitmani have adapted to the urban environment in this region and that Lu. cruzi is the most likely vector of VL in Jaciara. Moreover, maintenance of Leishmania in the environment is likely aided by the presence of birds and domestic and synanthropic animals.

Feeding preferences of Lutzomyia longipalpis (Diptera: Psychodidae), the sand fly vector, for Leishmania infantum (Kinetoplastida: Trypanosomatidae)

Leishmania infantum, the causative agent of visceral leishmaniasis (VL) in Brazil, is spread mostly by the bite of the sand fly Lutzomyia longipalpis (Lutz & Neiva). We trapped sand flies in endemic neighborhoods near Natal, Brazil, where cases of human and dog VL were documented. Amplification of species-specific cytochrome b (Cyt b) genes by polymerase chain reaction revealed that sand flies from rural and periurban areas harbored blood from different sources. The most common source ofbloodmeal was human, but blood from dog, chicken, and armadillo was also present. We tested the preference for a source of bloodmeal experimentally by feeding L. longipalpis F1 with blood from different animals. There were significant differences between the proportion of flies engorged and number of eggs laid among flies fed on different sources, varying from 8.4 to 19 (P < 0.0001). Blood from guinea pig or horse was best to support sand fly oviposition, but human blood also supported sand fly oviposition well. No sand flies fed on cats, and sand flies feeding on the opossum Monodelphis domestica Wagner produced no eggs. These data support the hypothesis that L. longipalpis is an eclectic feeder, and humans are an important source of blood for this sand fly species in periurban areas of Brazil.