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Ortiz de Frutos J, Serra Baldrich E, Tribó Boixareu MJ, Armario Hita JC, Carrascosa Carrillo JM, Nart IF, Menéndez ÁF, Pinto PH, Francisco Silvestre J. Consensus on the diagnostic algorithm for chronic nodular prurigo. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00342-9. [PMID: 38663729 DOI: 10.1016/j.ad.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/08/2024] [Accepted: 03/17/2024] [Indexed: 05/25/2024] Open
Abstract
Chronic nodular prurigo (CNP) is a chronic dermatological disease characterized by the presence of chronic pruritus and pruritic nodular lesions. The aim of this study was to reach consensus among a group of experts based on a non-systematic literature review and an algorithm for the clinical diagnosis of CNP. The resulting algorithm is structured in 3 blocks: 1) early identification of the patient with a possible diagnosis of CNP; 2) diagnosis and assessment of CNP; and 3) categorization of CNP (identification of the underlying causes or associated comorbidities). We believe that this clinical algorithm can facilitate the correct diagnosis of patients with CNP. Additionally, it raises awareness on the need for a multidisciplinary approach and specific treatment of CNP, steps of paramount importance to make better therapeutic decisions.
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Affiliation(s)
| | | | | | | | - J M Carrascosa Carrillo
- Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona (UAB), Instituto de Investigación Germans Trias i Pujol (IGTP), Badalona, España
| | | | - Á Flórez Menéndez
- Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | | | - J Francisco Silvestre
- Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
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Bi K, Li X, Zhang R, Zheng X, Wang F, Zou Y, Wang L. Clinical and laboratory characterization of cutaneous leishmaniasis in Chinese migrant workers returned from Iraq. PLoS Negl Trop Dis 2024; 18:e0012006. [PMID: 38437246 PMCID: PMC10939275 DOI: 10.1371/journal.pntd.0012006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/14/2024] [Accepted: 02/16/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Imported cutaneous leishmaniasis (CL) is a growing problem with increasing global travel to endemic areas. Returned travelers with CL are easy to be misdiagnosed and mistreated due to the lack of awareness for the disease to the physicians in non-endemic region that may lead to unfavorable outcome. Our study intends to summarize the characteristics of Leishmania infection imported from Iraq, so as to help Chinese physicians diagnose and treat the disease. All CL patients were treated with intralesional injection of antimony. METHODS The definitive diagnosis of CL is based on the parasite identification by microscopic examination directly on lesion smear or parasite culture, PCR amplification of Leishmania-specific internal transcribed spacer 1 (ITS-1). The phylogenetic analysis, the immunopathological examination and the cytokine detection were proceeded after the diagnosis. RESULTS We have identified 25 CL cases in migrant Chinese workers returned from Iraq for the first time with L. major as the major species of infected Leishmania parasite. Clinical features of the Iraq-imported CL include the history of skin exposure to sandflies bite and the lesions mostly on the exposed limbs. More ulcerative wet lesion was observed than nodular dry lesion. PCR is not only used to detect Leishmania parasite with high sensitivity, but also to identify the species of infected parasite through sequencing the amplified Leishmania-specific ITS-1 gene. The phylogenetic analysis based on the amplified ITS-1 sequences revealed that the infected Leishmania was closed related to the species and strains endemic in Iraq. The immunopathological examination revealed the T-cell filtrated cellular immune response with less B cells and NK cells involved. The cytokine profile measured in the skin lesion also confirmed the Th1 cellular response with higher expression levels of IFN-γ, IL-6 and IL-8. The skin lesions in CL patients were healed after being treated locally with antimony. CONCLUSIONS The clinical and parasitological features of these Chinese CL cases imported from Iraq provide useful information for the diagnosis and treatment of CL that is not commonly seen in Chinese local population.
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Affiliation(s)
- Kuo Bi
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Xiaoli Li
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Rui Zhang
- Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
| | - Xiaoyan Zheng
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Fei Wang
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Yang Zou
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
| | - Lei Wang
- Beijing Institute of Tropical Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China
- Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, PR China
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Abstract
In this work we reviewed historical and recent data on Leishmania spp. infection combining data collected in Turkmenistan, Uzbekistan, Kazakhstan, Kyrgyzstan, Iran, China and Mongolia. We specifically focused on a complex of co-existing species (Leishmania major, Leishmania turanica and Leishmania gerbilli) sharing the same animal reservoirs and vectors. In addition, we analysed the presence of dsRNA viruses in these species and discussed future research directions to identify species-specific traits, which may determine susceptibility of different Leishmania spp. to viral infection.
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Matrix-assisted laser desorption ionization time-of-flight mass spectrometry: An effective method for identification and phylogenetic analysis of Leishmania species. Exp Parasitol 2022; 240:108278. [PMID: 35764122 DOI: 10.1016/j.exppara.2022.108278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a rapid and reproducible method that has been widely applied for the identification of bacteria and fungi. However, this technique has not yet been applied in clinical laboratories for parasitology, such as for the study of the protozoan Leishmania. METHODOLOGY By using MALDI-TOF MS, mass spectra database entries (MSPs) were created with 7 World Health Organization reference strains in order to establish a rapid method for Leishmania species identification. Furthermore, cluster analysis was performed with 18 Chinese Leishmania isolates. PRINCIPAL FINDINGS The MSPs of Leishmania corresponded well with our past identification results, and the dendrogram analysis result was more or less similar to that of the phylogenetic analysis performed by multi-locus sequence typing. CONCLUSIONS/SIGNIFICANCE MALDI-TOF MS is a promising method that offers both rapidity and efficiency for the identification and dendrogram analysis of Leishmania species.
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Mutation Characteristics and Phylogenetic Analysis of Five Leishmania Clinical Isolates. Animals (Basel) 2022; 12:ani12030321. [PMID: 35158645 PMCID: PMC8833617 DOI: 10.3390/ani12030321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Leishmaniasis, a neglected tropical disease, is caused by infection with the Leishmania species, threatening millions of people in approximately 100 endemic countries. The emergence of antimony-resistant Leishmania strains have brought difficulties to the treatment and elimination of leishmaniasis. This study performed genome-wide resequencing and phylogenetic analysis of five isolates from the Leishmania donovani complex, focusing on finding mutations related to antimony resistance and virulence of the newly isolated Leishmania strain L_HCZ in 2016. By combining whole-genome sequencing and whole-genome phylogenetic analysis, Leishmania isolates L_801, L_9044 and L_Liu were identified as Leishmania donovani, and L_HCZ as Leishmania infantum. By discovering genome-wide single-nucleotide polymorphisms and structural variations, we identified mutations of drug resistance-related genes in the antimony-resistant Leishmania isolate L_HCZ. The new Leishmania isolate L_HCZ has strong virulence and strong drug resistance, which should be taken seriously by the relevant health departments and scientific researchers. Abstract Leishmaniasis is a neglected tropical disease threatening millions of people worldwide. The emergence of antimony-resistant Leishmania strains have brought difficulties to the treatment and elimination of leishmaniasis. This study performed genome sequencing, phylogenetic analysis and mutation analysis of five Leishmania clinical isolates, especially the Leishmania strain L_HCZ isolated in 2016, which shows strong virulence and antimony resistance. By phylogenetic analysis, four isolates (L_DD8, L_801, L_Liu and L_9044) were identified as Leishmania donovani, the isolate L_HCZ was identified as Leishmania infantum and the isolate L_DD8 as a standard strain of L.donovani. Genome-wide mutation analysis was applied to identify mutations related to the drug resistance and virulence of the newly isolated L_HCZ. Compared with the other four Leishmania isolates, L_HCZ had the most mutations in genes associated with antimony resistance, including the ABC transporter, ascorbate-dependent peroxidase, gamma–glutamylcysteine synthetase, glucose-6-phosphate 1-dehydrogenase, ATP-binding cassette protein subfamily A and multi-drug resistance protein-like genes. Among the genes associated with virulence, L_HCZ had the most mutations in cysteine peptidase A, cysteine peptidase B, cysteine peptidase C, heat-shock protein 70, gp63, acid phosphatase, kinesin k39, kinesin, phosphoglycan beta 1, amastin-like surface protein and amastin-like proteins. The mutations in L_HCZ might possibly contribute to its antimony resistance and strong virulence in clinical patients. Whole-genome resequencing has exhibited broad application prospects and may be put into clinical use in the future for parasite identifying and epidemiological investigations.
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Shoraka HR, Taheri Soodejani M, Allah Kalteh E, Chegeni M, Mahmudimanesh M, Sofizadeh A. Prevalence of Leishmania major Yakimoff and Schokhor (Kinetoplastida: Trypanosomatidae) in Sandflies in Iran: A Systematic Review and Meta-Analysis. JOURNAL OF MEDICAL ENTOMOLOGY 2021; 58:26-36. [PMID: 33078837 DOI: 10.1093/jme/tjaa185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Indexed: 06/11/2023]
Abstract
Cutaneous leishmaniasis is an important parasitic and vector-borne disease in Iran and can be transmitted to humans and animals through bites of infected female sand flies. The present study aimed to determine the pooled prevalence of Leishmania major in sand flies in Iran. A systematic review and meta-analysis was performed in the present study, so that databases, namely PubMed, Web of Sciences, Science Direct, ProQuest, Embase, Cochrane Reviews, and Scopus as well as IranDoc, SID, Elmnet, and Magiran were searched for finding Persian articles. Inclusion criteria of study contained the study in Iran and investigation of L. major parasite in sand flies. The quality of studies was examined by Joanna Briggs Institute Critical Appraisal Checklist for studies that reported prevalence data; and the data were analyzed by Stata 14 software. In total, 42 studies were evaluated, all of which had investigated the infection of Phlebotomus papatasi Scopoli (Diptera: Psychodidae). The infection of Phlebotomus caucasicus group was investigated in 13 studies, Phlebotomus ansarii Lewis in four studies, Phlebotomus salehi Mesghali and Rashti in five studies, and the infection of other species of sandflies in seven studies. According to the meta-analysis, the pooled prevalence of Ph. papatasi, Ph. caucasicus group, Ph. salehi, and Ph. ansarii were equal to 2.4, 6.2, 1.6, and 9.2%, respectively, with 95% confidence interval. According to reports of different rates of sand fly infection in different regions, all studies should have certain and standard forms and formats to determine the pooled prevalence of sand fly infection.
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Affiliation(s)
- Hamid Reza Shoraka
- Vector-borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Moslem Taheri Soodejani
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ehsan Allah Kalteh
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Maryam Chegeni
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran
| | - Marzieh Mahmudimanesh
- Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran
| | - Aioub Sofizadeh
- Infectious Disease Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Qian MB, Chen J, Bergquist R, Li ZJ, Li SZ, Xiao N, Utzinger J, Zhou XN. Neglected tropical diseases in the People's Republic of China: progress towards elimination. Infect Dis Poverty 2019; 8:86. [PMID: 31578147 PMCID: PMC6775666 DOI: 10.1186/s40249-019-0599-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/20/2019] [Indexed: 02/08/2023] Open
Abstract
Since the founding of the People’s Republic of China in 1949, considerable progress has been made in the control and elimination of the country’s initial set of 11 neglected tropical diseases. Indeed, elimination as a public health problem has been declared for lymphatic filariasis in 2007 and for trachoma in 2015. The remaining numbers of people affected by soil-transmitted helminth infection, clonorchiasis, taeniasis, and echinococcosis in 2015 were 29.1 million, 6.0 million, 366 200, and 166 100, respectively. In 2017, after more than 60 years of uninterrupted, multifaceted schistosomiasis control, has seen the number of cases dwindling from more than 10 million to 37 600. Meanwhile, about 6000 dengue cases are reported, while the incidence of leishmaniasis, leprosy, and rabies are down at 600 or fewer per year. Sustained social and economic development, going hand-in-hand with improvement of water, sanitation, and hygiene provide the foundation for continued progress, while rigorous surveillance and specific public health responses will consolidate achievements and shape the elimination agenda. Targets for poverty elimination and strategic plans and intervention packages post-2020 are important opportunities for further control and elimination, when remaining challenges call for sustainable efforts.
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Affiliation(s)
- Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Jin Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | | | - Zhong-Jie Li
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Ning Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Key Laboratory of Parasite and Vector Biology, Ministry of Health, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, WHO Collaborating Center for Tropical Diseases, Shanghai, People's Republic of China.
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8
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Zhang JR, Guo XG, Liu JL, Zhou TH, Gong X, Chen DL, Chen JP. Molecular detection, identification and phylogenetic inference of Leishmania spp. in some desert lizards from Northwest China by using internal transcribed spacer 1 (ITS1) sequences. Acta Trop 2016; 162:83-94. [PMID: 27338182 DOI: 10.1016/j.actatropica.2016.06.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/19/2016] [Accepted: 06/19/2016] [Indexed: 10/21/2022]
Abstract
Leishmaniasis caused by Leishmania is still endemic in Northwest China. It has been thought that reptiles could be a reservoir for mammalian leishmaniasis. However, data are still scarce on natural infection of lizards with Leishmania spp. in China. The present study deals with detection, identification and phylogenetic inference of Leishmania parasites at species and intraspecies levels isolated from six desert lizard species from 10 geographical locations in Northwest China using amplification and sequencing of ITS-rDNA. In total, 83 haplotypes were found among 137 ITS1 sequences obtained from up to 64.6% of all captured lizards. Representative sequences of Leishmania available in GenBank were compiled for comparison with the obtained haplotypes. Tree-based species delimitation was achieved by using Bayesian phylogenitc analyses and maximum parsimony approach. Phylogenetic trees congruently supported that the haplotypes were found to belong to three Leishmania species including L. (sauroleishmania) sp., Leishmania tropica and Leishmania donovani complex. A network approach revealed paraphyletic populations of L. (sauroleishmania) sp. and L. tropica at intraspecies level regarding geographical origin and low host specificity. Chinese L. tropica from lizards showed significant heterogeneity as the obtained haplotypes were distributed in different clusters from other countries. Common ancestry was observed between some sequences of L. tropica from lizards and other sequence types from clinical samples from other countries. This may lend support to the potential reservoir role of lizards for human leishmaniasis. Our results appear to be the first molecular evidence for natural infection of lizards in Northwest China with reptilian Leishmania and mammalian Leishmania species. Desert lizards may be considered as putative reservoir hosts for Leishmania in China. Further studies on persistence of the Leishmania parasites in lizards and sandflies are recommended for the better understanding of their epidemiological involvement.
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Wang JL, Li TT, Huang SY, Cong W, Zhu XQ. Major parasitic diseases of poverty in mainland China: perspectives for better control. Infect Dis Poverty 2016; 5:67. [PMID: 27476746 PMCID: PMC4967992 DOI: 10.1186/s40249-016-0159-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 06/20/2016] [Indexed: 02/07/2023] Open
Abstract
Significant progress has been made in the prevention, control, and elimination of human parasitic diseases in China in the past 60 years. However, parasitic diseases of poverty remain major causes of morbidity and mortality, and inflict enormous economic costs on societies.In this article, we review the prevalence rates, geographical distributions, epidemic characteristics, risk factors, and clinical manifestations of parasitic diseases of poverty listed in the first issue of the journal Infectious Diseases of Poverty on 25 October 2012. We also address the challenges facing control of parasitic diseases of poverty and provide suggestions for better control.
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Affiliation(s)
- Jin-Lei Wang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046 People’s Republic of China
| | - Ting-Ting Li
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046 People’s Republic of China
| | - Si-Yang Huang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046 People’s Republic of China
| | - Wei Cong
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046 People’s Republic of China
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046 People’s Republic of China
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Lun ZR, Wu MS, Chen YF, Wang JY, Zhou XN, Liao LF, Chen JP, Chow LMC, Chang KP. Visceral Leishmaniasis in China: an Endemic Disease under Control. Clin Microbiol Rev 2015; 28:987-1004. [PMID: 26354822 PMCID: PMC4575399 DOI: 10.1128/cmr.00080-14] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Visceral leishmaniasis (VL) caused by Leishmania spp. is an important vector-borne and largely zoonotic disease. In China, three epidemiological types of VL have been described: anthroponotic VL (AVL), mountain-type zoonotic VL (MT-ZVL), and desert-type ZVL (DT-ZVL). These are transmitted by four different sand fly species: Phlebotomus chinensis, P. longiductus, P. wui, and P. alexandri. In 1951, a detailed survey of VL showed that it was rampant in the vast rural areas west, northwest, and north of the Yangtze River. Control programs were designed and implemented stringently by the government at all administrative levels, resulting in elimination of the disease from most areas of endemicity, except the western and northwestern regions. The control programs consisted of (i) diagnosis and chemotherapy of patients, (ii) identification, isolation, and disposal of infected dogs, and (iii) residual insecticide indoor spraying for vector control. The success of the control programs is attributable to massive and effective mobilization of the general public and health workers to the cause. Nationally, the annual incidence is now very low, i.e., only 0.03/100,000 according to the available 2011 official record. The overwhelming majority of cases are reported from sites of endemicity in the western and northwestern regions. Here, we describe in some depth and breadth the current status of epidemiology, diagnosis, treatment, and prevention of the disease, with particular reference to the control programs. Pertinent information has been assembled from scattered literature of the past decades in different languages that are not readily accessible to the scientific community. The information provided constitutes an integral part of our knowledge on leishmaniasis in the global context and will be of special value to those interested in control programs.
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Affiliation(s)
- Zhao-Rong Lun
- Center for Parasitic Organisms, Key Laboratory of Gene Engineering of the Ministry of Education, State Key Laboratory of Biocontrol, School of Life Sciences, and Key Laboratory of Tropical Disease Control of the Ministry of Education, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Ming-Shui Wu
- Center for Parasitic Organisms, Key Laboratory of Gene Engineering of the Ministry of Education, State Key Laboratory of Biocontrol, School of Life Sciences, and Key Laboratory of Tropical Disease Control of the Ministry of Education, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yun-Fu Chen
- Center for Parasitic Organisms, Key Laboratory of Gene Engineering of the Ministry of Education, State Key Laboratory of Biocontrol, School of Life Sciences, and Key Laboratory of Tropical Disease Control of the Ministry of Education, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jun-Yun Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, the Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, the Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
| | - Li-Fu Liao
- Center for Disease Control and Prevention of Xinjiang and Research Center for Laboratory Animals of Xinjiang, Urumqi, Xinjiang, People's Republic of China
| | - Jian-Ping Chen
- Department of Parasitology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Larry M C Chow
- Department of Applied Biology and Chemical Technology and the State Key Laboratory for Chirosciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, People's Republic of China
| | - Kwang Poo Chang
- Department of Microbiology/Immunology, Chicago Medical School/Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
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11
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Babuadze G, Alvar J, Argaw D, de Koning HP, Iosava M, Kekelidze M, Tsertsvadze N, Tsereteli D, Chakhunashvili G, Mamatsashvili T, Beria N, Kalandadze I, Ejov M, Imnadze P. Epidemiology of visceral leishmaniasis in Georgia. PLoS Negl Trop Dis 2014; 8:e2725. [PMID: 24603768 PMCID: PMC3945224 DOI: 10.1371/journal.pntd.0002725] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 01/19/2014] [Indexed: 11/24/2022] Open
Abstract
This study investigated the transmission and prevalence of Leishmania parasite infection of humans in two foci of Visceral Leishmaniasis (VL) in Georgia, the well known focus in Tbilisi in the East, and in Kutaisi, a new focus in the West of the country. The seroprevalence of canine leishmaniasis was investigated in order to understand the zoonotic transmission. Blood samples of 1575 dogs (stray and pet) and 77 wild canids were tested for VL by Kalazar Detect rK39 rapid diagnostic tests. Three districts were investigated in Tbilisi and one in Kutaisi. The highest proportions of seropositive pet dogs were present in District #2 (28.1%, 82/292) and District #1 (26.9%, 24/89) in Tbilisi, compared to 17.3% (26/150) of pet dogs in Kutaisi. The percentage of seropositive stray dogs was also twice as high in Tbilisi (16.1%, n = 670) than in Kutaisi (8%, n = 50); only 2/58 wild animals screened were seropositive (2. 6%). A total of 873 Phlebotomine sand flies were collected, with 5 different species identified in Tbilisi and 3 species in Kutaisi; 2.3% of the females were positive for Leishmania parasites. The Leishmanin Skin Test (LST) was performed on 981 human subjects in VL foci in urban areas in Tbilisi and Kutaisi. A particularly high prevalence of LST positives was observed in Tbilisi District #1 (22.2%, 37.5% and 19.5% for ages 5-9, 15-24 and 25-59, respectively); lower prevalence was observed in Kutaisi (0%, 3.2% and 5.2%, respectively; P<0.05). This study shows that Tbilisi is an active focus for leishmaniasis and that the infection prevalence is very high in dogs and in humans. Although exposure is as yet not as high in Kutaisi, this is a new VL focus. The overall situation in the country is alarming and new control measures are urgently needed.
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Affiliation(s)
- Giorgi Babuadze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
- Ilia State University, Tbilisi, Georgia
| | - Jorge Alvar
- WHO/NTD/Leishmaniasis Program, Geneva, Switzerland
| | - Daniel Argaw
- World Health Organization/NTD, Geneva, Switzerland
| | - Harry P. de Koning
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Merab Iosava
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Merab Kekelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Nikoloz Tsertsvadze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - David Tsereteli
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | | | - Tamar Mamatsashvili
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Nino Beria
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Irine Kalandadze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Mikhail Ejov
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Paata Imnadze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
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