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Dewasurendra R, Samaranayake N, Silva H, Manamperi N, Senerath U, Senanayake S, de Silva N, Karunanayake P, Zhou G, Karunaweera N. Risk Factor Analysis of Cutaneous Leishmaniasis in Sri Lanka through a Nationwide Survey. Am J Trop Med Hyg 2024; 110:1110-1116. [PMID: 38593788 PMCID: PMC11154038 DOI: 10.4269/ajtmh.23-0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/16/2023] [Indexed: 04/11/2024] Open
Abstract
Leishmaniasis in Sri Lanka was first reported in the early 1990s. Cutaneous leishmaniasis (CL) cases have markedly increased in recent years, demanding due attention from health authorities. The spatial distribution of CL is not homogeneous. This case-control study investigated factors that may contribute to this heterogeneous distribution through a nationwide study. Information on sociodemographic, economic, and environmental characteristics was collected from study participants (cases, n = 303; controls, n = 2,762). All individuals were followed up for 3 years, and signs of CL or associated complications were recorded. Differences in possible risk factors between cases and controls were analyzed. Individuals <18 years old, electricity supply, spending >2 hours outdoors, visiting jungles/water bodies, and living near CL patients were identified as risk factors. Household members of 1.3% of cases, 2.3% of controls residing within a perimeter of 500 m from a patient, and 0.8% of controls living beyond 2 km from a case developed CL. Thus, CL in Sri Lanka appears intertwined with living environment and host behavior. Common environmental factors may be responsible for the higher risk of CL in individuals living in close proximity to CL patients. This may at least partly explain the clustering of CL cases in selected areas of the country.
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Affiliation(s)
- Rajika Dewasurendra
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nilakshi Samaranayake
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Hermali Silva
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nuwani Manamperi
- Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Upul Senerath
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sanath Senanayake
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nissanka de Silva
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayawardenapura, Nugegoda, Sri Lanka
| | - Panduka Karunanayake
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Guofa Zhou
- Department of Population Health and Disease Prevention, University of California, Irvine, California
| | - Nadira Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Bantie B, Kassaw G, Demelash AT, Abate MW, Nigat AB, Amare AT, Birlie TA, Tasew SF, Zeleke S, Kassie A, Tantigegn S, Ambaw LA, Muhamed AN, Melese BD. Magnitude and associated factors of cutaneous leishmaniasis among patients visiting Nefas Mewcha primary hospital, Northern Ethiopia, 2022: An institution-based Cross-sectional study. BMJ Open 2024; 14:e075549. [PMID: 38176880 PMCID: PMC10773395 DOI: 10.1136/bmjopen-2023-075549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is the most common neglected tropical disease, causing stigmatised skin lesions. It is an important public health concern, with 95% of cases occurring in low-income and middle-income countries. Despite its long-recognized endemicity and psychosocial impacts, it is largely overlooked. OBJECTIVE The main aim of this study is to investigate the magnitude and associated factors of CL in north-central Ethiopia. DESIGN An institution-based cross-sectional study was conducted. SETTING The study was conducted in Nefas Mewcha Primary Hospital (NMPH), north-central Ethiopia. PARTICIPANTS The study was conducted among 332 individuals visiting NMPH from June to July 2022. PRIMARY AND SECONDARY OUTCOMES The primary outcome was to estimate the burden of CL among patients visiting NMPH, and the secondary outcome was to identify factors associated with the presence or absence of CL. The association between predictor variables and CL was assessed using a binary logistic regression model. Statistical significance was declared at a p _value of <0.05. RESULT Out of the 332 study participants, 63 patients sought medical care with skin lesions, and 61 (18.37%, 95% CI: 14.5% to 22.9%) were patients with CL. Localized CL was the predominant type (86.9%). Male sex (adjusted OR (AOR): 4.51; 95% CI 1.94 to 10.45), older age (AOR 0.91, 95% CI: 0.87 to 0.94), secondary and tertiary educational status (AOR: 0.18, 95% CI: 0.05 to 0.6), poor knowledge of CL (AOR: 4.02, 95% CI: 1.81 to 9.76) and living with domestic animals (AOR: 5.29, 95% CI 3.24 to 7.5) were identified as predictors of CL. CONCLUSION In the study area, the magnitude of CL was found to be high. Being male and young, having low educational status, having poor knowledge and living with domestic animals increase the risk of acquiring CL. As a result, increasing the knowledge of the community through scaling up of health education programmes and reducing activities that increase individuals' exposure to sandflies should be prioritised.
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Affiliation(s)
- Berihun Bantie
- -Department of Comprhensive Nursing, College of Health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gebrie Kassaw
- -Department of Comprhensive Nursing, College of Health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Agmasie Tigabu Demelash
- -Department of Comprhensive Nursing, College of Health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Moges Wubneh Abate
- -Department of Comprhensive Nursing, College of Health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Adane Birhanu Nigat
- -Department of Comprhensive Nursing, College of Health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abraham Tsedalu Amare
- -Department of Comprhensive Nursing, College of Health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tekalign Amera Birlie
- Department of Comprehensive Nursing, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | | | - Shegaw Zeleke
- -Department of Comprhensive Nursing, College of Health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ayalew Kassie
- Department of Nursing, Bahir Dar Health Science College, Bahir Dar, Ethiopia
| | - Sharie Tantigegn
- Department of Public Health, Debre Markos University College of Health Science, Debre Markos, Amhara, Ethiopia
| | - Lidiya Anteneh Ambaw
- Department of Comprehensive Nursing, Debere Tabor University, Northwest, Ethiopia
| | - Ahmed Nuru Muhamed
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, SNNPR, Ethiopia
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Al-Dhafiri M, Alhajri A, Alwayel ZA, Alturaiki JA, Bu Izran SA, Alhammad FA, Aljumaiah RM. Cutaneous Leishmaniasis Prevalence and Clinical Overview: A Single Center Study from Saudi Arabia, Eastern Region, Al-Ahsa. Trop Med Infect Dis 2023; 8:507. [PMID: 38133439 PMCID: PMC10748161 DOI: 10.3390/tropicalmed8120507] [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: 10/03/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023] Open
Abstract
Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease that is transmitted via the bites of infected female sandflies. CL has been endemic in several countries worldwide for many decades, and numerous cases have been reported in Saudi Arabia, particularly across six regions; one of which is AL-Ahsa. Our research aimed to evaluate the epidemiological situation of CL among the patients in Al-Ahsa, Eastern region, Kingdom of Saudi Arabia, during the period from 2017 to 2023. The data were collected from the patients' registries and included 245 patients who were diagnosed with CL in Al-Ahsa, Saudi Arabia. Fewer than half of the cases (47.8%) were Saudi patients, with a significant number of them being males (84.5%). Over half of the cases (52.7%) were aged between 21 and 40 years, and about three-quarters (74.7%) of the cases resided in rural areas. Regarding the nature of the lesions, 38.4% of the cases had one lesion, which was mainly distributed on a lower extremity (62.0%) or an upper extremity (52.2%). A high percentage of the lesions (75.2%) were wet lesions and caused by L. major. Concerning risk factors, a greater number of patients (71.4%) had been in rural areas within the last three months. Additionally, more than half of the cases (54.3%) had close contact with rodents, followed by birds (28.2%), sheep (22.0%), dogs (16.3%), and other animals (1.2%). The results showed a low number of reported CL cases in 2020 and 2021, followed by a surge in 2022 and 2023. The study shows that cutaneous leishmaniasis is still a public health problem in Al-Ahsa and is primarily associated with rural areas.
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Affiliation(s)
- Mahdi Al-Dhafiri
- Department of Dermatology, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Abdulmohsen Alhajri
- Department of Dermatology, King Fahad Hospital, Al-Ahsa 31982, Saudi Arabia;
| | - Zahraa Ali Alwayel
- General Practitioner, The Ministry of Health, Al-Ahsa 31982, Saudi Arabia
| | | | - Shaima Ali Bu Izran
- Internal Medicine Resident, King Fahad Hospital, Al-Ahsa 31982, Saudi Arabia (R.M.A.)
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ULLAH Z, SAMAD F, BANO R, ARIF S, ZAMIR S, AZIZ N, KHAN H. Characterizing cutaneous leishmaniasis in a conflict-affected region: a study from North Waziristan, Pakistan. Turk J Med Sci 2023; 53:1767-1775. [PMID: 38813502 PMCID: PMC10760576 DOI: 10.55730/1300-0144.5746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/12/2023] [Accepted: 10/10/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim Cutaneous leishmaniasis is an emerging tropical disease that remains a serious public health issue in Pakistan, particularly in North Waziristan. The current research was carried out to investigate the presence of cutaneous leishmaniasis in this region. Materials and methods This prospective observational study was conducted from October 2018 to December 2020 at District Head Quarter Hospital Miranshah in North Waziristan with the collaboration of the Pathology Department of Gomal Medical College Dera Ismail Khan, Khyber Pakhtunkhwa. Needle aspirates were used for the microscopic Giemsa-stained slides. SPSS was used for data analysis. Results Of the 5406 clinically-suspected cases, 2603(48.2%) were positive by microscopic examination. Of these 2603 patients, 1474 (57%) were male and 1129 (43%) were female. Most of the lesions were on the face, followed by upper and lower limbs. The 5-10-year age group had the highest percentage of 1167 (45%). A single lesion affected 96.6% of the patients, while 2.7% had double lesions and 0.7% had triple lesions. A high number of cutaneous leishmaniasis were seen from April to August, while the lowest number was seen November to December. Conclusion This study provides extensive information in relation to the existence of cutaneous leishmaniasis in the North Waziristan district of Pakistan, as well as the detailed demographic features of those affected by the disease.
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Affiliation(s)
- Zahid ULLAH
- Department of Pathology, Gomal Medical College, Dera Ismail Khan,
Pakistan
| | - Fazeelat SAMAD
- Department of Pathology, Gomal Medical College, Dera Ismail Khan,
Pakistan
| | - Rahila BANO
- Department of Pathology, Gomal Medical College, Dera Ismail Khan,
Pakistan
| | - Sarah ARIF
- Department of Pathology, Gomal Medical College, Dera Ismail Khan,
Pakistan
| | - Sher ZAMIR
- Department of Physiology, Gomal Medical College, Dera Ismail Khan,
Pakistan
| | - Nighat AZIZ
- Department of Pharmacology, Gomal Medical College, Dera Ismail Khan,
Pakistan
| | - Hassan KHAN
- Faculty of Pharmacy, Gomal University, Dera Ismail Khan,
Pakistan
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Regmi A, Adhikari B, Karki P, Baral S, Adhikari IR. A rare case of cutaneous leishmaniasis in Kathmandu presenting with features of bacterial skin infection: A case report. Clin Case Rep 2023; 11:e7029. [PMID: 36919149 PMCID: PMC10008277 DOI: 10.1002/ccr3.7029] [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: 08/11/2022] [Revised: 01/13/2023] [Accepted: 02/13/2023] [Indexed: 03/13/2023] Open
Abstract
Leishmaniasis is an infectious disease caused by different species of genus Leishmania and transmitted by sandflies. Lesions of CL are most commonly present in the exposed areas, and the most familiar morphological type is papulo-nodular. The diagnosis of CL should be considered while dealing with common skin lesions, as well as encountering uncommon pathologies. We present a case of a 26-year-old man living in Kathmandu originally from Humla whose clinical course was complicated by unsuccessful treatment with suspicion of bacterial skin infection. The patient first presented with an erythematous papule with some scale and crust with central ulceration over the left side of his upper lip and mild fever. With the suspicion of bacterial infection, he was initially treated with antibiotics, which showed no improvement prompting the referral to a tertiary center with further diagnostic workup. Punch biopsy confirmed the presence of amastigote form of leishmaniasis Donovan bodies. Also, the rk39 antibody test was positive. Clinicians need to pay more effort to the diagnosis of CL and include it in the differential diagnoses of patients presenting with typical lesions even if the region is not known to be endemic for CL or in the patient with no known history of insect bite.
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Affiliation(s)
- Anil Regmi
- Nepal Medical College Teaching Hospital Kathmandu Nepal
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Dewasurendra R, Silva H, Samaranayake N, Manamperi N, de Silva N, Karunanayake P, Senarath U, Senanayake S, Zhou G, Karunaweera N. Assessment of knowledge and perceptions on leishmaniasis: An island-wide study in Sri Lanka. PLoS Negl Trop Dis 2022; 16:e0010821. [PMID: 36228029 PMCID: PMC9560589 DOI: 10.1371/journal.pntd.0010821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a notifiable disease in Sri Lanka with increasing case numbers reported from every part of the country. In addition to disease treatment and vector control measures, knowledge and perceptions in a community are key contributors to a successful intervention program. An island-wide survey was carried out to assess the knowledge and perceptions regarding CL across the island, with 252 confirmed CL cases and 2,608 controls. Data was collected by trained personnel, using a pre-tested Case Reporting Form (CRF). Although the percentage who referred to CL by its correct name was low (1.4%), majority stated that it is a fly induced skin disease (79.1%). Knowledge on the symptoms, curability and the name of the vector was high in these communities, but specific knowledge on vector breeding places, biting times and preventive methods were poor. The patients were more knowledgeable when compared to the controls. Differences in the level of knowledge could be identified according to the level of education of the participants as well as across the different areas of the country. The main source of information was through the healthcare system, but the involvement of media in educating the communities on the disease was minimal. While this study population was unaccustomed to the use of repellants or sprays, the use of bed nets was high (77.7% of the participants) in this study population. Although misconceptions and incorrect practices are rare in Sri Lankan communities, promoting health education programs which may improve disease awareness and knowledge on vector and its control will further strengthen the control and prevention strategies.
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Affiliation(s)
- Rajika Dewasurendra
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Hermali Silva
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nilakshi Samaranayake
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nuwani Manamperi
- Department of Parasitology, Faculty of Medicine University of Kelaniya, Ragama, Sri Lanka
| | - Nissanka de Silva
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayawardenapura, Gangodawila, Nugegoda, Sri Lanka
| | - Panduka Karunanayake
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Upul Senarath
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sanath Senanayake
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Guofa Zhou
- University of California, Irvin, California, United States of America
| | - Nadira Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Gunasekara SD, Nuwangi H, Wickramasinghe ND, Weerakoon K, Price HP, Dikomitis L, Agampodi SB. Placing Leishmaniasis in the Limelight through the Communicable Disease Surveillance System: An Experience from Sri Lanka. Pathogens 2022; 11:pathogens11060680. [PMID: 35745534 PMCID: PMC9227132 DOI: 10.3390/pathogens11060680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
Having an effective surveillance system is imperative to take timely and appropriate actions for disease control and prevention. In Sri Lanka, leishmaniasis was declared as a notifiable disease in 2008. This paper presents a comprehensive compilation of the up-to-date documents on the communicable disease and leishmaniasis surveillance in Sri Lanka in order to describe the importance of the existing leishmaniasis surveillance system and to identify gaps that need to be addressed. The documents perused included circulars, reports, manuals, guidelines, ordinances, presentations, and published articles. The disease trends reported were linked to important landmarks in leishmaniasis surveillance. The findings suggest that there is a well-established surveillance system in Sri Lanka having a massive impact on increased case detection, resulting in im-proved attention on leishmaniasis. However, the system is not without its short comings and there is room for further improvements.
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Affiliation(s)
- Sonali Dinushika Gunasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura 50008, Sri Lanka; (H.N.); (N.D.W.); (S.B.A.)
- Correspondence: ; Tel.: +94-71-140-4646
| | - Hasara Nuwangi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura 50008, Sri Lanka; (H.N.); (N.D.W.); (S.B.A.)
| | - Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura 50008, Sri Lanka; (H.N.); (N.D.W.); (S.B.A.)
| | - Kosala Weerakoon
- Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura 50008, Sri Lanka;
| | - Helen P. Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme ST5 5BG, UK;
| | - Lisa Dikomitis
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury CT2 7FS, UK;
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura 50008, Sri Lanka; (H.N.); (N.D.W.); (S.B.A.)
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De Silva NL, De Silva VNH, Deerasinghe ATH, Rathnapala UL, Itoh M, Takagi H, Weerasooriya MV, Kato H, Yahathugoda TC. Development of a Highly Sensitive Nested PCR and Its Application for the Diagnosis of Cutaneous Leishmaniasis in Sri Lanka. Microorganisms 2022; 10:990. [PMID: 35630433 PMCID: PMC9145043 DOI: 10.3390/microorganisms10050990] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 02/01/2023] Open
Abstract
The recent surge in cutaneous leishmaniasis (CL) in Sri Lanka has rendered clinical diagnosis difficult; thus, laboratory confirmation is indispensable. A modified (two novel inner primers to detect CL caused by Leishmania donovani) nested Internal Transcribed Spacer-1 (ITS1) PCR-Restriction Fragment Length Polymorphism (RFLP) method was developed and tested. The sensitivity of the modified nested PCR was tested using serial dilutions (103 to 10−2) of the DNA extract of a cultured L. donovani DD8 strain. Patients (n = 194) from Southern Sri Lanka were examined clinically, microscopically (Slit Skin Smear-SSS) and using the modified nested PCR. The modified nested PCR detected 2.55 fg of parasite DNA compared to ITS1 PCR (25 fg) and detected more cases than SSS (94.3% vs. 77.3%; p < 0.01). The RFLP pattern was L. donovani in all cases. The modified nested PCR performed well in clinically doubtful lesions (95% by PCR vs. 60% by SSS; p < 0.01), ulcerated nodules (91% vs. 71.8%; p < 0.01) and plaques (100% vs. 66.7%; p < 0.01). SSS demonstrated sensitivity (80.9%), specificity (81.8%), PPV (98.7%) and NPV (20.5%) against modified PCR. Low parasite loads and atypical lesions can be diagnosed by the proposed method with higher accuracy.
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Affiliation(s)
- Nirmitha Lalindi De Silva
- Department of Parasitology, Faculty of Medicine, University of Ruhuna, Galle 80000, Sri Lanka; (N.L.D.S.); (M.V.W.); (T.C.Y.)
| | | | | | | | - Makoto Itoh
- Department of Microbiology and Immunology, Aichi Medical University School of Medicine, Aichi 480-1195, Japan; (M.I.); (H.T.)
| | - Hidekazu Takagi
- Department of Microbiology and Immunology, Aichi Medical University School of Medicine, Aichi 480-1195, Japan; (M.I.); (H.T.)
| | | | - Hirotomo Kato
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi 329-0498, Japan
| | - Thishan Channa Yahathugoda
- Department of Parasitology, Faculty of Medicine, University of Ruhuna, Galle 80000, Sri Lanka; (N.L.D.S.); (M.V.W.); (T.C.Y.)
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Oranges T, Veraldi S, Granieri G, Fidanzi C, Janowska A, Dini V, Romanelli M. Parasites causing cutaneous wounds: Theory and practice from a dermatological point of view. Acta Trop 2022; 228:106332. [PMID: 35092728 DOI: 10.1016/j.actatropica.2022.106332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/27/2022]
Abstract
A wide range of parasites can infest open wounds, or cause wounds due to the effects of the infestation. Parasitic infestations can involve the skin and subcutaneous tissues, with various clinical manifestations. In case of cutaneous wounds related to infestations, protozoa, helminths and arthropods are the main groups of parasites involved and emerging new aspects have been recently reported. Treating the wound correctly is fundamental in these patients in order to reduce the development of pathological scars and prevent complications. In particular, a gentle debridement for devitalized/infested tissue removal, the appropriate use of topical antiseptics and dressings such as hydrogel, hydrocolloids and antimicrobial dressings can be useful to control superinfections, moisture balance, inflammation and to promote edge proliferation.
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Affiliation(s)
- Teresa Oranges
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy; Department of Pediatrics, Dermatology Unit, Meyer Children's University Hospital, Florence, Italy
| | - Stefano Veraldi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giammarco Granieri
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Cristian Fidanzi
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Valentina Dini
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Marco Romanelli
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy.
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Imran M, Khan SA, Abida, Alshrari AS, Eltahir Mudawi MM, Alshammari MK, Harshan AA, Alshammari NA. Small molecules as kinetoplastid specific proteasome inhibitors for Leishmaniasis: a patent review from 1998 to 2021. Expert Opin Ther Pat 2022; 32:591-604. [PMID: 35220857 DOI: 10.1080/13543776.2022.2045948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION : Leishmaniasis is a neglected tropical infectious disease. The available limited therapeutic options for leishmaniasis are inadequate due to their poor pharmacokinetic profile, resistance, toxicity, high cost, and compliance problems. This warrants identification of new targets for the development of safer and effective anti-Leishmania therapy. The kinetoplastid specific proteasome (KSP) is a novel validated target to develop drugs against leishmaniasis. AREA COVERED : This review focuses on all the published patent applications and granted patents related to the studied small molecules as KSP inhibitors (KSPIs) against Leishmania from 1998 to December 31, 2021. EXPERT OPINION : A little amount of work has been done on KSPIs, but the study results are quite encouraging. LXE408 and GSK3494245 are two KSPIs in different phases of clinical trials. Some other small molecules have also shown KSP inhibitory potential, but they are not in clinical trials. The KSPIs are promising next-generation orally active patient compliant drugs against kinetoplastid diseases, including leishmaniasis. However, the main challenge to discover the KSPIs will be the resistance development and their selectivity against the proteasome of eukaryotic cells.
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Affiliation(s)
- Mohd Imran
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia
| | - Shah Alam Khan
- College of Pharmacy, National University of Science and Technology, Muscat 130, Oman
| | - Abida
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia
| | - Ahmed Subeh Alshrari
- Medical Laboratory Technology Department, Faculty of Applied Medical Science, Northern Border University, Arar 91431, Saudi Arabia
| | | | - Mohammed Kanan Alshammari
- Department of Pharmaceutical Care, Rafha Central Hospital, North Zone, Rafha 91911, Kingdom of Saudi Arabia
| | - Aishah Ali Harshan
- Department of Pharmaceutical Care, Northern Area Armed Forces Hospital, King Khalid Military City Hospital, Hafr Al-Batin, Kingdom of Saudi Arabia
| | - Noufah Aqeel Alshammari
- Department of Pharmaceutical Care, Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia
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Silva H, Liyanage A, Deerasinghe T, Chandrasekara V, Chellappan K, Karunaweera ND. Treatment failure to sodium stibogluconate in cutaneous leishmaniasis: A challenge to infection control and disease elimination. PLoS One 2021; 16:e0259009. [PMID: 34679130 PMCID: PMC8535432 DOI: 10.1371/journal.pone.0259009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/09/2021] [Indexed: 11/18/2022] Open
Abstract
The first-line treatment for Leishmania donovani-induced cutaneous leishmaniasis (CL) in Sri Lanka is intra-lesional sodium stibogluconate (IL-SSG). Antimony failures in leishmaniasis is a challenge both at regional and global level, threatening the ongoing disease control efforts. There is a dearth of information on treatment failures to routine therapy in Sri Lanka, which hinders policy changes in therapeutics. Laboratory-confirmed CL patients (n = 201) who attended the District General Hospital Hambantota and Base Hospital Tangalle in southern Sri Lanka between 2016 and 2018 were included in a descriptive cohort study and followed up for three months to assess the treatment response of their lesions to IL-SSG. Treatment failure (TF) of total study population was 75.1% and the majority of them were >20 years (127/151,84%). Highest TF was seen in lesions on the trunk (16/18, 89%) while those on head and neck showed the least (31/44, 70%). Nodules were least responsive to therapy (27/31, 87.1%) unlike papules (28/44, 63.6%). Susceptibility to antimony therapy seemed age-dependant with treatment failure associated with factors such as time elapsed since onset to seeking treatment, number and site of the lesions. This is the first detailed study on characteristics of CL treatment failures in Sri Lanka. The findings highlight the need for in depth investigations on pathogenesis of TF and importance of reviewing existing treatment protocols to introduce more effective strategies. Such interventions would enable containment of the rapid spread of L.donovani infections in Sri Lanka that threatens the ongoing regional elimination drive.
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Affiliation(s)
- Hermali Silva
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Vasana Chandrasekara
- Department of Statistics & Computer Science, Faculty of Science, University of Kelaniya, Colombo, Sri Lanka
| | - Kalaivani Chellappan
- Department of Electrical, Electronic and System Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Nadira D Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Khan A, Sajid R, Gul S, Hussain A, Zehri MT, Naz S, Simsek S, Waseem S, Afzal MS, Naqvi SKUH, Qasim M, Ahmed H. Epidemiological and pathological characteristics of Cutaneous Leishmaniasis from Baluchistan Province of Pakistan. Parasitology 2021; 148:591-597. [PMID: 33353570 PMCID: PMC10950375 DOI: 10.1017/s0031182020002413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/27/2020] [Accepted: 12/09/2020] [Indexed: 12/18/2022]
Abstract
Cutaneous Leishmaniasis (CL) is considered a neglected tropical disease which in Pakistan can now be considered as a growing public health problem. The exact figures on the magnitude of the disease are lacking both at the national and regional level and only a few health centres are available for diagnosis of CL. The present study was designed to identify the epidemiology of CL infection from August 2018 to December 2019 and to assess clinical aspects of CL in Baluchistan Province of Pakistan. A total of 4072 clinically suspected CL cases were analysed statistically. The highest number of CL cases were reported in May, followed by April, January and then July, February and June and the lowest number of cases were observed in March and November. The highest prevalence rate was found in males where 38% of reported cases were aged 0-9 years. The majority (24.4%) of lesions were found on the hands followed by the face in which cheeks, ears and nose were the effected organs. About 50% of the participants have single lesion while 14% of the participants had two and nearly 3% of the participants have six lesions. The atypical clinical presentations were observed in Baluchistan and common unusual presentations were lupus erythematosus. The study findings suggest that more epidemiological studies and health education campaigns are needed for the population awareness regarding CL in Baluchistan. It is recommended that risk factors should be evaluated to establish control and management strategies to prevent disease at the individual and community level.
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Affiliation(s)
- Aisha Khan
- Department of Biosciences, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Rawan Sajid
- Department of Biosciences, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Shaista Gul
- Department of histopathology, Bolan Medical Complex Hospital, Quetta, Pakistan
| | - Ashiq Hussain
- Department of Microbiology, Bolan Medical Complex Hospital, Quetta, Pakistan
| | | | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
| | - Sami Simsek
- Department of Parasitology, Firat University, Elazig, Turkey
| | - Shahid Waseem
- Alpha Genomics Pvt. Ltd. Plot 4-C, Danyal Plaza, Block A, Main Double Road, PWD, Islamabad, Pakistan
| | - Muhammad Sohail Afzal
- Department of Life Sciences, University of Management & Technology (UMT), Lahore, Pakistan
| | | | - Muhammad Qasim
- Department of Economics, Finance and Statistics, Jönköping International Business School, Jönköping University, Jönköping, Sweden
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad, Pakistan
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Abuowarda M, AbuBakr HO, Ismael E, Shaalan M, Mohamed MA, Aljuaydi SH. Epidemiological and genetic characteristics of asymptomatic canine leishmaniasis and implications for human Leishmania infections in Egypt. Zoonoses Public Health 2021; 68:413-430. [PMID: 33715312 DOI: 10.1111/zph.12824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/30/2021] [Accepted: 02/10/2021] [Indexed: 12/23/2022]
Abstract
Leishmaniasis is a neglected zoonotic disease that poses significant veterinary and public health risks in developing countries. Dogs act as a reservoir host for leishmaniasis transmitted to humans. A total of 108 human cases of cutaneous leishmaniasis (CL) were identified in the Al-Houd Al-Marsoud Hospital in Cairo, Egypt, during 2018. Blood samples and skin biopsies were collected for further examination. Blood samples from 96 asymptomatic dogs were collected. All samples were subjected to molecular and phylogenetic analysis. Quantitative RT-PCR was used to measure the expression of genes related to mTOR signalling and inflammation in blood and tissue samples. The distribution pattern of human cases pointed to an endemic focus in North Sinai (66.67%). The prevalence of asymptomatic canine leishmaniasis was 66.60%. Histopathological examination of human skin lesions revealed a severe granulomatous inflammatory reaction, necrosis and ulceration. Moreover, leishmanial amastigotes could be detected in human tissue samples. Phylogenetic analysis revealed 100% identity of human isolates to Leishmania tropica (MN453682), and dog isolates to Leishmania infantum (MN453673), with 94.9% similarity between the two isolates. Gene expression related to mTOR signalling and inflammation in both species' samples confirmed a significant alteration of EIF4EBP1, CCR4 and INF-γ expression compared with control groups. In Egypt, increased incidence of asymptomatic carrier dogs acting as a significant reservoir host for Leishmania poses a public health hazard. Findings warrant further epidemiological investigation of CL in Egypt, as well as additional study of parasite differentiation and gene regulation.
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Affiliation(s)
- Mai Abuowarda
- Department of Parasitology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Huda O AbuBakr
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Elshaimaa Ismael
- Department of Veterinary Hygiene and Management, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Mohamed Shaalan
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Mona A Mohamed
- Cairo Dermatology and Venereology Hospital (Al-Houd Al-Marsoud Hospital), Cairo, Egypt
| | - Samira H Aljuaydi
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
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Bisetegn H, Zeleke AJ, Gadisa E, Shumie G, Damte D, Fenta T, Behaksra S, Bayih AG. Clinical, parasitological and molecular profiles of Cutaneous Leishmaniasis and its associated factors among clinically suspected patients attending Borumeda Hospital, North-East Ethiopia. PLoS Negl Trop Dis 2020; 14:e0008507. [PMID: 32841279 PMCID: PMC7473553 DOI: 10.1371/journal.pntd.0008507] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 09/04/2020] [Accepted: 06/22/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis is one of the most neglected tropical diseases increasing in its public health importance. In Ethiopia over 28 million people are living at risk of infection. METHOD Institution based cross-sectional study was conducted at Borumeda Hospital from February to May 2019. A total 205 leishmaniasis suspected patients were included by systematic random sampling technique. Socio demographic characteristics were collected using pre-tested questionnaires. Parasitological investigation was done from skin slit sample by using Geimsa staining method. Species identification was done by PCR-RFLP. Data were entered in to EpiData version 3.1 and analyzed using SPSS version 20 software. P-value of ≤ 0.05 was considered as statistically significant. RESULT A total of 205 participants consisting 59% male and 41% female included in this study. The mean age (±SD) of the study participants was 31.9 (±14.29). The overall prevalence of cutaneous leishmaniasis was 22.4% (46/205). The prevalence in males (13.7%) was higher than in females (8.8%). It was more prevalent in the age group 16-45years old (15.6%). Clinically, 60% of patients' hade single lesion with 1.55 average number of lesions. About 30.7% of patients' had indurated plaque type of lesion. Most of the lesions were found on head and face (59%). House near to farmland, presence of hyrax in the village and presence of other cutaneous leishmaniasis cases in the neighborhood were independent predicator of cutaneous leishmaniasis prevalence. L.aethopica was found to be the etiologic agent of cutaneous leishmaniasis in the study participants. CONCLUSION The prevalence of cutaneous leishmaniasis was 22.4%, this alerts the need of intervention. It is statistically associated with house near to farm land, presence of other cutaneous leishmaniasis cases in the neighborhood and presence of hyrax in village. Head and face were the most common sites of lesion.
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Affiliation(s)
- Habtye Bisetegn
- Department of Medical Laboratory science, College of Medicine and Health Sciences, Wollo University,Dessie, Ethiopia
- * E-mail:
| | - Ayalew Jejaw Zeleke
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Girma Shumie
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Demekech Damte
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Tiruework Fenta
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | | | - Abebe Genetu Bayih
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
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A Comprehensive Review of Cutaneous Leishmaniasis in Sri Lanka and Identification of Existing Knowledge Gaps. Acta Parasitol 2020; 65:300-309. [PMID: 32052240 PMCID: PMC7223001 DOI: 10.2478/s11686-020-00174-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/24/2020] [Indexed: 11/28/2022]
Abstract
Purpose Sri Lanka is endemic to cutaneous leishmaniasis and reported as the latest focus of leishmaniasis in the Asian subcontinent. Annually, the number of leishmaniasis cases is increasing; therefore, more efficient diagnostic tools, treatment methods and effective prevention measures are indispensable. For this reason, many studies were conducted regarding leishmaniasis infections in Sri Lanka; however, some areas need more attention. Thus, in this review, we comprehensively discussed the studies on leishmaniasis carried out in Sri Lanka. Methods Published articles on leishmaniasis in Sri Lanka were searched on PubMed, Google Scholar and ResearchGate databases. Inclusion criteria for the articles were based on keyword searches including ‘Leishmaniasis in Sri Lanka’, ‘Leishmaniasis vector in Sri Lanka’, ‘Sandfly species in Sri Lanka’, ‘Leishmaniasis epidemiology in Sri Lanka’ which are publicly accessible as of 15th July 2019. Results In this study, we evaluated and summarized the leishmaniasis reports in Sri Lanka and mainly focused on clinical presentation of leishmaniasis infection, genetic characteristics of Leishmania donovani Sri Lankan strain, geographical distribution and associated environmental factors, immunological aspects of the infection, vector, reservoir host, risk factors, diagnosis and treatment, and prevention and control. Furthermore, we identified the areas where further research is needed to fill the essential knowledge gaps. Conclusions Leishmaniasis has become a critically important parasitic infection in Sri Lanka, whereas the significant clinical form is cutaneous leishmaniasis. Prevalence of the leishmaniasis infections is reported from all the districts of the country. Therefore, more studies are essential to be carried out to fill the existing knowledge gaps emphasized in this review.
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Gunathilaka N, Semege S, Pathirana N, Manamperi N, Udayanga L, Wijesinghe H, Premaratne P, Fernando D. Prevalence of cutaneous leishmaniasis infection and clinico-epidemiological patterns among military personnel in Mullaitivu and Kilinochchi districts of the Northern Province, early war-torn areas in Sri Lanka. Parasit Vectors 2020; 13:263. [PMID: 32430014 PMCID: PMC7236442 DOI: 10.1186/s13071-020-04137-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/14/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The 30-year-old armed conflict in Sri Lanka resulted in a general breakdown of civil administration in the Northern and Eastern provinces, leading to mobilisation of many armed forces personnel to assist with reconstruction and resettlement. This occupational group has been identified as a priority risk group for leishmaniasis. METHODS Individuals enlisted at all military establishments in Mullaitivu and Kilinochchi districts, Northern Province of Sri Lanka were included. Five thousand individuals were screened for skin lesions between September 2018 and August 2019. Persons with lesions suspected as cutaneous leishmaniasis (CL) were further investigated. Information on sociodemographic/other potential risk factors was obtained through an interviewer-administered structured questionnaire. The diagnosis was confirmed by microscopic visualization of parasitic stages from different samples obtained (skin scraping, lesion aspirate and tissue impression smears), histopathology and polymerase chain reaction DNA amplification. RESULTS Among 5000 individuals screened, 74 individuals were suspected of having CL. Of these, 67.6% (n = 50) patients were confirmed for CL by microscopy. Around two third of both males (67.6%; n = 48) and females (66.6%; n = 2) were positive for Leishmania. The soldiers belonging to 26-35-year age group reported the highest susceptibility (83.3%; OR: 4.83, 95% CI: 3.49-6.20%). Of the sociodemographic factors, age, wearing short-sleeved upper body clothing as the uniform and non-use of insect repellents were identified as significant risk factors. Most of the CL patients had a single lesion (86.0%; n = 43) of an ulcerative type (34.0%; n = 17), mostly on their upper limb (67.9%; n = 34). Lesions were mostly 5-10 mm diameter (59.9%; n = 30) in size with poorly defined margins (72.0%; n = 36). Amongst the diagnostic techniques, microscopic examination of slit skin smear and tissue impression smear were able to discriminate the majority of patients (92.1%; n = 46) for CL. CONCLUSIONS In order to highlight the true burden of leishmaniasis in the military personnel, cases of leishmaniasis from military institutes should be recognized as a different entity per say and be included in the national figures so as to depict the real magnitude of the disease burden amongst this high-risk group.
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Affiliation(s)
- Nayana Gunathilaka
- Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Saveen Semege
- Directorate of Army Preventive Medicine & Mental Health Services, Army Headquarters, Sri Jayawardenepura, Sri Lanka
| | | | - Nuwani Manamperi
- Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Lahiru Udayanga
- Department of Biosystems Engineering, Faculty of Agriculture and Plantation Management, Wayamba University of Sri Lanka, Makandura, Sri Lanka
| | - Harshima Wijesinghe
- Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Prasad Premaratne
- Department of Parasitology, Faculty of Medicine, Kotalawela Defence University, Ratmalana, Sri Lanka
| | - Deepika Fernando
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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17
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Wijerathna T, Gunathilaka N, Gunawardena K, Rodrigo W. Socioeconomic, demographic and landscape factors associated with cutaneous leishmaniasis in Kurunegala District, Sri Lanka. Parasit Vectors 2020; 13:244. [PMID: 32398102 PMCID: PMC7216469 DOI: 10.1186/s13071-020-04122-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background Leishmaniasis is a neglected tropical disease that affects countries in the developing world. In Sri Lanka, cutaneous leishmaniasis is the most common form of the disease. It is prevalent in dry and intermediate zones, mostly associated with rural settings. Understanding basic risk factors is critical in the management of the disease with effective interventions. This study is focused on assessing the demographic, socioeconomic and landscape factors associated with leishmaniasis in Kurunegala District, Sri Lanka. Methods A descriptive cross-sectional study was conducted. Households of the past patients and randomly selected households, which had no history of leishmaniasis cases were interviewed. The clinical, socioeconomic, demographic, landscape and awareness-related data were obtained using a pre-tested, interviewer-administered questionnaire. Results A total of 101 patients and a similar number of controls were included in the study. All the patients had the cutaneous form of the disease. Housewives and personnel with monthly incomes less than Rs. 10,000 (56.76 USD) were 3.9- and 9.5-times more prone to the disease, respectively, according to multivariate analysis. Presence of decaying garbage, termite hills, unclear areas, wet soil and gardening areas were always associated with the increased odds of acquiring the disease. Conclusions Demographic factors do not play a pivotal role in the prevalence of leishmaniasis in the area. Housewives, inhabitants with low incomes and individuals who live in areas with conditions suitable for sand fly breeding and resting are major groups with a higher risk of infection. Special attention must be given in raising awareness and environmental management in control activities.![]()
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Affiliation(s)
- Tharaka Wijerathna
- Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Nayana Gunathilaka
- Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
| | - Kithsiri Gunawardena
- Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Wasana Rodrigo
- Biotechnology Unit, Industrial Technology Institute, Colombo 07, Sri Lanka
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Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review. Parasitol Res 2020; 119:365-384. [PMID: 31897789 DOI: 10.1007/s00436-019-06575-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
Abstract
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were "leishmaniasis" AND "risk factors" using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
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Loiseau R, Nabet C, Simon S, Ginouves M, Brousse P, Blanchet D, Demar M, Couppie P, Blaizot R. American cutaneous leishmaniasis in French Guiana: an epidemiological update and study of environmental risk factors. Int J Dermatol 2019; 58:1323-1328. [PMID: 31524286 PMCID: PMC6900021 DOI: 10.1111/ijd.14625] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/29/2019] [Accepted: 08/08/2019] [Indexed: 01/26/2023]
Abstract
Background American cutaneous leishmaniasis (ACL) is endemic in French Guiana. Its epidemiology is evolving, notably because of immigration, anthropization of natural areas, and new microbiological methods. Our first objective was to update epidemiological data. Our second objective was to look for risk factors of ACL. Methods This multicentric study was conducted from October 2017 to June 2018 in French Guiana. Patients with suspicion of mucocutaneous leishmaniasis were included in case of positive smear, culture, or PCR‐RFLP on skin biopsy. Results One hundred and twenty‐three patients met the inclusion criteria. Among those patients, 59.3% were Brazilian, mostly gold miners. Most of them (58%) were between 16 and 40 years old, and 69% were male. A large proportion of patients lived in traditional wooden houses (51%). Patients living in coastal towns were usually infected during trips to the primary forest (60%) and had a shorter time to diagnosis than workers of the hinterland. Among environmental risk factors, the presence of a water spring (40%) and dogs around houses (40%) were frequently reported. Leishmania guyanensis represented 80% of cases, followed by Leishmania braziliensis (6%), Leishmania naiffi (2%), and Leishmania amazonensis (1%). Conclusions Gold mining and trips to the primary forest represent high‐risk situations for ACL in French Guiana, where the population of infected patients is dominated by Brazilian immigrants. Possible environmental risk factors such as the presence of dogs, water sources, and traditional wooden houses require further investigation.
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Affiliation(s)
- Rémi Loiseau
- Département de Médecine Générale, Université des Antilles, Pointe-à-Pitre, Guadeloupe, France
| | - Cecile Nabet
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stephane Simon
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France
| | - Marine Ginouves
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France
| | - Paul Brousse
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana, France
| | - Denis Blanchet
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Magalie Demar
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Pierre Couppie
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Service de Dermatologie, Hôpital Andrée Rosemon, Cayenne, French Guiana, France
| | - Romain Blaizot
- Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université des Antilles et de la Guyane, Cayenne, French Guiana, France.,Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France.,Service de Dermatologie, Hôpital Andrée Rosemon, Cayenne, French Guiana, France
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20
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Trends in Recently Emerged Leishmania donovani Induced Cutaneous Leishmaniasis, Sri Lanka, for the First 13 Years. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4093603. [PMID: 31111052 PMCID: PMC6487155 DOI: 10.1155/2019/4093603] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/25/2019] [Indexed: 02/06/2023]
Abstract
Sri Lanka reports a large epidemic of cutaneous leishmaniasis (CL) caused by an atypical L. donovani while regional leishmaniasis elimination drive aims at achieving its targets in 2020. Visceralization, mucotrophism, and CL associated poor treatment response were recently reported. Long-term clinico-epidemiological trends (2001-2013) in this focus were examined for the first time. Both constant and changing features were observed. Sociodemographic patient characteristics that differ significantly from those of country profile, microchanges within CL profile, spatial expansion, constant biannual seasonal variation, and nondependency of clinical profile on age or gender were evident. Classical CL remains the main clinical entity without clinical evidence for subsequent visceralization indicating presence of parasite strain variation. These observations make a scientific platform for disease control preferably timed based on seasonal variation and highlights the importance of periodic and continued surveillance of clinic-epidemiological and other characteristics.
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Akhlagh A, Salehzadeh A, Zahirnia AH, Davari B. 10-Year Trends in Epidemiology, Diagnosis, and Treatment of Cutaneous Leishmaniasis in Hamadan Province, West of Iran (2007-2016). Front Public Health 2019; 7:27. [PMID: 30891438 PMCID: PMC6413056 DOI: 10.3389/fpubh.2019.00027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 02/01/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Cutaneous leishmaniasis is one of the most important infectious diseases in eastern Mediterranean countries. The aim of this study was to determine the epidemiological pattern of cutaneous leishmaniasis across a 10-year period in the Hamadan province. This study was considered necessary due to the lack of new information in recent years on the epidemiology of the disease. Methods: This is a descriptive study. The data of patients who were diagnosed with cutaneous leishmaniasis in Hamadan health centers were collected during 10 years (2007-2016) and were analyzed using SPSS software. Results: Of the 908 registered patients, 94% were male and 6% were female. The mean age was 32.7 ± 11.8. About 87.1% of patients had a history of travel to endemic areas. The highest incidence rate was observed in the year 2015 with a rate of 12.6, and the lowest was in 2008 at 1.5 per 100,000 people. Conclusion: Due to an increasing trend in the number of cutaneous leishmaniasis in Hamadan and the effect of occupation, high-risk groups such as lorry drivers should be informed of preventive measures such as using insect repellents. Also, considering the possibility of shaping a new hotspot in the province, thorough reviews and more comprehensive entomological studies are recommended.
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Affiliation(s)
- Azita Akhlagh
- Department of Medical Entomology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Aref Salehzadeh
- Department of Medical Entomology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Hossein Zahirnia
- Department of Medical Entomology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behrooz Davari
- Department of Medical Entomology, Hamadan University of Medical Sciences, Hamadan, Iran
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