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Ait Ali D, El Hamdi A, Boumeshouli N, Hakem A, El Khiat A, El Koutbi M, El Houate B, Bragazzi NL, Rizzo A, Chirico F, Khabbache H. Assessing the health-related quality of life of cutaneous Leishmaniasis patients in Draa-Tafilalet, southeastern Morocco. Parasitol Int 2024; 104:102963. [PMID: 39260684 DOI: 10.1016/j.parint.2024.102963] [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: 05/11/2024] [Revised: 08/19/2024] [Accepted: 09/08/2024] [Indexed: 09/13/2024]
Abstract
Cutaneous leishmaniasis is a significant public health concern globally. This study aims to evaluate the impact of cutaneous leishmaniasis on the quality of life of patients in the Draa-Tafilalet region of Morocco. In this cross-sectional study, data were collected from 87 patients between December 2022 and July 2023 using the Skindex-16 questionnaire. The results revealed that cutaneous leishmaniasis has a mild to moderate impact on health-related quality of life, with 26.4 % of participants reporting a low impact and 73.6 % reporting a moderate impact. A significant gender difference was observed in Skindex-16 scores, with moderate impact being more prevalent among females (60.90 % vs. 30.10 %, p = 0.002). Furthermore, facial lesions were associated with a statistically significant reduction in quality of life, particularly in the emotional (p < 0.001) and functioning (p = 0.01) domains. These findings highlight the need for targeted management strategies that address the substantial impact of cutaneous leishmaniasis on patients' quality of life. Future studies with larger sample sizes and extended follow-up periods are warranted to further elucidate the effects of cutaneous leishmaniasis on patients' well-being.
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Affiliation(s)
- Driss Ait Ali
- Laboratory of «Morocco: History, Theology and Languages», Department of Psychology, Faculty of Arts and Human Sciences Fès-Saïss, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
| | - Abdessamad El Hamdi
- Biological and health sciences team, Higher Institute of Nursing Professions and Health Techniques, Ministry of Health, B.P. 45000, Ouarzazate, Morocco
| | - Nourelwiam Boumeshouli
- Biological and health sciences team, Higher Institute of Nursing Professions and Health Techniques, Ministry of Health, B.P. 45000, Ouarzazate, Morocco
| | - Adnane Hakem
- Computer Systems and Vision Laboratory, Faculty of Sciences, Ibn Zohr University, Agadir, Morocco
| | - Abdelaati El Khiat
- Biological and health sciences team, Higher Institute of Nursing Professions and Health Techniques, Ministry of Health, B.P. 45000, Ouarzazate, Morocco
| | - Mohamed El Koutbi
- Biological and health sciences team, Higher Institute of Nursing Professions and Health Techniques, Ministry of Health, B.P. 45000, Ouarzazate, Morocco
| | - Brahim El Houate
- Biological and health sciences team, Higher Institute of Nursing Professions and Health Techniques, Ministry of Health, B.P. 45000, Ouarzazate, Morocco
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Amelia Rizzo
- Department of Clinical and Experimental Medicine, and Department of Cognitive Sciences, Psychological, Educational, and Cultural Studies, University of Messina, Italy.
| | - Francesco Chirico
- Post-Graduate School of Occupational Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Hicham Khabbache
- Laboratory of «Morocco: History, Theology and Languages», Department of Psychology, Faculty of Arts and Human Sciences Fès-Saïss, Sidi Mohamed Ben Abdellah University, Fez, Morocco; Director of Lifelong Learning Observatory (UNESCO/ USMBA), Fez, Morocco
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Lu C, Khan K, Khan F, Shah SU, Jamal M, Badshah N. Epidemiology of cutaneous leishmaniasis in children of Khyber Pakhtunkhwa, Pakistan. Trop Med Int Health 2024; 29:633-646. [PMID: 38740057 DOI: 10.1111/tmi.14005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVES In Pakistan, cutaneous leishmaniasis is an emerging tropical disease and a very high number (>70%) of children are afflicted by this marring infection. This study aimed to scrutinise the prevalence, spatial distribution and socio-demographic and behavioural risk factors associated with cutaneous leishmaniasis in children aged <5-15 years in Khyber Pakhtunkhwa. METHODS A total of 1, 559 clinically confirmed records of children diagnosed with cutaneous leishmaniasis (January-December) from 2020 and 2022 were obtained from selected district hospitals. In addition, a risk factors-related questionnaire was administered to 1, 011 households (400 in 2020 and 611 in 2022) in nine districts during a household survey. RESULTS The maximum number of cutaneous leishmaniasis cases was recorded in 2022 (n = 877, 56.25%) as compared to 2020 (n = 682, 43.75%). The hospital records showed a greater number of male patients in the 2022 cohort (n = 603, 68.76%). The highest number of cases were observed in children aged 5-9 years in 2022 (n = 282, 32.16%) and 2020 (n = 255, 37.39%). In 2020 and 2022, cutaneous leishmaniasis cases showed peak aggregation in March (n = 118, 17.3%) and January (n = 322, 36.72%). From a spatial analysis, the maximum number of cutaneous leishmaniasis cases was recorded at 59-1700 m elevation in various land-use/land-cover and climatic regions with quaternary alluvium rock formations. A multivariate logistic regression model analysis of risk factors from the households survey suggested that age group, socio-economic status, construction materials of the house, use of insect repellents, Afghan refugee camps in the village/district, knowledge and biting times of sand flies, frequent use of mosquito bed nets, presence of domestic animals in the house, knowledge of the transmission period and peak month of leishmaniasis infection increased the risk of acquiring cutaneous leishmaniasis (p value < 0.05). CONCLUSION Our analysis demonstrated that cutaneous leishmaniasis in children is influenced by a variety of environmental, socio-demographic and behavioural risk factors in Khyber Pakhtunkhwa. The increase in recorded cases of cutaneous leishmaniasis in children in 2022 compared to 2020 suggests that the infection likely extended to new foci in the province.
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Affiliation(s)
- Chao Lu
- Hefei University of Technology, Hefei, Anhui, China
| | - Khurshaid Khan
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Fawad Khan
- District Integrated Vector Control Department, Lower Dir, Khyber Pakhtunkhwa, Pakistan
| | - Safeer Ullah Shah
- National Centre of Excellence in Geology, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Muhsin Jamal
- Department of Microbiology, Abdul Wali Khan University Mardan, Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Noor Badshah
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Khyber Pakhtunkhwa, Pakistan
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Yizengaw E, Nibret E. Effects of cutaneous leishmaniasis on patients' quality of life. BMC Infect Dis 2024; 24:598. [PMID: 38890616 PMCID: PMC11186278 DOI: 10.1186/s12879-024-09518-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/17/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Cutaneous Leishmaniasis (CL) is caused by protozoan parasite called Leishmania. It is endemic in more than 100 countries globally. Despite its vast prevalence and impact on quality of life, it is one of the most neglected tropical dermatological diseases. The CL burden has often been expressed based on the physical disfigurement caused by the disease. However, considering the impact of the disease beyond physical impairment and changes in patients' appearance would help to better understand the disease as a public health problem. The effect of CL on patients' quality of life was determined in this study. METHODS The data that were related to quality of life were collected using Standard one-week Dermatology Life Quality Index (DLQI) questionnaire. The questions were categorized under seven domains: symptoms & feelings, daily activities, work and school, leisure, personal relationships, and treatment. Each question was scored on a three-point scale: Very much (3), A lot (2), A little (1), Undecided (0), and Not at all (0). The sum of the scores lied between 0 and 48. A higher score shows worse quality of life. The data were entered and analysed using Statistical Package for Social Science 23. Frequencies and proportions were used to describe the data. Differences were considered statistically significant at p < 0.05. RESULTS The lives of the majority of CL patients (60.7%) were significantly affected by CL. The quality of life of patients was moderately impacted by CL in 25% of the CL patients. In 32.1% of the CL patients, the effect of CL on patients' quality of life was very large. The quality of one CL patient's life was extremely largely affected. The disease had a small effect on 32.1% of the CL patients. Personal relationship was the most affected domain followed by symptoms and feelings and treatment. Future study including rural regions is required. CONCLUSION The Dermatology Life Quality Index demonstrates that CL has a small to extremely very large negative effect on the quality of life of patients.
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Affiliation(s)
- Endalew Yizengaw
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
- Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Endalkachew Nibret
- Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
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Rezende Ribeiro N, Magno Oliveira Santos L, Silva Costa S, Kei Myasaki C, Pagliara Lage D, Tamietti Martins V, Cristiane Fortes De Brito R, Chaves Freire L, Maria Ravena Severino Carvalho A, Victor Serafim Brigido B, José Alves R, Antonio Ferraz Coelho E, Mendes Roatt B, Menezes-Souza D, Costa Duarte M. Development of a topical treatment for tegumentary leishmaniasis using 8-hydroxyquinoline. Eur J Pharm Biopharm 2024; 199:114306. [PMID: 38679213 DOI: 10.1016/j.ejpb.2024.114306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/01/2024]
Abstract
In the context of neglected diseases, tegumentary leishmaniasis (TL) presents an emerging and re-emerging character in the national territory and in the world. The treatment of TL has limitations, such as intravenous administration route, high toxicity, and high treatment costs. Thus, several researchers work on new therapeutic strategies to improve the effectiveness of the treatment of leishmaniasis. In this light, the present study used a topical formulation, containing 8-hydroquinoline (8-HQN), for the treatment of Balb/c mice infected with L. amazonensis. After the treatment, the mean diameter of the lesion was measured, as well as the parasite load in organs and immunological parameters associated with the treatment. The results showed that the animals treated with 8-HQN 5%, when compared to controls, showed a reduction in the mean diameter of the lesion and in the parasite load. The animals treated with the ointment showed a type 1 cellular immune response profile associated with the production of cytokines such as INF-γ and TNF-α. In addition, the treatment did not demonstrate toxicity to mice. Therefore, the topical formulation containing 8-HQN 5% is a promising candidate in the topical treatment and could be considered, in the future, as an alternative for the treatment of TL.
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Affiliation(s)
- Naianda Rezende Ribeiro
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Magno Oliveira Santos
- Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Scarleth Silva Costa
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Kei Myasaki
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniela Pagliara Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vivian Tamietti Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rory Cristiane Fortes De Brito
- Laboratório de Morfopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Larissa Chaves Freire
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Maria Ravena Severino Carvalho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bryan Victor Serafim Brigido
- Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo José Alves
- Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno Mendes Roatt
- Laboratório de Morfopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Laboratório de Pesquisas Clínicas, Programa de Pós-graduação em Ciências Farmacêuticas/CiPharma, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Daniel Menezes-Souza
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Costa Duarte
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Tuwor RD, Mtuy TB, Amoako YA, Owusu L, Oppong MN, Agbanyo A, Agbavor B, Marks M, Walker SL, Yeboah-Manu D, Pullan RL, Dapaah JM, Phillips RO, Palmer J. Stigma experiences, effects and coping among individuals affected by Buruli ulcer and yaws in Ghana. PLoS Negl Trop Dis 2024; 18:e0012093. [PMID: 38683858 PMCID: PMC11081504 DOI: 10.1371/journal.pntd.0012093] [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: 07/11/2023] [Revised: 05/09/2024] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Stigma related to skin neglected tropical diseases like Buruli ulcer (BU) and yaws has remained underexplored and existing studies are limited to individual diseases despite the WHO call for integration in disease management. Within two districts in central Ghana, we explored stigma associated with BU and yaws to understand overlaps and disease-specific nuances to help guide integrated interventions. METHODOLOGY/PRINCIPAL FINDINGS In-depth interviews were conducted with 31 current or formerly affected individuals to assess the experiences, effects and coping strategies adopted to manage disease related stigma. Data were analysed along broad themes based on the sociological construct of macro and micro interaction and Goffman's treatise on stigma. Disapproving community labels fueled by misconceptions were noted among BU participants which contributed to macro stigma experiences, including exclusion, discrimination and avoidance. In contrast, a high level of social acceptance was reported among yaws participants although some micro-level stigma (anticipated, felt and self-stigma) were noted by individuals with both diseases. While younger participants experienced name-calling and use of derogatory words to address affected body parts, older participants and caregivers discussed the pain of public staring. Stigma experiences had negative consequences on psychosocial well-being, schooling, and social relations, particularly for BU affected people. Problem-focused strategies including confrontation, selective disclosure and concealment as well as emotion-focused strategies (religious coping and self-isolation) were noted. CONCLUSIONS AND SIGNIFICANCE The types and levels of stigma varied for BU and yaws. Stigma experiences also differed for adults and children in this setting and these differences should be accounted for in integrated interventions for these skin NTDs. School health programs need to prioritize educating school teachers about skin NTDs and the negative impact of stigma on the wellbeing of children.
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Affiliation(s)
- Ruth Dede Tuwor
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Tara B. Mtuy
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yaw Ampem Amoako
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lucy Owusu
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Ntiamoah Oppong
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abigail Agbanyo
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernadette Agbavor
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Marks
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stephen L. Walker
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Rachel L. Pullan
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonathan Mensah Dapaah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jennifer Palmer
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Adjorlolo S, Adimado EE, Setordzi M, Akorli VV. Prevalence, assessment and correlates of mental health problems in neglected tropical diseases: a systematic review. Int Health 2024; 16:i12-i21. [PMID: 38547348 PMCID: PMC10977955 DOI: 10.1093/inthealth/ihae001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/17/2023] [Accepted: 01/11/2024] [Indexed: 04/02/2024] Open
Abstract
Neglected tropical diseases (NTDs) are a group of disease conditions that affect the world's poorest people in low- and middle-income countries. NTDs are associated with negative behavioural experiences, including discrimination, rejection and stigmatization, that predisposes those affected to mental health problems. Consequently, researchers have shown profound interest in elucidating the mental health burden associated with NTDs. To address pertinent issues in the burgeoning literature relating to the prevalence, assessment and correlates of mental health problems in NTDs, a systematic review methodology was used. Underpinned by the PRISMA guidelines, a search was conducted of electronic databases, individual journals and bibliographies for articles that were screened and subjected to predetermined inclusion and exclusion criteria. Sixteen articles from African, Asian and South American countries were included in the review. Depression was the most widely investigated mental health issue, followed by stress and anxiety, with prevalence estimates of 7-54%, 8-43% and 19-53%, respectively. The PHQ-9 and GAD-7 and Self-Reporting Questionnaire were the most widely administered mental health screening tools. The major correlates of mental health problems are lower education and economic status and female gender. We recommend multisectoral and multilayered mental health and related interventions to address the increasing burden of mental health in NTDs.
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Affiliation(s)
- Samuel Adjorlolo
- Department of Mental Health Nursing, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana
- Research and Grant Institute of Ghana. P.O. Box LG 1004, Legon Post Office, Accra, Ghana
| | - Emma Efua Adimado
- Department of Research, Education and Administration, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana
| | - Mawuko Setordzi
- Department of Mental Health Nursing, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana
| | - Vincent Valentine Akorli
- Department of Nursing, School of Science and Technology, Knutsford University College, Accra, Ghana
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Elfaki NK, Alzahrani MJ, Abdalla YHA, Adeh AI, Osman Abdalla AMA, Alkhadher MA, Elrefaey SR, Abdelmagid WHH, Alshameri F, Jarelnape AA, Hakami MSA, Alghamdi FAA, Elhaj YHA, Dinar NMAA, Mohamed AAA, Abdulrahman EEH, Mohamed DHM, Sagiron EI, Ali MHM, Ahmed WAM. Perceived Social Stigma of Cutaneous Leishmaniasis in Hubuna, Saudi Arabia. J Multidiscip Healthc 2024; 17:867-876. [PMID: 38434481 PMCID: PMC10909324 DOI: 10.2147/jmdh.s454135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Cutaneous Leishmaniasis (CL) is a vector-borne skin infection that remains prevalent in regions with poor socioeconomic conditions. Stigmatization occurs when individuals with physical or psychological disorders interact with societal stereotypes. The aim of this study was to explore the perceived social stigma surrounding CL among people residing in Hubuna, Saudi Arabia. Methods This cross-sectional community-based survey recruited 618 individuals aged 18 years and above using the snowball sampling technique to reach hidden cases within the target population. Data was collected using a self-administered questionnaire and the Explanatory Model Interview Catalogue for Perceived Social Stigma (EMIC-SS-12) was used to assess the level of perceived social stigma. It includes questions on demographic variables, behaviors, and experiences. The analysis was performed using SPSS. Results The study included 618 participants, the majority of whom were women and girls (54.2%), with a mean age of 28 ± 12.7 years. The median score for perceived social stigma was 26.0. Only 2.1% (n = 13) of participants had the highest EMIC-SS-12 score of 36, while 7.6% (n = 47) scored zero. The mean score for overall perceived social stigma was 1.89 ± 0.91, while the mean score for experienced stigma was 1.99 ± 1.02. Univariate analysis showed that sex, employment, location of lesions, and number of lesions were insignificantly associated with stigmatization (P-value < 0.05), because these associations were uncertain because the CI includes or very close to 1. Conclusion The study reveals insights into stigmatization associated with CL in the Habuna area of Saudi Arabia. It found that the median of perceived social stigma was 26. Factors such as sex, employment status, and location of the lesion are uncertainly associated with stigma. It is crucial to explore negative behaviors and perceptions and develop suitable health education programs.
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Affiliation(s)
- Nahid K Elfaki
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Yahya Hussein Ahmed Abdalla
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Abdullah I Adeh
- Internal Medicine Department, College of Medicine, Najran University, Najran, Saudi Arabia
| | | | - Mugahed A Alkhadher
- Medical- Surgical Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Samah R Elrefaey
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Faroq Alshameri
- Nursing Department, Faculty of Medical Sciences and Nursing, Alrayan Colleges, Almadina, Saudi Arabia
| | | | | | | | - Yagoub Hamadt Allah Elhaj
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | | | | | | | | | - Elwaleed Idris Sagiron
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Maha Hamed Mohamed Ali
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
- Public Health Department, Faculty of Applied Medical Sciences, King Khalid University, Khamis Mushait Aseer, Saudi Arabia
| | - Waled A M Ahmed
- Faculty of Nursing, Al-Baha University, Al-Baha, Saudi Arabia
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Castro MDM, Erber AC, Arana B, Cota G, Denkinger CM, Harrison N, Kutyi J, López-Carvajal L, Plugge E, Walochnik J, Olliaro P. Involving patients in drug development for Neglected Tropical Diseases (NTDs): A qualitative study exploring and incorporating preferences of patients with cutaneous leishmaniasis into Target Product Profile development. PLoS Negl Trop Dis 2024; 18:e0011975. [PMID: 38381805 DOI: 10.1371/journal.pntd.0011975] [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: 09/21/2023] [Revised: 03/26/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Target Product Profiles (TPPs) are instrumental to help optimise the design and development of therapeutics, vaccines, and diagnostics - these products, in order to achieve the intended impact, should be aligned with users' preferences and needs. However, patients are rarely involved as key stakeholders in building a TPP. METHODOLOGY Thirty-three cutaneous leishmaniasis (CL) patients from Brazil, Colombia, and Austria, infected with New-World Leishmania species, were recruited using a maximum variation approach along geographic, sociodemographic and clinical criteria. Semi-structured interviews were conducted in the respective patient's mother tongue. Transcripts, translated into English, were analysed using a framework approach. We matched disease experiences, preferences, and expectations of CL patients to a TPP developed by DNDi (Drug for Neglected Diseases initiative) for CL treatment. PRINCIPAL FINDINGS Patients' preferences regarding treatments ranged from specific efficacy and safety endpoints to direct and significant indirect costs. Respondents expressed views about trade-offs between efficacy and experienced discomfort/adverse events caused by treatment. Reasons for non-compliance, such as adverse events or geographical and availability barriers, were discussed. Considerations related to accessibility and affordability were relevant from the patients' perspective. CONCLUSIONS/SIGNIFICANCE NTDs affect disadvantaged populations, often with little access to health systems. Engaging patients in designing adapted therapies could significantly contribute to the suitability of an intervention to a specific context and to compliance, by tailoring the product to the end-users' needs. This exploratory study identified preferences in a broad international patient spectrum. It provides methodological guidance on how patients can be meaningfully involved as stakeholders in the construction of a TPP of therapeutics for NTDs. CL is used as an exemplar, but the approach can be adapted for other NTDs.
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Affiliation(s)
- María Del Mar Castro
- Centro Internacional de Entrenamiento de Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
- Division of Infectious Diseases and Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany; German Center of Infection Research, partner site Heidelberg
| | - Astrid C Erber
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom
| | - Byron Arana
- Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland
| | - Gláucia Cota
- Instituto René Rachou (IRR), Fundação Oswaldo Cruz (FIOCRUZ), Minas Gerais, Brazil
| | - Claudia M Denkinger
- Division of Infectious Diseases and Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany; German Center of Infection Research, partner site Heidelberg
| | - Nicole Harrison
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Austria
| | - Julia Kutyi
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Austria
| | - Liliana López-Carvajal
- Programa de Estudio y Control de Enfermedades Tropicales (PECET), Universidad de Antioquia, Medellín, Colombia
| | - Emma Plugge
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Piero Olliaro
- International Severe Acute Respiratory and Emerging Infection Consortium, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
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9
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Nogueira de Brito R, Tanner S, Runk JV, Hoyos J. Looking through the lens of social science approaches: A scoping review of leishmaniases and Chagas disease research. Acta Trop 2024; 249:107059. [PMID: 37918504 DOI: 10.1016/j.actatropica.2023.107059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Scholars have called for increased attention to sociocultural, economic, historical, and political processes shaping Neglected Tropical Diseases (NTDs) ecology. We conducted a scoping review to identify major research themes and the knowledge gaps in social science literature in leishmaniases or Chagas disease (CD). Following the scoping review protocol, we first determined the focus of the review to be centered on identifying research that approaches leishmaniases and CD from social science perspective and was indexed by large, biomedically focused databases. We then searched PubMed and Web of Science using "Leishmaniasis" and "Chagas disease" with "social science" or "anthropology" as search terms. We analyzed 199 articles (123 on leishmaniases and 76 on CD), categorizing them into three main research themes. Sociocultural dimensions of the diseases (leishmaniases=60.2 %; CD=68.4 %) primarily focused on individuals' knowledge, practices, and behaviors, barriers to accessing healthcare (especially in endemic regions), psychosocial effects, stigma, and traditional treatments. Research focused on socioeconomic dimensions of the diseases (leishmaniases=29.3 %; CD=19.7 %) included topics like household characteristics, social capital, and infrastructure access. A final theme, the historical and political contexts of the diseases (Leishmaniases=10.5 %; CD=11.9 %) was less common than other themes. Here, studies consider civil war and the (re)emergence of leishmaniasis, as well as the significance of CD discovery for scientific and public health in Brazil, which is the most common country for research on both leishmaniases and CD that draws on social science approaches. Future directions for research include focusing on how social institutions and economic factors shape diseases education, control measures, healthcare access, and quality of life of people affected by NTDs. Greater attention to social sciences can help mitigate and undo the ways that structural biases have infiltrated biomedicine.
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Affiliation(s)
- Raíssa Nogueira de Brito
- Department of Anthropology, University of Georgia, Athens, GA 30602, United States; Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA 30602, United States.
| | - Susan Tanner
- Department of Anthropology, University of Georgia, Athens, GA 30602, United States
| | - Julie Velásquez Runk
- Environment and Sustainability Studies Program, Wake Forest University, Winston Salem, NC 27109, United States; Smithsonian Tropical Research Institute, Balboa, Ciudad de Panamá 0843-03092, Republic of Panama
| | - Juliana Hoyos
- Odum School of Ecology, University of Georgia, Athens, GA 30602, United States
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10
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Silva KA, Ribeiro AJ, Gandra IB, Resende CAA, da Silva Lopes L, Couto CAP, de Araujo Freire V, Barcelos ICS, Pereira SP, Xavier SR, da Paz MC, Giunchetti RC, Chávez-Fumagalli MA, Gonçalves AAM, Coelho EAF, Galdino AS. A Review on the use of Synthetic and Recombinant Antigens for the Immunodiagnosis of Tegumentary Leishmaniasis. Curr Med Chem 2024; 31:4763-4780. [PMID: 38509682 PMCID: PMC11348456 DOI: 10.2174/0109298673298705240311114203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024]
Abstract
Improving the diagnostic technology used to detect tegumentary leishmaniasis (TL) is essential in view of it being a widespread, often neglected tropical disease, with cases reported from the Southern United States to Northern Argentina. Recombinant proteins, recombinant multiepitope proteins, and synthetic peptides have been extensively researched and used in disease diagnosis. One of the benefits of applying these antigens is a measurable increase in sensitivity and specificity, which improves test accuracy. The present review aims to describe the use of these antigens and their diagnostic effectiveness. With that in mind, a bibliographic survey was conducted on the PudMed platform using the search terms "tegumentary leishmaniasis" AND "diagno", revealing that recombinant proteins have been described and evaluated for their value in TL diagnosis since the 1990s. However, there was a spike in the number of publications using all of the antigens between 2013 and 2022, confirming an expansion in research efforts to improve diagnosis. Moreover, all of the studies involving different antigens had promising results, including improved sensitivity and specificity. These data recognize the importance of doing research with new technologies focused on developing quick, more effective diagnostic kits as early diagnosis facilitates treatment.
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Affiliation(s)
- Kamila Alves Silva
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Anna Júlia Ribeiro
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Isadora Braga Gandra
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Carlos Ananias Aparecido Resende
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Lucas da Silva Lopes
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Carolina Alves Petit Couto
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Verônica de Araujo Freire
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Isabelle Caroline Santos Barcelos
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Sabrina Paula Pereira
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Sandra Rodrigues Xavier
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Mariana Campos da Paz
- Laboratório de Bioativos e Nanobiotecnologia, Universidade Federal de São João Del-Rei, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Minas Gerais, Brasil
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Ana Alice Maia Gonçalves
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, 30130-100, Minas Gerais, Brasil
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Departamento de Bioquímica, Universidade Federal de Sao Joao Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis, 35501-296, Minas Gerais, Brasil
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11
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Nuwangi H, Dikomitis L, Weerakoon KG, Agampodi SB, Agampodi TC. The psychosocial burden of cutaneous leishmaniasis in rural Sri Lanka: A multi-method qualitative study. PLoS Negl Trop Dis 2024; 18:e0011909. [PMID: 38236911 PMCID: PMC10826957 DOI: 10.1371/journal.pntd.0011909] [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: 07/27/2023] [Revised: 01/30/2024] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
Leishmaniasis is a tropical infectious disease affecting some of the world's most economically disadvantaged and resource-poor regions. Cutaneous leishmaniasis (CL) is the most common out of the three clinical types of Leishmaniasis. Since 1904 this disease has been endemic in Sri Lanka. CL is considered a disfiguring stigmatising disease with a higher psychosocial burden. However, there needs to be a more in-depth, holistic understanding of the psychosocial burden of this disease, both locally and internationally. An in-depth understanding of the disease burden beyond morbidity and mortality is required to provide people-centred care. We explored the psychosocial burden of CL in rural Sri Lanka using a complex multimethod qualitative approach with community engagement and involvement. Data collection included participant observation, an auto-ethnographic diary study by community researchers with post-diary interviews, and a Participant Experience Reflection Journal (PERJ) study with post-PERJ interviews with community members with CL. The thematic analysis revealed three major burden-related themes on perceptions and reflections on the disease: wound, treatment, and illness-experience related burden. Fear, disgust, body image concerns, and being subjected to negative societal reactions were wound-related. Treatment interfering with day-to-day life, pain, the time-consuming nature of the treatment, problems due to the ineffectiveness of the treatment, and the burden of attending a government hospital clinic were the treatment-related burdens. Anxiety/worry due to wrongly perceived disease severity and negative emotions due to the nature of the disease made the illness experience more burdensome. Addressing the multifaceted psychosocial burden is paramount to ensure healthcare seeking, treatment compliance, and disease control and prevention. We propose a people-centred healthcare model to understand the contextual nature of the disease and improve patient outcomes.
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Affiliation(s)
- Hasara Nuwangi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka
| | - Lisa Dikomitis
- Centre for Health Services Studies and Kent and Medway Medical School, University of Kent
| | - Kosala Gayan Weerakoon
- Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka
| | - Suneth Buddhika Agampodi
- International Vaccine Institute, Seoul, South Korea
- Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka
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12
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Nuwangi H, Agampodi TC, Price HP, Shepherd T, Weerakoon KG, Agampodi SB. Stigma associated with cutaneous and mucocutaneous leishmaniasis: A systematic review. PLoS Negl Trop Dis 2023; 17:e0011818. [PMID: 38153950 PMCID: PMC10781107 DOI: 10.1371/journal.pntd.0011818] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/10/2024] [Accepted: 11/24/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Cutaneous (CL) and mucocutaneous leishmaniasis (MCL) are parasitic diseases caused by parasites of the genus leishmania leading to stigma caused by disfigurations. This study aimed to systematically review the dimensions, measurement methods, implications, and potential interventions done to reduce the CL- and MCL- associated stigma, synthesising the current evidence according to an accepted stigma framework. METHODS This systematic review followed the PRISMA guidelines and was registered in PROSPERO (ID- CRD42021274925). The eligibility criteria included primary articles discussing stigma associated with CL and MCL published in English, Spanish, or Portuguese up to January 2023. An electronic search was conducted in Medline, Embase, Scopus, PubMed, EBSCO, Web of Science, Global Index Medicus, Trip, and Cochrane Library. The mixed methods appraisal tool (MMAT) was used for quality checking. A narrative synthesis was conducted to summarise the findings. RESULTS A total of 16 studies were included. The studies report the cognitive, affective, and behavioural reactions associated with public stigma. Cognitive reactions included misbeliefs about the disease transmission and treatment, and death. Affective reactions encompass emotions like disgust and shame, often triggered by the presence of scars. Behavioural reactions included avoidance, discrimination, rejection, mockery, and disruptions of interpersonal relationships. The review also highlights self-stigma manifestations, including enacted, internalised, and felt stigma. Enacted stigma manifested as barriers to forming proper interpersonal relationships, avoidance, isolation, and perceiving CL lesions/scars as marks of shame. Felt stigma led to experiences of marginalisation, rejection, mockery, disruptions of interpersonal relationships, the anticipation of discrimination, fear of social stigmatisation, and facing disgust. Internalised stigma affected self-identity and caused psychological distress. CONCLUSIONS There are various manifestations of stigma associated with CL and MCL. This review highlights the lack of knowledge on the structural stigma associated with CL, the lack of stigma interventions and the need for a unique stigma tool to measure stigma associated with CL and MCL.
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Affiliation(s)
- Hasara Nuwangi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Helen Philippa Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme, Staffordshire, United Kingdom
| | - Thomas Shepherd
- School of Medicine, Keele University, Newcastle-under-Lyme, Staffordshire, United Kingdom
| | - Kosala Gayan Weerakoon
- Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Suneth Buddhika Agampodi
- Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, United States of America
- International Vaccine Institute, Seoul, Republic of Korea
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13
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Vargas Roman VC, Bezemer J, Calvopiña M, Ortega F, Salazar NB, Schallig HDFH, de Vries HJC. Multi-sensorial perceptions of risk: the aesthetics behind (muco)cutaneous leishmaniasis-related stigma in Ecuador. Anthropol Med 2023; 30:362-379. [PMID: 37781888 DOI: 10.1080/13648470.2023.2259184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
Previous research on the stigma associated with cutaneous leishmaniasis, a vector-transmitted parasitic disease, focuses on aesthetic appearance affectation as the leading cause of stigmatisation. However, Indigenous populations in the hinterland of Amazonian Ecuador trigger stigma expressions by recognising (muco)cutaneous leishmaniasis, primarily through atypical smell, followed by the odd voice sound, appearance and taste. This empirical way of recognising symptoms relies on embodied forms of identifying a disease, contrasting the Western supremacy of visuality and demanding to be understood via multi-sensorial anthropology. Through ethnographic research and data retrieved from eighty-three semistructured interviews and fifteen focus groups in seven Ecuadorian ethnic groups - including six Indigenous groups in the Amazon region - this paper analyses how the sensorium is a health thermometer. Findings reveal that differentiated cultural responses to a sense of peril, contagion and social (self)rejection, understood as stigma expressions, are linked to the holistic approach to health (or well-being) shared by Indigenous populations. In forest societies, well-being is explained through successful (non-)human relationships, and disease permeates through bodies that lack balanced relations.
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Affiliation(s)
- Veronica C Vargas Roman
- Department of Social and Cultural Anthropology, KU Leuven, Leuven, Belgium
- Department of Dermatology, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
| | - Jacob Bezemer
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centers (UMC), Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
- Fundación Misión Cristiana de Salud, Hospital Shell, Shell, Ecuador
| | - Manuel Calvopiña
- Facultad de Ciencias de la Salud, Carrera de Medicina, OneHealth Research Group, Universidad de las Américas, Quito, Ecuador
| | | | - Noel B Salazar
- Department of Social and Cultural Anthropology, KU Leuven, Leuven, Belgium
| | - Henk D F H Schallig
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centers (UMC), Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
| | - Henry J C de Vries
- Department of Dermatology, Amsterdam University Medical Centers (UMC), Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunology, Infectious Diseases, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Department of Infectious Diseases, Public Health Service Amsterdam, Center for Sexual Health, Amsterdam, The Netherlands
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14
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Doni S, Yeneneh K, Hailemichael Y, Gebremichael M, Skarbek S, Ayele S, Tadesse AW, Lambert S, Walker SL, Gadisa E. Health-related quality of life of adults with cutaneous leishmaniasis at ALERT Hospital, Addis Ababa, Ethiopia. PLoS Negl Trop Dis 2023; 17:e0011196. [PMID: 37903149 PMCID: PMC10645367 DOI: 10.1371/journal.pntd.0011196] [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: 02/24/2023] [Revised: 11/14/2023] [Accepted: 09/21/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a growing public health threat in Ethiopia. Leishmania aethiopica is the predominant causative organism. Affected individuals develop chronic skin lesions on exposed parts of the body, mostly on the face, which are disfiguring and cause scarring. The effects of CL on the health-related quality of life (HRQoL) of affected individuals has not been assessed in Ethiopia. OBJECTIVE To assess HRQoL in adults with active CL at ALERT Hospital, Addis Ababa, Ethiopia. METHODS A cross-sectional study was done using the Amharic version of the Dermatology Life Quality Index (DLQI). Trained health staff administered the DLQI. RESULTS Three hundred and two adults with active CL participated and all of them exhibited a reduced HRQoL. The median DLQI score was 10 (IQR 8). Almost half of the participants reported very poor HRQoL, 36.4% and 11.3% fell within the very large and extremely large effect categories respectively. DLQI scores were higher (median 18) in patients diagnosed with diffuse cutaneous leishmaniasis (DCL) compared to those with localized cutaneous leishmaniasis (LCL). The DLQI domain of 'work and school' was the most affected, scoring 73.3% and 66.6% of total possible score for female and male respectively, followed by that of 'symptom and feeling' (at 50.0% and 56.6% for female and male respectively). Men were more affected than women in the domains of 'leisure' (P = 0.002) and 'personal relationships' (P = 0.001). In the multivariate ordinal logistic regression site of lesion, clinical phenotype and age of participant remained associated with significantly poor HRQoL. CONCLUSION The HRQoL impairment associated with CL is significant. Thus, patient-reported outcome measure should be used to assess the efficacy of treatments along with clinical outcome measures.
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Affiliation(s)
| | | | - Yohannes Hailemichael
- Armauer Hansen Research Institute, NTD and Malaria Research Directorate, Addis Ababa, Ethiopia
| | - Mikyas Gebremichael
- Armauer Hansen Research Institute, NTD and Malaria Research Directorate, Addis Ababa, Ethiopia
| | - Sophie Skarbek
- Leeds Teaching Hospitals NHS Foundation Trust, Leeds, United Kingdom
| | - Samuel Ayele
- Armauer Hansen Research Institute, NTD and Malaria Research Directorate, Addis Ababa, Ethiopia
| | - Abay Woday Tadesse
- Armauer Hansen Research Institute, NTD and Malaria Research Directorate, Addis Ababa, Ethiopia
| | - Saba Lambert
- ALERT Hospital, Addis Ababa, Ethiopia
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stephen L. Walker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Endalamaw Gadisa
- Armauer Hansen Research Institute, NTD and Malaria Research Directorate, Addis Ababa, Ethiopia
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15
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Sarmadi M, Bagherian Z, Ahmadi-Soleimani SM, Rezaiemanesh MR, Khodamoradi F, Rahimi S, Azizi H. Environmental health risk factors and cutaneous leishmaniasis (CL): A case-control study in northeastern Iran. J Vector Borne Dis 2023; 60:372-381. [PMID: 38174514 DOI: 10.4103/0972-9062.374236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Background & objectives Cutaneous leishmaniasis (CL) is one of the main causes of vector-born diseases in younger population. To evaluate the association of environmental health factors on the odds of CL incidence, a case-control study was conducted in northeastern Iran. Methods This study was conducted within 2020-2021 based on individual and household data from a tertiary referral center. Cases were patients diagnosed with CL by PCR method; controls were selected among the patients' relatives, and information was obtained from a health registry system. Demographic and socioeconomic data of 1871 subjects, included age, sex, household information and environmental health factors. Multivariable models with environmental factors in various conditions and CL were separately fit by univariate and mixed multiple unconditional logistic regression. Results Participants included 617 cases (mean [SD] age, 13.62[13.72] years; 58.20% male) and 1264 controls (mean [SD] age, 16.45[15.44] years; 50.40% male). Results revealed that the use of well-water sources compared to surface water is significantly associated with CL (odds ratio [OR]=0.204; 95%CI, 0.13-0.33;P<0.001). Muddy houses, ruined buildings or wastelands and stagnant water, canals and rivers near the houses were also associated with CL (OR=3.85; 95%CI, 1.66-8.89; P=.002; OR=2.47; 95%CI, 1.76-3.47; P<.001). Besides, existence of pine tree was found to be a risk factor (OR=3.25; 95%CI, 2.12-4.99; P<.001) and similarly for the use of waste collection system (OR=4.43; 95%CI, 3.32-7.51; P<.001). Interpretation & conclusion Environmental factors related to houses were significantly associated with CL and may represent the modifiable risk factors of CL disease.
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Affiliation(s)
- Mohammad Sarmadi
- Department of Environmental Health Engineering, School of Health; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Zahra Bagherian
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - S Mohammad Ahmadi-Soleimani
- Health Sciences Research Center; Department of Physiology, School of Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammad Reza Rezaiemanesh
- Health Sciences Research Center; Department of Laboratory Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Farzad Khodamoradi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sajjad Rahimi
- Department of Environmental Health Engineering, School of Health; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Hakim Azizi
- Department of Medical Parasitology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
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16
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Rai T, Shrestha S, Prajapati S, Bastola A, Parajuli N, Ghimire PG, Bhandari P, Pandey K, Jain M, Matlashewski G, Bras-Goncalves R, Manandhar KD. Leishmania donovani persistence and circulation causing cutaneous leishmaniasis in unusual-foci of Nepal. Sci Rep 2023; 13:12329. [PMID: 37516780 PMCID: PMC10387047 DOI: 10.1038/s41598-023-37458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/22/2023] [Indexed: 07/31/2023] Open
Abstract
Cutaneous leishmaniasis cases have increased dramatically in recent years in Nepal. The study offers molecular identification of the Leishmania species using 40 patient's aspiration biopsy samples, targeting markers kinetoplast minicircle DNA (kDNA) and internal transcribed spacer-1 (ITS1). Among molecularly diagnosed 22 cutaneous leishmaniasis cases, L. donovani complex was identified in 13 instances and L. major in 9 cases. The ITS1 PCR was positive in 12 of the positive nested- kDNA PCR cases (12/22), confirming L. donovani complex in seven of the cases and L. major in five of the cases. In addition, the study conclude that concurrent occurrence of atypical cutaneous infections caused by L. donovani parasite in 59.1% of cases and typical cutaneous infections caused by L. major parasite in 40.9% of cases. A Phylogentic analaysis showed that the detected L. donovani species present null genetic distances from seven references of L. donovani, but slight differences between ITS1 sequences and not grouped into a significant monophyletic cluster.
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Affiliation(s)
- Tinmaya Rai
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Srijan Shrestha
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Sabita Prajapati
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Anup Bastola
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, 44600, Nepal
| | | | | | | | - Kishor Pandey
- Central Department of Zoology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal
| | - Manju Jain
- Department of Biochemistry, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, QC, H3A 0G4, Canada
| | | | - Krishna Das Manandhar
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Kathmandu, 44600, Nepal.
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17
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Saidi N, Blaizot R, Prévot G, Aoun K, Demar M, Cazenave PA, Bouratbine A, Pied S. Clinical and immunological spectra of human cutaneous leishmaniasis in North Africa and French Guiana. Front Immunol 2023; 14:1134020. [PMID: 37575260 PMCID: PMC10421664 DOI: 10.3389/fimmu.2023.1134020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/10/2023] [Indexed: 08/15/2023] Open
Abstract
Cutaneous leishmaniasis (CL) caused by infection with the parasite Leishmania exhibits a large spectrum of clinical manifestations ranging from single healing to severe chronic lesions with the manifestation of resistance or not to treatment. Depending on the specie and multiple environmental parameters, the evolution of lesions is determined by a complex interaction between parasite factors and the early immune responses triggered, including innate and adaptive mechanisms. Moreover, lesion resolution requires parasite control as well as modulation of the pathologic local inflammation responses and the initiation of wound healing responses. Here, we have summarized recent advances in understanding the in situ immune response to cutaneous leishmaniasis: i) in North Africa caused by Leishmania (L.) major, L. tropica, and L. infantum, which caused in most cases localized autoresolutives forms, and ii) in French Guiana resulting from L. guyanensis and L. braziliensis, two of the most prevalent strains that may induce potentially mucosal forms of the disease. This review will allow a better understanding of local immune parameters, including cellular and cytokines release in the lesion, that controls infection and/or protect against the pathogenesis in new world compared to old world CL.
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Affiliation(s)
- Nasreddine Saidi
- Univ. Lille, Univ. French Guiana, CNRS UMR 9017-INSERM U1019, Center for Infection and Immunity of Lille-CIIL, Institut Pasteur de Lille, Lille, France
- Laboratoire de Recherche, LR 16-IPT-06, Parasitoses Médicales, Biotechnologies et Biomolécules, Institut Pasteur de Tunis, Université Tunis El-Manar, Tunis, Tunisia
| | - Romain Blaizot
- Univ. Lille, Univ. French Guiana, CNRS UMR 9017-INSERM U1019, Center for Infection and Immunity of Lille-CIIL, Institut Pasteur de Lille, Lille, France
- Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France
- Service de Dermatologie, Hôpital de Cayenne, Cayenne, French Guiana, France
| | - Ghislaine Prévot
- Univ. Lille, Univ. French Guiana, CNRS UMR 9017-INSERM U1019, Center for Infection and Immunity of Lille-CIIL, Institut Pasteur de Lille, Lille, France
| | - Karim Aoun
- Laboratoire de Recherche, LR 16-IPT-06, Parasitoses Médicales, Biotechnologies et Biomolécules, Institut Pasteur de Tunis, Université Tunis El-Manar, Tunis, Tunisia
- Service de Parasitologie-Mycologie, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Magalie Demar
- Univ. Lille, Univ. French Guiana, CNRS UMR 9017-INSERM U1019, Center for Infection and Immunity of Lille-CIIL, Institut Pasteur de Lille, Lille, France
- Centre National de Référence des Leishmanioses, Laboratoire Associé, Hôpital Andrée Rosemon, Cayenne, French Guiana, France
- Service de Dermatologie, Hôpital de Cayenne, Cayenne, French Guiana, France
| | - Pierre André Cazenave
- Univ. Lille, Univ. French Guiana, CNRS UMR 9017-INSERM U1019, Center for Infection and Immunity of Lille-CIIL, Institut Pasteur de Lille, Lille, France
| | - Aida Bouratbine
- Laboratoire de Recherche, LR 16-IPT-06, Parasitoses Médicales, Biotechnologies et Biomolécules, Institut Pasteur de Tunis, Université Tunis El-Manar, Tunis, Tunisia
- Service de Parasitologie-Mycologie, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Sylviane Pied
- Univ. Lille, Univ. French Guiana, CNRS UMR 9017-INSERM U1019, Center for Infection and Immunity of Lille-CIIL, Institut Pasteur de Lille, Lille, France
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18
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Elfaki N, Alzahrani M, Abdalla YHA, Alkhadher MA, Osman AM, Taha W, Alghamdi W, Alshameri FA, Ahmed WAM. Self-reported depression and anxiety rates among females with cutaneous leishmaniasis in Hubuna, Saudi Arabia. PeerJ 2023; 11:e15582. [PMID: 37361033 PMCID: PMC10289083 DOI: 10.7717/peerj.15582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
Background Cutaneous leishmaniasis (CL) is a parasitic disease transmitted through the bite of infected sandflies, causing disfiguring skin lesions and a range of physical symptoms. However, the psychological impact of CL is often overlooked despite the significant burden it imposes on the affected individuals and communities. This is especially true in Saudi Arabia, where limited research exists on the psychological consequences of CL, particularly among females. This study aimed to address this knowledge gap by investigating the perceived psychological problems associated with CL among females living in the Hubuna area of Saudi Arabia. Methods This cross-sectional study recruited 213 females with CL in the Hubuna area of Saudi Arabia using purposive sampling. Data was collected using a self-administered electronic questionnaire that included socio-demographic characteristics and measures of depression and anxiety using the BDI and GAD-7 tools. Descriptive analysis was used to determine the psychological impact of CL, including means and standard deviations for the BDI and GAD-7 scores, as well as frequencies and percentages for other variables of interest. Logistic regression was performed to identify independent predictors of anxiety and depression, including variables such as age, marital status, education, occupation, number and location of lesions. The significance level for all statistical tests was set at p < 0.05. The study was carried out between September and December of 2022. Results The study found that the mean Beck Depression Inventory (BDI) and Generalized Anxiety Disorder-7 (GAD-7) scores among the participants were 8.67 ± 4.82 out of 63 and 8.20 ± 7.08 out of 21, respectively. Furthermore, the prevalence of depression and anxiety was 55.9% and 68.1%, respectively, indicating a significant psychological burden associated with CL in the study population. The results of the logistic regression analysis showed that anxiety and depression were significantly associated with age, marital status, number of lesions, and location of the lesions on the body, highlighting the importance of considering these factors when designing interventions aimed at improving the mental health of CL patients. Conclusions In conclusion, this study highlights the significant psychological impact of CL among females in the Hubuna area of Saudi Arabia, calling for urgent action to address this neglected aspect of the disease. By integrating mental health considerations into CL prevention and management efforts, healthcare providers can improve the overall well-being of affected individuals and contribute to the broader goal of eliminating CL as a public health concern.
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Affiliation(s)
- Nahid Elfaki
- Community Health Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Mohammed Alzahrani
- Pediatric Department, College of Medicine, Najran University, Najran, Saudi Arabia
| | | | - Mugahed Ali Alkhadher
- Medical and Surgical Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Wargaa Taha
- Maternity and Child Health Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Wael Alghamdi
- Nursing Department, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | | | - Waled A. M. Ahmed
- Nursing Department, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
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19
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Karami M, Gorgani-Firouzjaee T, Chehrazi M. Prevalence of cutaneous Leishmaniasis in the Middle East: a systematic review and meta-analysis. Pathog Glob Health 2023; 117:356-365. [PMID: 36222473 PMCID: PMC10177677 DOI: 10.1080/20477724.2022.2133452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Cutaneous leishmaniasis (CL), caused by an obligate intracellular protozoan parasite from the genus Leishmania, imposing a significant burden on underdeveloped countries especially those located in the Middle East. Four electronic databases were searched to evaluate the prevalence of CL in the Middle East. The random effects model (95% confidence intervals (CI)) were applied to determine the overall and subgroup pooled prevalence. Heterogeneity was assessed by Cochran's Q test and I2 statistics. Among 2424 peer-reviewed papers, 37 datasets from 34 studies were included in the current meta-analysis. 285560 individuals were assessed across 9 Middle Eastern countries. The pooled prevalence of CL was estimated at 12% (95% CI 9-15 %; 10718/285560). The highest prevalence rate was observed in Syria (39%, 37-42%), and the lowest one was found in Iraq and Lebanon (0%, 0-1%). The prevalence of CL in studies that applied LST assays had the highest rate (48%, 17-80%). The infection rate in males was similar to females (7%, 4-10%). The prevalence of infection in individuals living in urban areas was higher than in rural areas (14%, 10-19%). The prevalence of CL in the age group 0-15 years was higher than in individuals 16-40 and >40 years (9%, 6-13%). Most of the lesions were found on the face, and single lesions were more prevalent than two and three ones. In conclusion, the occurrence of CL was considerable in Middle Eastern countries. Therefore, more efforts should be made to precisely report the CL in this region for developing appropriate preventive and controlling strategies. .
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Affiliation(s)
- Mohsen Karami
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Tahmineh Gorgani-Firouzjaee
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Health Science, Babol University of Medical Sciences, Babol, Iran
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20
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Nuwangi H, Agampodi TC, Price HP, Shepherd T, Weerakoon KG, Agampodi SB. The stigma associated with cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (MCL): A protocol for a systematic review. PLoS One 2023; 18:e0285663. [PMID: 37167276 PMCID: PMC10174477 DOI: 10.1371/journal.pone.0285663] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/29/2023] [Indexed: 05/13/2023] Open
Abstract
Leishmaniasis is a neglected tropical disease with three main clinical types; cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL). CL and MCL are considered to be highly stigmatizing due to potentially disfiguring skin pathology. CL and MCL-associated stigma are reported across the world in different contexts assimilating different definitions and interpretations. Stigma affects people with CL, particularly in terms of quality of life, accessibility to treatment, and psycho-social well-being. However, evidence on CL- and MCL-associated stigma is dispersed and yet to be synthesized. This systematic review describes the types, measurements, and implications of the stigma associated with CL and MCL and identifies any preventive strategies/interventions adopted to address the condition. This study was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement which is registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols PROSPERO (ID- CRD42021274925). We will perform an electronic search in MEDLINE, Embase, Scopus, PubMed, EBSCO, Web of Science, Global Index Medicus, Trip, and Cochrane Library databases, and in Google Scholar, using a customized search string. Any article that discusses any type of CL- and/or MCL-associated stigma in English, Spanish and Portuguese will be included. Articles targeting veterinary studies, sandfly vector studies, laboratory-based research and trials, articles focusing only on visceral leishmaniasis, and articles on diagnostic or treatment methods for CL and MCL will be excluded. Screening for titles and abstracts and full articles and data extraction will be conducted by two investigators. The risk of bias will be assessed through specific tools for different study types. A narrative synthesis of evidence will then follow. This review will identify the knowledge gap in CL-associated stigma and will help plan future interventions.
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Affiliation(s)
- Hasara Nuwangi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Helen Philippa Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme, Staffordshire, United Kingdom
| | - Thomas Shepherd
- School of Medicine, Keele University, Newcastle-under-Lyme, Staffordshire, United Kingdom
| | - Kosala Gayan Weerakoon
- Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Suneth Buddhika Agampodi
- Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, United States of America
- International Vaccine Institute, Seoul, Republic of Korea
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21
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Alemayehu B, Kelbore AG, Alemayehu M, Adugna C, Bibo T, Megaze A, Leirs H. Knowledge, attitude, and practice of the rural community about cutaneous leishmaniasis in Wolaita zone, southern Ethiopia. PLoS One 2023; 18:e0283582. [PMID: 36976758 PMCID: PMC10047512 DOI: 10.1371/journal.pone.0283582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a neglected tropical disease that is caused by a Leishmania parasite and transmitted by the bite of infected female sandflies. Community awareness is an essential component of disease control and prevention. Therefore, this study aimed to assess the community's knowledge, attitude, and practice toward CL in Wolaita zone, southern Ethiopia. METHODS A community-based cross-sectional study design was employed to include 422 study subjects selected using a systematic sampling technique from two districts, Kindo Didaye and Sodo Zuria. A pretested structured questionnaire was used to collect data from the household heads. Bivariate and multivariate logistic regression analyses were performed to determine the relationship between the participants' knowledge about CL and socio-demographic characteristics. RESULTS Out of the 422 study participants, only 19% had good knowledge of CL in general. Most (67.1%) of the respondents knew CL by its local name ("bolbo" or "moora") though this knowledge varied highly over the study districts. The majority (86.3%) of respondents did not know how CL is acquired, though they considered CL a health problem. Most (62.8%) respondents believed that CL was an untreatable disease. Most (77%) participants responded that CL patients preferred to go to traditional healers for treatment. Herbal treatment was the most (50.2%) used to treat CL. Knowledge about CL was significantly associated with sex, age, and study districts. CONCLUSION The overall knowledge, attitude, and practice about CL and its prevention in the study area were low. This emphasizes the need to implement health education and awareness campaign to reduce the risk of CL infection. Policymakers and stakeholders should also give due attention to the prevention and treatment of CL in the study area.
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Affiliation(s)
- Bereket Alemayehu
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Abraham Getachew Kelbore
- Department of Dermatology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Mihiretu Alemayehu
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Chimdesa Adugna
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tessema Bibo
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Aberham Megaze
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Herwig Leirs
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
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22
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Mounia A, Mohamed E, Mohamed H, Samia B. A Community Based Survey of Knowledge, Attitudes, and Practices Concerning Leishmaniasis in Central Morocco. J Community Health 2022; 47:932-942. [PMID: 35921052 DOI: 10.1007/s10900-022-01126-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 12/26/2022]
Abstract
Leishmaniasis is a major health problem caused by a protozoan of the genus Leishmania, most commonly transmitted by infected female sand flies. Intersectoral collaboration is essential for the implementation of integrated vector management control with community participation. The present study aims to evaluate the knowledge, attitude and practices of the population toward leishmaniasis in central Morocco. A quantitative cross-sectional study was conducted using an administered questionnaire assisted by health professionals, on 750 people in the Marrakech Safi, endemic region of cutaneous leishmaniasis (CL). Of those, 702 agreed to be recruited for our study, of which 63,5% were women, 48,1% were aged between 18 and 40 years, and more than half of the participants (60%) were from rural areas. Overall, the knowledge, attitude and practices (KAPs) for leishmaniasis are too poor for more than 85% of the population in the study area. Basic knowledge and perceptions of leishmaniasis were good for 14,6% of respondents. While, 4,5% of the members had good knowledge of CL, only 0,7% had good level of knowledge about vesciral leishmaniasis (VL). Furthermore 3,7% of those polled have favorable attitudes and preventive practices. No association was found between knowledge and age, province or occupation. However, rural residents were four times more likely than urbain residents to have good basic knowledge (ORA = 4,74; CI95%: 1,04 -22,05). In addition, the female gender also has the chance to possess good basic knowledge and perceptions 3 times more than the men (ORA = 3,18; CI95%: 1,16 -8,69). The low level of KAPs regarding leishmaniasis proves the lack of community participation in the fight against leishmaniasis in central Morocco.
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Affiliation(s)
- Amane Mounia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.
| | - Echchakery Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Hafidi Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - Boussaa Samia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Ministry of Health and Social Protection, ISPITS-Higher Institute of Nursing and Technical Health Occupations, Rabat, Morocco
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23
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Community-Based Interventions for the Prevention and Control of Cutaneous Leishmaniasis: A Systematic Review. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organization. We searched nine electronic databases for intervention-based studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD: 1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore, we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access).
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24
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Fusco D, Martínez-Pérez GZ, Remkes A, De Pascali AM, Ortalli M, Varani S, Scagliarini A. A sex and gender perspective for neglected zoonotic diseases. Front Microbiol 2022; 13:1031683. [PMID: 36338031 PMCID: PMC9632621 DOI: 10.3389/fmicb.2022.1031683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Daniela Fusco
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg, Germany
- *Correspondence: Daniela Fusco
| | | | - Aaron Remkes
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg, Germany
| | - Alessandra Mistral De Pascali
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Margherita Ortalli
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stefania Varani
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessandra Scagliarini
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
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25
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Debash H, Ebrahim H, Bisetegn H. Epidemiological and clinical characteristics of cutaneous leishmaniasis among patients attending at Tefera Hailu Memorial Hospital, Sekota, Northeast Ethiopia: A five-year trend analysis (2016-2020). SAGE Open Med 2022; 10:20503121221129720. [PMID: 36246535 PMCID: PMC9558864 DOI: 10.1177/20503121221129720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This study was designed to determine the epidemiological and clinical characteristics of cutaneous leishmaniasis among patients attending at Tefera Hailu Memorial Hospital, Sekota, Northeast Ethiopia over the last 5 years. Methods A 5-year retrospective study was conducted at Tefera Hailu Memorial Hospital, Northeast Ethiopia. Data were summarized and analysed using Microsoft Excel and SPSS 26 version software, respectively. To present the data and evaluate the patterns in cutaneous leishmaniasis cases across the 5 years, months, and seasons, descriptive statistics were utilized. In multivariable logistic regression analysis of determinants in relation to cutaneous leishmaniasis positivity, p-value less than 0.05 was considered as statistically significant. Result The overall positivity rate of cutaneous leishmaniasis was 31.1% (452 out of 1455) over the last 5 years at Tefera Hailu Memorial Hospital. The result showed a fluctuating yet declining trend in cutaneous leishmaniasis infections. The highest number of cases was registered in 2016, while the lowest was in 2020. Males and the age group of 15-49 years, accounted 78.5% and 79.9% of the patients, respectively, were the hardest hit by cutaneous leishmaniasis in the area. Similarly, the highest number of cases was observed in Dehana district (268). From all registered confirmed cases, 54 (10.7%) were previously treated cases. Moreover, the majority of cases, 423 (93.6%) were localized cutaneous leishmaniasis and most of the lesions were on the face. Conclusion Although the results indicate a fluctuating yet declining trend, the positivity rate of confirmed cutaneous leishmaniasis cases in the area remains alarming and indicates a major public health burden. Therefore, efforts are required to reduce the disease burden through continuous monitoring and evaluation of control measures in the study area.
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Affiliation(s)
- Habtu Debash
- Habtu Debash, Department of Medical
Laboratory Sciences, College of Medicine and Health Sciences, Wollo University,
Dessie, Ethiopia.
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26
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Wenning B, Price H, Nuwangi H, Reda KT, Walters B, Ehsanullah R, Viana G, Andras A, Dikomitis L. Exploring the cultural effects of gender on perceptions of cutaneous leishmaniasis: a systematic literature review. Glob Health Res Policy 2022; 7:34. [PMID: 36163191 PMCID: PMC9511709 DOI: 10.1186/s41256-022-00266-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/12/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how the cultural effects of gender shape perceptions and experiences of CL. This review aims to bring together and analyse existing studies which use qualitative data to explore these differences. These studies offered insights into our specific research questions. METHODS We conducted a systematic review of the literature pertaining to either CL or muco-cutaneous leishmaniasis (MCL) through EBSCO, EMBASE, Medline, Scopus and Web of Science databases. To meet inclusion criteria, articles had to be either qualitative or mixed-method with a qualitative component. They also had to include a reflection on how the gender of participants impacted the findings and addressed the lived experiences of CL. We did not exclude articles based on the language they were published in or in which country the study took place. RESULTS From a total of 1589 potential articles, we found that thirteen met the inclusion criteria. These articles were published in English, Spanish or Portuguese and reported on studies carried out in various countries in Africa, Asia and South America. After using the principles of a meta-ethnography to analyse these studies, we generated several key themes. We found that health-seeking behaviours, treatment choices, stigma and the impact of scarring are shaped by gender in a variety of contexts. CONCLUSIONS Gender impacts on an individual's experience of CL. In particular, women are more constricted in their health-seeking behaviours and experience more stigma both from the active lesions and from scarring than men. In many contexts, however, men are more at risk of becoming infected by the parasite that causes CL and may turn to more harmful or aggressive self-treatments. We recommend that future research on CL should consider the impact of gender as this can create very different experiences for individuals.
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Affiliation(s)
- Brianne Wenning
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, CT2 7FS, UK
| | - Helen Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme, UK
| | - Hasara Nuwangi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | | | - Ben Walters
- Royal Stoke University Hospital, Stoke-on-Trent, UK
| | | | - Greice Viana
- State University of Rio de Janeiro (UERJ) and Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Alina Andras
- School of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Lisa Dikomitis
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, CT2 7FS, UK.
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Bezemer JM, Hinojosa MC, Zabala AEC, Pérez FO, Román VCV, Schallig HDFH, de Vries HJC. Quality of life of cutaneous leishmaniasis suspected patients in the Ecuadorian Pacific and Amazon regions: a cross sectional study. BMC Infect Dis 2022; 22:748. [PMID: 36153487 PMCID: PMC9509548 DOI: 10.1186/s12879-022-07733-4] [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: 06/22/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Yearly, up to 1 million patients worldwide suffer from cutaneous leishmaniasis (CL). In Ecuador, CL affects an estimated 5000 patients annually. CL leads to reduced Health Related Quality of Life (HRQL) as a result of stigma in the Asian and Mediterranean contexts, but research is lacking for Ecuador. The objective of this study was to explore the influence of CL suspected lesions on the quality of life of patients in the Pacific and Amazon regions. Methods Patients for this study were included in the Amazonian Napo, Pastaza, and Morona Santiago provinces and the Pacific region of the Pichincha province. Participating centers offered free of charge CL treatment. All patients suspected of CL and referred for a cutaneous smear slide microscopy examination were eligible. This study applied the Skindex-29 questionnaire, a generic tool to measure HRQL in patients with skin diseases. All statistical analysis was done with SPSS Statistics version 28. Results The skindex-29 questionnaire was completed adequately by 279 patients who were included in this study. All patient groups from the Amazon scored significantly (P < 0.01) higher (indicating worse HRQL) on all the dimensions of the Skindex-29 questionnaire than Mestizo patients from the Pacific region. The percentage of patients with health seeking delay of less than a month was significantly (P < 0.01) lower in the Amazon region (38%) than in the Pacific (66%). Conclusions The present study revealed that the influence of suspected CL lesions on the HRQL of patients in the Ecuadorian Amazon and Pacific depends on the geographic region more than on patient characteristics such as gender, age, number of lesions, lesion type, location of lesions, health seeking delay, or posterior confirmation of the Leishmania parasite. The health seeking delay in the Amazon might result from a lack of health infrastructure or related stigma. Together, the impaired HRQL and prolonged health seeking delay in the Amazon lead to prolonged suffering and a worse health outcome. Determinants of health seeking delay should be clarified in future studies and CL case finding must be improved. Moreover, HRQL analysis in other CL endemic regions could improve local health management. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07733-4.
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Hassan R, Deribe K, Simpson H, Bremner S, Elhadi O, Alnour M, Fahal AH, Newport M, Bakhiet S. Individual Risk Factors of Mycetoma Occurrence in Eastern Sennar Locality, Sennar State, Sudan: A Case-Control Study. Trop Med Infect Dis 2022; 7:tropicalmed7080174. [PMID: 36006266 PMCID: PMC9412883 DOI: 10.3390/tropicalmed7080174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Mycetoma is a serious chronic subcutaneous granulomatous inflammatory disease that is endemic in tropical and subtropical regions, where it impacts profoundly on patients, families, and communities. Individual-level risk factors for the disease are poorly understood. To address this, a case-control study was conducted based on data collected from 60 villages in Eastern Sennar Locality, Sennar State, Sudan. Based on the presence of swelling in any part of the body, or sinus formation with or without grain discharge evident from the lesion by ultrasound examination, we diagnosed 359 cases of mycetoma. For each case, we included three healthy sex-matched persons, with no evidence of mycetoma, from the same village as the control group (n = 1077). The odds for mycetoma were almost three times higher in individuals in the age group 16–30 years (Adjusted Odds Ratio (AOR) = 2.804, 95% CI = 1.424–5.523) compared to those in age group ≤ 15 years. Other factors contributing to the odds of mycetoma were history of local trauma (AOR = 1.892, 95% CI = 1.425–2.513), being unmarried (AOR = 3.179, 95% CI = 2.339–4.20) and owning livestock (AOR = 3.941, 95% CI = 2.874–5.405). In conclusion, certain factors found to be associated with mycetoma in this study could inform a high index of suspicion for mycetoma diagnosis, which would improve early case detection. Other factors found to be associated could inform the development of an interventional program for mycetoma control in Sudan, including education on healthy farming practices and the risks of puncture wounds for individuals residing in endemic areas. However, this work was conducted in one endemic state, while mycetoma cases occur in all states of Sudan. Replicating this study over a wider area would give a fuller picture of the situation, providing the control program with more comprehensive information on the risk factors for the disease.
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Affiliation(s)
- Rowa Hassan
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
- Correspondence:
| | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
- Children’s Investment Fund Foundation, Addis Ababa P.O. Box 9086, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
| | - Hope Simpson
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Stephen Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Osama Elhadi
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
| | - Mustafa Alnour
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
- Department of Radiography, Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | - Ahmed Hassan Fahal
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
| | - Melanie Newport
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Sahar Bakhiet
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
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Boozhmehrani MJ, Eslami G, Khamesipour A, Jafari AA, Vakili M, Hosseini SS, Askari V. The role of ATP-binding cassette transporter genes expression in treatment failure cutaneous leishmaniasis. AMB Express 2022; 12:78. [PMID: 35710996 PMCID: PMC9203622 DOI: 10.1186/s13568-022-01419-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022] Open
Abstract
Leishmaniasis is one of the common diseases transmitted by sand flies in tropical and subtropical regions of the world. Currently, antimonial derivatives are the first line of treatment. Some of the members of the ATP-binding cassette (ABC) family of Leishmania are shown to be associated with no response to treatment. In this study, we evaluated ABCI4, ABCG2, ABCC7, ABCB4, and ABCC3 genes expression in Leishmania isolated from patients with non-healing cutaneous leishmaniasis and treatment response isolates. We selected 17 clinical isolates including 8 treatment failure and 9 treatment response samples from September 2020 to March 2021. The isolates were obtained from patients of Health Center Laboratory of Varzaneh, Isfahan, Iran with cutaneous leishmaniasis. The diagnosis was performed using microscopic observation. The samples were directly collected from the lesions. The expression profiling of genes was assessed using SYBR Green real-time PCR that was analyzed with delta-delta Ct. All treatment failure clinical isolates were L. major. Gene expression analysis in treatment failure isolates showed that the ABC transported genes had a different pattern in each isolate. Treatment failure has been reported for cutaneous leishmaniasis worldwide. Knowledge of the molecular mechanisms of treatment failure could solve this problem. ABC transporter genes are considered controversial over the mechanisms of treatment failure outcomes. In this study, we showed that ABC transporter genes could be considered one of the important mechanisms.
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Affiliation(s)
- Mohammad Javad Boozhmehrani
- Department of Parasitology and Mycology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Gilda Eslami
- Department of Parasitology and Mycology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ali Jafari
- Department of Parasitology and Mycology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Vakili
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saeedeh Sadat Hosseini
- Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Vahideh Askari
- Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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30
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Assolini JP, Carloto ACM, Bortoleti BTDS, Gonçalves MD, Tomiotto Pellissier F, Feuser PE, Cordeiro AP, Hermes de Araújo PH, Sayer C, Miranda Sapla MM, Pavanelli WR. Nanomedicine in leishmaniasis: A promising tool for diagnosis, treatment and prevention of disease - An update overview. Eur J Pharmacol 2022; 923:174934. [PMID: 35367420 DOI: 10.1016/j.ejphar.2022.174934] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 12/17/2022]
Abstract
Leishmaniasis is a neglected tropical disease that has a wide spectrum of clinical manifestations, ranging from visceral to cutaneous, with millions of new cases and thousands of deaths notified every year. The severity of the disease and its various clinical forms are determined by the species of the causative agent, Leishmania, as well as the host's immune response. Major challenges still exist in the diagnosis and treatment of leishmaniasis, and there is no vaccine available to prevent this disease in humans. Nanotechnology has emerged as a promising tool in a variety of fields. In this review, we highlight the main and most recent advances in nanomedicine to improve the diagnosis and treatment, as well as for the development of vaccines, for leishmaniasis. Nanomaterials are nanometric in size and can be produced by a variety of materials, including lipids, polymers, ceramics, and metals, with varying structures and morphologies. Nanotechnology can be used as biosensors to detect antibodies or antigens, thus improving the sensitivity and specificity of such immunological and molecular diagnostic tests. While in treatment, nanomaterials can act as drug carriers or, be used directly, to reduce any toxic effects of drug compounds to the host and to be more selective towards the parasite. Furthermore, preclinical studies show that different nanomaterials can carry different Leishmania antigens, or even act as adjuvants to improve a Th1 immune response in an attempt to produce an effective vaccine.
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Affiliation(s)
- João Paulo Assolini
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, PR, Brazil; Universidade Alto Vale do Rio Peixe, Caçador, SC, Brazil.
| | | | | | | | | | - Paulo Emilio Feuser
- Department of Chemical Engineering and Food Engineering, Federal University of Santa Catarina, SC, Brazil
| | - Arthur Poester Cordeiro
- Department of Chemical Engineering and Food Engineering, Federal University of Santa Catarina, SC, Brazil
| | | | - Claudia Sayer
- Department of Chemical Engineering and Food Engineering, Federal University of Santa Catarina, SC, Brazil
| | | | - Wander Rogério Pavanelli
- Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, PR, Brazil.
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Predictors for Estimating Scars’ Internalization in Victims with Post-Traumatic Scars versus Patients with Postsurgical Scars. Healthcare (Basel) 2022; 10:healthcare10030550. [PMID: 35327027 PMCID: PMC8951544 DOI: 10.3390/healthcare10030550] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/06/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Scars are the consequence of physiological inherent healing processes of post-traumatic and surgical lesions with a psychological impact. Post-traumatic scarring may induce emotional and behavioral changes through social stigma. In this study we analyze the internalization of scars and their impact on hopelessness, depression, or the perception of social support in subjects with post-traumatic scars compared to people with surgical scars. (2) Methods: to research this suggested model, we analyzed data collected from 110 participants 61 women and 49 men, aged between 18 and 64 years; 55 participants had post-traumatically and 55 surgically acquired scars. They all were examined to assess the characteristics of scars, were asked to complete four psycho-social scales, and the results were compared. (3) Results: our results indicate that people with post-traumatic scars are oriented toward the internalization of scars, depending on their shape and size. We argue that hopelessness, appreciation of scars, age, and how scars are produced are important predictors of internalization. (4) Conclusions: the patient’s attitude toward the appearance of a scar is an indicator of how he/she will react in the future and it could predict the vulnerability to hopelessness. Finally, we nuance the impact of objective bodily harm on the psychological and moral suffering.
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Polidano K, Parton L, Agampodi SB, Agampodi TC, Haileselassie BH, Lalani JMG, Mota C, Price HP, Rodrigues S, Tafere GR, Trad LAB, Zerihun Z, Dikomitis L. Community Engagement in Cutaneous Leishmaniasis Research in Brazil, Ethiopia, and Sri Lanka: A Decolonial Approach for Global Health. Front Public Health 2022; 10:823844. [PMID: 35242734 PMCID: PMC8885625 DOI: 10.3389/fpubh.2022.823844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a parasitic skin disease endemic in at least 88 countries where it presents an urgent, albeit often “neglected” public health problem. In this paper, we discuss our model of decolonial community engagement in the ECLIPSE global health research program, which aims to improve physical and mental health outcomes for people with CL. The ECLIPSE program has four interlinked phases and underpinning each of these phases is sustained and robust community engagement and involvement that guides and informs all activities in ECLIPSE. Our decolonial approach implies that the model for community engagement will be different in Brazil, Ethiopia and Sri Lanka. Indeed, we adopt a critical anthropological approach to engaging with community members and it is precisely this approach we evaluate in this paper. The data and material we draw on were collected through qualitative research methods during community engagement activities. We established 13 Community Advisory Groups (CAGs): in Brazil (n = 4), Ethiopia (n = 6), and Sri Lanka (n = 3). We identified four overarching themes during a thematic analysis of the data set: (1) Establishing community advisory groups, (2) CAG membership and community representation, (3) Culturally appropriate and context-bespoke engagement, and (4) Relationships between researchers and community members. During our first period of ECLIPSE community engagement, we have debunked myths (for instance about communities being “disempowered”), critiqued our own practices (changing approaches in bringing together CAG members) and celebrated successes (notably fruitful online engagement during a challenging COVID-19 pandemic context). Our evaluation revealed a gap between the exemplary community engagement frameworks available in the literature and the messy, everyday reality of working in communities. In the ECLIPSE program, we have translated ideal(istic) principles espoused by such community engagement guidance into the practical realities of “doing engagement” in low-resourced communities. Our community engagement was underpinned by such ideal principles, but adapted to local sociocultural contexts, working within certain funding and regulatory constraints imposed on researchers. We conclude with a set of lessons learned and recommendations for the conduct of decolonial community engagement in global health research.
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Affiliation(s)
- Kay Polidano
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Linda Parton
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Suneth B. Agampodi
- Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Thilini C. Agampodi
- Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | | | | | - Clarice Mota
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Helen P. Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Steffane Rodrigues
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | | | - Leny A. B. Trad
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Zenawi Zerihun
- Department of Psychology, Mekelle University, Mekelle, Ethiopia
| | - Lisa Dikomitis
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, United Kingdom
- *Correspondence: Lisa Dikomitis
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Ali O, Kinfe M, Semrau M, Tora A, Tesfaye A, Mengiste A, Davey G, Fekadu A. A qualitative study on the implementation of a holistic care package for control and management of lymphoedema: experience from a pilot intervention in northern Ethiopia. BMC Health Serv Res 2021; 21:1065. [PMID: 34625080 PMCID: PMC8501530 DOI: 10.1186/s12913-021-07088-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/21/2021] [Indexed: 01/02/2023] Open
Abstract
Background Neglected Tropical Diseases (NTDs) such as podoconiosis, lymphatic filariasis (LF) and leprosy mainly affect communities in low resource settings. These diseases are associated with physical disability due to lymphoedema as well as poor mental health and psychosocial outcomes. Integration of care across these NTDs at primary health care level, which includes mental health and psychosocial care alongside physical health care, is increasingly recommended. Methods A holistic integrated care package was developed and piloted as part of the EnDPoINT project in Gusha district, Awi zone, Ethiopia. The intervention was conducted at the health care organization, health facility and community levels. To assess the impact of the care package in terms of acceptability, scalability, sustainability and barriers to implementation, a qualitative study was conducted in January 2020. This included four focus group discussions (29 participants) and ten key informant interviews with decision makers, health professionals, patients, and community representatives. Results The integrated lymphoedema care package was found to be efficient compared to vertical programs in saving time and resources. It also resulted in improved awareness of the causes, treatment and prevention of lymphoedema, in marked improvements in the lymphoedema, and in reduced stigma and discrimination. The care package was found to be acceptable to patients, health professionals and decision makers. The barriers to integrated care were unrealistic patient expectations, inadequate dissemination across health workers, and poor transportation access. Health professionals, decision makers and patients believed the integrated lymphoedema care package to be scalable and sustainable. Conclusion The integrated holistic care package was found to be acceptable to patients, health professionals and decision makers. We recommend its scale-up to other endemic districts. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07088-7.
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Affiliation(s)
- Oumer Ali
- CDT-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. .,Centre for Global Health Research, Brighton and Sussex Medical School, Falmer Campus, University of Sussex, Brighton, BN1 9PX, UK.
| | - Mersha Kinfe
- CDT-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Maya Semrau
- Centre for Global Health Research, Brighton and Sussex Medical School, Falmer Campus, University of Sussex, Brighton, BN1 9PX, UK
| | - Abebayehu Tora
- CDT-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia
| | - Abraham Tesfaye
- CDT-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Asrat Mengiste
- CDT-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gail Davey
- Centre for Global Health Research, Brighton and Sussex Medical School, Falmer Campus, University of Sussex, Brighton, BN1 9PX, UK.,College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- CDT-Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Centre for Global Health Research, Brighton and Sussex Medical School, Falmer Campus, University of Sussex, Brighton, BN1 9PX, UK
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Rosa-Teijeiro C, Wagner V, Corbeil A, d'Annessa I, Leprohon P, do Monte-Neto RL, Fernandez-Prada C. Three different mutations in the DNA topoisomerase 1B in Leishmania infantum contribute to resistance to antitumor drug topotecan. Parasit Vectors 2021; 14:438. [PMID: 34454601 PMCID: PMC8399852 DOI: 10.1186/s13071-021-04947-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background The evolution of drug resistance is one of the biggest challenges in leishmaniasis and has prompted the need for new antileishmanial drugs. Repurposing of approved drugs is a faster and very attractive strategy that is gaining supporters worldwide. Different anticancer topoisomerase 1B (TOP1B) inhibitors have shown strong antileishmanial activity and promising selective indices, supporting the potential repurposing of these drugs. However, cancer cells and Leishmania share the ability to become rapidly resistant. The aim of this study was to complete a whole-genome exploration of the effects caused by exposure to topotecan in order to highlight the potential mechanisms deployed by Leishmania to favor its survival in the presence of a TOP1B inhibitor. Methods We used a combination of stepwise drug resistance selection, whole-genome sequencing, functional validation, and theoretical approaches to explore the propensity of and potential mechanisms deployed by three independent clones of L. infantum to resist the action of TOP1B inhibitor topotecan. Results We demonstrated that L. infantum is capable of becoming resistant to high concentrations of topotecan without impaired growth ability. No gene deletions or amplifications were identified from the next-generation sequencing data in any of the three resistant lines, ruling out the overexpression of efflux pumps as the preferred mechanism of topotecan resistance. We identified three different mutations in the large subunit of the leishmanial TOP1B (Top1BF187Y, Top1BG191A, and Top1BW232R). Overexpression of these mutated alleles in the wild-type background led to high levels of resistance to topotecan. Computational molecular dynamics simulations, in both covalent and non-covalent complexes, showed that these mutations have an effect on the arrangement of the catalytic pentad and on the interaction of these residues with surrounding amino acids and DNA. This altered architecture of the binding pocket results in decreased persistence of topotecan in the ternary complex. Conclusions This work helps elucidate the previously unclear potential mechanisms of topotecan resistance in Leishmania by mutations in the large subunit of TOP1B and provides a valuable clue for the design of improved inhibitors to combat resistance in both leishmaniasis and cancer. Our data highlights the importance of including drug resistance evaluation in drug discovery cascades. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04947-4.
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Affiliation(s)
- Chloé Rosa-Teijeiro
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Victoria Wagner
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Audrey Corbeil
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Ilda d'Annessa
- Medtronic EMEA, Study and Scientific Solutions, Milan, Italy
| | - Philippe Leprohon
- Centre de Recherche en Infectiologie du Centre de Recherche du Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, Canada
| | | | - Christopher Fernandez-Prada
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada. .,The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada. .,Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Montréal, QC, Canada.
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35
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Parkash V, Ashwin H, Sadlova J, Vojtkova B, Jones G, Martin N, Greensted E, Allgar V, Kamhawi S, Valenzuela JG, Layton AM, Jaffe CL, Volf P, Kaye PM, Lacey CJN. A clinical study to optimise a sand fly biting protocol for use in a controlled human infection model of cutaneous leishmaniasis (the FLYBITE study). Wellcome Open Res 2021; 6:168. [PMID: 34693027 PMCID: PMC8506224 DOI: 10.12688/wellcomeopenres.16870.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 02/02/2023] Open
Abstract
Background: Leishmaniasis is a globally important yet neglected parasitic disease transmitted by phlebotomine sand flies. With new candidate vaccines in or near the clinic, a controlled human challenge model (CHIM) using natural sand fly challenge would provide a method for early evaluation of prophylactic efficacy. Methods : We evaluated the biting frequency and adverse effects resulting from exposure of human volunteers to bites of either Phlebotomus papatasi or P. duboscqi, two natural vectors of Leishmania major. 12 healthy participants were recruited (mean age 40.2 ± 11.8 years) with no history of significant travel to regions where L. major-transmitting sand flies are prevalent. Participants were assigned to either vector by 1:1 allocation and exposed to five female sand flies for 30 minutes in a custom biting chamber. Bite frequency was recorded to confirm a bloodmeal was taken. Participant responses and safety outcomes were monitored using a visual analogue scale (VAS), clinical examination, and blood biochemistry. Focus groups were subsequently conducted to explore participant acceptability. Results: All participants had at least one successful sand fly bite with none reporting any serious adverse events, with median VAS scores of 0-1/10 out to day 21 post-sand fly bite. Corresponding assessment of sand flies confirmed that for each participant at least 1/5 sand flies had successfully taken a bloodmeal (overall mean 3.67±1.03 bites per participant). There was no significant difference between P. papatasi and P. duboscqi in the number of bites resulting from 5 sand flies applied to human participants (3.3±0.81 vs 3.00±1.27 bites per participant; p=0.56) . In the two focus groups (n=5 per group), themes relating to positive participant-reported experiences of being bitten and the overall study, were identified. Conclusions: These results validate a protocol for achieving successful sand fly bites in humans that is safe, well-tolerated and acceptable for participants. Clinicaltrials.gov registration: NCT03999970 (27/06/2019).
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Affiliation(s)
- Vivak Parkash
- York Biomedical Research Institute, Hull York Medical School, University of York, York, N.Yorks, YO10 5DD, UK
- Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Helen Ashwin
- York Biomedical Research Institute, Hull York Medical School, University of York, York, N.Yorks, YO10 5DD, UK
| | - Jovana Sadlova
- Department of Parasitology, Charles University, Prague, Czech Republic
| | - Barbora Vojtkova
- Department of Parasitology, Charles University, Prague, Czech Republic
| | - Georgina Jones
- School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Nina Martin
- School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - Elizabeth Greensted
- York Biomedical Research Institute, Hull York Medical School, University of York, York, N.Yorks, YO10 5DD, UK
| | - Victoria Allgar
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | - Shaden Kamhawi
- Laboratory of Malaria and Vector Research, National Institutes of Health, Rockville, MD, USA
| | - Jesus G. Valenzuela
- Laboratory of Malaria and Vector Research, National Institutes of Health, Rockville, MD, USA
| | - Alison M. Layton
- York Biomedical Research Institute, Hull York Medical School, University of York, York, N.Yorks, YO10 5DD, UK
| | - Charles L. Jaffe
- Department of Microbiology and Molecular Genetics, The Hebrew University – Hadassah Medical School, Jerusalem, Israel
| | - Petr Volf
- Department of Parasitology, Charles University, Prague, Czech Republic
| | - Paul M. Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, N.Yorks, YO10 5DD, UK
| | - Charles J. N. Lacey
- York Biomedical Research Institute, Hull York Medical School, University of York, York, N.Yorks, YO10 5DD, UK
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Feiz Haddad MH, Lomei J, Shokri A, Habibpour H, Rezvan H, Nourian A, Mahmoudi MR. Review of Development of Live Vaccines against Leishmaniasis. JOURNAL OF CHILD SCIENCE 2021. [DOI: 10.1055/s-0041-1731336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractLeishmaniasis is a serious public health problem in both tropical and temperate regions, caused by protozoan parasites of the genus Leishmania. Cutaneous leishmaniasis is the most common form of leishmaniasis worldwide. After recovery from the initial infection in most of the patients, a long-lasting natural immunity will be established. In individuals with HIV infection or in immune deficient patients, the more dangerous forms can occur. Despite many attempts, there is no efficient vaccine for leishmaniasis. The main concern for live-attenuated vaccines is the possibility of returning to the virulent form. Therefore, the safety is an important point in designing a successful vaccine. Nonvirulent parasites as vaccine candidates are achievable through gamma-irradiation, long-term culture, random mutations induced by chemical agents, and temperature-sensitive mutations. The type of change(s) in such parasites is not known well and drawbacks such as reversion to virulent forms was soon realized. Leishmania tarentolae with capacity of adaptation to mammalian system has a potential to be used as nonpathogenic vector in vaccine programs. Due to its nonpathogenic intrinsic property, it does not have the ability to replace with the pathogen form. Moreover, the main problems are associated with the production of live vaccines, including lyophilization, storage, standards, and quality control that must be considered. In this review, we focused on the importance of different approaches concerning the development of a live vaccine against leishmaniasis.
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Affiliation(s)
- Mohammad Hossein Feiz Haddad
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Jalal Lomei
- Division of Integrative Physiology, Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Azar Shokri
- Vector-borne Disease Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Habib Habibpour
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Rezvan
- Department of Pathobiology, Faculty of Veterinary Science, Bu-Ali Sina University, Hamedan, Iran
| | - Alireza Nourian
- Department of Pathobiology, Faculty of Veterinary Science, Bu-Ali Sina University, Hamedan, Iran
| | - Mohammad Reza Mahmoudi
- Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Grifferty G, Shirley H, McGloin J, Kahn J, Orriols A, Wamai R. Vulnerabilities to and the Socioeconomic and Psychosocial Impacts of the Leishmaniases: A Review. Res Rep Trop Med 2021; 12:135-151. [PMID: 34188584 PMCID: PMC8236266 DOI: 10.2147/rrtm.s278138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/06/2021] [Indexed: 11/23/2022] Open
Abstract
The leishmaniases are a group of four vector-borne neglected tropical diseases (NTDs) with 1.6 billion people in some 100 countries at risk. They occur in certain eco-epidemiological foci that reflect manipulation by human activities, such as migration, urbanization and deforestation, of which poverty, conflict and climate change are key drivers. Given their synergistic impacts, risk factors and the vulnerabilities of poor populations and the launch of a new 2030 roadmap for NTDs in the context of the global sustainability agenda, it is warranted to update the state of knowledge of the leishmaniases and their effects. Using existing literature, we review socioeconomic and psychosocial impacts of leishmaniasis within a framework of risk factors and vulnerabilities to help inform policy interventions. Studies show that poverty is an overarching primary risk factor. Low-income status fosters inadequate housing, malnutrition and lack of sanitation, which create and exacerbate complexities in access to care and treatment outcomes as well as education and awareness. The co-occurrence of the leishmaniases with malnutrition and HIV infection further complicate diagnosis and treatment, leading to poor diagnostic outcomes and therapeutic response. Even with free treatment, households may suffer catastrophic health expenditure from direct and indirect medical costs, which compounds existing financial strain in low-income communities for households and healthcare systems. The dermatological presentations of the leishmaniases may result in long-term severe disfigurement, leading to stigmatization, reduced quality of life, discrimination and mental health issues. A substantial amount of recent literature points to the vulnerability pathways and burden of leishmaniasis on women, in particular, who disproportionately suffer from these impacts. These emerging foci demonstrate a need for continued international efforts to address key risk factors and population vulnerabilities if leishmaniasis control, and ultimately elimination, is to be achieved by 2030.
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Affiliation(s)
- Grace Grifferty
- Department of Biology, Northeastern University, College of Science, Boston, MA, USA
| | - Hugh Shirley
- Department of Biochemistry, Northeastern University, College of Science, Boston, MA, USA.,Program in Medical Education, Harvard Medical School, Boston, MA, USA
| | - Jamie McGloin
- Department of Health Sciences, Northeastern University, Bouvé College of Health Sciences, Boston, MA, USA
| | - Jorja Kahn
- Department of Behavioral Neuroscience, Northeastern University, College of Science, Boston, MA, USA
| | - Adrienne Orriols
- Department of Behavioral Neuroscience, Northeastern University, College of Science, Boston, MA, USA
| | - Richard Wamai
- Department of Cultures, Societies and Global Studies, Northeastern University, College of Social Sciences and Humanities, Integrated Initiative for Global Health, Boston, MA, USA
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Discovery of 1,3,4,5-tetrasubstituted pyrazoles as anti-trypanosomatid agents: Identification of alterations in flagellar structure of L. amazonensis. Bioorg Chem 2021; 114:105082. [PMID: 34147880 DOI: 10.1016/j.bioorg.2021.105082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/28/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
Trypanosoma cruzi and Leishmania species are causative agents of Chagas disease and Leishmaniasis, respectively, known as Neglected Tropical Diseases. Up to now, the treatments are inadequate and based on old drugs. Thus, we report herein the discovery of 1,3,4,5-tetrasubstituted pyrazole derivatives that presented potent and selective inhibition against promastigote forms of L. amazonensis, and epimastigote forms of T. cruzi. The structure-activity relationship led to the identification of three compounds (2m, 2n and 2p) with an in vitro IC50 of 7.4 µM (selective index - SI ≥ 133.0), 3.8 µM (SI in the range of 148.4 to 200.8), and 7.3 µM (SI in the range of 87.2 to 122.4) against L. amazonensis, respectively. Also, those compounds exhibited in vitro IC50 of 9.7 µM (SI ≥ 101.5), 4.5 µM (SI in the range of 125.3 to 169.6) and 17.1 µM (SI in the range of 37.2 to 52.2) against T. cruzi, respectively. A preliminary study about the reaction mechanism in promastigotes showed that 2n caused an increase of the production of ROS and of lipid storage bodies. Furthermore, 2n induced abnormalities in the flagellum that may have an impact on the parasite motility.
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Wanitphakdeedecha R, Sudhipongpracha T, Ng JNC, Yan C, Jantarakolica T. Self-stigma and psychosocial burden of patients with port-wine stain: A systematic review and meta-analysis. J Cosmet Dermatol 2021; 20:2203-2210. [PMID: 33949094 DOI: 10.1111/jocd.14199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Port-wine stain (PWS) is a congenital malformation that does not resolve spontaneously and can lead to social and self-stigma. However, little is known about how PWS affects the patients' quality of life (QoL) and psychosocial well-being. In this article, we examine the existing empirical evidence on self-stigma caused by PWS. METHODS A systematic review was done using MEDLINE, PubMed, Embase, and Cochrane databases on January 15, 2021 to retrieve all case reports, cohort studies, and clinical trials written in English. The keywords used in this literature search included port-wine stain, quality of life, self-stigma, and social stigma. RESULTS From the 74 initial records, eight articles were quantitative studies that assessed the QoL and self-stigma experienced by PWS patients. With regard to perceived stigma or the patients' understanding of how others think and act toward them, we found that the parents of children with facial PWS tend to have more perceived stigma than the children. For anticipated stigma or expectations of future stigma, young patients with PWS have less or no concern about their skin conditions. In terms of enacted stigma or experiences with discriminatory acts, there were significant differences in the QoL score between patients with facial PWS and those with non-facial PWS. CONCLUSION This study suggests that self-stigma caused by PWS affects young patients and their parents. The parents in particular tend to suffer more than their children from perceived and anticipated stigma. Psychological support and early treatment can improve the livelihoods of young patients and their parents.
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Affiliation(s)
- Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,College of Interdisciplinary Studies, Thammasat University, Bangkok, Thailand
| | | | - Janice Natasha C Ng
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Yedidia Moser R, Ben-Shimol S, Sagi O, Horev A. Comparison between cutaneous leishmaniasis patients with facial and non-facial lesions. Int J Dermatol 2021; 60:1109-1113. [PMID: 33846973 DOI: 10.1111/ijd.15582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/04/2021] [Accepted: 03/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND We compared demographic, clinical, treatment, and outcome characteristics of facial cutaneous leishmaniasis (CL) and non-facial CL. METHODS In this retrospective cohort study, polymerase chain reaction confirmed Leishmania major CL patients with ≥2 documented hospital visits, 2014-2019, were included. RESULTS Overall, 134 patients (34% and 66% with facial and non-facial CL, respectively) were included. Facial CL patients were younger (43% vs. 8% <18 years, P < 0.001), with a higher proportion of females (41% vs. 25%, P = 0.07) compared with non-facial CL. Clinical characteristics, including number and size of lesions and ulcer appearance, were similar in both the groups. Higher paromomycin/methylbenzethonium chloride ointment treatment rates were noted in facial CL (85% vs. 64%, P = 0.02). Intralesional sodium stibogluconate was given to 41% and 53% of facial CL and non-facial CL patients, respectively (P = 0.21). Cryotherapy and surgery were only used in non-facial CL patients (5% and 1% of all CL cases, respectively). Systemic treatment (oral miltefosine, intravenous [IV] sodium stibogluconate, IV liposomal amphotericin B) was used in <5% of the cases in both the groups. Overall, 84% of patients showed signs of improvement, including decreased lesion size or clinical improvement in 73% and 75% of patients, respectively. Only 5% of all cases healed without scarring. Outcome rates were similar in both groups. CONCLUSIONS Facial CL patients were younger and received more frequently Leishmania-specific topical treatment than non-facial CL patients. In contrast, the two groups were similar regarding clinical characteristics and outcome. These findings suggest differences in disease severity perception by patients and physicians.
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Affiliation(s)
| | | | - Orli Sagi
- Soroka University Medical Center, Beer-Sheva, Israel
| | - Amir Horev
- Soroka University Medical Center, Beer-Sheva, Israel
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Arraché Gonçalves G, Eifler-Lima VL, von Poser GL. Revisiting nature: a review of iridoids as a potential antileishmanial class. PHYTOCHEMISTRY REVIEWS : PROCEEDINGS OF THE PHYTOCHEMICAL SOCIETY OF EUROPE 2021; 21:101-126. [PMID: 33746658 PMCID: PMC7960493 DOI: 10.1007/s11101-021-09750-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
Leishmaniasis still stands as one of the most prevalent neglected tropical diseases in the least developed and emerging countries. The recommended therapeutic arsenal to treat leishmaniasis is characterized by several shortcomings, and resistance has already been reported. Hence, this dramatic background highlights the pressing need to develop novel, affordable, and safe antileishmanial drugs. Multiple classes of natural compounds have been reported to possess antileishmanial activity. Among these classes, iridoids stand out as a special type of monoterpenoids with diverse biological properties-including their antileishmanial potential. This review aims to discuss the available literature between 1991 and 2020 related to the antileishmanial activity of the iridoid class. Throughout the past decades, various investigations attributed antileishmanial action to assorted iridoid types, including inhibitory potential towards validated drug targets and immunomodulatory activity. The latter deserves special attention due to the ability of some iridoids to improve the host's immune response against parasites. It opens the possibility of iridoids become adjuncts in leishmaniasis treatments by improving the efficacy of currently employed drugs. Furthermore, the present study intends to provide a convenient visual representation of which iridoids and Leishmania spp. species have been most investigated as a guide for further researches.
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Affiliation(s)
- Guilherme Arraché Gonçalves
- Laboratório de Síntese Orgânica Medicinal (LaSOM), Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000 Brazil
| | - Vera Lucia Eifler-Lima
- Laboratório de Síntese Orgânica Medicinal (LaSOM), Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000 Brazil
| | - Gilsane Lino von Poser
- Laboratório de Farmacognosia, Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS 90610-000 Brazil
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Kitano H, Sanjoba C, Goto Y, Iwamoto K, Kitagawa H, Nomura T, Omori K, Shigemoto N, Hide M, Matsumoto Y, Ohge H. Complicated cutaneous leishmaniasis caused by an imported case of Leishmania tropica in Japan: a case report. Trop Med Health 2021; 49:20. [PMID: 33676584 PMCID: PMC7937276 DOI: 10.1186/s41182-021-00312-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leishmaniasis is not endemic in Japan, and imported cases are rare. However, there are increasing concerns regarding imported cases of cutaneous leishmaniasis from endemic countries to Japan. This report describes a case of imported cutaneous leishmaniasis that was diagnosed and treated in Japan. CASE PRESENTATION A 53-year-old Pakistani man presented with skin lesions on both malleoli of his right ankle and the dorsum of the left foot. The skin lesions manifested as erythematous nodules surrounding an ulcer in the center of the lesion. The lesions of the malleoli of his right ankle each measured 3 × 3 cm, and the lesion on the top of his left foot measured 5 × 4 cm. He had been living and working in Japan but had a history of a visit to Pakistan for about 2 months in 2018. The skin lesions were biopsied. Giemsa and hematoxylin and eosin staining of biopsy samples showed amastigotes of Leishmania in macrophages, and the presence of Leishmania was confirmed by skin tissue culture. Polymerase chain reaction using biopsy specimens identified Leishmania parasites, and DNA sequence analysis revealed that the species was Leishmania tropica. The patient was treated with intravenous liposomal amphotericin B for 6 days. The erythema disappeared, and the erythematous nodules resolved within 3 weeks. CONCLUSION This is the first report of imported cutaneous leishmaniasis caused by L. tropica from Pakistan, and it is interesting that all three testing modalities showed positive results in this case.
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Affiliation(s)
- Hiroyuki Kitano
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan.
| | - Chizu Sanjoba
- Laboratory of Molecular Immunology, Department of Animal Resource Sciences, Graduate School of Agricultural and Life Sciences, Tokyo University, 1-1-1 Yayoi, Bunkyo-Ku, Tokyo, Tokyo, 113-8657, Japan
| | - Yasuyuki Goto
- Laboratory of Molecular Immunology, Department of Animal Resource Sciences, Graduate School of Agricultural and Life Sciences, Tokyo University, 1-1-1 Yayoi, Bunkyo-Ku, Tokyo, Tokyo, 113-8657, Japan
| | - Kazumasa Iwamoto
- Department of Dermatology, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Hiroki Kitagawa
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Toshihito Nomura
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Keitaro Omori
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Norifumi Shigemoto
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Michihiro Hide
- Department of Dermatology, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Yoshitsugu Matsumoto
- Laboratory of Molecular Immunology, Department of Animal Resource Sciences, Graduate School of Agricultural and Life Sciences, Tokyo University, 1-1-1 Yayoi, Bunkyo-Ku, Tokyo, Tokyo, 113-8657, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, 1-2-3 Minamiku Kasumi, Minamiku, Hiroshima City, Hiroshima, 734-8551, Japan
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Caridha D, Sciotti RJ, Sousa J, Vesely B, Teshome T, Bonkoungou G, Vuong C, Leed S, Khraiwesh M, Penn E, Kreishman-Deitrick M, Lee P, Pybus B, Lazo JS, Sharlow ER. Combination of Subtherapeutic Doses of Tretazicar and Liposomal Amphotericin B Suppresses and Cures Leishmania major-Induced Cutaneous Lesions in Murine Models. ACS Infect Dis 2021; 7:506-517. [PMID: 33529014 DOI: 10.1021/acsinfecdis.0c00886] [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] [Indexed: 02/07/2023]
Abstract
Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis affecting human populations, yet CL remains largely ignored in drug discovery programs. CL causes disfiguring skin lesions and often relapses after "clinical cure" using existing therapeutics. To expand the pool of anti-CL lead candidates, we implemented an integrated screening platform comprising three progressive Leishmania parasite life cycle forms. We identified tretazicar (CB1954, 5-(aziridin-1-yl)-2,4-dinitrobenzamide) as a potent inhibitor of Leishmania parasite viability across multiple Leishmania species, which translated into complete and prolonged in vivo suppression of CL lesion formation in BALB/c mice when used as a monotherapy and which was superior to liposomal amphotericin B. In addition, oral twice a day administration of tretazicar healed the majority of existing Leishmania major (L. major) cutaneous lesions. In drug combination studies, there was a strong potentiation when subtherapeutic doses of liposomal amphotericin B and tretazicar were simultaneously administered. This drug combination decreased L. major lesion size in mice earlier than individual monotherapy drug treatments and maintained all animals lesion free for up to 64 days after treatment cessation. In contrast, administration of subtherapeutic doses of tretazicar or amphotericin B as monotherapies resulted in no or partial lesion cures, respectively. We propose that tretazicar should be explored as a component of a systemic CL combination therapy and potentially for other diseases where amphotericin B is a first line therapy.
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Affiliation(s)
- Diana Caridha
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Richard J. Sciotti
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Jason Sousa
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Brian Vesely
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Tesfaye Teshome
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Gustave Bonkoungou
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Chau Vuong
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Susan Leed
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Mozna Khraiwesh
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Erica Penn
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Mara Kreishman-Deitrick
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Patricia Lee
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Brandon Pybus
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - John S. Lazo
- University of Virginia, Department of Pharmacology, 409 Lane Road, MR4, Charlottesville, Virginia 22908, United States
| | - Elizabeth R. Sharlow
- University of Virginia, Department of Pharmacology, 409 Lane Road, MR4, Charlottesville, Virginia 22908, United States
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Ashwin H, Sadlova J, Vojtkova B, Becvar T, Lypaczewski P, Schwartz E, Greensted E, Van Bocxlaer K, Pasin M, Lipinski KS, Parkash V, Matlashewski G, Layton AM, Lacey CJ, Jaffe CL, Volf P, Kaye PM. Characterization of a new Leishmania major strain for use in a controlled human infection model. Nat Commun 2021; 12:215. [PMID: 33431825 PMCID: PMC7801518 DOI: 10.1038/s41467-020-20569-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022] Open
Abstract
Leishmaniasis is widely regarded as a vaccine-preventable disease, but the costs required to reach pivotal Phase 3 studies and uncertainty about which candidate vaccines should be progressed into human studies significantly limits progress in vaccine development for this neglected tropical disease. Controlled human infection models (CHIMs) provide a pathway for accelerating vaccine development and to more fully understand disease pathogenesis and correlates of protection. Here, we describe the isolation, characterization and GMP manufacture of a new clinical strain of Leishmania major. Two fresh strains of L. major from Israel were initially compared by genome sequencing, in vivo infectivity and drug sensitivity in mice, and development and transmission competence in sand flies, allowing one to be selected for GMP production. This study addresses a major roadblock in the development of vaccines for leishmaniasis, providing a key resource for CHIM studies of sand fly transmitted cutaneous leishmaniasis.
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Affiliation(s)
- Helen Ashwin
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Jovana Sadlova
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, Prague, Czech Republic
| | - Barbora Vojtkova
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, Prague, Czech Republic
| | - Tomas Becvar
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, Prague, Czech Republic
| | - Patrick Lypaczewski
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada
| | - Eli Schwartz
- The Center for Geographic Medicine and Tropical Diseases, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Elizabeth Greensted
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Katrien Van Bocxlaer
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | | | | | - Vivak Parkash
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada
| | - Alison M Layton
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Charles J Lacey
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Charles L Jaffe
- The Hebrew University-Hadassah Medical School, Jerusalem, Israel.
| | - Petr Volf
- Department of Parasitology, Faculty of Science, Charles University, Viničná 7, Prague, Czech Republic.
| | - Paul M Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK.
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45
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Vergara-de-la-Campa L, Cembrero-Saralegui H, Luna-Bastante L, Martínez-Lorenzo ER, Alfageme-Roldán F. Usefulness of ultrasound for treatment and follow-up of cutaneous leishmaniasis. J Ultrasound 2020; 24:573-576. [PMID: 33247813 DOI: 10.1007/s40477-020-00540-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Local therapy is the preferred option of treatment for most cutaneous leishmaniasis (CL); however, local therapy could be challenging, depth and size of the skin lesions are not always clinically evident and treatment response evaluation could occasionally be misleading. High frequency ultrasound is a non-invasive imaging tool which allows initial depth assessment ultrasound-guided infiltrations and ultrasound monitoring until resolution. METHODS We present two cases of CL treated with ultrasound-guided infiltrations and ultrasound monitoring until resolution. RESULTS Ultrasound imaging allowed a more accurate diagnosis of CL, defining more precisely the depth and size of the skin lesions. During follow-up, progressive decrease in dermal involvement, marked attenuation of the echogenicity of subcutaneous cellular tissue and a decrease in vascularization in the color Doppler mode was observed, which aided in evaluation of treatment response. Hypodermal inflammation observed through sonography was addressed with image-guided infiltration. CONCLUSION We would like to highlight the usefulness of skin ultrasound (both B-mode and color Doppler mode) in the diagnosis, depth assessment, imaging guided treatment, and follow-up in CL.
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Affiliation(s)
- L Vergara-de-la-Campa
- Dermatology Department, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Ctra Cobisa S/N, 45071, Toledo, Spain.
| | | | - L Luna-Bastante
- Dermatology Department, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Ctra Cobisa S/N, 45071, Toledo, Spain
| | - E R Martínez-Lorenzo
- Dermatology Department, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Ctra Cobisa S/N, 45071, Toledo, Spain
| | - F Alfageme-Roldán
- Dermatology Department, Hospital Puerta de Hierro de Madrid, Madrid, Spain
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Evaluation of a New Topical Treatment for the Control of Cutaneous Leishmaniasis. Microorganisms 2020; 8:microorganisms8111803. [PMID: 33212818 PMCID: PMC7696824 DOI: 10.3390/microorganisms8111803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/19/2022] Open
Abstract
Leishmania major (L. major) causes cutaneous leishmaniasis in the Old World. The infection mostly induces a localized lesion restricted to the sand fly bite. The costs and the side effects of current treatments render imperative the development of new therapies that are affordable and easy to administrate. Topical treatment would be the ideal option for the treatment of cutaneous leishmaniasis. MF29 is a 3-haloacetamidobenzoate that was shown in vitro to inhibit tubulin assembly in Leishmania. Here, we tested a topical cream formulated with MF29. BALB/c mice were infected in the ear dermis with L. major metacyclic promastigotes and once the lesion appeared, mice were treated with different concentrations of MF29 and compared to the control group treated with the cream used as the vehicle. We observed that topical application of MF29 reduced the progression of the infection while control groups developed an unhealing lesion that became necrotic. The treatment decreased the type 2 immune response. Comparison with SinaAmphoLeish, another topical treatment, revealed that MF29 treatment once a day was sufficient to control lesion development, while application SinaAmphoLeish needed applications twice daily. Collectively, our data suggest that MF-29 topical application could be a promising topical treatment for cutaneous leishmaniasis.
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Aqueous ozone therapy improves the standard treatment of leishmaniasis lesions in animals leading to local and systemic alterations. Parasitol Res 2020; 119:4243-4253. [PMID: 33048207 DOI: 10.1007/s00436-020-06925-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
The current treatment of leishmaniasis presents some problems, such as cell toxicity, parenteral route, and time of treatment. Ozone emerges as an option to accelerate the standard treatment due to the immunomodulatory, antioxidant, and wound healing activity reported in the literature. This work aimed to evaluate the efficacy of aqueous ozone as an adjuvant to the standard treatment of cutaneous lesions caused by Leishmania amazonensis in an experimental model. For in vivo experiments, mice were randomly distributed in 6 groups, which were infected with L. amazonensis and treated in five different schedules using the standard treatment with Glucantime® with or without aqueous ozone. After the last day of treatment, the animals were euthanized and were analyzed: the thickness of lesions; collagen deposition, the parasitic burden of the lesions; blood leukocyte number; NO; and cytokine dosages and arginase activity from peritoneal macrophages. All treated groups showed a decrease in the lesion, but with a significative deposition of collagen in lesions with local ozone treatment. The parasite burden showed that ozone enhanced the leishmanicidal activity of the reference drug. The reduction of NO production and blood leukocyte count and increases in the arginase activity showed an immunomodulatory activity of ozone in the treated animals. Thus, ozone therapy has been shown to work as an adjuvant in the treatment of Leishmania lesions, enhancing leishmanicidal and wound healing activity of standard treatment.
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48
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Gonçalves GA, Spillere AR, das Neves GM, Kagami LP, von Poser GL, Canto RFS, Eifler-Lima V. Natural and synthetic coumarins as antileishmanial agents: A review. Eur J Med Chem 2020; 203:112514. [DOI: 10.1016/j.ejmech.2020.112514] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/18/2020] [Accepted: 05/25/2020] [Indexed: 12/11/2022]
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49
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Husein‐ElAhmed H, Gieler U, Steinhoff M. Evidence supporting the enhanced efficacy of pentavalent antimonials with adjuvant therapy for cutaneous leishmaniasis: a systematic review and meta‐analysis. J Eur Acad Dermatol Venereol 2020; 34:2216-2228. [DOI: 10.1111/jdv.16333] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 02/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- H. Husein‐ElAhmed
- Department of Dermatology and Venereology Hospital de Baza Granada Spain
- Translational Research Institute Academic Health System Medical School Hamad Medical Corporation Doha Qatar
| | - U. Gieler
- Translational Research Institute Academic Health System Medical School Hamad Medical Corporation Doha Qatar
- Department of Dermatology and Venereology Hamad Medical Corporation Doha Qatar
| | - M. Steinhoff
- Translational Research Institute Academic Health System Medical School Hamad Medical Corporation Doha Qatar
- Department of Dermatology and Venereology Hamad Medical Corporation Doha Qatar
- College of Medicine Weill Cornell Medicine‐Qatar Doha Qatar
- Medical School Qatar University Doha Qatar
- College of Medicine Weill Cornell University New York NY USA
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50
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Gómez LJ, van Wijk R, van Selm L, Rivera A, Barbosa MC, Parisi S, van Brakel WH, Arevalo J, Quintero W, Waltz M, Puchner KP. Stigma, participation restriction and mental distress in patients affected by leprosy, cutaneous leishmaniasis and Chagas disease: a pilot study in two co-endemic regions of eastern Colombia. Trans R Soc Trop Med Hyg 2020; 114:476-482. [PMID: 32052043 PMCID: PMC7334822 DOI: 10.1093/trstmh/trz132] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/21/2019] [Accepted: 12/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Leprosy, cutaneous leishmaniasis (CL) and Chagas disease (CD) are neglected tropical diseases with a high psychosocial burden (PSB). These conditions are endemic in Norte de Santander and Arauca in Colombia, but data on the related PSB are scarce. Therefore, we assessed mental distress, participation restriction and stigma among CD, CL and leprosy patients. METHODS In 2018, 305 leprosy, CD or CL patients were interviewed using a self-report questionnaire to assess mental distress, participation scale for participation restriction and explanatory model interview catalogue (EMIC) for stigma. Descriptive statistics and the significance of median score differences were compared. RESULTS Fifty percent of CD patients and 49% of leprosy patients exhibited mental distress, percentages which were significantly higher than that of CL (26%). Twenty-seven percent of leprosy patients experienced participation restriction, which was lower for CL (6%) and CD (12%). Median EMIC scores were significantly higher for leprosy patients than for CD (27%) and CL (17%) patients. CONCLUSIONS We found high levels of PSB among leprosy, CD and CL patients. Mental distress was highest among CD patients. Participation restriction and stigma were more prevalent in leprosy patients. Rural residence or lower educational status may impact PSB. Further investigation is needed to formulate evidence-based, holistic interventions.
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Affiliation(s)
- Libardo J Gómez
- German Leprosy and TB Relief Association, DAHW América del Sur, Calle 128 B No. 56 C 05, Bogotá, Colombia
| | - Robin van Wijk
- NLR, Wibautstraat 137k, 1097 DN Amsterdam, the Netherlands
| | - Lena van Selm
- NLR, Wibautstraat 137k, 1097 DN Amsterdam, the Netherlands
| | - Alberto Rivera
- German Leprosy and TB Relief Association, DAHW América del Sur, Calle 128 B No. 56 C 05, Bogotá, Colombia
| | - Martha C Barbosa
- German Leprosy and TB Relief Association, DAHW América del Sur, Calle 128 B No. 56 C 05, Bogotá, Colombia
| | - Sandra Parisi
- German Leprosy and TB Relief Association, DAHW América del Sur, Calle 128 B No. 56 C 05, Bogotá, Colombia
| | | | - Jofren Arevalo
- Francisco de Paula Santander University, 12E96 Avenida Gran Colombia, Cúcuta, Colombia
| | - William Quintero
- Francisco de Paula Santander University, 12E96 Avenida Gran Colombia, Cúcuta, Colombia
| | - Mitzi Waltz
- Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - Karl Philipp Puchner
- German Leprosy and TB Relief Association, Raiffeisenstraße 3, 97080 Würzburg, Germany
- Global Health–Disaster Medicine, Medical School, National and Kapodistrian University of Athens, Mikras Asias 17, Athens, 115 27, Greece
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