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Acosta-España JD, Dueñas-Espín I, Grijalva Narvaez DF, Altamirano-Jara JB, Gómez-Jaramillo AM, Rodriguez-Morales AJ. Analysis of inpatient data on dengue fever, malaria and leishmaniasis in Ecuador: A cross-sectional national study, 2015-2022. New Microbes New Infect 2024; 60-61:101421. [PMID: 38818245 PMCID: PMC11137557 DOI: 10.1016/j.nmni.2024.101421] [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: 06/07/2023] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
Background Despite concerted efforts in South America, these diseases continue to pose a significant burden of morbidity and mortality in endemic regions. This study aimed to analyse hospital data and investigate the hospitalisation rates of dengue fever, leishmaniasis, and malaria in Ecuador between 2015 and 2022. Methods Open-access databases from the National Institute of Statistics and Censuses of Ecuador between 2015 and 2022 were analysed. Data were filtered using specific terms for each disease (ICD-10), and descriptive statistics of geographical distributions were calculated using Microsoft Excel, Stata 14.2, and Rstudio. Results Dengue had the highest burden, with 31,616 reported cases, followed by malaria (1,316) and leishmaniasis (283). From 2015 to 2022, the highest hospitalisation rate per 105 inhabitants for dengue was observed in Sucumbios province (697.2), for malaria in Pastaza province (108.4), and for leishmaniasis in Morona Santiago province (18.8). The data's trend analysis revealed a slight increase in dengue and mild downward trends in hospitalisation for malaria and leishmaniasis. Conclusions The results suggest that vector-borne disease control has failed in Ecuador. Unfortunately, there was no significant trend towards a decrease in dengue, malaria, and leishmaniasis in Ecuador during the years studied. This study highlights the need to optimise sustainable vector control programs and emphasises continuous monitoring of disease incidence and control measures.
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Affiliation(s)
- Jaime David Acosta-España
- Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador
- Postgraduate Program in Infectious Diseases, School of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Institute of Microbiology, Friedrich Schiller University Jena, Jena, Germany
| | - Ivan Dueñas-Espín
- Instituto de Salud Pública, Postgrado de Medicina Familiar y Comunitaria, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | | | - Jenny Belén Altamirano-Jara
- Medical Graduate of the Faculty of Medicine of the Evandro Chagas University Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana María Gómez-Jaramillo
- Pontifical Catholic University of Ecuador, Quito, Ecuador
- Centro de Investigación para la Salud en América Latina (CISeAL), Quito, Ecuador
| | - Alfonso J. Rodriguez-Morales
- Master Program of Clinical Epidemiology and Biostatistics, School of Medicine, Universidad Científica del Sur, Lima, 4861, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, P.O. Box 36, Lebanon
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Coba-Males MA, Medrano-Vizcaíno P, Enríquez S, Brito-Zapata D, Martin-Solano S, Ocaña-Mayorga S, Carrillo-Bilbao GA, Narváez W, Salas JA, Arrivillaga-Henríquez J, González-Suárez M, Poveda A. From roads to biobanks: Roadkill animals as a valuable source of genetic data. PLoS One 2023; 18:e0290836. [PMID: 38060478 PMCID: PMC10703236 DOI: 10.1371/journal.pone.0290836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/15/2023] [Indexed: 12/18/2023] Open
Abstract
To protect biodiversity we must understand its structure and composition including the bacteria and microparasites associated with wildlife, which may pose risks to human health. However, acquiring this knowledge often presents challenges, particularly in areas of high biodiversity where there are many undescribed and poorly studied species and funding resources can be limited. A solution to fill this knowledge gap is sampling roadkill (animals that die on roads as a result of collisions with circulating vehicles). These specimens can help characterize local wildlife and their associated parasites with fewer ethical and logistical challenges compared to traditional specimen collection. Here we test this approach by analyzing 817 tissue samples obtained from 590 roadkill vertebrate specimens (Amphibia, Reptilia, Aves and Mammalia) collected in roads within the Tropical Andes of Ecuador. First, we tested if the quantity and quality of recovered DNA varied across roadkill specimens collected at different times since death, exploring if decomposition affected the potential to identify vertebrate species and associated microorganisms. Second, we compared DNA stability across taxa and tissues to identify potential limitations and offer recommendations for future work. Finally, we illustrate how these samples can aid in taxonomic identification and parasite detection. Our study shows that sampling roadkill can help study biodiversity. DNA was recovered and amplified (allowing species identification and parasite detection) from roadkill even 120 hours after death, although risk of degradation increased overtime. DNA was extracted from all vertebrate classes but in smaller quantities and with lower quality from amphibians. We recommend sampling liver if possible as it produced the highest amounts of DNA (muscle produced the lowest). Additional testing of this approach in areas with different environmental and traffic conditions is needed, but our results show that sampling roadkill specimens can help detect and potentially monitor biodiversity and could be a valuable approach to create biobanks and preserve genetic data.
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Affiliation(s)
- Manuel Alejandro Coba-Males
- Grupo de Investigación en Biodiversidad, Zoonosis y Salud Pública (GIBCIZ), Instituto de Investigación en Zoonosis (CIZ), Facultad de Ciencias Químicas (FCQ), Universidad Central del Ecuador, Quito, Ecuador
| | - Pablo Medrano-Vizcaíno
- Ecology and Evolutionary Biology, School of Biological Sciences, University of Reading, Reading, United Kingdom
- Universidad Regional Amazónica IKIAM, Grupo de Investigación Población y Ambiente, Tena, Ecuador
- Red Ecuatoriana para el Monitoreo de Fauna Atropellada-REMFA, Quito, Ecuador
| | - Sandra Enríquez
- Grupo de Investigación en Biodiversidad, Zoonosis y Salud Pública (GIBCIZ), Instituto de Investigación en Zoonosis (CIZ), Facultad de Ciencias Químicas (FCQ), Universidad Central del Ecuador, Quito, Ecuador
| | - David Brito-Zapata
- Red Ecuatoriana para el Monitoreo de Fauna Atropellada-REMFA, Quito, Ecuador
- Instituto iBIOTROP, Museo de Zoología & Laboratorio de Zoología Terrestre, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Sarah Martin-Solano
- Grupo de Investigación en Sanidad Animal y Humana (GISAH), Carrera Ingeniería en Biotecnología, Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas—ESPE, Sangolquí, Ecuador
| | - Sofía Ocaña-Mayorga
- Centro de Investigación para la Salud en América Latina, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Gabriel Alberto Carrillo-Bilbao
- Grupo de Investigación en Biodiversidad, Zoonosis y Salud Pública (GIBCIZ), Instituto de Investigación en Zoonosis (CIZ), Facultad de Ciencias Químicas (FCQ), Universidad Central del Ecuador, Quito, Ecuador
| | - Wilmer Narváez
- Grupo de Investigación en Biodiversidad, Zoonosis y Salud Pública (GIBCIZ), Instituto de Investigación en Zoonosis (CIZ), Facultad de Ciencias Químicas (FCQ), Universidad Central del Ecuador, Quito, Ecuador
| | - Jaime Antonio Salas
- Facultad de Ciencias Naturales, Carrera de Biología, Universidad de Guayaquil, Guayaquil, Ecuador
| | - Jazzmín Arrivillaga-Henríquez
- Grupo de Investigación en Biodiversidad, Zoonosis y Salud Pública (GIBCIZ), Instituto de Investigación en Zoonosis (CIZ), Facultad de Ciencias Químicas (FCQ), Universidad Central del Ecuador, Quito, Ecuador
| | - Manuela González-Suárez
- Ecology and Evolutionary Biology, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Ana Poveda
- Grupo de Investigación en Biodiversidad, Zoonosis y Salud Pública (GIBCIZ), Instituto de Investigación en Zoonosis (CIZ), Facultad de Ciencias Químicas (FCQ), Universidad Central del Ecuador, Quito, Ecuador
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3
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Bezemer JM, Merckx J, Freire Paspuel BP, Calvopiña M, de Vries HJC, Schallig HDFH, Leeflang MMG, Dendukuri N. Diagnostic accuracy of qPCR and microscopy for cutaneous leishmaniasis in rural Ecuador: A Bayesian latent class analysis. PLoS Negl Trop Dis 2023; 17:e0011745. [PMID: 38019756 PMCID: PMC10686511 DOI: 10.1371/journal.pntd.0011745] [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: 04/14/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Clinical and laboratory diagnosis of cutaneous leishmaniasis (CL) is hampered by under-ascertainment of direct microscopy. METHODS This study compared the diagnostic accuracy of qPCR on DNA extracted from filter paper to the accuracy of direct smear slide microscopy in participants presenting with a cutaneous lesion suspected of leishmaniasis to 16 rural healthcare centers in the Ecuadorian Amazon and Pacific regions, from January 2019 to June 2021. We used Bayesian latent class analysis to estimate test sensitivity, specificity, likelihood ratios (LR), and predictive values (PV) with their 95% credible intervals (95%CrI). The impact of sociodemographic and clinical characteristics on predictive values was assessed as a secondary objective. RESULTS Of 320 initially included participants, paired valid test results were available and included in the diagnostic accuracy analysis for 129 from the Amazon and 185 from the Pacific region. We estimated sensitivity of 68% (95%CrI 49% to 82%) and 73% (95%CrI 73% to 83%) for qPCR, and 51% (95%CrI 36% to 66%) and 76% (95%CrI 65% to 86%) for microscopy in the Amazon and Pacific region, respectively. In the Amazon, with an estimated disease prevalence among participants of 73%, negative PV for qPCR was 54% (95%CrI 5% to 77%) and 44% (95%CrI 4% to 65%) for microscopy. In the Pacific, (prevalence 88%) the negative PV was 34% (95%CrI 3% to 58%) and 37% (95%CrI 3% to 63%). The addition of qPCR parallel to microscopy in the Amazon increases the observed prevalence from 38% to 64% (+26 (95%CrI 19 to 34) percentage points). CONCLUSION The accuracy of either qPCR on DNA extracted from filter paper or microscopy for CL diagnosis as a stand-alone test seems to be unsatisfactory and region-dependent. We recommend further studies to confirm the clinically relevant increment found in the diagnostic yield due to the addition of qPCR.
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Affiliation(s)
- Jacob M. Bezemer
- Hospital Shell, Fundación Misión Cristiana de Salud, Shell, Pastaza, Ecuador
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centers location Academic Medical Center at the University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for infection and Immunity, Infectious Diseases Program, Amsterdam, the Netherlands
| | - Joanna Merckx
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Department of Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Byron P. Freire Paspuel
- Laboratorios de Investigación, Universidad de las Américas, Quito, Ecuador
- Vall d’Hebron Research Institute, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Manuel Calvopiña
- OneHealth Research Group, Facultad de Medicina, Universidad de las Américas, Quito, Ecuador
| | - Henry J. C. de Vries
- Amsterdam Institute for infection and Immunity, Infectious Diseases Program, Amsterdam, the Netherlands
- Department of Infectious Diseases, Center for Sexual Health, Public Health Service, Amsterdam, the Netherlands
| | - Henk D. F. H. Schallig
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centers location Academic Medical Center at the University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for infection and Immunity, Infectious Diseases Program, Amsterdam, the Netherlands
| | - Mariska M. G. Leeflang
- Department of Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Nandini Dendukuri
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
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Calvopiña M, Fonseca-Carrera D, Villacrés-Granda I, Toapanta A, Chiluisa-Guacho C, Bastidas-Caldes C. New Primers for Detection and Differentiation between Leishmania viannia and L. leishmania Subgenera by Polymerase Chain Reaction. IRANIAN JOURNAL OF PARASITOLOGY 2023; 18:351-361. [PMID: 37886249 PMCID: PMC10597875 DOI: 10.18502/ijpa.v18i3.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/23/2022] [Indexed: 10/28/2023]
Abstract
Background Leishmania is the parasitic protozoan responsible for leishmaniases, a disease that can cause a range of cutaneous, mucosal, and visceral infections. Two subgenera L. Viannia and L. Leishmania are known to infect humans in the tropics and subtropics of the Americas. The aim of the present study was to develop a new pair of primers for the two subgenera and test in clinical samples. Methods We designed two new pairs of primers for a PCR method from two conserved genes, cysteine proteinase B (cpb) and N-acetylglucosamine-6-phosfate deacetylase-like protein (nagA), as specific markers for those two respective subgenera. Primers were tested with 16 microscopical positive clinical samples from the Amazon region of Ecuador obtained in 2010-2020 period. Results The cpb presented a band of 172 bp and the nagA a band of 300 bp, thus clearly differentiating L. viannia from L. leishmania. Additionally, primers identified and differentiated the clinical samples in the two subgenera. Conclusion The new primers targeting different two genes and standardized in a PCR assay could identified and differentiated Leishmania parasites at subgenus level. This protocol could be used for Leishmania genus identification and diagnosis at the subgenus level and for determining the parasite's geographical distribution where different Leishmania subgenera are found in the same area.
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Affiliation(s)
- Manuel Calvopiña
- One Health Research Group, Faculty of Medicine, Universidad de las Américas (UDLA), Quito, Ecuador
| | - David Fonseca-Carrera
- Biotechnology Engineering, Faculty of Engineering and Applied Sciences (FICA), Universidad de las Américas (UDLA), Quito, Ecuador
| | - Irina Villacrés-Granda
- Biotechnology Engineering, Faculty of Engineering and Applied Sciences (FICA), Universidad de las Américas (UDLA), Quito, Ecuador
| | - Alberto Toapanta
- Biotechnology Engineering, Faculty of Engineering and Applied Sciences (FICA), Universidad de las Américas (UDLA), Quito, Ecuador
| | - Carlos Chiluisa-Guacho
- National Institute for Investigation in Public Health “Leopoldo Izquieta Pérez (INSPI)”, Tena, Ecuador
| | - Carlos Bastidas-Caldes
- One Health Research Group, Faculty of Medicine, Universidad de las Américas (UDLA), Quito, Ecuador
- Biotechnology Engineering, Faculty of Engineering and Applied Sciences (FICA), Universidad de las Américas (UDLA), Quito, Ecuador
- Doctoral Program in Public and Animal Health, Universidad de Extremadura, Extremadura, Spain
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5
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Bezemer JM, Freire-Paspuel BP, Schallig HDFH, de Vries HJC, Calvopiña M. Leishmania species and clinical characteristics of Pacific and Amazon cutaneous leishmaniasis in Ecuador and determinants of health-seeking delay: a cross-sectional study. BMC Infect Dis 2023; 23:395. [PMID: 37308815 DOI: 10.1186/s12879-023-08377-8] [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: 02/15/2023] [Accepted: 06/06/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Cutaneous Leishmaniasis (CL) affects up to 5.000 people in Ecuador each year. L. guyanensis and L. braziliensis are the most common of the eight CL-causing Leishmania species. Earlier CL research concentrated on the easily accessible Pacific region. This study aims to describe the Leishmania species in Pacific and Amazon ecoregions, to analyze regional differences in CL patient clinical presentation, and to identify determinants of health-seeking delay. METHODS All cases in this cross-sectional study were diagnosed using smear slide microscopy, PCR, or both. Cytochrome B gene sequencing was used to identify the causative Leishmania species in qPCR-positive samples. RESULTS This study included 245 patients, with 154 (63%) infected in the Pacific region and 91 (37%) infected in the Amazon. Causative Leishmania species were identified in 135 patients (73% of qPCR positives). L. guyanensis was identified in 76% (102/135) of the samples and L. braziliensis in 19% (26/135). The Pacific region had a low prevalence of 6% (5/89) of L. braziliensis. For the first time, we report L. guyanensis from the central Amazon, L. braziliensis from the northern Pacific, and L. lainsoni from both the central Amazon and northern Pacific. Amazon cases had a longer median health-seeking delay in months (2.0, IQR 3.0) than Pacific cases (1.0, IQR 1.5). Prolonged health-seeking delay was associated with older age, Amerindian ethnicity, infection at lower altitudes, non-ulcerative lesions, and lesions on the lower limbs. CONCLUSIONS In the Pacific region, health-seeking delay is relatively short and L. braziliensis prevalence remains low. Limited access to health care and stigma might explain the prolonged health-seeking delay in the Amazon. We recommend larger studies on the distribution of Leishmania species in Amazon CL cases and additional regional research into diagnostic test accuracy. Furthermore, the determinants of health-seeking delay in Ecuador should be investigated further.
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Affiliation(s)
- Jacob M Bezemer
- Fundación Misión Cristiana de Salud, Hospital Shell, Shell, Pastaza, Ecuador.
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands.
- Amsterdam Institute for infection and Immunity (AII), Infectious Diseases Program, Amsterdam, the Netherlands.
| | - Byron P Freire-Paspuel
- Laboratorios de Investigación, Universidad de las Américas, Quito, Ecuador
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Henk D F H Schallig
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for infection and Immunity (AII), Infectious Diseases Program, Amsterdam, the Netherlands
| | - Henry J C de Vries
- Amsterdam Institute for infection and Immunity (AII), Infectious Diseases Program, Amsterdam, the Netherlands
- Department of dermatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Public Health Service, Center for Sexual Health, Department of Infectious Diseases, Amsterdam, the Netherlands
| | - Manuel Calvopiña
- Facultad de Medicina, Universidad de las Américas, OneHealth Research Group, Quito, Ecuador
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6
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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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Khoshnood S, Tavalla M, Mohaghegh MA, Khamesipour F, Hejazi SH. Genetic diversity of Leishmania major strains isolated from Phlebotomus papatasi and Phlebotomus alexandri in western Iran based on minicircle kDNA. J Parasit Dis 2021; 45:838-844. [PMID: 34475667 PMCID: PMC8368947 DOI: 10.1007/s12639-021-01369-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/12/2021] [Indexed: 02/05/2023] Open
Abstract
This study aimed to screen the natural infection rate of Leishmania major in Phlebotomus papatasi and Phlebotomus alexandri in two counties (Mehran and Dehloran) of Ilam province as cutaneous leishmaniasis endemic areas in the west of Iran. Furthermore, the genetic diversity of parasite species that are isolated from vectors, was investigated. Sandflies were collected by sticky traps from May 2018 to October 2018. Afterward, specimens were prepared for species identification by morphological features. DNA was extracted from female sandflies, and minicircle kDNA was used to identify Leishmania isolates through nested-PCR, followed by genetic diversity between Leishmania isolates was investigated by sequence analysis of the amplified minicircle kDNA. Natural infection of the L. major was shown in all positive specimens using nested-PCR. Analysis of data from 14 isolates displayed a high level of genetic diversity in L. major. In the phylogenetic trees, all of the L. major isolates occurred in six clusters. Clusters I, II, III, and VI contained isolated strains from P. papatasi. While clusters IV and V contained isolated strains from P. alexandri. Genetic diversity of L. major isolated from vectors was investigated in western Iran for the first time. According to the results of this study, probably "various clones of L. major populations are distributed in the study area.
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Affiliation(s)
- Saleh Khoshnood
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Tavalla
- Department of Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Ali Mohaghegh
- Department of Laboratory Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Faham Khamesipour
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Seyed Hossein Hejazi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Kato H, Cáceres AG, Gomez EA, Tabbabi A, Mizushima D, Yamamoto DS, Hashiguchi Y. Prevalence of Genetically Complex Leishmania Strains With Hybrid and Mito-Nuclear Discordance. Front Cell Infect Microbiol 2021; 11:625001. [PMID: 33732663 PMCID: PMC7959773 DOI: 10.3389/fcimb.2021.625001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/14/2021] [Indexed: 12/02/2022] Open
Abstract
Approximately 20 Leishmania species are known to cause cutaneous, mucocutaneous, and visceral disorders in humans. Identification of the causative species in infected individuals is important for appropriate treatment and a favorable prognosis because infecting species are known to be the major determinant of clinical manifestations and may affect treatments for leishmaniasis. Although Leishmania species have been conventionally identified by multilocus enzyme electrophoresis, genetic analysis targeting kinetoplast and nuclear DNA (kDNA and nDNA, respectively) is now widely used for this purpose. Recently, we conducted countrywide epidemiological studies of leishmaniasis in Ecuador and Peru to reveal prevalent species using PCR-RFLP targeting nDNA, and identified unknown hybrid parasites in these countries together with species reported previously. Furthermore, comparative analyses of kDNA and nDNA revealed the distribution of parasites with mismatches between these genes, representing the first report of mito-nuclear discordance in protozoa. The prevalence of an unexpectedly high rate (~10%) of genetically complex strains including hybrid strains, in conjunction with the observation of mito-nuclear discordance, suggests that genetic exchange may occur more frequently than previously thought in natural Leishmania populations. Hybrid Leishmania strains resulting from genetic exchanges are suggested to cause more severe clinical symptoms when compared with parental strains, and to have increased transmissibility by vectors of the parental parasite species. Therefore, it is important to clarify how such genetic exchange influences disease progression and transmissibility by sand flies in nature. In addition, our aim was to identify where and how the genetic exchange resulting in the formation of hybrid and mito-nuclear discordance occurs.
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Affiliation(s)
- Hirotomo Kato
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Abraham G Cáceres
- Sección de Entomología, Instituto de Medicina Tropical "Daniel A. Carrión" y Departamento Académico de Microbiología Médica, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru.,Laboratorio de Entomología, Instituto Nacional de Salud, Lima, Peru
| | - Eduardo A Gomez
- Departamento de Parasitología y Medicina Tropical, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Ahmed Tabbabi
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Daiki Mizushima
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Daisuke S Yamamoto
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Yoshihisa Hashiguchi
- Departamento de Parasitología y Medicina Tropical, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Gonçalves LP, Santos TVD, Campos MB, Lima LVDR, Ishikawa EAY, Silveira FT, Ramos PKS. Further insights into the eco-epidemiology of American cutaneous leishmaniasis in the Belem metropolitan region, Pará State, Brazil. Rev Soc Bras Med Trop 2020; 53:e20200255. [PMID: 33331607 PMCID: PMC7747830 DOI: 10.1590/0037-8682-0255-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: In the Belém Metropolitan Region (BMR), Pará State, Brazil, American
cutaneous leishmaniasis (ACL) is endemic; however, very little is known
regarding its causative agents. Therefore, we used our standard diagnostic
approach combined with an RNA polymerase II largest subunit
(RNAPOIILS)-polymerase chain reaction (PCR) followed by analysis of
restriction fragment length polymorphism (PCR-RFLP) to identify
Leishmania spp. ACL agents in this region. METHODS: Thirty-two Leishmania spp. isolates from patients with ACL
in the BMR during 1995-2018 were analyzed. Leishmania spp.
DNA samples were amplified using the primers RPOR2/RPOF2, and the 615-bp PCR
products were subjected to enzymatic digestion using TspRI
and HgaI endonucleases. RESULTS: ACL etiological agents in the BMR comprised Leishmania (Viannia)
lindenbergi (43.7%) followed by Leishmania (Viannia)
lainsoni (34.4%), Leishmania (Leishmania)
amazonensis (12.5%), and Leishmania (Viannia)
braziliensis (9.4%). CONCLUSIONS: To our knowledge, the results of the study revealed for the first time that
L. (V.) lindenbergi and L. (V.)
lainsoni are the main ACL agents in BMR.
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Affiliation(s)
- Lucas Pantoja Gonçalves
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | - Thiago Vasconcelos Dos Santos
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | - Marliane Batista Campos
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | - Luciana Vieira do Rêgo Lima
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | | | - Fernando Tobias Silveira
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil.,Universidade Federal do Pará, Núcleo de Medicina Tropical, Belém, PA, Brasil
| | - Patrícia Karla Santos Ramos
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
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10
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Nuclear and kinetoplast DNA analyses reveal genetically complex Leishmania strains with hybrid and mito-nuclear discordance in Peru. PLoS Negl Trop Dis 2020; 14:e0008797. [PMID: 33075058 PMCID: PMC7595639 DOI: 10.1371/journal.pntd.0008797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 10/29/2020] [Accepted: 09/16/2020] [Indexed: 02/05/2023] Open
Abstract
Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of the mannose phosphate isomerase (mpi) gene was applied to 134 skin samples collected from patients with cutaneous leishmaniasis (CL) in Peru for identification of the infecting parasite at the species level, and the results were compared with those of cytochrome b (cyt b) gene sequencing obtained in previous studies. Although most results (121/134) including 4 hybrids of Leishmania (Viannia) braziliensis and L. (V.) peruviana corresponded to those obtained in the previous study, PCR-RFLP analyses revealed the distribution of putative hybrid strains between L. (V.) peruviana and L. (V.) lainsoni in two samples, which has never been reported. Moreover, parasite strains showing discordance between kinetoplast and nuclear genes (kDNA and nDNA), so-called mito-nuclear discordance, were identified in 11 samples. Of these, six strains had the kDNAs of L. (V.) braziliensis or L. (V.) peruviana and nDNAs of L. (V.) guyanensis, and three strains had the kDNAs of L. (V.) shawi and nDNAs of L. (V.) braziliensis. The rest were identified as mito-nuclear discordance strains having kDNAs of L. (V.) braziliensis or L. (V.) peruviana and nDNAs of L. (V.) lainsoni, and kDNAs of L. (V.) lainsoni and nDNAs of L. (V.) braziliensis. The results demonstrate that Leishmania strains in Peru are genetically more complex than previously considered. Protozoan parasites of the genus Leishmania are able to undergo genetic exchange during their growth. The previous description of hybrids in Peru and the recent discovery of unexpected genetically complex strains having characteristics of both hybrid and mito-nuclear discordance in its neighbouring country (Ecuador) with a similar eco-epidemiological situation led us to consider that the genetic structure of Leishmania strains in Peru is more complicated than previously thought. In an effort to revise the data on Leishmania strain dispersion in Peru and to search for evidence of genetic recombination, the present study was conducted. A polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis targeting the mannose phosphate isomerase (mpi) gene sequence was performed to identify the infecting parasite at the species level in 134 skin samples collected from patients with cutaneous leishmaniasis (CL) in Peru, and the results were compared with those of cytochrome b (cyt b) gene sequencing obtained in previous studies. Most results (121/134) including 4 hybrids between L. (V.) braziliensis and L. (V.) peruviana showed agreement between PCR-RFLP of the mpi gene and cyt b gene sequence analysis; however, 13 of 134 samples revealed the distribution of strains with hybrids and mito-nuclear discordance. The results demonstrate that genetically complex Leishmania strains are present in Peru. These findings indicate that Leishmania strain dispersion in Peru is genetically more complex than previously considered. Further prospective studies including larger samples and the isolation of parasite strains are required to update the available data.
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11
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Calvopina M, Jijon S, Serrano E, Kato H. Case Report: Successful Treatment with Miltefosine of Severe New World Mucosal Leishmaniasis Caused by Leishmania guyanensis. Am J Trop Med Hyg 2020; 103:752-755. [PMID: 32524951 DOI: 10.4269/ajtmh.19-0867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
An 88-year-old man with mutilating mucosal leishmaniasis (ML) involving septal perforation, with granulomas in the pharynx and larynx, was treated with oral miltefosine, 50 mg three times/day for 28 days. Miltefosine, an antineoplastic agent, is considered an alternative option for the treatment of ML, showing efficacies of 75-92% in Bolivia, Brazil, and Argentina. The patient denied having previous cutaneous (CL) leishmaniasis, and no CL lesions were recognized by physical examination. Parasites obtained from mucosal lesions were identified by cytochrome b gene sequencing as Leishmania guyanensis. Clinical cure was observed 2 months posttreatment, and no evidence of reactivation was observed in the 3-year follow-up. Adverse effects such as nausea, loss of appetite, and epigastric pain were experienced during treatment with miltefosine. There is a need for improved access to miltefosine in leishmaniasis-endemic areas of Latin America and a greater awareness of ML and its treatment among physicians working in endemic countries.
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Affiliation(s)
- Manuel Calvopina
- OneHealth Research Group, Carrera de Medicina, Facultad de Ciencias de la Salud, Universidad De Las Américas (UDLA), Quito, Ecuador
| | - Sara Jijon
- OneHealth Research Group, Carrera de Medicina, Facultad de Ciencias de la Salud, Universidad De Las Américas (UDLA), Quito, Ecuador
| | - Esteban Serrano
- Servicio de Otorrinolaringología, Hospital de Especialidades Eugenio Espejo, Quito, Ecuador
| | - Hirotomo Kato
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
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12
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Herrera G, Barragán N, Luna N, Martínez D, De Martino F, Medina J, Niño S, Páez L, Ramírez A, Vega L, Velandia V, Vera M, Zúñiga MF, Bottin MJ, Ramírez JD. An interactive database of Leishmania species distribution in the Americas. Sci Data 2020; 7:110. [PMID: 32245983 PMCID: PMC7125201 DOI: 10.1038/s41597-020-0451-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/12/2020] [Indexed: 11/09/2022] Open
Abstract
The Americas have an elevated number of leishmaniasis cases (accounting for two-thirds of the worldwide disease burden) and circulating Leishmania species, and are therefore of interest in terms of epidemiological surveillance. Here, we present a systematic review of Leishmania parasite species circulating in the countries of the American continent, together with complementary information on epidemiology and geospatial distribution. A database was built from data published between 1980 and 2018 on Leishmania species identified in most of the American countries. A total of 1499 georeferenced points were extracted from published articles and subsequently located to 14 countries in the Americas. This database could be used as a reference when surveilling the occurrence of Leishmania species in the continent.
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Affiliation(s)
- Giovanny Herrera
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Natalia Barragán
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Nicolás Luna
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - David Martínez
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Frasella De Martino
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Julián Medina
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Niño
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Luisa Páez
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Angie Ramírez
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Laura Vega
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Valeria Velandia
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Michelle Vera
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - María Fernanda Zúñiga
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Marius Jean Bottin
- Grupo de Ecología Funcional y Ecosistémica, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.
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13
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Miranda LDFC, Pacheco RDS, Pimentel MIF, Salgueiro MDM, da Silva AF, de Mello CX, Barros JHDS, Valete-Rosalino CM, Madeira MDF, Xavier SCDC, Schubach ADO. Geospatial analysis of tegumentary leishmaniasis in Rio de Janeiro state, Brazil from 2000 to 2015: Species typing and flow of travelers and migrants with leishmaniasis. PLoS Negl Trop Dis 2019; 13:e0007748. [PMID: 31730650 PMCID: PMC6857848 DOI: 10.1371/journal.pntd.0007748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 09/04/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We identified the species of Leishmania isolated from traveling and migrant patients attended in a reference center from 2000 to 2015, we performed the georeferencing of these species in Rio de Janeiro (RJ) state and we had knowledge about the human flows between the likely location of infection (LLI) and place of residence (PR) in RJ state, Brazil. METHODOLOGY/PRINCIPAL FINDINGS This is a retrospective cross-sectional study including 171 patients diagnosed with ATL. Google Maps, OpenStreetMap, and Bing Maps were tools used to georeference LLI and PR. For etiological identification, we used isoenzyme electrophoresis, polymerase chain reaction-restriction fragment length polymorphism (molecular target hsp70C with restriction enzymes HaeIII and BstUI), and sequencing of the internal transcribed spacer of ribosomal DNA. ARCGIS software was used to create maps of the geographic distribution of Leishmania species in the state and municipality of RJ, together with flows between the LLI and PR. Isolates from 104 patients were identified as: L. (Viannia) braziliensis (80.8%), L. (V.) naiffi (7.7%), L. (V.) guyanensis (6.7%), L. (Leishmania) amazonensis (1%), and genetic variants of L. (V.) braziliensis (3.8%). The flow maps showed that the LLI included 4 countries, 19 Brazilian states, and 18 municipalities of RJ state. The Brazilian states with the highest density of cases were Amazonas (n = 32), Bahia (n = 18), and Ceará (n = 15). CONCLUSIONS/SIGNIFICANCE This work is the first contribution to the knowledge of the routes of Leishmania species introduced in RJ state by migrants and travelers patients. L. (V.) braziliensis, L. (V.) guyanensis, L. (V.) naiffi, L. (L.) amazonensis, and genetic variants of L. (V.) braziliensis were identified in RJ state. To determine whether the autochthonous transmission of these imported species is possible it is necessary the adaptation of these species to environmental conditions as well as the presence of reservoirs and phlebotomine vectors in this region.
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Affiliation(s)
- Luciana de Freitas Campos Miranda
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Raquel da Silva Pacheco
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Maria Inês Fernandes Pimentel
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Mariza de Matos Salgueiro
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Aline Fagundes da Silva
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Cíntia Xavier de Mello
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Claudia Maria Valete-Rosalino
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Maria de Fátima Madeira
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Armando de Oliveira Schubach
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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14
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Morales D, Paredes M, Morales-Butler EJ, Cruz-Aponte M, Arriola L, Cevallos V, Ponce P, Mubayi A. Data scarcity and ecological complexity: the cutaneous leishmaniasis dynamics in Ecuador. J R Soc Interface 2019; 16:20190141. [PMID: 31455165 DOI: 10.1098/rsif.2019.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a neglected tropical disease transmitted by species of Phlebotominae sand flies. CL is responsible for more than 1000 reported cases per year in Ecuador. Vector collection studies in Ecuador suggest that there is a strong association between the ecological diversity of an ecosystem, the presence of potential alternative or reservoir hosts and the abundance of sand fly species. Data collected from a coastal community in Ecuador showed that Leishmania parasites may be circulating in diverse hosts, including mammalian and potentially avian species, and these hosts may serve as potential hosts for the parasite. There has been limited reporting of CL cases in Ecuador because the disease is non-fatal and its surveillance system is passive. Hence, the actual incidence of CL is unknown. In this study, an epidemic model was developed and analysed to understand the complexity of CL transmission dynamics with potential non-human hosts in the coastal ecosystem and to estimate critical epidemiological quantities for Ecuador. The model is fitted to the 2010 CL outbreak in the town of Valle Hermoso in the Santo Domingo de los Tsachilas province of Ecuador and parameters such as CL transmission rates in different types of hosts (primary and alternative), and levels of case reporting in the town are estimated. The results suggest that the current surveillance in this region fails to capture 38% (with 95% CI (29%, 47%)) of the actual number of cases under the assumption that alternative hosts are dead-end hosts and that the mean CL reproduction number in the town is 3.9. This means that on the average 3.9 new human CL cases were generated by a single infectious human in the town during the initial period of the 2010 outbreak. Moreover, major outbreaks of CL in Ecuador in coastal settings are unavoidable until reporting through the surveillance system is improved and alternative hosts are managed properly. The estimated infection transmission probabilities from alternative hosts to sand flies, and sand flies to alternative hosts are 27% and 32%, respectively. The analysis highlights that vector control and alternative host management are two effective programmes for Ecuador but need to be implemented concurrently to avoid future major outbreaks.
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Affiliation(s)
- Diego Morales
- Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, Ecuador
| | - Marlio Paredes
- Department of Mathematics, Universidad del Valle, Calle 13 No. 100-00, Cali 760032, Colombia.,Instituto de Ciencia, Tecnología e Innovación, Universidad Francisco Gavidia, San Salvador, El Salvador.,Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ 85287, USA
| | | | - Mayteé Cruz-Aponte
- Department of Mathematics-Physics, University of Puerto Rico at Cayey, Cayey, PR 00736, USA
| | - Leon Arriola
- Mathematics Department, University of Wisconsin-Whitewater, Whitewater, WI 53190, USA
| | - Varsovia Cevallos
- Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, Ecuador.,Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ 85287, USA
| | - Patricio Ponce
- Yachay Tech University, San Miguel de Urcuquí, Ecuador.,Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ 85287, USA
| | - Anuj Mubayi
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ 85287, USA.,School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85287, USA
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15
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Kato H, Cáceres AG, Seki C, Silupu García CR, Holguín Mauricci C, Castro Martínez SC, Moreno Paico D, Castro Muniz JL, Troyes Rivera LD, Villegas Briones ZI, Guerrero Quincho S, Sulca Jayo GL, Tineo Villafuerte E, Manrique de Lara Estrada C, Arias FR, Passara FS, Ruelas Llerena N, Kubo M, Tabbabi A, Yamamoto DS, Hashiguchi Y. Further insight into the geographic distribution of Leishmania species in Peru by cytochrome b and mannose phosphate isomerase gene analyses. PLoS Negl Trop Dis 2019; 13:e0007496. [PMID: 31220120 PMCID: PMC6605678 DOI: 10.1371/journal.pntd.0007496] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/02/2019] [Accepted: 05/27/2019] [Indexed: 11/18/2022] Open
Abstract
To obtain further insight into geographic distribution of Leishmania species in Peru, a countrywide survey, including central to southern rainforest areas where information on causative parasite species is limited, was performed based on cytochrome b (cyt b) and mannose phosphate isomerase (mpi) gene analyses. A total of 262 clinical samples were collected from patients suspected of cutaneous leishmaniasis (CL) in 28 provinces of 13 departments, of which 99 samples were impregnated on FTA (Flinders Technology Associates) cards and 163 samples were Giemsa-stained smears. Leishmania species were successfully identified in 83 (83.8%) of FTA-spotted samples and 59 (36.2%) of Giemsa-stained smear samples. Among the 142 samples identified, the most dominant species was Leishmania (Viannia) braziliensis (47.2%), followed by L. (V.) peruviana (26.1%), and others were L. (V.) guyanensis, L. (V.) lainsoni, L. (V.) shawi, a hybrid of L. (V.) braziliensis and L. (V.) peruviana, and Leishmania (Leishmania) amazonensis. Besides the present epidemiological observations, the current study provided the following findings: 1) A hybrid of L. (V.) braziliensis and L. (V.) peruviana is present outside the Department of Huanuco, the only place reported, 2) Many cases of CL due to L. (V.) lainsoni, an uncommon causative species in Peru, were observed, and 3) L. (V.) shawi is widely circulating in southern Amazonian areas in Peru.
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Affiliation(s)
- Hirotomo Kato
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Abraham G. Cáceres
- Sección de Entomología, Instituto de Medicina Tropical “Daniel A. Carrión” y Departamento Académico de Microbiología Médica, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perúu
- Laboratorio de Entomología, Instituto Nacional de Salud, Lima, Perúu
| | - Chisato Seki
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Carmen Rosa Silupu García
- Laboratorio de Parasitología, Dirección de Laboratorio de Salud Pública, Dirección Regional de Salud Piura, Piura, Peru
| | - Carlos Holguín Mauricci
- Laboratorio de Parasitología, Dirección de Laboratorio de Salud Pública, Dirección Regional de Salud Piura, Piura, Peru
| | - Salvadora Concepción Castro Martínez
- Laboratorio del Centro de Salud Motupe, Micro Red de Salud Motupe, Red de Salud Lambayeque, Gerencia Regional de Salud Lambayeque, Lambayeque, Peru
| | - Dafne Moreno Paico
- Laboratorio del Centro de Salud Motupe, Micro Red de Salud Motupe, Red de Salud Lambayeque, Gerencia Regional de Salud Lambayeque, Lambayeque, Peru
| | - Josefa Leila Castro Muniz
- Laboratorio del Comité Local de Administración en Salud (CLAS) de Colasay, Sub Región de Salud Jaén, Dirección Regional de Salud Cajamarca, Cajamarca, Peru
| | - Lucinda Doriz Troyes Rivera
- Laboratorio del Comité Local de Administración en Salud (CLAS) de Colasay, Sub Región de Salud Jaén, Dirección Regional de Salud Cajamarca, Cajamarca, Peru
| | - Zoila Isabel Villegas Briones
- Laboratorio del Comité Local de Administración en Salud (CLAS) de Colasay, Sub Región de Salud Jaén, Dirección Regional de Salud Cajamarca, Cajamarca, Peru
| | - Silvia Guerrero Quincho
- Laboratorio de Referencia Regional de Salud Pública, Dirección Regional de Salud Ayacucho, Ayacucho, Peru
| | - Guísela Lucy Sulca Jayo
- Laboratorio de Referencia Regional de Salud Pública, Dirección Regional de Salud Ayacucho, Ayacucho, Peru
| | - Edwin Tineo Villafuerte
- Laboratorio de Referencial Regional de Salud Púbica, Dirección Regional de Salud Madre de Dios, Madre de Dios, Peru
| | | | - Fernando Rafael Arias
- Laboratorio de Referencia Regional de Salud Pública, Dirección Regional de Salud Puno, Puno, Peru
| | - Fredy Santiago Passara
- Laboratorio de Referencia Regional de Salud Pública, Dirección Regional de Salud Puno, Puno, Peru
| | - Nancy Ruelas Llerena
- Departamento de Microbiología y Patología, Facultad de Medicina, Universidad Nacional de San Agustín, Arequipa, Peru
| | - Makoto Kubo
- Division of Immunology, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
| | - Ahmed Tabbabi
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Daisuke S. Yamamoto
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Yoshihisa Hashiguchi
- Departamento de Parasitologia y Medicina Tropical, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
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16
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Kato H, Gomez EA, Seki C, Furumoto H, Martini-Robles L, Muzzio J, Calvopiña M, Velez L, Kubo M, Tabbabi A, Yamamoto DS, Hashiguchi Y. PCR-RFLP analyses of Leishmania species causing cutaneous and mucocutaneous leishmaniasis revealed distribution of genetically complex strains with hybrid and mito-nuclear discordance in Ecuador. PLoS Negl Trop Dis 2019; 13:e0007403. [PMID: 31059516 PMCID: PMC6522058 DOI: 10.1371/journal.pntd.0007403] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/16/2019] [Accepted: 04/22/2019] [Indexed: 01/19/2023] Open
Abstract
PCR-Restriction Fragment Length Polymorphism (RFLP) analyses targeting multiple nuclear genes were established for the simple and practical identification of Leishmania species without using expensive equipment. This method was applied to 92 clinical samples collected at 33 sites in 14 provinces of Ecuador, which have been identified at the species level by the kinetoplast cytochrome b (cyt b) gene sequence analysis, and the results obtained by the two analyses were compared. Although most results corresponded between the two analyses, PCR-RFLP analyses revealed distribution of hybrid strains between Leishmania (Viannia) guyanensis and L. (V.) braziliensis and between L. (V.) guyanensis and L. (V.) panamensis, of which the latter was firstly identified in Ecuador. Moreover, unexpected parasite strains having the kinetoplast cyt b gene of L. (V.) braziliensis and nuclear genes of L. (V.) guyanensis, L. (V.) panamensis, or a hybrid between L. (V.) guyanensis and L. (V.) panamensis were identified. This is the first report of the distribution of a protozoan parasite having mismatches between kinetoplast and nuclear genes, known as mito-nuclear discordance. The result demonstrated that genetically complex Leishmania strains are present in Ecuador. Since genetic exchanges such as hybrid formation were suggested to cause higher pathogenicity in Leishmania and may be transmitted by more species of sand flies, further country-wide epidemiological studies on clinical symptoms, as well as transmissible vectors, will be necessary.
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Affiliation(s)
- Hirotomo Kato
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Eduardo A. Gomez
- Departamento de Parasitologia y Medicina Tropical, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Chisato Seki
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Hayato Furumoto
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Luiggi Martini-Robles
- Hospital de Especialidades Guayaquil “Dr. Abel Gilberto Pinton”, Ministerio de Salud Publica, Guayaquil, Ecuador
| | - Jenny Muzzio
- Departamento de Parasitologia, Insitituto de Investigacion de Salud Publica, Guayaquil, Ecuador
| | - Manuel Calvopiña
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad De Las Américas (UDLA), Quito, Ecuador
| | - Lenin Velez
- Departamento de Parasitologia y Medicina Tropical, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Makoto Kubo
- Division of Immunology, Kitasato University School of Allied Health Sciences, Kanagawa, Japan
| | - Ahmed Tabbabi
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Daisuke S. Yamamoto
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
| | - Yoshihisa Hashiguchi
- Departamento de Parasitologia y Medicina Tropical, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
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Anucherngchai S, Chontananarth T, Tejangkura T, Chai JY. The study of Cytochrome B ( CYTB): species-specific detection and phylogenetic relationship of Echinostoma revolutum, (Froelich, 1802). J Parasit Dis 2019; 43:66-74. [PMID: 30956448 PMCID: PMC6423160 DOI: 10.1007/s12639-018-1057-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 11/15/2018] [Indexed: 01/16/2023] Open
Abstract
Echinostoma revolutum is known as a significant intestinal trematode in various species of animals and humans. It presents complexities in terms of both the morphological and molecular biological data. This is the first study of the application of Cytochrome B gene (CYTB) as a target for studying the phylogeny and designing species-specific primer of E. revolutum. Adult trematodes were harvested from experimentally infected hamsters at 18 days of post-infection. Each worm was identified based on their morphological appearance. The novel CYTB primers were designed from other Echinostoma species to initially amplify CYTB region in E. revolutum. All sequence data of E. revolutum in five provinces of Central Thailand were used as the target for designing the species-specific primer for E. revolutum. The results revealed that CYTB gene can separate E. revolutum into two sister groups by geographical distribution, comprising the eastern and western area groups. Moreover, it also separates E. revolutum from other Echinostoma species, including two sibling species; E. caproni and E. paraensei. In addition, we developed the high performance species-specific primer of E. revolutum. It can detect DNA from a single egg, as well as cercaria, metacercaria and adult stages of this trematode with no cross-reactions to other trematodes and their hosts. Therefore, this research is a positive initial step for the future study of E. revolutum CYTB. The future studies based on this gene should be continued with all species in revolutum complex to overcome the problems of systemic classification that arise in this complex group.
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Affiliation(s)
- Sothorn Anucherngchai
- Applied Parasitology Research Laboratory, Department of Biology, Faculty of Science, Srinakharinwirot University, Bangkok, Thailand
| | - Thapana Chontananarth
- Applied Parasitology Research Laboratory, Department of Biology, Faculty of Science, Srinakharinwirot University, Bangkok, Thailand
- Center of Excellence in Animal, Plant and Parasitic Biotechnology, Srinakharinwirot University, Bangkok, Thailand
| | - Thanawan Tejangkura
- Applied Parasitology Research Laboratory, Department of Biology, Faculty of Science, Srinakharinwirot University, Bangkok, Thailand
- Center of Excellence in Animal, Plant and Parasitic Biotechnology, Srinakharinwirot University, Bangkok, Thailand
| | - Jong-Yil Chai
- Korean Association of Health Promotion, Seoul, South Korea
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18
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Mohammadpour I, Hatam GR, Handjani F, Bozorg-Ghalati F, PourKamal D, Motazedian MH. Leishmania cytochrome b gene sequence polymorphisms in southern Iran: relationships with different cutaneous clinical manifestations. BMC Infect Dis 2019; 19:98. [PMID: 30696426 PMCID: PMC6352432 DOI: 10.1186/s12879-018-3667-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/28/2018] [Indexed: 01/04/2023] Open
Abstract
Background Cutaneous leishmaniasis (CL) caused by Leishmania species, is a geographically extensive disease that infects humans and animals. CL is endemic in half of the 31 provinces of Iran, with 29,201 incidence cases reported in Fars province from 2010 to 2015. CL is polymorphic and may result in lesions characterized by different clinical features. Parasite genetic diversity is proposed to be one of the factors affecting the clinical outcome and lesion characteristics in CL patients. However, there is still very limited data regarding the genetic variation of Leishmania spp. based on the sequencing of Cytochrome b (Cyt b) gene. Methods All patients originated from endemic regions in Fars province. The amplification of the Cyt b gene from isolates of 100 patients with disparate clinical forms of CL was accomplished using Nested-PCR. Sequence analysis of the amplified Cyt b was used to scrutinize the genetic variations among Leishmania isolates and connect the results with clinical pictures. The clinical demonstrations were basically of two types, typical and atypical lesions. Molecular phylogenetic tree was constructed using the Neighbor-Joining method, with species/strains from this study compared to species/strains from other geographical regions. Results Leishmania major was identified as the predominant infecting Leishmania spp. (86% of cases), with the remainder of cases being infected by Leishmania tropica. Clinical examination of patients revealed 12 different clinical CL forms. Among Leishmania samples analyzed, five distinct haplotypes were recognized: three in L. major and two in L. tropica. We found a correlation between clinical outcomes and Cyt b sequence variation of Leishmania spp. involved. Moreover, we observed a higher presence of polymorphisms in L. major compared with L. tropica. This difference may be due to the different eco-epidemiologies of both species, with L. tropica being an anthroponosis compared to L. major, which is a zoonosis. Conclusions The sequence analysis of Cyt b gene from 25 L. major and L. tropica strains demonstrated genetic variability of L. major and L. tropica causing CL in southern Iran, and a feasible connection amid the genetic heterogeneity of the parasite, geographical source and clinical appearance of the disease in human was detected.
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Affiliation(s)
- Iraj Mohammadpour
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Gholam Reza Hatam
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Handjani
- Molecular Dermatology Research Center, Department of Dermatology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Bozorg-Ghalati
- Department of Molecular Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Daniel PourKamal
- Fajr Health Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Motazedian
- Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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19
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Quiroga C, Cevallos V, Morales D, Baldeón ME, Cárdenas P, Rojas-Silva P, Ponce P. Molecular Identification of Leishmania spp. in Sand Flies (Diptera: Psychodidae, Phlebotominae) From Ecuador. JOURNAL OF MEDICAL ENTOMOLOGY 2017; 54:1704-1711. [PMID: 28981860 PMCID: PMC5850347 DOI: 10.1093/jme/tjx122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Indexed: 05/26/2023]
Abstract
The detection and identification of natural infections in sand flies by Leishmania protozoan species in endemic areas is a key factor in assessing the risk of leishmaniasis and in designing prevention and control measures for this infectious disease. In this study, we analyzed the Leishmania DNA using nuclear ribosomal internal transcript spacer (ITS) sequences. Parasite DNA was extracted from naturally infected, blood-fed sand flies collected in nine localities considered leishmaniasis-endemic foci in Ecuador. The species of parasites identified in sand flies were Leishmania major-like, Leishmania naiffi, Leishmania mexicana, Leishmania lainsoni, and “Leishmania sp. siamensis”. Sand fly specimens of Brumptomyia leopoldoi, Mycropigomyia cayennensis, Nyssomyia yuilli yuilli, Nyssomyia trapidoi, Pressatia triacantha, Pressatia dysponeta, Psychodopygus carrerai carrerai, Psychodopygus panamensis, and Trichophoromyia ubiquitalis were found positive for Leishmania parasite. These findings contribute to a better understanding of the epidemiology and transmission dynamics of the disease in high-risk areas of Ecuador.
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Affiliation(s)
- Cristina Quiroga
- Instituto Nacional de Investigación en Salud Pública, Centro Nacional de Referencia e Investigación en Vectores, Quito, Ecuador (; ; ; )
- Universidad de Las Américas, Centro de Investigación Traslacional, Quito, Ecuador (; ; )
| | - Varsovia Cevallos
- Instituto Nacional de Investigación en Salud Pública, Centro Nacional de Referencia e Investigación en Vectores, Quito, Ecuador (; ; ; )
| | - Diego Morales
- Instituto Nacional de Investigación en Salud Pública, Centro Nacional de Referencia e Investigación en Vectores, Quito, Ecuador (; ; ; )
| | - Manuel E Baldeón
- Universidad de Las Américas, Centro de Investigación Traslacional, Quito, Ecuador (; ; )
- Universidad Tecnológica Equinoccial, Centro de Investigación Biomédica, Facultad de Ciencias de la Salud Eugenio Espejo, Quito, Ecuador
| | - Paúl Cárdenas
- Universidad de Las Américas, Centro de Investigación Traslacional, Quito, Ecuador (; ; )
- Universidad San Francisco de Quito, Instituto de Microbiología, Quito, Ecuador
| | - Patricio Rojas-Silva
- Universidad de Las Américas, Centro de Investigación Traslacional, Quito, Ecuador (; ; )
- Universidad Tecnológica Equinoccial, Centro de Investigación Biomédica, Facultad de Ciencias de la Salud Eugenio Espejo, Quito, Ecuador
| | - Patricio Ponce
- Instituto Nacional de Investigación en Salud Pública, Centro Nacional de Referencia e Investigación en Vectores, Quito, Ecuador (; ; ; )
- Universidad Central del Ecuador, Instituto de Biomedicina, Facultad de Biología, Quito, Ecuador
- Yachay Tech University, School of Biological Sciences and Engineering. Urcuquí, Ecuador
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20
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Calvopiña M, Cevallos W, Paredes Y, Puebla E, Flores J, Loor R, Padilla J. Intralesional Infiltration with Meglumine Antimoniate for the Treatment of Leishmaniasis Recidiva Cutis in Ecuador. Am J Trop Med Hyg 2017; 97:1508-1512. [PMID: 29016328 DOI: 10.4269/ajtmh.17-0340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Meglumine Antimoniate (MA), administered intramuscularly for 21 continuous days is the recommended treatment of leishmaniases in Ecuador. However, because of its toxicity and requirement for intramuscular injections, treatment is frequently abandoned before completion. In addition, therapeutic failure and reactivation are not uncommon. Here we evaluate the efficacy and safety of MA administered intralesionally (IL) in leishmaniasis recidiva cutis (LRC). LRC is a special clinical variant of cutaneous leishmaniasis, characterized by reactivation at the edges of a primary cured lesion, presenting with active papules around the scar. Twenty-one patients were included in the study. All were diagnosed parasitologically by one of three diagnostic methods (smear, culture, and Leishmanin skin test). Each patient received MA intralesionally weekly for 4 weeks. Each papule was infiltrated until complete saturation. On average, patients received 1 mL of MA per administration. The criterion of cure was the complete resolution of the papules. Follow up was performed at 30, 90, and 180 days after treatment. At day 30 after treatment, 19 (90.5%) of 21 patients were clinically cured. The two patients, who did not heal by the fourth application, were cured on the seventh and eighth dose, achieving a clinical cure of 100% without subsequent reactivation. Mild to moderate local pain during infiltration was the only adverse reaction experienced by 81% of patients. In one case, subsequent infiltrations were discontinued because of a local allergic reaction. Complete compliance of patients to treatment and the small volume of drug administered make this method of administering MA an effective, safe, and inexpensive alternative. Consequently, IL could replace intramuscular administration in the treatment of LRC in Ecuador.
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Affiliation(s)
- Manuel Calvopiña
- Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad De Las Américas (UDLA), Quito, Ecuador
| | - William Cevallos
- Carrera de Medicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Yolanda Paredes
- Laboratorio de Patología Clínica, Carrera de Laboratorio Clínico, Universidad Central del Ecuador, Quito, Ecuador
| | - Edison Puebla
- Carrera de Medicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Jessica Flores
- Carrera de Medicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Richard Loor
- Carrera de Medicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - José Padilla
- Epidemiología, Distrito de Salud 17 D-12, Ministerio de Salud Pública del Ecuador, Quito, Ecuador
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Herrera G, Hernández C, Ayala MS, Flórez C, Teherán AA, Ramírez JD. Evaluation of a Multilocus Sequence Typing (MLST) scheme for Leishmania (Viannia) braziliensis and Leishmania (Viannia) panamensis in Colombia. Parasit Vectors 2017; 10:236. [PMID: 28499458 PMCID: PMC5429539 DOI: 10.1186/s13071-017-2175-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/03/2017] [Indexed: 11/30/2022] Open
Abstract
Background Leishmaniases are parasitic vector-borne diseases affecting more than 12 million people in 98 countries. In Colombia, leishmaniasis is widespread and the most common clinical manifestation is cutaneous, mainly caused by L. panamensis and L. braziliensis. Currently, the genetic diversity of these species in Colombia is unknown. To address this, we applied molecular techniques for their characterization, using multilocus sequence typing (MLST) to explore the genetic variability and phylodynamics of the disease. Methods Seven previously described genetic markers were selected highlighting the implementation of a mitochondrial marker. Markers were applied to 163 samples from isolates obtained between 1980 and 2001. Results The identification of the samples showed an excellent correlation with typing tests previously applied (MLEE, monoclonal antibodies). Isolates of L. braziliensis showed greater genetic diversity than L. panamensis, and a greater number of diploid sequence types (DSTs). In addition, the geographical distribution of DSTs for each species were obtained through georeferencing maps. Conclusions To our knowldge, this study represents the first description of the genetic variability of L. panamensis in Colombia and South America, and is the first to propose a scheme of MLST for epidemiological surveillance of leishmaniasis in the country. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2175-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giovanny Herrera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Carrera 24 No. 63C-69, Bogotá, Colombia
| | - Carolina Hernández
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Carrera 24 No. 63C-69, Bogotá, Colombia
| | - Martha S Ayala
- Grupo de Parasitología, Instituto Nacional de Salud, Avenida Calle 26 #51-20, Bogotá, Colombia
| | - Carolina Flórez
- Grupo de Parasitología, Instituto Nacional de Salud, Avenida Calle 26 #51-20, Bogotá, Colombia
| | - Aníbal A Teherán
- Residente Medicina de Emergencias, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Carrera 24 No. 63C-69, Bogotá, Colombia
| | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Carrera 24 No. 63C-69, Bogotá, Colombia.
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22
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Eco-epidemiological aspects, natural detection and molecular identification of Leishmania spp. in Lutzomyia reburra, Lutzomyia barrettoi majuscula and Lutzomyia trapidoi. BIOMEDICA 2017; 37:83-97. [DOI: 10.7705/biomedica.v37i0.3536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Indexed: 11/21/2022]
Abstract
Introducción. La provincia de Pichincha, Ecuador, es un área endémica de leishmaniasis cutánea, en donde se han determinado como vectores los flebotomíneos antropofílicos con infección natural por Leishmania spp. Sin embargo, no se ha evaluado el papel en la transmisión de las especies zoofílicas.Objetivo. Evaluar la infección natural por Leishmania en dos especies de flebotomíneos zoofílicos, Lutzomyia reburra y Lu. barrettoi majuscula, y en una antropofílica, Lu. trapidoi, así como la endofagia y la sinantropía de estas especies en el noroccidente de Pichincha.Materiales y métodos. Los flebotomíneos se recolectaron en trampas de luz CDC colocadas en diferentes hábitats y altitudes en sitios que son focos de leishmaniasis cutánea. La infección con Leishmania spp. se detectó en el ADN genómico de hembras de las especies de flebotomíneos de interés. Se amplificó el gen espaciador interno de la transcripción del ARN ribosómico, unidad I (ITS1), y los genes de las topoiso-merasas mitocondrial II (mtTOPOII) y nuclear II (TopoII). Se determinaron los porcentajes de positividad para Leishmania a escala espaciotemporal, la proporción de endofagia y el índice de sinantropía.Resultados. Se determinó la presencia de infección natural por Le. amazonensis en Lu. reburra (9,5 %) y Lu. b. majuscula (23,8 %); en Lu. trapidoi se detectaron Le. amazonensis, Le. brazilienis y Le. naiffi-lainsoni. Los flebotomíneos eran asinantrópicos y con baja endofagia.Conclusión. Se registró por primera vez la presencia de infección natural en Lu. reburra y Lu. barrettoi majuscula por Le. amazonensis, y se demostró la importancia de los flebotomíneos zoofílicos en el mantenimiento del ciclo de transmisión de Leishmania spp. en focos endémicos.
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Calvopina M, Aguirre C, Cevallos W, Castillo A, Abbasi I, Warburg A. Coinfection of Leishmania guyanensis and Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome: Report of a Case of Disseminated Cutaneous Leishmaniasis in Ecuador. Am J Trop Med Hyg 2017; 96:1151-1154. [PMID: 28193741 DOI: 10.4269/ajtmh.16-0431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractReported herein is the first case of Leishmania-human immunodeficiency virus (HIV) coinfection in Ecuador. In Ecuador, HIV infections overlap endemic areas of leishmaniasis. Immunosuppression is a well-established risk factor for developing severe disease. This is a severe case of a 32-year-old man presenting with disseminated pleomorphic ulcers, papules, and cutaneous plaque-like lesions over his whole body. Numerous amastigotes were observed in both skin scrapings and biopsies. The sequence of the cytochrome b gene confirmed the presence of Leishmania guyanensis. The patient was treated but failed to respond to meglumine antimoniate and amphotericin B. Six months later, the patient died due to bacterial septic shock.
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Affiliation(s)
- Manuel Calvopina
- Carrera de Medicina, Universidad De Las Americas (UDLA), Quito, Ecuador
| | - Cristina Aguirre
- Servicio de Medicina Interna, Hospital Eugenio Espejo, Quito, Ecuador
| | - William Cevallos
- Carrera de Medicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Alberto Castillo
- Servicio de Medicina Interna, Hospital Eugenio Espejo, Quito, Ecuador
| | - Ibrahim Abbasi
- The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alon Warburg
- The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University of Jerusalem, Jerusalem, Israel.,PROMETEO, Secretaría Nacional de Educación Superior, Ciencia, Tecnología e Innovación (SENESCYT), Ecuador
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