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de Melo SN, Soeiro Barbosa D, Câmara DCP, César Simões T, Buzanovsky LP, Sousa Duarte AG, Maia-Elkhoury ANS, Cardoso DT, Edel Donato L, Werneck GL, Bruhn FRP, Silva Belo V. Tegumentary leishmaniasis in Brazil: priority municipalities and spatiotemporal relative risks from 2001 to 2020. Pathog Glob Health 2024:1-11. [PMID: 38904099 DOI: 10.1080/20477724.2024.2367442] [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: 06/22/2024] Open
Abstract
Understanding the distribution of tegumentary leishmaniasis (TL) in different periods enables the adequate conduction of actions at the public health level. The present study analyzes the spatiotemporal evolution of TL incidence rates in the municipalities of Brazil and identifies priority areas from 2001 to 2020. Notifications of new cases were analyzed employing space-time scan statistics and Local Indicators of Spatial Association. As TL incidence rates presented a downward trend in most Brazilian municipalities, spatiotemporal clusters of high relative risks (RR) were more frequent in the first decade of the series. There was a concentration of those clusters in the North and Northeast regions, mainly in the Legal Amazon area. More recent high-RR areas were identified in municipalities of different regions. The number of priority municipalities showed a stable trend in Brazil. There was a great concentration of such municipalities in the states of Acre, Mato Grosso, Rondônia, Pará, and Amapá, as well as large areas in Roraima, Amazonas, Maranhão, and Tocantins, and smaller areas in the states of Goiás, Ceará, Bahia, Minas Gerais, São Paulo, and Paraná. The present study contributes to the understanding of the historical evolution of TL in Brazil and subsidizes actions to combat the disease.
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Affiliation(s)
- Saulo Nascimento de Melo
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, MG, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | | | - Ana Nilce Silveira Maia-Elkhoury
- Communicable Diseases, Prevention, Control & Elimination (CDE) - VT, Organização Pan-Americana da Saúde, Rio de Janeiro, RJ, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas Edel Donato
- Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Brasília, DF, Brazil
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Vinícius Silva Belo
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, MG, Brazil
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Awoke TD, Kassa SM, Morupisi KS, Tsidu GM. Sex-structured disease transmission model and control mechanisms for visceral leishmaniasis (VL). PLoS One 2024; 19:e0301217. [PMID: 38564571 PMCID: PMC10986940 DOI: 10.1371/journal.pone.0301217] [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: 11/28/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Leishmaniasis are a group of diseases caused by more than 20 species of the protozoan that are transmitted through the bite of female sand fly. The disease is endemic to 98 countries of the world. It affects most commonly the poorest of the poor and mainly males. Several research has been conducted to propose disease control strategies. Effective medical care, vector control, environmental hygiene, and personal protection are the mainstays of the current preventative and control methods. The mathematical models for the transmission dynamics of the disease studied so far did not consider the sex-biased burden of the disease into consideration. METHODOLOGY Unlike the previous VL works, this study introduces a new deterministic sex-structured model for understanding the transmission dynamics of visceral leishmaniasis. Basic properties of the model including basic reproduction number ([Formula: see text]), and conditions for the existence of backward bifurcation of the model are explored. Baseline parameter values were estimated after the model was fitted to Ethiopia's VL data. Sensitivity analysis of the model was performed to identify the parameters that significantly impact the disease threshold. Numerical simulations were performed using baseline parameter values, and scenario analysis is performed by changing some of these parameters as appropriate. CONCLUSION The analysis of the model shows that there is a possibility for a backward bifurcation for [Formula: see text], which means bringing [Formula: see text] to less than unity may not be enough to eradicate the disease. Our numerical result shows that the implementation of disease-preventive strategies, as well as effectively treating the affected ones can significantly reduce the disease prevalence if applied for more proportion of the male population. Furthermore, the implementation of vector management strategies also can considerably reduce the total prevalence of the disease. However, it is demonstrated that putting more effort in treating affected reservoir animals may not have any significant effect on the overall prevalence of the disease as compared to other possible mechanisms. The numerical simulation infers that a maximum of 60% of extra preventative measures targeted to only male population considerably reduces the total prevalence of VL by 80%. It is also possible to decrease the total prevalence of VL by 69.51% when up to 50% additional infected males receive treatment with full efficacy. Moreover, applying a maximum of 15% additional effort to reduce the number of vectors, decreases the total VL prevalence by 57.71%. Therefore, in order to reduce the disease burden of visceral leishmaniasis, public health officials and concerned stakeholders need to give more emphasis to the proportion of male humans in their intervention strategies.
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Affiliation(s)
- Temesgen Debas Awoke
- Department of Mathematical and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Semu Mitiku Kassa
- Department of Mathematical and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Kgomotso Suzan Morupisi
- Department of Mathematical and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Gizaw Mengistu Tsidu
- Department of Earth and Environmental Sciences, Botswana International University of Science and Technology, Palapye, Botswana
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3
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Kaye PM, Matlashewski G, Mohan S, Le Rutte E, Mondal D, Khamesipour A, Malvolti S. Vaccine value profile for leishmaniasis. Vaccine 2023; 41 Suppl 2:S153-S175. [PMID: 37951693 DOI: 10.1016/j.vaccine.2023.01.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 11/14/2023]
Abstract
Leishmania infections are global, occurring in 98 countries and all World Health Organization (WHO) regions with 600 million to 1 billion people at risk of infection. Visceral leishmaniasis is associated with almost 20,000 reported deaths annually, with children under 5 years of age being at the greatest risk of mortality. Amongst WHO-recognised Neglected Tropical Diseases (NTDs), leishmaniasis is one of the most important in terms of mortality and morbidity. With an increasing global burden of disease and a growing threat from climate change, urbanisation and drug resistance, there remains an imperative to develop leishmaniasis vaccines. New tools to understand correlates of protection and to assess vaccine efficacy are being developed to ease the transition into larger scale efficacy trials or provide alternate routes to licensure. Early indications suggest a diverse portfolio of manufacturers exists in endemic countries with an appetite to develop leishmaniasis vaccines. This Vaccine Value Profile (VVP) provides a high-level, comprehensive assessment of the currently available data to inform the potential public health, economic, and societal value of leishmaniasis vaccines. The leishmaniasis VVP was developed by a working group of subject matter experts from academia, public health groups, policy organizations, and non-profit organizations. All contributors have extensive expertise on various elements of the leishmaniasis VVP and have collectively described the state of knowledge and identified the current gaps. The VVP was developed using only existing and publicly available information.
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Affiliation(s)
- Paul M Kaye
- 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.
| | - Sakshi Mohan
- Center for Health Economics (CHE), University of York, York, UK.
| | - Epke Le Rutte
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Dinesh Mondal
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
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Derakhshani A, Sharifi I, Salarkia E, Keyhani A, Agha Kuchak Afshari S, Iranmanesh B, Lashkarizadeh M, Nejad Biglari H, Lari Najafi M, Bamorovat M. Antileishmanial potentials of azacitidine and along with meglumine antimoniate on Leishmania major: In silico prediction and in vitro analysis. PLoS One 2023; 18:e0291321. [PMID: 37682979 PMCID: PMC10490874 DOI: 10.1371/journal.pone.0291321] [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: 04/13/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
This study aimed to investigate the in vitro and in silico antileishmanial activity of azacitidine (AZA) on Leishmania major promastigotes and amastigotes. The in silico method was used to evaluate the possibility of the interaction of AZA into the binding pocket of inducible nitric oxide synthase (iNOS), a leading defensive oxidative metabolite. Following that, in vitro anti-promastigote, and anti-amastigote activity of AZA was determined using an MTT assay and a macrophage model, respectively. Cytotoxic effects of AZA and meglumine antimoniate (MA) were also assessed by MTT assay on murine macrophages. All experiments were performed in triplicate. The results showed that AZA interacted with Ser133, Gln134, and Lys13 amino acids of iNOS, and the molecular docking score was obtained at -241.053 kcal/mol. AZA in combination with MA significantly (P<0.001) inhibited the growth rate of nonclinical promastigote (IC50 247.6±7.3 μM) and 8.5-fold higher of clinical intramacrophage amastigote stage (29.8±5.3 μM), compared to the untreated group. A significant upsurge of Th1 subsets and transcription genes and a meaningful decline in Th2 cytokines subclasses at the equivalent concentrations of AZA and MA was observed (P<0.001). The apoptosis effect of AZA along with MA was significantly induced on L. major in a dose-dependent manner (P<0.001). The present study demonstrated that AZA possesses antileishmanial activity in in vitro and in silico models. However, AZA combined with MA was more effective than AZA alone in inhibiting the growth rate of promastigotes and amastigotes of L. major. This study indicates that AZA in combination with MA demonstrated a potent antileishmanial mechanism, promoting immune response and enhancing an immunomodulatory role toward the Th1 pathway. This experimental study is a basic study for applying more knowledge about the mechanisms of AZA along with MA in animal models in the future.
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Affiliation(s)
- Ali Derakhshani
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Salarkia
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Keyhani
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Behzad Iranmanesh
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdieh Lashkarizadeh
- Department of Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Nejad Biglari
- Department of Surgery, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Moslem Lari Najafi
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Belo VS, Bruhn FRP, Barbosa DS, Câmara DCP, Simões TC, Buzanovsky LP, Duarte AGS, de Melo SN, Cardoso DT, Donato LE, Maia-Elkhoury ANS, Werneck GL. Temporal patterns, spatial risks, and characteristics of tegumentary leishmaniasis in Brazil in the first twenty years of the 21st Century. PLoS Negl Trop Dis 2023; 17:e0011405. [PMID: 37285388 DOI: 10.1371/journal.pntd.0011405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/22/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Tegumentary leishmaniasis (TL) is a significant public health issue in Brazil. The present ecological study describes the clinical and epidemiological characteristics of TL cases reported in the country, and analyzes the spatial and temporal patterns of the incidences and risks of occurrence across the five geopolitical regions and 27 federative units. METHODOLOGY/PRINCIPAL FINDINGS Data regarding new cases of TL notified between 2001 and 2020 were obtained from the Information System for Notifiable Diseases of the Brazilian Ministry of Health. Joinpoint and spatial and temporal generalized additive models were used to establish trends in the evolution of TL during the target period. The incidence rate for the entire period was 226.41 cases/100,000 inhabitants. All regions of Brazil showed trends of decreasing incidence rates, albeit with fluctuations at specific times, with the exception of the Southeast where rates have increased since 2014, most particularly in Minas Gerais state. The disease was concentrated predominantly in the North region, with Acre state leading the incidence rank in the whole country, followed by Mato Grosso (Midwest), Maranhão and Bahia (Northeast) states. The spatial distribution of the risk of TL occurrence in relation to the annual averages was relatively stable throughout the period. The cutaneous form of TL was predominant and cases most frequently occurred in rural areas and among men of working age. The ages of individuals contracting TL tended to increase during the time series. Finally, the proportion of confirmations by laboratory tests was lower in the Northeast. CONCLUSION/SIGNIFICANCE TL shows a declining trend in Brazil, but its widespread occurrence and the presence of areas with increasing incidence rates demonstrate the persistent relevance of this disease and the need for constant monitoring. Our findings reinforce the importance of temporal and spatial tools in epidemiologic surveillance routines and are valuable for targeting preventive and control actions.
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Affiliation(s)
- Vinícius Silva Belo
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - Fábio Raphael Pascoti Bruhn
- Departamento de Veterinária Preventiva, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniel Cardoso Portela Câmara
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taynãna César Simões
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Lia Puppim Buzanovsky
- Centro Pan-Americano de Febre Aftosa, Organização Pan-Americana da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
- Organização Pan-Americana da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Anna Gabryela Sousa Duarte
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - Saulo Nascimento de Melo
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, Minas Gerais, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Sharifi I, Khosravi A, Aflatoonian MR, Salarkia E, Bamorovat M, Karamoozian A, Moghadam MN, Sharifi F, Afshar AA, Afshari SAK, Gharachorloo F, Shirzadi MR, Amiri B, Zainali M, Doosti S, Zamani O, Gouya MM. Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan. Front Public Health 2023; 11:1091709. [PMID: 37188278 PMCID: PMC10176454 DOI: 10.3389/fpubh.2023.1091709] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989-2020. However, we emphasized the current trends, 2013-2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported.
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Affiliation(s)
- Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Khosravi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Ehsan Salarkia
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Karamoozian
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmoud Nekoei Moghadam
- Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sharifi
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Aghaei Afshar
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Faranak Gharachorloo
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Reza Shirzadi
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Behzad Amiri
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Zainali
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Sara Doosti
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Omid Zamani
- Universal Health Coverage for Communicable Diseases (UHC: CD), World Health Organization, Country Office, Tehran, Iran
| | - Mohammad Mahdi Gouya
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
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Zarei Z, Mohebali M, Dehghani H, Khamesipour A, Tavakkol-Afshari J, Akhoundi B, Abbaszadeh-Afshar MJ, Alizadeh Z, Skandari SE, Asl AD, Razmi GR. Live attenuated Leishmania infantum centrin deleted mutant (LiCen -/-) as a novel vaccine candidate: A field study on safety, immunogenicity, and efficacy against canine leishmaniasis. Comp Immunol Microbiol Infect Dis 2023; 97:101984. [PMID: 37119594 DOI: 10.1016/j.cimid.2023.101984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/01/2023]
Abstract
This study was designed to evaluate the safety, immunogenicity, and efficacy of a single dose of L. infantum (LiCen-/-) live attenuated candidate vaccine against canine leishmaniasis (CanL). Eighteen healthy domestic dogs with no anti-Leishmania antibodies and negative leishmanin skin test (LST) were randomly inoculated intravenously with either L. infantum (LiCen-/-) vaccine candidate in 10 dogs or phosphate-buffered saline (PBS) in 8 dogs. The safety, immunogenicity, and efficacy rate of L. infantum (LiCen-/-) vaccine candidate against CanL were evaluated by different criteria, including clinical manifestations, injection-site lesion, hematology and biochemistry values, anti-Leishmania antibodies using direct agglutination test (DAT), delayed-type hypersensitivity (DTH) using LST, and CD4+ and CD8+ T-cells subsets, as well as by measuring interferon (IFN-γ), interleukin (IL-23), IL-17, and IL-10 cytokines. Spleen aspiration and detection of Leishmania parasite using parasitological examinations (microscopy and culture) were performed in both vaccinated and control groups. Two months after intervention, each dog was challenged intraperitoneally (IP) with wide type (WT) L. infantum. Two-month follow-up post vaccination showed no clinical signs and serious side effects associated with the vaccination. A significant increase was found in the expression of IL-17, CD4+, and CD8+ gene transcripts in PBMCs, as well as increased levels of Th1 cytokines, and reduction of Th2 cytokine. The efficacy of the vaccine candidate was calculated to be 42.85%. While the time window for assessing the vaccine's effectiveness was too limited to draw any real conclusions but the preliminary results showed a moderate efficacy rate due to inoculation a single dose of L. infantum (LiCen-/-) vaccine candidate. Further investigations with more sample sizes and multiple doses of the vaccine candidate using natural challenges in the endemic areas of CanL are recommended.
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Affiliation(s)
- Zabihollah Zarei
- Department of Pathobiology, School Veterinary Medicine, Ferdowsi University of Mashhad, P.O. Box 91775-1793, Mashhad, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, P.O. Box 14155-6446, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, P.O. Box 14155-6446, Tehran, Iran; Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.
| | - Hesam Dehghani
- Department of Basic Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalil Tavakkol-Afshari
- Immunogenetics and Tissue Culture Department, Immunology Research Center, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behnaz Akhoundi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, P.O. Box 14155-6446, Tehran, Iran
| | - Mohammad Javad Abbaszadeh-Afshar
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, P.O. Box 14155-6446, Tehran, Iran
| | - Zahra Alizadeh
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, P.O. Box 14155-6446, Tehran, Iran
| | - Seyed Ebrahim Skandari
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolhossein Dalimi Asl
- Department of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Gholam Reza Razmi
- Department of Pathobiology, School Veterinary Medicine, Ferdowsi University of Mashhad, P.O. Box 91775-1793, Mashhad, Iran.
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8
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Pandey K, Dumre SP, Shah Y, Acharya BK, Khanal L, Pyakurel UR, Kaneko O, Pandey BD. Forty years (1980-2019) of visceral leishmaniasis in Nepal: trends and elimination challenges. Trans R Soc Trop Med Hyg 2023:7008737. [PMID: 36715092 DOI: 10.1093/trstmh/trad001] [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: 09/02/2022] [Revised: 10/17/2022] [Accepted: 01/05/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is an important re-emerging neglected tropical disease associated with poverty. Despite the elimination initiative started in 2005, VL cases have been expanding into geographic areas in Nepal. The present study aims at exploring the trends of VL from 1980 to 2019. METHODS This retrospective analysis covers 40 y of VL cases reported by the Epidemiology Diseases Control Division, Nepal. Subgroup analyses for annual incidence were performed by age, sex, seasons, districts and provinces, and VL cases were visualized on in-country maps. RESULTS A total of 34 564 cases and 584 deaths of VL were reported during 1980-2019. VL persistently increased until 2006 and was reported from all seven provinces of the country. The highest number of confirmed cases (n=2229) was reported in 2003 and the lowest (n=60) in 1983. VL cases expanded from 12 to 23 endemic districts. The key components of the VL elimination program are early diagnosis; enhanced surveillance; integrated vector management; social mobilization; research and treatment. CONCLUSIONS Expansion of VL towards the hilly and mountain regions of Nepal has posed challenges to the elimination program. Urgent VL control measures are required to achieve the elimination goals.
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Affiliation(s)
- Kishor Pandey
- Central Departm ent of Zoology, Institute of Science and Technology, Tribhuvan University, Kathmandu 44060, Nepal
| | - Shyam Prakash Dumre
- Central Department of Microbiology, Institute of Science and Technology, Tribhuvan University, Kathmandu 44618, Nepal
| | - Yogendra Shah
- Everest International Clinic and Research Center, Kathmandu 44060, Nepal
| | - Bipin Kumar Acharya
- Institute of Fundamental Research and Studies (InFeRS), Kathmandu 44600, Nepal
| | - Laxman Khanal
- Central Departm ent of Zoology, Institute of Science and Technology, Tribhuvan University, Kathmandu 44060, Nepal
| | | | - Osamu Kaneko
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki 852-8523, Japan
| | - Basu Dev Pandey
- Department of Molecular Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki 852-8523, Japan
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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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Cutaneous Leishmaniasis: A 2022 Updated Narrative Review into Diagnosis and Management Developments. Am J Clin Dermatol 2022; 23:823-840. [PMID: 36103050 PMCID: PMC9472198 DOI: 10.1007/s40257-022-00726-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 01/10/2023]
Abstract
This review is an update of an earlier narrative review published in 2015 on developments in the clinical management of cutaneous leishmaniasis (CL) including diagnosis, treatment, prevention and control measurements. CL is a vector-borne infection caused by the protozoan parasite Leishmania. The vector is the female sandfly. Globally, CL affects 12 million cases and annually 2 million new cases occur. CL is endemic in almost 100 countries and the total risk population is approximately 350 million people. WHO lists CL an emerging and uncontrolled disease and a neglected tropical disease. Local experience-based evidence remains the mainstay for the management of CL. Whereas intralesional therapeutic options are the first treatment option for most CL patients, those with mucocutaneous and disseminated involvement require a systemic therapeutic approach. Moreover, different Leishmania species can vary in their treatment outcomes. Therefore, species determination is critical for optimal CL clinical management. New DNA techniques allow for relatively easy Leishmania species determination, yet they are not easily implemented in resource-limited settings. There is a desperate need for novel, less toxic, and less painful treatment options, especially for children with CL. Yet, the large and well conducted studies required to provide the necessary evidence are lacking. To further control and potentially eliminate CL, we urgently need to improve vector control, and diagnostics, and we require efficient and safe vaccines. Alas, since CL primarily affects poor people, biotechnical companies dedicate little investment into the research programs that could lead to diagnostic, pharmaceutical, and vaccine innovations.
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Chowdhury SR, Bhoumik A, Gupta VK, Majumder HK. Type II DNA Topoisomerases in trypanosomatid and apicomplexan parasites. Acta Trop 2022; 234:106613. [PMID: 35905776 DOI: 10.1016/j.actatropica.2022.106613] [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: 03/06/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/01/2022]
Abstract
Diseases caused by trypanosomatid parasites have no commercially available vaccines for human application. Treatment modalities completely rely on chemotherapeutics strategies that often exhibit clinical drawbacks, like host toxicity, side effects and treatment failure for drug resistance. These, in many instances, are costly, making them unaffordable for certain groups of beneficiaries. To find reasonable solutions, researchers are attempting to identify and validate new drug targets that would offer parasite specificity. DNA topoisomerases in parasites present a consolidated class of drug targets due to their multiple structural and functional differences with host homologs. Type II DNA topoisomerases in these parasites, in particular, have been attracting interest of scientific community attributable to their pivotal role in the replication of the atypical DNA. In this article, we present a detailed review of structural and functional features of type II DNA topoisomerases of clinically-relevant trypanosomatid and apicomplexan parasites. Also, we provide up-to-date information on different molecules that target these enzymes. Altogether, the review will largely help in understanding the rationale for exploiting type II DNA topoisomerases in these groups of parasites as drug targets.
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Affiliation(s)
- Somenath Roy Chowdhury
- Institut für Physikalische Chemie, Westfälische Wilhelms-Universität Münster, Correnstrasse 28, 48149, Münster.
| | - Arpita Bhoumik
- Infectious Diseases & Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, 700 032
| | - Vivek Kumar Gupta
- Organic and Medicinal Chemistry Division, CSIR-Indian Institute of Chemical Biology, Kolkata 700 032
| | - Hemanta K Majumder
- Infectious Diseases & Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, 700 032
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12
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Lage DP, Vale DL, Linhares FP, Freitas CS, Machado AS, Cardoso JMO, de Oliveira D, Galvani NC, de Oliveira MP, Oliveira-da-Silva JA, Ramos FF, Tavares GSV, Ludolf F, Bandeira RS, Pereira IAG, Chávez-Fumagalli MA, Roatt BM, Machado-de-Ávila RA, Christodoulides M, Coelho EAF, Martins VT. A Recombinant Chimeric Protein-Based Vaccine Containing T-Cell Epitopes from Amastigote Proteins and Combined with Distinct Adjuvants, Induces Immunogenicity and Protection against Leishmania infantum Infection. Vaccines (Basel) 2022; 10:vaccines10071146. [PMID: 35891310 PMCID: PMC9317424 DOI: 10.3390/vaccines10071146] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/13/2022] [Accepted: 07/16/2022] [Indexed: 02/06/2023] Open
Abstract
Currently, there is no licensed vaccine to protect against human visceral leishmaniasis (VL), a potentially fatal disease caused by infection with Leishmania parasites. In the current study, a recombinant chimeric protein ChimT was developed based on T-cell epitopes identified from the immunogenic Leishmania amastigote proteins LiHyp1, LiHyV, LiHyC and LiHyG. ChimT was associated with the adjuvants saponin (Sap) or monophosphoryl lipid A (MPLA) and used to immunize mice, and their immunogenicity and protective efficacy were evaluated. Both ChimT/Sap and ChimT/MPLA induced the development of a specific Th1-type immune response, with significantly high levels of IFN-γ, IL-2, IL-12, TNF-α and GM-CSF cytokines produced by CD4+ and CD8+ T cell subtypes (p < 0.05), with correspondingly low production of anti-leishmanial IL-4 and IL-10 cytokines. Significantly increased (p < 0.05) levels of nitrite, a proxy for nitric oxide, and IFN-γ expression (p < 0.05) were detected in stimulated spleen cell cultures from immunized and infected mice, as was significant production of parasite-specific IgG2a isotype antibodies. Significant reductions in the parasite load in the internal organs of the immunized and infected mice (p < 0.05) were quantified with a limiting dilution technique and quantitative PCR and correlated with the immunological findings. ChimT/MPLA showed marginally superior immunogenicity than ChimT/Sap, and although this was not statistically significant (p > 0.05), ChimT/MPLA was preferred since ChimT/Sap induced transient edema in the inoculation site. ChimT also induced high IFN-γ and low IL-10 levels from human PBMCs isolated from healthy individuals and from VL-treated patients. In conclusion, the experimental T-cell multi-epitope amastigote stage Leishmania vaccine administered with adjuvants appears to be a promising vaccine candidate to protect against VL.
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Affiliation(s)
- Daniela P. Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Danniele L. Vale
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Flávia P. Linhares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Camila S. Freitas
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Amanda S. Machado
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Jamille M. O. Cardoso
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Departamento de Ciências Biológicas, Insituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto CEP 35400-000, MG, Brazil; (J.M.O.C.); (B.M.R.)
| | - Daysiane de Oliveira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, SC, Brazil; (D.d.O.); (R.A.M.-d.-Á.)
| | - Nathália C. Galvani
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Marcelo P. de Oliveira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - João A. Oliveira-da-Silva
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Fernanda F. Ramos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Grasiele S. V. Tavares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Fernanda Ludolf
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Raquel S. Bandeira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Isabela A. G. Pereira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
| | - Miguel A. Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Urb. San José S/N, Umacollo, Arequipa 04000, Peru;
| | - Bruno M. Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Departamento de Ciências Biológicas, Insituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto CEP 35400-000, MG, Brazil; (J.M.O.C.); (B.M.R.)
| | - Ricardo A. Machado-de-Ávila
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, SC, Brazil; (D.d.O.); (R.A.M.-d.-Á.)
| | - Myron Christodoulides
- Neisseria Research Group, Molecular Microbiology, Faculty of Medicine, School of Clinical and Experimental Sciences, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
- Correspondence: ; Tel.: +44-02381-205120
| | - Eduardo A. F. Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
- Departamento de Patologia Clínica, Colégio Técnico (COLTEC), Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte 31270-901, MG, Brazil
| | - Vívian T. Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte 30130-100, MG, Brazil; (D.P.L.); (D.L.V.); (F.P.L.); (C.S.F.); (A.S.M.); (N.C.G.); (M.P.d.O.); (J.A.O.-d.-S.); (F.F.R.); (G.S.V.T.); (F.L.); (R.S.B.); (I.A.G.P.); (E.A.F.C.); (V.T.M.)
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Faber C, Montenegro Quiñonez C, Horstick O, Rahman KM, Runge-Ranzinger S. Indoor residual spraying for the control of visceral leishmaniasis: A systematic review. PLoS Negl Trop Dis 2022; 16:e0010391. [PMID: 35587498 PMCID: PMC9159594 DOI: 10.1371/journal.pntd.0010391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 06/01/2022] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
Indoor Residual Spraying (IRS) is one of the interventions to control the vectors of Visceral Leishmaniasis (VL). Different insecticides are used in affected countries, also in the Regional Initiative for the Elimination of VL in South-East Asia. This systematic review assesses all available studies analysing the effectiveness of IRS on the key vectors of VL. The systematic review followed PRISMA guidelines, with a broad search strategy, applied to seven key databases. Inclusion criteria were studies focusing on 1) Visceral leishmaniasis 2) Indoor Residual Spraying (IRS) or synonyms, and 3) all primary research methods. 21 studies were included, five cluster randomised controlled trials (cRCTs), one randomised controlled trial (RCT), 11 intervention studies, also included were three modelling studies and one survey. 19 out of 21 included studies were published between 2009 and 2020. 18 of the studies were conducted in the context of the Regional Initiative. Effects of IRS on vector populations are positive, confirmed in terms of effectiveness and by the availability of studies. Deltamethrin and alpha-Cypermethrin reduce total sandfly counts, and/or Phlebotomus argentipes counts by up to 95% with an effect of a minimum of one month. Prolonged effects are not regularly seen. DDT has been used in India only: whereas in the 1990s a good effect could be measured, this effect waned over time. Two intervention studies, embedded in larger programmes in 2019 and 2020, replaced DDT with alpha-Cypermethrin throughout the study. Combinations of different interventions are not systematically researched, however showing some promising results, for example for the combination of IRS and Temephos. Constant monitoring of insecticide resistancies and quality delivery of IRS are confirmed as key issues for programmes. No human transmission data are available to directly relate an effect of IRS-although modelling studies confirm the effect of IRS on human transmission. Concluding, IRS continues to be an effective intervention for Phlebotomus argentipes control. Delivery requires constant monitoring and quality assurance. Further studies need to assess IRS in different geographical areas affected by VL and combinations of interventions.
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Affiliation(s)
- Claudia Faber
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Carlos Montenegro Quiñonez
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Instituto de Investigaciones, Centro Universitario de Zacapa, Universidad de San Carlos de Guatemala, Zacapa, Guatemala
| | - Olaf Horstick
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Kazi Mizanur Rahman
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- * E-mail:
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14
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Machado AS, Lage DP, Vale DL, Freitas CS, Linhares FP, Cardoso JMO, Oliveira-da-Silva JA, Pereira IAG, Ramos FF, Tavares GSV, Ludolf F, Bandeira RS, Maia LGN, Menezes-Souza D, Duarte MC, Chávez-Fumagalli MA, Roatt BM, Christodoulides M, Martins VT, Coelho EAF. Leishmania LiHyC protein is immunogenic and induces protection against visceral leishmaniasis. Parasite Immunol 2022; 44:e12921. [PMID: 35437797 DOI: 10.1111/pim.12921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
AIMS Treatment against visceral leishmaniasis (VL) presents problems by toxicity of drugs, high cost and/or emergence of resistant strains. The diagnosis is hampered by variable sensitivity and/or specificity of tests. In this context, prophylactic vaccination could represent a control measure against disease. In this study, the protective efficacy from Leishmania LiHyC protein was evaluated in murine model against Leishmania infantum infection. METHODS AND RESULTS LiHyC was used as recombinant protein (rLiHyC) associated with saponin (rLiHyC/S) or Poloxamer 407-based polymeric micelles (rLiHyC/M) to immunize mice. Animals received also saline, saponin or empty micelles as controls. The immunogenicity was evaluated before and after challenge, and results showed that vaccination with rLiHyC/S or rLiHyC/M induced the production of high levels of IFN-γ, IL-12 and GM-CSF in cell culture supernatants, as well as higher IFN-γ expression evaluated by RT-qPCR and involvement from CD4+ and CD8+ T cell subtypes producing IFN-γ, TNF-α and IL-2. A positive lymphoproliferative response was also found in cell cultures from vaccinated animals, besides high levels of rLiHyC- and parasite-specific nitrite and IgG2a antibodies. Immunological assays correlated with significant reductions in the parasite load in spleens, livers, bone marrows and draining lymph nodes from vaccinated mice, when compared to values found in the controls. The micellar composition showed slightly better immunological and parasitological data, as compared to rLiHyC/S. CONCLUSION Results suggest that rLiHyC associated with adjuvants could be considered for future studies as a vaccine candidate against VL.
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Affiliation(s)
- Amanda S Machado
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Daniela P Lage
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Danniele L Vale
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Camila S Freitas
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Flávia P Linhares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Jamille M O Cardoso
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Departamento de Ciências Biológicas, Insituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - João A Oliveira-da-Silva
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Isabela A G Pereira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda F Ramos
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Grasiele S V Tavares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Ludolf
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Raquel S Bandeira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Luiz G N Maia
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Daniel Menezes-Souza
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil.,Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana C Duarte
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil.,Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Miguel A Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Urb. San José S/N, Umacollo, Arequipa, Peru
| | - Bruno M Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Departamento de Ciências Biológicas, Insituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Myron Christodoulides
- Neisseria Research Group, Molecular Microbiology, School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, England
| | - Vívian T Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo A F Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Minas Gerais, Brazil.,Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901, Belo Horizonte, Minas Gerais, Brazil
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15
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Montenegro-Quiñonez CA, Buhler C, Horstick O, Runge-Ranzinger S, Rahman KM. Efficacy and community-effectiveness of insecticide treated nets for the control of visceral leishmaniasis: A systematic review. PLoS Negl Trop Dis 2022; 16:e0010196. [PMID: 35235556 PMCID: PMC8890655 DOI: 10.1371/journal.pntd.0010196] [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: 06/25/2021] [Accepted: 01/24/2022] [Indexed: 12/28/2022] Open
Abstract
Visceral leishmaniasis (VL) has been targeted for elimination from Southeast Asia (SEA). The disease has been endemic in SEA, and in other parts of the world involving both humans and animals. One of the key strategies for combating VL is controlling for the vector sandfly. There are a few vector control strategies that are currently in practice. We sought to assess the efficacy and community effectiveness of insecticide treated nets (ITNs) in controlling the burden of sandfly and the occurrence of VL among humans. We conducted a systematic review following a study protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) criteria. 6331 initial hits were retrieved from Google Scholar, Lilacs, PubMed, Science Direct, WHOlis, WHOiris and PAHOiris. 25 met the full inclusion criteria. Findings show that the insecticide impregnated bednets and the commercially treated long lasting insecticidal nets (LLINs) are effective in controlling sandflies, with mortalities as high as 75% lasting over a year; although their role in controlling VL in the community was not extensively studied, since effectiveness was usually measured with sandflies densities. Findings also show that insecticide impregnated bednets are low cost and well accepted in the community, however, early erosion of insecticides from nets could occur. Some studies also showed that killing of sandflies may not translate into reduction of VL, therefore sandfly knock down and killing data needs to be interpreted with caution. Conclusions of this review are (1) combining insecticide impregnated bednets, as targeted interventions, with another vector control measure, particularly indoor residual spraying, and in conjunction with case detection, could be the way forward to controlling VL in resource limited settings. (2) Given the current low incidence of VL in SEA, it can be difficult to further research the community effectiveness of those control measures in reducing VL. Visceral leishmaniasis (VL) is a vector borne disease endemic in Southeast Asia (SEA) and present in other regions of the world. In SEA the disease has been targeted for elimination. VL is transmitted by different species of sandflies and key strategies against VL rely on the control of the vectors. This systematic review assesses the efficacy and community effectiveness of insecticide treated nets (ITNs) in controlling sandflies and VL occurrence among humans. After a revision of 6331 initial hits, 25 studies were included in this systematic review. Main findings indicated that insecticide impregnated bednets and long-lasting insecticidal nets (LLINs) can effectively control sandflies, however, it was not possible to fully assess the role of ITNs in controlling VL transmission. Additional results showed that insecticide impregnated bednets are low cost and well accepted in the community, however early erosion of insecticides from the nets could occur. If insecticide impregnated bednets are combined with other vector control measures, such as indoor residual spraying, and together with case detection, it could be an important strategy to control VL in resource limited settings.
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Affiliation(s)
- Carlos Alberto Montenegro-Quiñonez
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
- Instituto de Investigaciones, Centro Universitario de Zacapa, Universidad de San Carlos de Guatemala, Zacapa, Guatemala
- * E-mail:
| | - Claudia Buhler
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
| | - Olaf Horstick
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
| | - Kazi Mizanur Rahman
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
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