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Patel A, Bandino F, Achanta M, Walker SL, Joseph JA. Ear, nose and throat manifestations of leishmaniasis: Case series from a tertiary centre in the United Kingdom. Clin Otolaryngol 2024; 49:258-263. [PMID: 37997482 DOI: 10.1111/coa.14127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/25/2023]
Affiliation(s)
- A Patel
- Department of Rhinology, Royal National Ear, Nose and Throat Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - F Bandino
- Department of Rhinology, Royal National Ear, Nose and Throat Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - M Achanta
- Department of Rhinology, Royal National Ear, Nose and Throat Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - S L Walker
- Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
- Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
| | - J A Joseph
- Department of Rhinology, Royal National Ear, Nose and Throat Hospital, University College London Hospitals NHS Foundation Trust, London, UK
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Vargas Roman VC, Bezemer J, Calvopiña M, Ortega F, Salazar NB, Schallig HDFH, de Vries HJC. Multi-sensorial perceptions of risk: the aesthetics behind (muco)cutaneous leishmaniasis-related stigma in Ecuador. Anthropol Med 2023; 30:362-379. [PMID: 37781888 DOI: 10.1080/13648470.2023.2259184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
Previous research on the stigma associated with cutaneous leishmaniasis, a vector-transmitted parasitic disease, focuses on aesthetic appearance affectation as the leading cause of stigmatisation. However, Indigenous populations in the hinterland of Amazonian Ecuador trigger stigma expressions by recognising (muco)cutaneous leishmaniasis, primarily through atypical smell, followed by the odd voice sound, appearance and taste. This empirical way of recognising symptoms relies on embodied forms of identifying a disease, contrasting the Western supremacy of visuality and demanding to be understood via multi-sensorial anthropology. Through ethnographic research and data retrieved from eighty-three semistructured interviews and fifteen focus groups in seven Ecuadorian ethnic groups - including six Indigenous groups in the Amazon region - this paper analyses how the sensorium is a health thermometer. Findings reveal that differentiated cultural responses to a sense of peril, contagion and social (self)rejection, understood as stigma expressions, are linked to the holistic approach to health (or well-being) shared by Indigenous populations. In forest societies, well-being is explained through successful (non-)human relationships, and disease permeates through bodies that lack balanced relations.
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Affiliation(s)
- Veronica C Vargas Roman
- Department of Social and Cultural Anthropology, KU Leuven, Leuven, Belgium
- Department of Dermatology, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
| | - Jacob Bezemer
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centers (UMC), Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
- Fundación Misión Cristiana de Salud, Hospital Shell, Shell, Ecuador
| | - Manuel Calvopiña
- Facultad de Ciencias de la Salud, Carrera de Medicina, OneHealth Research Group, Universidad de las Américas, Quito, Ecuador
| | | | - Noel B Salazar
- Department of Social and Cultural Anthropology, KU Leuven, Leuven, Belgium
| | - Henk D F H Schallig
- Amsterdam Institute for Infection and Immunology, Infectious Diseases Programme, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centers (UMC), Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
| | - Henry J C de Vries
- Department of Dermatology, Amsterdam University Medical Centers (UMC), Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunology, Infectious Diseases, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
- Department of Infectious Diseases, Public Health Service Amsterdam, Center for Sexual Health, Amsterdam, The Netherlands
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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, Toro M, Bastidas-Caldes C, Vasco-Julio D, Muñoz G. A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis-Molecular Diagnosis and Identification. Pathogens 2023; 12:1112. [PMID: 37764920 PMCID: PMC10538155 DOI: 10.3390/pathogens12091112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 09/29/2023] Open
Abstract
Histoplasmosis is an endemic mycosis in the Americas. However, its diagnosis is challenging due to the complexity and limited availability of conventional laboratory techniques-antigen tests, culture, and staining. Microscopic preparations often confuse with other pathogens, such as Leishmania spp. The genus Histoplasma capsulatum comprises three varieties: var. capsulatum, var. duboissi, and var. farciminosum, which cannot be distinguished using conventional techniques. An infant from a tropical region of Ecuador was hospitalized for fever, bloody diarrhea, and anemia persisting for two months. Upon admission, he received antibiotics and immunosuppressants. Histopathological examination of the lymph nodes, intestines, and bone marrow aspirate reported the presence of Leishmania-like amastigotes, and treatment was initiated with meglumine antimoniate and conventional amphotericin B. However, subsequent analysis of samples using PCR and DNA sequencing identified H. capsulatum var. capsulatum but not Leishmania. Despite fluconazole and amphotericin B, the infant succumbed to the disease. The delay in clinical and laboratory diagnosis of histoplasmosis and the use of nonspecific and ineffective drugs such as fluconazole led to disease dissemination and, ultimately, death. Implementing molecular diagnosis and antigen tests in laboratories located in endemic regions and reference hospitals is crucial.
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Affiliation(s)
- Manuel Calvopiña
- One Health Research Group, Universidad de Las Américas (UDLA), Quito 170124, Ecuador;
| | - Marcelo Toro
- Hospital Pediátrico “Baca Ortiz”, Quito 170523, Ecuador; (M.T.); (G.M.)
| | | | - David Vasco-Julio
- Programa de Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca 62050, Mexico
| | - Greta Muñoz
- Hospital Pediátrico “Baca Ortiz”, Quito 170523, Ecuador; (M.T.); (G.M.)
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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 PMCID: PMC10258766 DOI: 10.1186/s12879-023-08377-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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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Wenning B, Price H, Nuwangi H, Reda KT, Walters B, Ehsanullah R, Viana G, Andras A, Dikomitis L. Exploring the cultural effects of gender on perceptions of cutaneous leishmaniasis: a systematic literature review. Glob Health Res Policy 2022; 7:34. [PMID: 36163191 PMCID: PMC9511709 DOI: 10.1186/s41256-022-00266-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/12/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how the cultural effects of gender shape perceptions and experiences of CL. This review aims to bring together and analyse existing studies which use qualitative data to explore these differences. These studies offered insights into our specific research questions. METHODS We conducted a systematic review of the literature pertaining to either CL or muco-cutaneous leishmaniasis (MCL) through EBSCO, EMBASE, Medline, Scopus and Web of Science databases. To meet inclusion criteria, articles had to be either qualitative or mixed-method with a qualitative component. They also had to include a reflection on how the gender of participants impacted the findings and addressed the lived experiences of CL. We did not exclude articles based on the language they were published in or in which country the study took place. RESULTS From a total of 1589 potential articles, we found that thirteen met the inclusion criteria. These articles were published in English, Spanish or Portuguese and reported on studies carried out in various countries in Africa, Asia and South America. After using the principles of a meta-ethnography to analyse these studies, we generated several key themes. We found that health-seeking behaviours, treatment choices, stigma and the impact of scarring are shaped by gender in a variety of contexts. CONCLUSIONS Gender impacts on an individual's experience of CL. In particular, women are more constricted in their health-seeking behaviours and experience more stigma both from the active lesions and from scarring than men. In many contexts, however, men are more at risk of becoming infected by the parasite that causes CL and may turn to more harmful or aggressive self-treatments. We recommend that future research on CL should consider the impact of gender as this can create very different experiences for individuals.
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Affiliation(s)
- Brianne Wenning
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, CT2 7FS, UK
| | - Helen Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme, UK
| | - Hasara Nuwangi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | | | - Ben Walters
- Royal Stoke University Hospital, Stoke-on-Trent, UK
| | | | - Greice Viana
- State University of Rio de Janeiro (UERJ) and Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Alina Andras
- School of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Lisa Dikomitis
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, CT2 7FS, UK.
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Bezemer JM, Hinojosa MC, Zabala AEC, Pérez FO, Román VCV, Schallig HDFH, de Vries HJC. Quality of life of cutaneous leishmaniasis suspected patients in the Ecuadorian Pacific and Amazon regions: a cross sectional study. BMC Infect Dis 2022; 22:748. [PMID: 36153487 PMCID: PMC9509548 DOI: 10.1186/s12879-022-07733-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Yearly, up to 1 million patients worldwide suffer from cutaneous leishmaniasis (CL). In Ecuador, CL affects an estimated 5000 patients annually. CL leads to reduced Health Related Quality of Life (HRQL) as a result of stigma in the Asian and Mediterranean contexts, but research is lacking for Ecuador. The objective of this study was to explore the influence of CL suspected lesions on the quality of life of patients in the Pacific and Amazon regions. Methods Patients for this study were included in the Amazonian Napo, Pastaza, and Morona Santiago provinces and the Pacific region of the Pichincha province. Participating centers offered free of charge CL treatment. All patients suspected of CL and referred for a cutaneous smear slide microscopy examination were eligible. This study applied the Skindex-29 questionnaire, a generic tool to measure HRQL in patients with skin diseases. All statistical analysis was done with SPSS Statistics version 28. Results The skindex-29 questionnaire was completed adequately by 279 patients who were included in this study. All patient groups from the Amazon scored significantly (P < 0.01) higher (indicating worse HRQL) on all the dimensions of the Skindex-29 questionnaire than Mestizo patients from the Pacific region. The percentage of patients with health seeking delay of less than a month was significantly (P < 0.01) lower in the Amazon region (38%) than in the Pacific (66%). Conclusions The present study revealed that the influence of suspected CL lesions on the HRQL of patients in the Ecuadorian Amazon and Pacific depends on the geographic region more than on patient characteristics such as gender, age, number of lesions, lesion type, location of lesions, health seeking delay, or posterior confirmation of the Leishmania parasite. The health seeking delay in the Amazon might result from a lack of health infrastructure or related stigma. Together, the impaired HRQL and prolonged health seeking delay in the Amazon lead to prolonged suffering and a worse health outcome. Determinants of health seeking delay should be clarified in future studies and CL case finding must be improved. Moreover, HRQL analysis in other CL endemic regions could improve local health management. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07733-4.
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Bezemer JM, Meesters K, Naveda CL, Machado PRL, Calvopiña M, Leeflang MMG, Schallig HDFH, de Vries HJC. Clinical criteria for Mucosal Leishmaniasis diagnosis in rural South America: A systematic literature review. PLoS Negl Trop Dis 2022; 16:e0010621. [PMID: 35947553 PMCID: PMC9365133 DOI: 10.1371/journal.pntd.0010621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mucosal Leishmaniasis (ML), a neglected tropical disease caused by Leishmania parasites, impairs the quality of life of under-resourced populations in South America. If not treated promptly, this disease progresses to facial deformities and death. The low sensitivity of microscopy results and the unavailability of other accurate tests hamper the diagnosis. As clinical criteria are readily available in any setting, these may be combined in a syndromic algorithm, which in turn can be used as a diagnostic tool. We explore potential clinical criteria for a syndromic diagnostic algorithm for ML in rural healthcare settings in South America. METHODOLOGY/PRINCIPAL FINDINGS The protocol for this systematic review was pre-registered in PROSPERO with the number: CRD42017074148. In patients with ML, described in case series identified through a systematic retrieval process, we explored the cumulative ML detection rates of clinical criteria. Participants: all patients with active mucosal disease from an endemic area in South America. Any original, non-treatment study was eligible, and case reports were excluded. PUBMED, EMBASE, Web of Science, SCIELO, and LILACS databases were searched without restrictions. The risk of bias was assessed with the JBI checklist for case series. We included 10 full texts describing 192 ML patients. Male gender had the highest detection rate (88%), followed by ulcer of the nasal mucosa (77%), age >15 (69%), and symptom duration >4 months (63%). SIGNIFICANCE Within this selection of patients, we found that the male gender, ulcer of the nasal mucosa, age >15, and symptom duration >4 months lead to the highest detection rates. However, higher detection comes -naturally- with a higher rate of false positives as well. As we only included ML patients, this could not be verified. Therefore, the criteria that we found to be most promising should be validated in a well-designed prospective study.
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Affiliation(s)
- Jacob M. Bezemer
- Fundación Misión Cristiana de Salud, 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
| | - Kevin Meesters
- Department of Pediatrics, Division of Infectious Diseases, University of British Columbia, Vancouver, Canada
| | | | - Paulo R. L. Machado
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Manuel Calvopiña
- OneHealth Research Group, Carrera de Medicina, Facultad de Ciencias de la Salud, Universidad de las Americas, Quito, Ecuador
| | - Mariska M. G. Leeflang
- Department of Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - 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
- Center for Sexual Health, Department of Infectious Diseases, Public Health Service, Amsterdam, the Netherlands
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Silveira KRD, Nogueira PM, Soares RP. Effect of hybridization on Lipophosphoglycan expression in Leishmania major. Cell Biol Int 2022; 46:1169-1174. [PMID: 35312138 DOI: 10.1002/cbin.11798] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/07/2022]
Abstract
Leishmania major is the causative agent of cutaneous leishmaniasis (CL). It is one of the most studied Leishmania species not only during vector interaction, but also in the vertebrate host. Lipophosphoglycan (LPG) is the Leishmania multifunctional virulence factor during host-parasite interaction, whose polymorphisms are involved in the immunopathology of leishmaniasis. Although natural hybrids occur in nature, hybridization of L. major strains in the laboratory was successfully demonstrated. However, LPG expression in the hybrids remains unknown. LPGs from parental (Friedlin-Fn and Seidman-Sd) and hybrids (FnSd3, FnSd4A, FnSd4B and FnSd6F) were extracted, purified and their repeat units analyzed by immunoblotting and fluorophore-assisted carbohydrate electrophoresis (FACE). Parental strains have distinct profiles in LPG expression, and a mixed profile was observed for all hybrids. Variable levels of NO production by macrophages were detected after LPG exposure (parental and hybrids) and were strain specific. This article is protected by copyright. All rights reserved.
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Comparative genomics of Leishmania isolates from Brazil confirms the presence of Leishmania major in the Americas. Int J Parasitol 2021; 51:1047-1057. [PMID: 34329650 DOI: 10.1016/j.ijpara.2021.05.009] [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: 12/23/2020] [Revised: 05/06/2021] [Accepted: 05/24/2021] [Indexed: 11/22/2022]
Abstract
Leishmania (Leishmania) major is an important agent of cutaneous leishmaniasis, having as a vector sandflies belonging to the genus Phlebotomus. Although this species has been described as restricted to the Old World, parasites similar to L. major have been isolated from South American patients who have never travelled abroad. These parasites were named "L. major-like", and several studies have been carried out to characterise them biochemically, molecularly, and biologically. However, the phylogenetic origin of these isolates is still unknown. In the present study we characterised three L. major-like isolates, named BH49, BH121 and BH129, using comparative genomics approaches. We evaluated the presence of gene and segmental duplications/deletions and the presence of aneuploidies that could explain the differences in infectivity observed in the BH49 and BH121 isolates. All isolates presented a pattern of mosaic aneuploidy and gene copy number variation, which are common in the genus Leishmania. Virulence factors such as phosphatases and peptidases were found to have increased gene copy numbers in the infective isolate, which could explain the difference in infectivity previously observed between BH121 and BH49. Phylogenetic analyses revealed that BH49, BH121 and BH129 L. major-like grouped with L. major isolates, and suggest they were imported from the Old World in at least two independent events. We suggest that new epidemiological inquiries should also evaluate L. major infections in South America, to assess the epidemiological importance of this species in the New World.
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Rodrigues WF, Mendes NS, de Carvalho Ribeiro P, Mendes Filho D, Parreira RC, Chaves KCB, de Abreu MCM, Miguel CB. A critical review of the applicability of serological screening for Leishmaniasis in blood banks in Brazil. J Parasit Dis 2021; 45:109-117. [PMID: 33746394 PMCID: PMC7921252 DOI: 10.1007/s12639-020-01283-9] [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: 03/28/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022] Open
Abstract
Leishmaniasis is a group of diseases caused by several species of protozoa. It is a major public health concern in its visceral form, accounting annually for 59,000 deaths, and an estimated 12 million infected patients per year. The importance of VL resides not only in its high incidence and wide distribution but also in the possibility of the disease progressing to the severe and lethal forms, especially in children and immunosuppressed individuals, when associated with malnutrition and concomitant infections. This study is a bibliographical review, aiming to understand the sensitivity and specificity parameters of the tests used to detect Leishmaniasis, as well as to understand if there is any relevance in proposing a serological screening for Leishmaniasis in blood banks. In general, we observed that there are currently several types of tests for detecting Leishmaniasis: parasitological, serological and molecular. In such tests, many serological methods and kits are available for the detection of asymptomatic visceral leishmaniasis, but there is variability in sensitivity and specificity among the methods. The gold standard for the diagnosis of visceral leishmaniasis is the parasitological method, through the aspiration of bone marrow, with higher sensitivity by splenic puncture. Due to the relevance of the disease and the available data from research centers, there is evidence to propose a transfusion serological screening for visceral Leishmaniasis, pointing to the need for further studies.
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Affiliation(s)
| | - Niege Silva Mendes
- Department of Genetics, Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP Brazil
| | - Patrícia de Carvalho Ribeiro
- Laboratory of Immunology and Experimental Transplantation, Medical School of São José do Rio Preto (FAMERP), São José do Rio Preto, SP Brazil
- Nanocell Institute, Divinópolis, Brazil
| | - Daniel Mendes Filho
- Nanocell Institute, Divinópolis, Brazil
- Department of Physiology, Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP Brazil
| | - Ricardo Cambraia Parreira
- Nanocell Institute, Divinópolis, Brazil
- Biochemistry and Immunology by the Institute of Biological Sciences of the Federal University of Minas Gerais (UFMG), Belo Horizonte, MG Brazil
- University Centre of Mineiros (UNIFIMES), Trindade, GO Brazil
| | | | | | - Camila Botelho Miguel
- University Centre of Mineiros (UNIFIMES), Rua 22, Setor Aeroporto, Mineiros, GO 75.830-000 Brazil
- Tropical Medicine and Infectious Diseases, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG Brazil
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Duque PL, Arrivillaga-Henríquez J, Enríquez S, Ron-Garrido L, Benítez W, Navarro JC. Spatial-Temporal Analysis of Lutzomyia trapidoi and Lutzomyia reburra (Diptera: Phlebotominae), in Rural Tourist Locations, Biosphere Reserve and Leishmaniasis Endemic Area, Ecuador. JOURNAL OF MEDICAL ENTOMOLOGY 2020; 57:1905-1912. [PMID: 32533171 DOI: 10.1093/jme/tjaa102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Indexed: 06/11/2023]
Abstract
This research represents the first attempt to assess the spatial and temporal distribution based on micro-meso scales on two species with different host preference habits (anthropophilic vs zoophilic), in the major Leishmaniasis endemic area in Ecuador, tourist locations, and Biosphere reserve. Phlebotomine species, Lutzomyia trapidoi (Fairchild) and Lutzomyia reburra (Fairchild and Hertig), were analyzed by trap/habitat/month/locality/altitude, through the Poisson generalized regression model. Our data reveal a bimodal pattern for both species related with low precipitations and preference for forest habitat. Altitude, proximity to the forest, and the river were the variables that determine the hypervolume of the spatial distribution of relative abundance, where the overlap of these two species increases the risk of translocation and circulation of the etiological agent of leishmaniasis in sylvatic environments to rural-tourist-biosphere reserve areas and vice versa. The ecological characteristics of these two phlebotomines could explain the permanence of the major active and endemic focus of cutaneous leishmaniasis in the North-Western Ecuador a key aspect in tourism health-security in alternative tourism.
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Affiliation(s)
- Paul L Duque
- Unidad de Entomología Aplicada - Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Grupo de Investigación GIBCIZ-UCE. Quito, Ecuador
- Centro de Biodiversidad, Enfermedades Emergentes y Salud Ambiental, Facultad de Ciencias Naturales y Ambientales, Universidad Internacional SEK. Quito, Ecuador
- Egresado de la Facultad de Biología, Universidad Central del Ecuador, Quito, Ecuador
| | - Jazzmín Arrivillaga-Henríquez
- Unidad de Entomología Aplicada - Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Grupo de Investigación GIBCIZ-UCE. Quito, Ecuador
- Línea Salud, Calidad y Biodiversidad. Área Ambiente y Territorio. Carrera Turismo THC- FACSO, Universidad Central del Ecuador, Quito, Ecuador
| | - Sandra Enríquez
- Unidad de Entomología Aplicada - Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Grupo de Investigación GIBCIZ-UCE. Quito, Ecuador
| | - Lenin Ron-Garrido
- Unidad de Entomología Aplicada - Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Grupo de Investigación GIBCIZ-UCE. Quito, Ecuador
- Facultad de Ciencias Veterinarias y Zootecnia, Universidad Central del Ecuador, Quito, Ecuador
| | - Washington Benítez
- Unidad de Entomología Aplicada - Instituto de Investigaciones en Zoonosis (CIZ), Universidad Central del Ecuador, Grupo de Investigación GIBCIZ-UCE. Quito, Ecuador
- Facultad de Ciencias Veterinarias y Zootecnia, Universidad Central del Ecuador, Quito, Ecuador
| | - Juan-Carlos Navarro
- Centro de Biodiversidad, Enfermedades Emergentes y Salud Ambiental, Facultad de Ciencias Naturales y Ambientales, Universidad Internacional SEK. Quito, Ecuador
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Human myiasis in Ecuador. PLoS Negl Trop Dis 2020; 14:e0007858. [PMID: 32084134 PMCID: PMC7055958 DOI: 10.1371/journal.pntd.0007858] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 03/04/2020] [Accepted: 10/18/2019] [Indexed: 11/19/2022] Open
Abstract
We review epidemiological and clinical data on human myiasis from Ecuador, based on data from the Ministry of Public Health (MPH) and a review of the available literature for clinical cases. The larvae of four flies, Dermatobia hominis, Cochliomyia hominivorax, Sarcophaga haemorrhoidalis, and Lucilia eximia, were identified as the causative agents in 39 reported clinical cases. The obligate D. hominis, causing furuncular lesions, caused 17 (43.5%) cases distributed along the tropical Pacific coast and the Amazon regions. The facultative C. hominivorax was identified in 15 (38%) clinical cases, infesting wound and cavitary lesions including orbital, nasal, aural and vaginal, and occurred in both subtropical and Andean regions. C. hominivorax was also identified in a nosocomial hospital-acquired wound. Single infestations were reported for S. haemorrhoidalis and L. eximia. Of the 39 clinical cases, 8 (21%) occurred in tourists. Ivermectin, when it became available, was used to treat furuncular, wound, and cavitary lesions successfully. MPH data for 2013–2015 registered 2,187 cases of which 54% were reported in men; 46% occurred in the tropical Pacific coast, 30% in the temperate Andes, 24% in the tropical Amazon, and 0.2% in the Galapagos Islands. The highest annual incidence was reported in the Amazon (23 cases/100,000 population), followed by Coast (5.1/100,000) and Andes (4.7/100,000). Human myiasis is a neglected and understudied ectoparasitic infestation, being endemic in both temperate and tropical regions of Ecuador. Improved education and awareness among populations living in, visitors to, and health personnel working in high-risk regions, is required for improved epidemiological surveillance, prevention, and correct diagnosis and treatment. Human myiasis is a neglected disease caused by ectoparasitic infestations of the skin, cavities and wounds by larvae of a wide variety of dipteran flies. Here, we review available data on human myiasis in Ecuador using a national registry of 2,187 cases and other information sources (39 clinical cases). We conclude that myiasis is endemic in both temperate and tropical regions of the country with greatest endemicity in the tropical lowlands of the Amazon (estimated annual incidence of 23 cases/100,000 population). Almost half clinical cases were cutaneous furuncular myiasis caused by Dermatobia hominis, which produced single lesions that were treated successfully with oral ivermectin followed by manual extraction. Also relatively common were infestations by Cochliomyia hominivorax, found in tropical and temperate regions in the Andean highlands, which infested wounds and cavities, occasionally involving hundreds of larvae and causing severe tissue damage when unrecognized. Our data shows that myiasis is a significant and unrecognized health problem in Ecuador, is likely to be significantly under-reported, and requires improved awareness among affected populations and improved education among health professionals for its diagnosis, treatment, and recognition of fly species.
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Alcover MM, Ribas A, Guillén MC, Berenguer D, Tomás-Pérez M, Riera C, Fisa R. Wild mammals as potential silent reservoirs of Leishmania infantum in a Mediterranean area. Prev Vet Med 2019; 175:104874. [PMID: 31901603 DOI: 10.1016/j.prevetmed.2019.104874] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/13/2019] [Accepted: 12/17/2019] [Indexed: 01/17/2023]
Abstract
A molecular survey of wild mammals was performed to assess their potential as reservoirs of L. infantum. A total of 156 specimens of wild mammalian fauna were obtained for analysis from areas in Catalonia with a reported incidence of canine leishmaniasis. They consisted of 124 small mammals: 35 Mus spretus (Muridae); 64 Erinaceus europaeus (Erinaceidae), 25 Sciurus vulgaris (Sciuridae) and 32 carnivores: 11 Vulpes vulpes (Canidae), 1 Felis catus (Felidae), 15 Meles meles, 4 Martes foina and 1 Mustela vison (Mustelidae). The analysis was performed on samples of liver, spleen, skin (ear) and blood extracted from the heart. Leishmania DNA was determined by a qPCR and specific anti-Leishmania antibodies were detected by an in-house (ELISA). Among the 156 specimens studied, 29.48% were positive in at least one of the samples studied and considered infected. In M. spretus, Leishmania DNA was detected in the liver, spleen or skin of 37.1% of 35 specimens, and 2 of the 13 specimens tested serologically were positive (15.38%). In E. europaeus, 34.4% of the 64 specimens were infected. Leishmania DNA was detected in 19/51 spleens and 5/50 skins; 2 of the 37 specimens analysed in both spleen and skin gave positive results in both samples. Serology was positive in 12.8% (6/47) by ELISA; 3 specimens were positive by both ELISA and qPCR. In S. vulgaris, Leishmania DNA was detected in 5 of 25 specimens (20%). Of the 32 carnivore specimens analysed, Leishmania DNA was detected in both samples studied (spleen and liver) of 4 (12.5%) (2 M. foina, 1 M. vison and 1 F. catus), which were not studied serologically. The data obtained indicate that small mammals, above all wild rodents and carnivores, could act as naturally infected hosts of L. infantum in this endemic area. Among the rodents, M. spretus stands out with the highest prevalence of infection. In E. europaeus, the presence of L. infantum DNA in spleen and skin, and antibodies in heart blood, reported here for the first time, indicates this small mammal could be a possible reservoir. Additionally, S. vulgaris, not previously studied as an L. infantum reservoir, showed non-negligible prevalence values, indicating a potential role in leishmaniasis transmission.
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Affiliation(s)
- M Magdalena Alcover
- Parasitology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Av. de Joan XXIII, 27-31, 08028, Barcelona, Spain.
| | - Alexis Ribas
- Parasitology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Av. de Joan XXIII, 27-31, 08028, Barcelona, Spain; Institut de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Av. Diagonal, 645, 08028, Barcelona, Spain.
| | - M Carmen Guillén
- Parasitology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Av. de Joan XXIII, 27-31, 08028, Barcelona, Spain.
| | - Diana Berenguer
- Parasitology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Av. de Joan XXIII, 27-31, 08028, Barcelona, Spain.
| | - Míriam Tomás-Pérez
- Parasitology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Av. de Joan XXIII, 27-31, 08028, Barcelona, Spain.
| | - Cristina Riera
- Parasitology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Av. de Joan XXIII, 27-31, 08028, Barcelona, Spain.
| | - Roser Fisa
- Parasitology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Science, University of Barcelona, Av. de Joan XXIII, 27-31, 08028, Barcelona, Spain.
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15
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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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S. L. Figueiredo de Sá B, Rezende AM, de Melo Neto OP, de Brito MEF, Brandão Filho SP. Identification of divergent Leishmania (Viannia) braziliensis ecotypes derived from a geographically restricted area through whole genome analysis. PLoS Negl Trop Dis 2019; 13:e0007382. [PMID: 31170148 PMCID: PMC6581274 DOI: 10.1371/journal.pntd.0007382] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 06/18/2019] [Accepted: 04/10/2019] [Indexed: 01/22/2023] Open
Abstract
Leishmania braziliensis, the main etiological agent of cutaneous leishmaniasis (CL) in Latin America, is characterized by major differences in basic biology in comparison with better-known Leishmania species. It is also associated with a high phenotypic and possibly genetic diversity that need to be more adequately defined. Here we used whole genome sequences to evaluate the genetic diversity of ten L. braziliensis isolates from a CL endemic area from Northeastern Brazil, previously classified by Multi Locus Enzyme Electrophoresis (MLEE) into ten distinct zymodemes. These sequences were first mapped using the L. braziliensis M2904 reference genome followed by identification of Single Nucleotide Polymorphisms (SNPs). A substantial level of diversity was observed when compared with the reference genome, with SNP counts ranging from ~95,000 to ~131,000 for the different isolates. When the genome data was used to infer relationship between isolates, those belonging to zymodemes Z72/Z75, recovered from forested environments, were found to cluster separately from the others, generally associated with more urban environments. Among the remaining isolates, those from zymodemes Z74/Z106 were also found to form a separate group. Phylogenetic analyses were also performed using Multi-Locus Sequence Analysis from genes coding for four metabolic enzymes used for MLEE as well as the gene sequence coding for the Hsp70 heat shock protein. All 10 isolates were firmly identified as L. braziliensis, including the zymodeme Z26 isolate previously classified as Leishmania shawi, with the clustering into three groups confirmed. Aneuploidy was also investigated but found in general restricted to chromosome 31, with a single isolate, from zymodeme Z27, characterized by extra copies for other chromosomes. Noteworthy, both Z72 and Z75 isolates are characterized by a much reduced heterozygosity. Our data is consistent with the existence of distinct evolutionary groups in the restricted area sampled and a substantial genetic diversity within L. braziliensis.
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Affiliation(s)
| | - Antonio M. Rezende
- Department of Microbiology, Aggeu Magalhães Institute/FIOCRUZ, Recife, Pernambuco, Brazil
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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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Marcondes M, Day MJ. Current status and management of canine leishmaniasis in Latin America. Res Vet Sci 2019; 123:261-272. [PMID: 30708238 DOI: 10.1016/j.rvsc.2019.01.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/18/2019] [Accepted: 01/20/2019] [Indexed: 12/14/2022]
Abstract
Latin America encompasses diverse geographical, cultural and socio-economic conditions, which are reflected in the challenges for infectious disease control in the region. One of the most significant regional infectious diseases for humans and domestic dogs is leishmaniasis, occurring as visceral leishmaniasis (VL) caused by Leishmania infantum (syn. L. chagasi) transmitted by sand flies (Lutzomyia longipalpis) and with a canine reservoir, and the more common cutaneous leishmaniasis (CL) involving multiple Leishmania spp. (particularly L. braziliensis), sand fly vectors and reservoir hosts. VL is spreading within Latin America for reasons related to mass migration of human and canine populations, with incursion into novel environments (e.g. related to deforestation) coupled with a background of poverty and poor public health infrastructure. The challenges for control of VL also include: (1) the accurate identification of infected dogs (particularly subclinically infected dogs) with the current reliance on serological rather than molecular diagnostic methods, (2) controversy surrounding the ethics and efficacy of culling of seropositive dogs, (3) the limited efficacy of currently available canine vaccines and their potential to interfere with interpretation of serological testing, (4) the expense associated with distribution of insecticidal dog collars, which may prove to be the most valuable control method, and (5) the cost and therefore accessibility of licensed medical treatment for canine leishmaniasis by the general population. Resolution of these isssues will necessitate a 'One Health' approach to co-ordination of resources between human and veterinary healthcare.
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Affiliation(s)
- Mary Marcondes
- São Paulo State University (Unesp), School of Veterinary Medicine, Araçatuba, 16050-680 Araçatuba, São Paulo, Brazil.
| | - Michael J Day
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
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Leishmaniasis caused by Leishmania (Viannia) guyanensis in north-central Pacific region of Ecuador: A clinico-epidemiological feature. Acta Trop 2018; 185:204-211. [PMID: 29852129 DOI: 10.1016/j.actatropica.2018.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/08/2018] [Accepted: 05/26/2018] [Indexed: 10/14/2022]
Abstract
The current four year study was undertaken to investigate the clinical and epidemiological features of Leishmania (Viannia) guyanensis infections in Valle Hermoso, Santo Domingo de Los Tsachilas province, north-central Pacific areas of Ecuador. A total of 155 parasitologically confirmed (Leishmania-amastigote-positive) clinical cases diagnosed at a rural health center during January 2014-December 2017 were analyzed thoroughly. Molecular characterization of the causative Leishmania parasites from different endemic sites within the study areas was performed by PCR amplification of cytochrome b (cyt b) sequencing. All the FTA-card and/or smear impregnated materials tested were characterized, and identified as L. (V.) guyanensis, without detecting any other Leishmania species. The following features were described: 1) the majority of patients were suffered from a single ulcer lesion (simple and mild to chronic), followed by multiple lesions, including recidiva cutis-"like" and Chiclero's ulcer-"like" clinical forms; 2) the majority (65.70%) of lesions were less than 10 mm in size, and distributed mainly on the upper body regions (arm, forearm, face, and neck including ear and head); 3) about 30% (29.68%) of the subjects tested were less than 10 years of age, strongly suggesting the intra- and/or peri-domestic transmission of the disease in the areas. The current clinico-epidemiological feature detected emphasizes the need for further such investigations of the L. (V.) guyanensis infections prevalent at different Pacific ecoregions of Ecuador, including Amazon regions.
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Guimarães AC, Nogueira PM, Silva SDO, Sadlova J, Pruzinova K, Hlavacova J, Melo MN, Soares RP. Lower galactosylation levels of the Lipophosphoglycan from Leishmania (Leishmania) major-like strains affect interaction with Phlebotomus papatasi and Lutzomyia longipalpis. Mem Inst Oswaldo Cruz 2018. [PMID: 29513819 PMCID: PMC5853761 DOI: 10.1590/0074-02760170333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Leishmania major is an Old World species causing cutaneous leishmaniasis and is transmitted by Phlebotomus papatasi and Phlebotomus duboscqi. In Brazil, two isolates from patients who never left the country were characterised as L. major-like (BH49 and BH121). Using molecular techniques, these isolates were indistinguishable from the L. major reference strain (FV1). OBJECTIVES We evaluated the lipophosphoglycans (LPGs) of the strains and their behaviour in Old and New World sand fly vectors. METHODS LPGs were purified, and repeat units were qualitatively evaluated by immunoblotting. Experimental in vivo infection with L. major-like strains was performed in Lutzomyia longipalpis (New World, permissive vector) and Ph. papatasi (Old World, restrictive or specific vector). FINDINGS The LPGs of both strains were devoid of arabinosylated side chains, whereas the LPG of strain BH49 was more galactosylated than that of strain BH121. All strains with different levels of galactosylation in their LPGs were able to infect both vectors, exhibiting colonisation of the stomodeal valve and metacyclogenesis. The BH121 strain (less galactosylated) exhibited lower infection intensity compared to BH49 and FV1 in both vectors. MAIN CONCLUSIONS Intraspecific variation in the LPG of L. major-like strains occur, and the different galactosylation levels affected interactions with the invertebrate host.
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Affiliation(s)
- Agna Cristina Guimarães
- Departamento de Parasitologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | | | - Jovana Sadlova
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Katerina Pruzinova
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jana Hlavacova
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Maria Norma Melo
- Departamento de Parasitologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Rodrigo Pedro Soares
- Instituto René Rachou, Fundação Oswaldo Cruz-Fiocruz, Belo Horizonte, MG, Brasil
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Dynamics of American tegumentary leishmaniasis in a highly endemic region for Leishmania (Viannia) braziliensis infection in northeast Brazil. PLoS Negl Trop Dis 2017; 11:e0006015. [PMID: 29095818 PMCID: PMC5685640 DOI: 10.1371/journal.pntd.0006015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/14/2017] [Accepted: 10/05/2017] [Indexed: 11/19/2022] Open
Abstract
Background American Tegumentary Leishmaniasis (ATL) caused by Leishmania braziliensis is endemic in Corte de Pedra, Northeast Brazil. Most L. braziliensis infections manifest as localized cutaneous leishmaniasis (CL). Disseminated manifestations include mucosal leishmaniasis (ML), present at a low constant level for several decades, and newly emerging disseminated leishmaniasis (DL). Surprisingly, DL has recently surpassed ML in its spatial distribution. This led us to hypothesize that distinct forms of ATL might spread in different patterns through affected regions. Methodology/Principal findings We explored the incidence and geographic dispersion of the three clinical types of ATL over a span of nearly two decades in Corte de Pedra. We obtained the geographic coordinates of the homes of patients with ATL during 1992–1996, 1999–2003 and 2008–2011. The progressive dispersion of ML or DL in each time period was compared to that of CL in 2008–2011 with the Cusick and Edward’s geostatistical test. To evaluate whether ATL occurred as clusters, we compared each new case in 2008–2011 with the frequency of and distance from cases in the previous 3 to 12 months. The study revealed that DL, ML and CL actively spread within that region, but in distinct patterns. Whereas CL and DL propagated in clusters, ML occurred as sporadic cases. DL had a wider distribution than ML until 2003, but by 2011 both forms were distributed equally in Corte de Pedra. The incidence of ML fluctuated over time at a rate that was distinct from those of CL and DL. Conclusions/Significance These findings suggest that CL and DL maintain endemic levels through successive outbreaks of cases. The sporadic pattern of ML cases may reflect the long and variable latency before infected patients develop clinically detectable mucosal involvement. Intimate knowledge of the geographic distribution of leishmaniasis and how it propagates within foci of active transmission may guide approaches to disease control. American tegumentary leishmaniasis (ATL) caused by Leishmania braziliensis is characterized by lesions to the skin and/or mucosal surfaces of the oropharynx. It is widely distributed in endemic regions of northeast Brazil and has been difficult to control. Three common clinical forms of L. braziliensis infections are localized skin ulcers called cutaneous leishmaniasis (CL), mucosal leishmaniasis (ML) affecting mucosal surfaces, and disseminated leishmaniasis (DL), a recently described form with widespread skin lesions. Using GPS and epidemiologic data we explored the incidence and pattern of spread of ATL in the highly endemic region of Corte de Pedra, Brazil between 1992 and 2011. Geographic clusters of CL and DL cases were observed. In contrast, there was a sporadic non-clustered pattern of ML cases in the study area. The numbers of new cases of CL and DL presented similar fluctuation during the study period, but ML incidences were never correlated to those of CL and DL. We conclude that all forms of ATL actively spread within affected foci, but in different patterns. CL and DL cases occur in clusters suggesting active spread of causative parasite strains, whereas ML cases occurred in a sporadic pattern suggesting it may emerge due to factors such as host immunity or environmental conditions.
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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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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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Paniz-Mondolfi AE, Talhari C, García Bustos MF, Rosales T, Villamil-Gomez WE, Marquez M, Pérez Alvarez AM, Tálamo Sánchez AI, Rodriguez-Morales AJ. American cutaneous leishmaniasis in infancy and childhood. Int J Dermatol 2017; 56:1328-1341. [PMID: 28741648 DOI: 10.1111/ijd.13664] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 03/12/2017] [Accepted: 04/25/2017] [Indexed: 12/26/2022]
Abstract
Infant and young child skin diseases are among the most common features of morbidity throughout the tropics. Because the skin is directly exposed to the environment, it is considerably affected by climatic and local conditions such as vectors and microorganisms, as in the case of leishmaniasis. In America the observed magnitude of cutaneous leishmaniasis in children has led to the study of increased risk of exposure of this group due to the possibility of peri- and intradomiciliary transmission. The present review pretends to make a concrete approach all through the broad and main figures of this parasitic disease, including the clinical, physiopathological, epidemiological, diagnostic, and therapeutic aspects, in order to be used as a practical source of reference for pediatricians leading with tropical cutaneous pathology in the region.
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Affiliation(s)
- Alberto E Paniz-Mondolfi
- Department of Infectious Diseases and Tropical Medicine/Infectious Diseases Pathology Laboratory, Hospital Internacional, Barquisimeto, Venezuela.,Laboratory of Biochemistry, Instituto de Biomedicina/IVSS, Caracas, Venezuela
| | - Carolina Talhari
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Universidade Nilton Lins, Manaus, Amazonas, Brasil
| | - María F García Bustos
- Instituto de Patología Experimental, Facultad de Ciencias de la Salud, Universidad Nacional de Salta, Salta, Argentina
| | | | - Wilmer E Villamil-Gomez
- Infectious Diseases and Infection Control Reserch Group, Hospital Universitario de Sincelejo, Sincelejo, Sucre, Colombia
| | - Marilianna Marquez
- Department of Infectious Diseases and Tropical Medicine/Infectious Diseases Pathology Laboratory, Hospital Internacional, Barquisimeto, Venezuela.,Universidad Centroccidental Lisandro Alvarado (UCLA), Barquisimeto, Venezuela
| | - Alexandra M Pérez Alvarez
- Department of Infectious Diseases and Tropical Medicine/Infectious Diseases Pathology Laboratory, Hospital Internacional, Barquisimeto, Venezuela
| | - Alejandra I Tálamo Sánchez
- Department of Infectious Diseases and Tropical Medicine/Infectious Diseases Pathology Laboratory, Hospital Internacional, Barquisimeto, Venezuela.,Universidad Centroccidental Lisandro Alvarado (UCLA), Barquisimeto, Venezuela
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
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25
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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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Hashiguchi Y, Velez LN, Villegas NV, Mimori T, Gomez EA, Kato H. Leishmaniases in Ecuador: Comprehensive review and current status. Acta Trop 2017; 166:299-315. [PMID: 27919688 DOI: 10.1016/j.actatropica.2016.11.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/17/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
Abstract
This article reviews current knowledge about leishmaniases in Ecuador, proceeding from 1920, when the first human case was described, to the present, mainly focusing on the recent research events published. Regarding basic situations, it appears that 23 of Ecuador's 24 provinces have leishmaniasis-case reports. The disease is one of the mandatory notification infectious diseases in the country since 2005. All the 21,305 cases notified to the Ministry of Public Health, during the period from 2001 through 2014, were said to involve different clinical features of cutaneous leishmaniasis (CL) but not visceral (VL). Eight Leishmania species, L. (Viannia) guyanensis, L. (V.) panamensis, L. (V.) braziliensis, L. (Leishmania) mexicana, L. (L.) amazonensis, L. (L.) major-like, L. (V.) naiffiand L. (V.) lainsoni were characterized. The last two species were most recently reported from the Ecuadorian Amazon regions. Of the 73 Ecuadorian Lutzomyia species (43 man-biting species) recorded, only four, Lu. trapidoi, Lu. gomezi, Lu. ayacuchensis, and Lu. tortura were incriminated as vectors of the Leishmania parasites. Current knowledge on the reservoir hosts of Leishmania in Ecuador is extremely poor. Recently, in Ecuador different kinds of molecular techniques were developed for diagnosis and mass screening of the disease, employing various materials derived from patients and sand fly vectors. These are PCR-RFLP, colorimetric FTA-LAMP etc. Brief comments and recommendations were also given, for future research and control of leishmaniases in Ecuador.
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Kato H, Gomez EA, Martini-Robles L, Muzzio J, Velez L, Calvopiña M, Romero-Alvarez D, Mimori T, Uezato H, Hashiguchi Y. Geographic Distribution of Leishmania Species in Ecuador Based on the Cytochrome B Gene Sequence Analysis. PLoS Negl Trop Dis 2016; 10:e0004844. [PMID: 27410039 PMCID: PMC4943627 DOI: 10.1371/journal.pntd.0004844] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/22/2016] [Indexed: 11/18/2022] Open
Abstract
A countrywide epidemiological study was performed to elucidate the current geographic distribution of causative species of cutaneous leishmaniasis (CL) in Ecuador by using FTA card-spotted samples and smear slides as DNA sources. Putative Leishmania in 165 samples collected from patients with CL in 16 provinces of Ecuador were examined at the species level based on the cytochrome b gene sequence analysis. Of these, 125 samples were successfully identified as Leishmania (Viannia) guyanensis, L. (V.) braziliensis, L. (V.) naiffi, L. (V.) lainsoni, and L. (Leishmania) mexicana. Two dominant species, L. (V.) guyanensis and L. (V.) braziliensis, were widely distributed in Pacific coast subtropical and Amazonian tropical areas, respectively. Recently reported L. (V.) naiffi and L. (V.) lainsoni were identified in Amazonian areas, and L. (L.) mexicana was identified in an Andean highland area. Importantly, the present study demonstrated that cases of L. (V.) braziliensis infection are increasing in Pacific coast areas.
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Affiliation(s)
- Hirotomo Kato
- Division of Medical Zoology, Department of Infection and Immunity, Jichi Medical University, Tochigi, Japan
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
- * E-mail:
| | - Eduardo A. Gomez
- Departamento de Parasitologia y Medicina Tropical, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Luiggi Martini-Robles
- Departamento de Parasitologia, Insitituto de Investigacion de Salud Publica, Guayaquil, Ecuador
| | - Jenny Muzzio
- Departamento de Parasitologia, Insitituto de Investigacion de Salud Publica, Guayaquil, Ecuador
| | - Lenin Velez
- Departamento de Parasitologia y Medicina Tropical, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Manuel Calvopiña
- Centro de Biomedicina, Facultad de Medicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Daniel Romero-Alvarez
- Centro de Biomedicina, Facultad de Medicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Tatsuyuki Mimori
- Department of Microbiology, Faculty of Life Sciences, Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroshi Uezato
- Department of Dermatology, Faculty of Medicine, University of the Ryukyus, Okinawa, 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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First Human Cases of Leishmania (Viannia) lainsoni Infection and a Search for the Vector Sand Flies in Ecuador. PLoS Negl Trop Dis 2016; 10:e0004728. [PMID: 27191391 PMCID: PMC4871579 DOI: 10.1371/journal.pntd.0004728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/02/2016] [Indexed: 11/19/2022] Open
Abstract
An epidemiological study of leishmaniasis was performed in Amazonian areas of Ecuador since little information on the prevalent Leishmania and sand fly species responsible for the transmission is available. Of 33 clinical specimens from patients with cutaneous leishmaniasis (CL), causative parasites were identified in 25 samples based on cytochrome b gene analysis. As reported previously, Leishmania (Viannia) guyanensis and L. (V.) braziliensis were among the causative agents identified. In addition, L. (V.) lainsoni, for which infection is reported in Brazil, Bolivia, Peru, Suriname, and French Guiana, was identified in patients with CL from geographically separate areas in the Ecuadorian Amazon, corroborating the notion that L. (V.) lainsoni is widely distributed in South America. Sand flies were surveyed around the area where a patient with L. (V.) lainsoni was suspected to have been infected. However, natural infection of sand flies by L. (V.) lainsoni was not detected. Further extensive vector searches are necessary to define the transmission cycle of L. (V.) lainsoni in Ecuador. In Ecuador, leishmaniasis is endemic in Pacific coast subtropical, Amazonian, and Andean highland areas. Seven Leishmania species, Leishmania (Leishmania) mexicana, L. (L.) amazonensis, L. (L.) major-like, Leishmania (Viannia) guyanensis, L. (V.) panamensis, L. (V.) braziliensis, and L. (V.) naiffi, are reported to be associated with human cutaneous (CL) and mucocutaneous leishmaniases (MCL). Causative parasites have been studied extensively in Pacific coast and Andean areas; however, information such as prevalent Leishmania species and their vector sand fly species is very sparse in Amazonian areas. Giemsa-stained smears taken from patients’ skin ulcers and used for routine diagnosis of CL and Flinders Technology Associates (FTA) card-spotted samples were utilized as DNA sources, and causative parasites were identified on the basis of cytochrome b gene analysis. Causative parasites in 25 samples were successfully identified, and, in addition to previously reported species, L. (V.) guyanensis and L. (V.) braziliensis, L. (V.) lainsoni was identified from two patients living in different areas situated more than 200 km apart. Sand flies were examined in areas where one of the L. (V.) lainsoni infected patient was suspected to have been infected. Although 1,104 female sand flies were dissected and examined for species identification and detection of natural infection with flagellates in the gut, human-infective Leishmania species including L. (V.) lainsoni were not detected. Further extensive investigation of sand fly fauna is necessary to incriminate the vector of this parasite in Ecuador.
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Hashiguchi Y, Gomez EL, Kato H, Martini LR, Velez LN, Uezato H. Diffuse and disseminated cutaneous leishmaniasis: clinical cases experienced in Ecuador and a brief review. Trop Med Health 2016; 44:2. [PMID: 27398061 PMCID: PMC4934146 DOI: 10.1186/s41182-016-0002-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In Ecuador, cutaneous leishmaniasis (CL) is prevalent countrywide, but only one case of diffuse-CL and two cases of disseminated-CL were experienced during our research activities more than 30 years from 1982 to date. These three patients suffered from multiple lesions distributed at a wide range of the body surface, revealing difficulty to clinically differentiate each other. METHODS There is a considerable confusion of the use and/or differentiation of the terminologies (terms) between the two disease forms, diffuse-CL and disseminated-CL. One of the aims of the present study is to clarify the difference between the two disease forms, mainly based on the cases experienced in Ecuador. RESULTS The disseminated-CL case newly reported here was clinically very similar to the diffuse-CL case, but the former showed the following marked differences from the latter: (1) the organisms isolated were identified as the parasites of Leishmania (Viannia) guyanensis/panamensis, which are also known as the causative agents of disseminated-CL in different endemic countries of the New World; (2) the patient was sensitive against antimonials; and (3) mucosal involvement was observed, which is never observed in diffuse-CL. CONCLUSIONS In the text, three clinical cases, one diffuse-CL and two disseminated-CL, were presented. Furthermore, a bibliographic comparison of the features between the two disease forms was made, and a brief comment was also given.
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Affiliation(s)
- Yoshihisa Hashiguchi
- />Facultad de Medicina, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
- />Proyecto Prometeo, Secretaría Nacional de Educación Superior, Ciencia, Tecnología e Innovación (SENESCYT), Quito, Ecuador
- />Department of Parasitology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Eduardo L. Gomez
- />Departamento de Medicina Tropical, Facultad de Medicina, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
- />Servicio Nacional de Erradicacion de la Malaria (SNEM), Ministerio de Salud, Guayaquil, Ecuador
| | - Hirotomo Kato
- />Laboratory of Parasitology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Luiggi R. Martini
- />Departamento de Parasitología, Instituto Nacional de Investigación de la Salud Pública, Guayaquil, Ecuador
| | - Lenin N. Velez
- />Departamento de Medicina Tropical, Facultad de Medicina, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
- />Servicio Nacional de Erradicacion de la Malaria (SNEM), Ministerio de Salud, Guayaquil, Ecuador
| | - Hiroshi Uezato
- />Department of Dermatology, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
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Anaguano DF, Ponce P, Baldeón ME, Santander S, Cevallos V. Blood-meal identification in phlebotomine sand flies (Diptera: Psychodidae) from Valle Hermoso, a high prevalence zone for cutaneous leishmaniasis in Ecuador. Acta Trop 2015; 152:116-120. [PMID: 26361709 DOI: 10.1016/j.actatropica.2015.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/03/2015] [Accepted: 09/05/2015] [Indexed: 10/23/2022]
Abstract
Cutaneous leishmaniasis is a neglected tropical disease transmitted by phlebotomine sand flies of the genus Lutzomyia. In South America, cutaneous leishmaniasis is endemic in the majority of countries. There are no previous reports of phlebotomine sand fly host feeding sources in Ecuador. We identified blood meal sources for phlebotomine sand fly species in Valle Hermoso, a hyper endemic area for leishmaniasis in Ecuador. Phlebotomine sand fly collections were carried out during the dry and rainy seasons. PCR and multiplex PCR were performed from DNA extracted from the abdomens of blood-fed females to specifically identify the avian and mammalian blood meal sources. Avian-blood (77%), mammalian-blood (16%) and mixed avian-mammalian blood (7%) were found in the samples. At the species level, blood from chickens (35.5%), humans (2.8%), cows (2.8%) and dogs (1.9%) was specifically detected. Nyssomyia trapidoi was the most common species of Lutzomyia found that fed on birds. The present results may aid the development of effective strategies to control leishmaniasis in Ecuador.
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Bennis I, De Brouwere V, Ameur B, El Idrissi Laamrani A, Chichaoui S, Hamid S, Boelaert M. Control of cutaneous leishmaniasis caused by Leishmania major in south-eastern Morocco. Trop Med Int Health 2015; 20:1297-305. [PMID: 25975767 DOI: 10.1111/tmi.12543] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The incidence of cutaneous leishmaniasis (CL) caused by Leishmania major has increased in Morocco over the last decade, prompting the Ministry of Health to take intersectoral response measures including vector and reservoir control. The aim of this article was to describe the CL outbreak response measures taken in the province of Errachidia, where the reservoir of L. major, a sand rat (Meriones shawi), was targeted using strychnine-poisoned wheat baits from 2010 to 2012. METHOD We analysed routine surveillance data and other information using the data of the CL control programme. RESULTS We present data on the evolution and the extension of CL in this province as well as the epidemiological profile of the disease. Between 2004 and 2013, 7099 cases of CL were recorded in Errachidia Province, gradually affecting all districts. Our results demonstrate that more women were affected than men and that all age groups were represented. CONCLUSION Errachidia Province was the epicentre of the recent CL outbreak in Morocco. A notable decline in incidence rates was observed after 2011. The outbreak control measures may have contributed to this decline, as well as climatic trends or progressing herd immunity.
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Affiliation(s)
- Issam Bennis
- National School of Public Health, Rabat, Morocco.,Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Btissam Ameur
- Directorate of Epidemiology and Diseases Control, Ministry of Health, Rabat, Morocco
| | | | | | - Sahibi Hamid
- Department of Parasitology, Agronomic and Veterinary Institute Hassan II, Rabat, Morocco
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An analysis of reported cases of leishmaniasis in the southern Ecuadorian Amazon region, 1986-2012. Acta Trop 2015; 146:119-26. [PMID: 25796313 DOI: 10.1016/j.actatropica.2015.03.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/07/2015] [Accepted: 03/10/2015] [Indexed: 11/23/2022]
Abstract
An analysis of reported cases of cutaneous leishmaniasis (CL) was performed using the data registered in the southern Ecuadorian Amazon region during 27 years from 1986 to 2012. The cases/subjects with both the suspected CL lesions and the amastigote-positive results were recruited for the analysis. The yearly occurrence of cases showed a markedly higher number during the six years, 1988 and 1993. After 1994 when the insecticide spraying campaign using helicopter in 1993-1994, the number dropped remarkably. Then, the yearly occurrence gradually fluctuated from 101 cases in 1996 to 11 in 2009, maintaining a low number of cases after the campaign. The monthly occurrence of cases showed a markedly high number during March and August, suggesting a correlation to the rainy season (months) in the areas. A statistical significance was found between the monthly average number of the CL case and the average precipitation (p=0.01474). It was suggested that the time of transmission of CL would depend on the rainy seasons at each endemic area of Ecuador, which has a diverse climatic feature depending on the geographic regions. Such information at given leishmaniasis-endemic areas of Ecuador would be important for the future planning of the disease control. Molecular analysis and characterization of clinical samples revealed the presence of Leishmania (Viannia) braziliensis.
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Soares L, Abad-Franch F, Ferraz G. Epidemiology of cutaneous leishmaniasis in central Amazonia: a comparison of sex-biased incidence among rural settlers and field biologists. Trop Med Int Health 2014; 19:988-95. [DOI: 10.1111/tmi.12337] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Letícia Soares
- Biological Dynamics of Forest Fragments Project; Smithsonian Tropical Research Institute & Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Graduate Program in Ecology; Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Department of Biology; University of Missouri St Louis; St Louis, MO USA
| | | | - Gonçalo Ferraz
- Biological Dynamics of Forest Fragments Project; Smithsonian Tropical Research Institute & Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Graduate Program in Ecology; Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Departamento de Ecologia; Instituto de Biociências; Universidade Federal do Rio Grande do Sul; Porto Alegre RS Brazil
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Calvopiña Hinojosa M, Romero Alvarez D, Kato H, Hashiguchi Y. [Cutaneous sporotrichoid lesion in a patient from a subtropical region of Ecuador]. Enferm Infecc Microbiol Clin 2014; 32:465-6. [PMID: 24713105 DOI: 10.1016/j.eimc.2014.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 02/14/2014] [Accepted: 02/24/2014] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Hirotomo Kato
- Laboratory of Parasitology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Yoshihisa Hashiguchi
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; PROMETEO, Secretaria Nacional de Educación Superior, Ciencia, Tecnología e Innovación (SENESCYT), Ecuador; Department of Parasitology, Kochi Medical School, Kochi University, Kochi, Japan
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Abstract
Leishmaniasis is a global term for cutaneous and visceral anthroponotic and zoonotic diseases caused by the vector-borne parasites of the genus Leishmania. These diseases afflict at least 2 million people each year with more than 350 million at risk in 98 countries worldwide. These are diseases mostly of the impoverished making prevention, diagnosis and treatment difficult. Therapy of leishmaniasis ranges from local treatment of cutaneous lesions to systemic, often toxic, therapy for disseminated cutaneous, mucocutaneous and deadly visceral disease. This review is a summary of the clinical syndromes caused by Leishmania and treatment regimens currently used for various forms of leishmaniasis.
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Affiliation(s)
- B.S. McGwire
- From the Division of Infectious Diseases and Center for Microbial Interface Biology, Department of Internal Medicine, The Wexner Medical Center, The Ohio State University, Columbus, OH, USA and Departments of Pathology and Microbiology, The Ohio State University, Columbus, OH, USA
| | - A.R. Satoskar
- From the Division of Infectious Diseases and Center for Microbial Interface Biology, Department of Internal Medicine, The Wexner Medical Center, The Ohio State University, Columbus, OH, USA and Departments of Pathology and Microbiology, The Ohio State University, Columbus, OH, USA
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Kato H, Calvopiña M, Criollo H, Hashiguchi Y. First human cases of Leishmania (Viannia) naiffi infection in Ecuador and identification of its suspected vector species. Acta Trop 2013; 128:710-3. [PMID: 24044975 DOI: 10.1016/j.actatropica.2013.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/02/2013] [Indexed: 10/26/2022]
Abstract
Epidemiological surveillance of leishmaniasis was conducted in a northern Amazonian region of Ecuador, in which cutaneous leishmaniasis cases were recently reported. Sand flies were captured in the military training camp, and the natural infection of sand flies by Leishmania species was examined. Out of 334 female sand flies dissected, the natural infection by flagellates was microscopically detected in 3.9% of Lutzomyia yuilli yuilli and 3.7% of Lutzomyia tortura, and the parasite species were identified as Endotrypanum and Leishmania (Viannia) naiffi, respectively. After the sand fly surveillance, specimens from cutaneous leishmaniasis (CL) patients considered to have acquired the infection in the training camp area were obtained, and the infected parasite species were identified as L. (V.) naiffi. The present study reported first cases of CL caused by L. (V.) naiffi infection in Ecuador. In addition, a high ratio of infection of Lu. tortura by L. (V.) naiffi in the same area strongly suggested that Lu. tortura is responsible for the transmission of L. (V.) naiffi in this area.
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González-Salazar C, Stephens CR. Constructing ecological networks: a tool to infer risk of transmission and dispersal of leishmaniasis. Zoonoses Public Health 2013; 59 Suppl 2:179-93. [PMID: 22958263 DOI: 10.1111/j.1863-2378.2012.01479.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We extend a recently developed method for constructing ecological networks to infer potential biotic interactions between species and to also include environmental factors, in particular land cover, thus permitting a simultaneous analysis of the interaction between environment and species distribution as well as inter-species interactions. We apply the method to the transmission and dispersal of leishmaniasis in Mexico. We find that the most important potential vectors and reservoirs can be classified into assemblages associated with different types of habitat. This in turn can be used to understand and map potential transmission risk, as well as to construct risk scenarios for the dispersal of disease from one geographical region to another.
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Affiliation(s)
- C González-Salazar
- Instituto de Biología, Universidad Nacional Autónoma de México, México DF, México
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Zapata S, Mejía L, Le Pont F, León R, Pesson B, Ravel C, Bichaud L, Charrel R, Cruaud C, Trueba G, Depaquit J. A study of a population of Nyssomyia trapidoi (Diptera: Psychodidae) caught on the Pacific coast of Ecuador. Parasit Vectors 2012; 5:144. [PMID: 22824472 PMCID: PMC3425330 DOI: 10.1186/1756-3305-5-144] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 07/23/2012] [Indexed: 12/05/2022] Open
Abstract
Background Cutaneous leishmaniasis is endemic to the Pacific coast of Ecuador, and Nyssomyia trapidoi is considered to be its main vector. Dujardin et al. [1] recorded some differences in body pigmentation and isoenzymatic profiles in sympatric populations of Ny. trapidoi from the Pacific coast of Ecuador and suggested the existence of two cryptic species. Methods Entomological collections were performed in November 2008 and March 2011 in the locality of Paraíso Escondido using CDC miniature light traps and human bait. Morphological, isoenzymatical and molecular (sequencing of cytochome b and cytochrome c oxidase 1 of the mitochondrial DNA) analyses, such as detection of Leishmania DNA and phlebovirus RNA in some females, were performed. Results Neighbor-joining trees from mitochondrial sequences grouped all of Ecuadorian Ny. trapidoi (including the two color variants) in one cluster, except for two specimens which clustered separately in both genes. Isoenzymatic characterization confirmed that the color variants belong to the same population. Additionally, 11.5% of females were found by PCR to contain Endotrypanum monterogeii kinetoplastid DNA. All pools of Ny. trapidoi were negative for phlebovirus RNA. Conclusion Analysis of mitochondrial gene sequences and isoenzymes was unable to support the existence of two sibling species within Ny. trapidoi, which is a probable vector of Endotrypanum monterogeii.
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Affiliation(s)
- S Zapata
- Université de Reims Champagne-Ardenne, ANSES, EA 4688 USC Transmission vectorielle et épidémiosurveillance de maladies parasitaires, VECPAR, France
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Jones LA, Cohnstaedt LW, Beati L, Terán R, León R, Munstermann LE. NEW RECORDS OF PHLEBOTOMINE SAND FLIES (DIPTERA: PSYCHODIDAE) FROM ECUADOR. PROCEEDINGS OF THE ENTOMOLOGICAL SOCIETY OF WASHINGTON 2010; 112:47-53. [PMID: 22628901 PMCID: PMC3357946 DOI: 10.4289/0013-8797-112.1.47] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The number of recorded phlebotomine sand fly species in Ecuador has nearly doubled during the past 20 years as a result of surveys. In 2005, a sand fly survey of two localities, Tiputini in the Amazon rain forest and Paraiso Escondido in the Pacific coastal lowland forest, resulted in the capture of 25 species. New records for Ecuador consisted of five species from the Amazonian region and one from Paraiso Escondido. The Amazonian species were Nyssomyia richardwardi (Ready and Fraiha), Psathyromyia dreisbachi (Causey and Damasceno), Psathyromyia runoides (Fairchild and Hertig), Trichophoromyia pabloi (Barretto, Burbano and Young), and Trichopygomyia witoto (Young and Morales). The Pacific coastal lowland species was Psathyromyia punctigeniculata (Floch and Abonnenc).
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Kuang-Yao Pan W, Erlien C, Bilsborrow RE. Morbidity and mortality disparities among colonist and indigenous populations in the Ecuadorian Amazon. Soc Sci Med 2009; 70:401-411. [PMID: 19906478 DOI: 10.1016/j.socscimed.2009.09.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Indexed: 11/16/2022]
Abstract
Rural populations living in the northern Ecuadorian Amazon (NEA) experience the highest health burden of any region in the country. Two independent studies of colonist and indigenous groups living in the NEA are used to compare their morbidity and mortality experiences. Colonist data are from a probability sample of land plots in 1999, while indigenous data are from a representative sample of the five largest ethnicities (Quichua, Shuar, Huaorani, Cofan, Secoya) collected in 2001. Poisson regression was used to compare morbidity. Results indicate clear differences in health between populations. Indigenous groups had 30% higher probability of mortality and 63% higher incidence rate of all-cause morbidity compared to colonists. Vector-borne, chronic, gastrointestinal, and diseases of unknown origin were particularly high among indigenous groups. Factors associated with morbidity varied: morbidity rates were similar for the two youngest age groups (0-4 and 5-9), but indigenous people aged 15-39 and 40+ had almost double the morbidity compared to colonists; larger households, later months of data collection and less pollution were associated with less morbidity in both groups; better infrastructure access (electricity and roads) was generally associated with lower morbidity in both groups; and associations of land use were different by group with more cultivation of perennials and fewer annuals associated with less morbidity for colonists, but more for indigenous groups. These results demonstrate the health disparities that exist among indigenous and non-indigenous populations even when living in the same geographic region. Land use itself exemplifies the cultural and contextual differences that are evident in health, since land use decisions are related to broader demographic and economic factors that influence overall ecological and human health. Ongoing population-environment and/or environment-health research needs to recognize the broader factors involved when studying relationships between population health, development and deforestation.
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Affiliation(s)
- William Kuang-Yao Pan
- The Johns Hopkins Bloomberg School of Public Health, Department of International Health, 615N Wolfe Street, E5545, Baltimore, MD 21205, United States.
| | - Christine Erlien
- Duke University, Thompson Writing Program, Durham NC 27708, United States
| | - Richard E Bilsborrow
- University of North Carolina at Chapel Hill, Department of Biostatistics, Chapel Hill, NC 27516, United States
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Kuwahara K, Kato H, Gomez EA, Uezato H, Mimori T, Yamamoto YI, Calvopiña M, Cáceres AG, Iwata H, Hashiguchi Y. Genetic diversity of ribosomal RNA internal transcribed spacer sequences in Lutzomyia species from areas endemic for New World cutaneous leishmaniasis. Acta Trop 2009; 112:131-6. [PMID: 19631188 DOI: 10.1016/j.actatropica.2009.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Accepted: 07/14/2009] [Indexed: 11/24/2022]
Abstract
In this study, each of 60 rRNA internal transcribed spacer (ITS) 1 and ITS2 sequences was determined from 44 individuals of 14 morphologically identified New World sand fly Lutzomyia species in Ecuador, and their interspecies and intraspecies genetic diversity was compared. Distinguishing between related species based on the ITS1 sequence was difficult because of variability, while the genetic diversity of ITS2 was distinct even among closely related species. Further, an assessment of intraspecies ITS sequence diversity in the subgenus Helcocyrtomyia revealed no correlation between sequence variation and geographic distribution. The results strongly suggested ITS2 to be a more suitable marker than ITS1 for the taxonomic analysis of Lutzomyia species including closely related species. Moreover, neither ITS sequence may be useful for the analysis of population structures in Lutzomyia species.
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Schriefer A, Guimarães LH, Machado PRL, Lessa M, Lessa HA, Lago E, Ritt G, Góes-Neto A, Schriefer ALF, Riley LW, Carvalho EM. Geographic clustering of leishmaniasis in northeastern Brazil. Emerg Infect Dis 2009; 15:871-6. [PMID: 19523284 PMCID: PMC2727348 DOI: 10.3201/eid1506.080406] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Different forms of this disease are spreading rapidly in distinct geographic clusters in this region. To determine whether disease outcomes and clades of Leishmania braziliensis genotypes are associated, we studied geographic clustering of clades and most severe disease outcomes for leishmaniasis during 1999–2003 in Corte de Pedra in northeastern Brazil. Highly significant differences were observed in distribution of mucosal leishmaniasis versus disseminated leishmaniasis (DL) (p<0.0001). Concordance was observed between distribution of these disease forms and clades of L. braziliensis genotypes shown to be associated with these disease forms. We also detected spread of DL over this region and an inverse correlation between frequency of recent DL diagnoses and distance to a previous DL case. These findings indicate that leishmaniasis outcomes are distributed differently within transmission foci and show that DL is rapidly spreading in northeastern Brazil.
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Leishmania OligoC-TesT as a simple, rapid, and standardized tool for molecular diagnosis of cutaneous leishmaniasis in Peru. J Clin Microbiol 2009; 47:2560-3. [PMID: 19553579 DOI: 10.1128/jcm.00259-09] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Molecular methods such as PCR have become attractive tools for diagnosis of cutaneous leishmaniasis (CL), both for their high sensitivity and for their specificity. However, their practical use in routine diagnosis is limited due to the infrastructural requirements and the lack of any standardization. Recently, a simplified and standardized PCR format for molecular detection of Leishmania was developed. The Leishmania OligoC-TesT is based on simple and rapid detection using a dipstick with PCR-amplified Leishmania DNA. In this study, we estimated the diagnostic accuracy of the Leishmania OligoC-TesT for 61 specimens from 44 CL-suspected patients presenting at the leishmaniasis clinic of the Instituto de Medicina Tropical Alexander von Humboldt, Peru. On the basis of parasitological detection and the leishmanin skin test (LST), patients were classified as (i) confirmed CL cases, (ii) LST-positive cases, and (iii) LST-negative cases. The sensitivities of the Leishmania OligoC-TesT was 74% (95% confidence interval (CI), 60.5% to 84.1%) for lesion aspirates and 92% (95% CI, 81.2% to 96.9%) for scrapings. A significantly higher sensitivity was observed with a conventional PCR targeting the kinetoplast DNA on the aspirates (94%) (P = 0.001), while there was no significant difference in sensitivity for the lesion scrapings (88%) (P = 0.317). In addition, the Leishmania OligoC-TesT was evaluated for 13 CL-suspected patients in two different peripheral health centers in the central jungle of Peru. Our findings clearly indicate the high accuracy of the Leishmania OligoC-TesT for lesion scrapings for simple and rapid molecular diagnosis of CL in Peru.
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Terayama Y, Kato H, Gomez EA, Uezato H, Calvopiña M, Iwata H, Hashiguchi Y. Molecular typing of sand fly species (Diptera, Psychodidae, Phlebotominae) from areas endemic for Leishmaniasis in Ecuador by PCR-RFLP of 18S ribosomal RNA gene. J Vet Med Sci 2008; 70:907-13. [PMID: 18840964 DOI: 10.1292/jvms.70.907] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Surveillance of the distribution of sand fly species is important for prediction of the risk and expansion of Leishmania infection in endemic and surrounding areas. In the present study, a simple and reliable method of typing New World Lutzomyia species circulating in endemic areas in Ecuador was established by using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) technique. PCR-RFLP of 18S ribosomal RNA (rRNA) genes with the restriction enzyme AfaI and subsequently HinfI successfully identified seven sand fly species in nine endemic areas in Ecuador. Although intraspecific genetic-diversity affecting the RFLP-patterns was detected in a species, the patterns were species specific. The method promises to be a powerful tool for the classification of New World Lutzomyia species.
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Affiliation(s)
- Yoshimi Terayama
- Department of Veterinary Hygiene, Faculty of Agriculture, Yamaguchi University, Yamaguchi, Japan
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46
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Llanos-Cuentas A, Tulliano G, Araujo-Castillo R, Miranda-Verastegui C, Santamaria-Castrellon G, Ramirez L, Lazo M, De Doncker S, Boelaert M, Robays J, Dujardin JC, Arevalo J, Chappuis F. Clinical and Parasite Species Risk Factors for Pentavalent Antimonial Treatment Failure in Cutaneous Leishmaniasis in Peru. Clin Infect Dis 2008; 46:223-31. [DOI: 10.1086/524042] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rodríguez-González I, Marín C, Longoni SS, Mateo H, Alunda JM, Minaya G, Gutiérrez-Sánchez R, Vargas F, Sánchez-Moreno M. Identification of New WorldLeishmaniaspecies from Peru by biochemical techniques and multiplex PCR assay. FEMS Microbiol Lett 2007; 267:9-16. [PMID: 17233673 DOI: 10.1111/j.1574-6968.2006.00574.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We have characterized diverse strains or species of Leishmania isolated in humans that are currently circulating throughout Peru, by means of isoenzymatic characterization, kDNA analysis by restriction enzymes, and multiplex PCR assay. The cluster analysis gave five groups. Cluster 1 includes L. (L.) donovani together with the isolates LP4 and LP7, forming the donovani complex. Thus, this complex corresponds to the New World visceral form, L. (L.) chagasi. Cluster 2 is formed by the isolates LP1-LP3, LP6, LP10, LP9, and LP11, phylogenetically intermediate between Cluster 1 and Cluster 3, or they can be treated as hybrids. Cluster 3 is divided into two subgroups: one formed by L. (V.) peruviana, together with the isolates LP14 and LP5, and the second one formed by L. (V.) brazilensis and the isolate LP8. These two subgroups form part of the brazilensis complex. The three strains of L. (L.) infantum [L. (L.) infantum I and II and la LSI] make up Cluster 4. In Cluster 5, we include the three Mexican strains (LM1-LM3) forming one subgroup while we would place L. (L.) amazonensis in another subgroup. These two subgroups would comprise the complex mexicana.
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Affiliation(s)
- Isabel Rodríguez-González
- Instituto de Biotecnología, Departamento de Parasitología, Facultad de Ciencias, Universidad de Granada, Granada, Spain
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Calvopina M, Armijos RX, Marco JD, Uezato H, Kato H, Gomez EA, Korenaga M, Barroso PA, Mimori T, Cooper PJ, Nonaka S, Hashiguchi Y. Leishmania isoenzyme polymorphisms in Ecuador: relationships with geographic distribution and clinical presentation. BMC Infect Dis 2006; 6:139. [PMID: 16968553 PMCID: PMC1578576 DOI: 10.1186/1471-2334-6-139] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2006] [Accepted: 09/13/2006] [Indexed: 11/10/2022] Open
Abstract
Background Determinants of the clinical presentation of the leishmaniases are poorly understood but Leishmania species and strain differences are important. To examine the relationship between clinical presentation, species and isoenzyme polymorphisms, 56 Leishmania isolates from distinct presentations of American tegumentary leishmaniasis (ATL) from Ecuador were analyzed. Methods Isolates were characterized by multilocus enzyme electrophoresis for polymorphisms of 11 isoenzymes. Patients were infected in four different ecologic regions: highland and lowland jungle of the Pacific coast, Amazonian lowlands and Andean highlands. Results Six Leishmania species constituting 21 zymodemes were identified: L. (Viannia) panamensis (21 isolates, 7 zymodemes), L. (V.) guyanensis (7 isolates, 4 zymodemes), L. (V.) braziliensis (5 isolates, 3 zymodemes), L. (Leishmania) mexicana (11 isolates, 4 zymodemes), L. (L.) amazonensis (10 isolates, 2 zymodemes) and L. (L.) major (2 isolates, 1 zymodeme). L. panamensis was the species most frequently identified in the Pacific region and was associated with several clinical variants of cutaneous disease (CL); eight cases of leishmaniasis recidiva cutis (LRC) found in the Pacific highlands were associated with 3 zymodemes of this species. Mucocutaneous leishmaniasis found only in the Amazonian focus was associated with 3 zymodemes of L. braziliensis. The papular variant of CL, Uta, found in the Andean highlands was related predominantly with a single zymodeme of L. mexicana. Conclusion Our data show a high degree of phenotypic variation within species, and some evidence for associations between specific variants of ATL (i.e. Uta and LRC) and specific Leishmania zymodemes. This study further defines the geographic distribution of Leishmania species and clinical variants of ATL in Ecuador.
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Affiliation(s)
- Manuel Calvopina
- Department of Parasitology, Kochi Medical School, Kochi University, Kochi 783–8505, Japan
| | - Rodrigo X Armijos
- Health Sciences Program, College of Health Sciences, University of Texas at El Paso, El Paso, TX 79902–0581, USA
| | - Jorge D Marco
- Department of Parasitology, Kochi Medical School, Kochi University, Kochi 783–8505, Japan
| | - Hiroshi Uezato
- Department of Dermatology, Faculty of Medicine, University of the Ryukyus, Okinawa 903–0215, Japan
| | - Hirotomo Kato
- Department of Veterinary Hygiene, Faculty of Agriculture, Yamaguchi University, Yamaguchi 753–8515, Japan
| | - Eduardo A Gomez
- Departamento de Medicina Tropical, Facultad de Medicina, Universidad Católica Santiago de Guayaquil, Ecuador
| | - Masataka Korenaga
- Department of Parasitology, Kochi Medical School, Kochi University, Kochi 783–8505, Japan
| | - Paola A Barroso
- Department of Parasitology, Kochi Medical School, Kochi University, Kochi 783–8505, Japan
| | - Tatsuyuki Mimori
- Department of Microbiology, School of Health Sciences, Kumamoto University, Kumamoto 862–0976, Japan
| | - Philip J Cooper
- Laboratorio de Investigaciones, Hospital Pedro Vicente Maldonado, Pichincha Province, Ecuador; and Centre for Infection, St George's University of London, London, UK
| | - Shigeo Nonaka
- Department of Dermatology, Faculty of Medicine, University of the Ryukyus, Okinawa 903–0215, Japan
| | - Yoshihisa Hashiguchi
- Department of Parasitology, Kochi Medical School, Kochi University, Kochi 783–8505, Japan
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