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Guha SK, Sardar AA, Misra AK, Saha P, Samanta A, Maji D, Mandal A, Saha P, Halder S, Ali KA, Karmakar S, Sharma D, Maji AK. Active Community-Based Case Finding of Endemic Leishmaniasis in West Bengal, India. J Epidemiol Glob Health 2024:10.1007/s44197-024-00260-2. [PMID: 38884694 DOI: 10.1007/s44197-024-00260-2] [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: 02/16/2024] [Accepted: 06/03/2024] [Indexed: 06/18/2024] Open
Abstract
INTRODUCTION The ongoing visceral leishmaniasis (VL) elimination programme in India is targeting the elimination of the disease VL but not the pathogen. The persistence of hidden parasite pool may initiate a resurgence in suitable conditions. This study dealt with a novel approach to unearth such pathogen pool and their proper management to prevent the resurgence of VL. MATERIALS AND METHODS We deployed a new approach for detection of pathogen pool by following up the VL and post kala-azar dermal leishmaniasis patients treated during the last 10 years along with mass sero-surveillance within a radius of 500 m of recently treated individuals. RESULTS We followed up 72.6% (3026/4168) previously treated VL and post kala-azar dermal leishmaniasis patients and diagnosed 42 (1.4%) new and 38 (1.3%) recurrent post kala-azar dermal leishmaniasis. We detected 93 asymptomatic leishmanial infection, 8 VL and 1 post kala-azar dermal leishmaniasis by mass sero-surveillance. CONCLUSION Our three-step process including mapping and follow-up of previously treated cases, mass surveillance within 500 m of radius of known cases, and 6 monthly follow-on clinical and serological screening of asymptomatic cases, enabled detection of previously undetected cases of post kala-azar dermal leishmaniasis and VL. Recurrent post kala-azar dermal leishmaniasis deserves special attention regarding their treatment guideline. Early diagnosis and effective treatment of all leishmaniasis cases will hasten pathogen elimination and prevent resurgence of VL. This may help the policymakers to develop appropriate strategy for elimination of pathogen to prevent resurgence of VL.
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Affiliation(s)
- Subhasish Kamal Guha
- Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India.
| | - Ashif Ali Sardar
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Amartya Kumar Misra
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Pabitra Saha
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
- Department of Zoology, P. R. Thakur Government College, Thakurnagar, North 24 Parganas, West Bengal, India
| | - Anwesha Samanta
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Dipankar Maji
- Department of Health and Family Welfare, Government of West Bengal, Swasthya Bhavan, Salt Lake City, Kolkata, West Bengal, India
| | - Amitabha Mandal
- Office of the Chief Medical Officer of Health, Public Health Wing, Malda Medical College Campus, Malda, West Bengal, India
| | - Punita Saha
- R. N. Ray Rural Hospital, Bulbulchandi, Habibpur, Malda, West Bengal, India
| | - Supriya Halder
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Kabiul Akhter Ali
- Office of the Chief Medical Officer of Health, Public Health Wing, Malda Medical College Campus, Malda, West Bengal, India
| | - Sibajyoti Karmakar
- Office of the Chief Medical Officer of Health, Public Health Wing, Raiganj, Uttar Dinajpur, West Bengal, India
| | - Dipendra Sharma
- Office of the Chief Medical Officer of Health, Public Health Wing, Siliguri, Darjeeling, West Bengal, India
| | - Ardhendu Kumar Maji
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
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Amane M, El Mazini S, Echchakery M, Hafidi M, Lemrani M, Boussaa S. Entomological, parasitological and molecular investigations in a new focus of cutaneous leishmaniasis in Youssoufia region, Morocco. Zoonoses Public Health 2024; 71:248-257. [PMID: 38105536 DOI: 10.1111/zph.13105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND AND AIMS Leishmaniasis is a neglected tropical infection caused by Leishmania parasite that affect human and animal. In Morocco, the cutaneous leishmaniasis has spread substantially to the new areas. The surveillance limited to active foci may underestimate the occurrence of cutaneous leishmaniasis (CL). This study aims to investigate the local transmission of CL in rural districts of Youssoufia province, central Morocco, as a potential focus of CL. METHODS For this purpose, parasitological, molecular and entomological investigations were carried out in this area. Data collection concerns potential vectors and human cases. Thus, 402 patients were examined for suspected leishmaniasis lesions in three localities of the province of Youssoufia. In these same localities, 983 sand flies were collected by CDC light traps and sticky paper during one-night per month during 6 months. These sand flies were all identified morphologically using the Moroccan identification key. RESULTS The results showed that among the 25 skin lesions detected in a population of 402 individuals, 18 were confirmed by kDNA nested PCR as CL positive patients, of which only 25% were positive by direct examination. Leishmania tropica and Leishmania major were identified as causative agents of CL in the study area. Direct parasitological examination showed a low sensitivity (27.78%), especially for L. major, although its specificity was evaluated at 100%. Regarding entomological results, both genera of the Moroccan sand fly were collected in the study area: Genus/Phlebotomus (75.28%) and Sergentomyia (24.72%). Phlebotomus (P) papatasi, the proven vector of L. major, was the most abundant species (33.98%), followed by Paralongicollum sergenti (22.58%), the confirmed vector of L. tropica; while Sergentomyia (S) minuta, P. longicuspis, S. fallax and P. kazeruni were collected with, respectively, 17.60%, 16.99%, 7.12% and 1.73%. CONCLUSION This study constitutes the first report of CL in the study areas, as well as the coexistence of L. tropica and L. major in these rural localities. Local transmission of CL is highly probable, as indicated by the prevalence of the two proven vectors of L. major and L. tropica. To control the spread of this disease, our results suggest the use of highly sensitive molecular methods to detect CL cases in potential leishmaniasis foci, which will improve surveillance.
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Affiliation(s)
- Mounia Amane
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - Sara El Mazini
- Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca, Morocco
- Laboratory of Microbial Biotechnology and Bioactive Molecules, Faculty of Sciences and Technologies, Sidi Mohammed Ben Abdellah University, Fes, Morocco
| | - Mohamed Echchakery
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University, Settat, Morocco
| | - Mohamed Hafidi
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | - Meryem Lemrani
- Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Samia Boussaa
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
- ISPITS-Higher Institute of Nursing and Technical Health Occupations, Ministry of Health and Social Protection, Rabat, Morocco
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Pagniez J, Petitdidier E, Parra-Zuleta O, Pissarra J, Bras-Gonçalves R. A systematic review of peptide-based serological tests for the diagnosis of leishmaniasis. Parasite 2023; 30:10. [PMID: 37010451 PMCID: PMC10069404 DOI: 10.1051/parasite/2023011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
Serological methods should meet the needs of leishmaniasis diagnosis due to their high sensitivity and specificity, economical and adaptable rapid diagnostic test format, and ease of use. Currently, the performances of serological diagnostic tests, despite improvements with recombinant proteins, vary greatly depending on the clinical form of leishmaniasis and the endemic area. Peptide-based serological tests are promising as they could compensate for antigenic variability and improve performance, independently of Leishmania species and subspecies circulating in the endemic areas. The objective of this systematic review was to inventory all studies published from 2002 to 2022 that evaluate synthetic peptides for serological diagnosis of human leishmaniases and also to highlight the performance (e.g., sensitivity and specificity) of each peptide reported in these studies. All clinical forms of leishmaniasis, visceral and tegumentary, and all Leishmania species responsible for these diseases were considered. Following PRISMA statement recommendations, 1,405 studies were identified but only 22 articles met the selection criteria and were included in this systematic review. These original research articles described 77 different peptides, of which several have promising performance for visceral or tegumentary leishmaniasis diagnosis. This review highlights the importance of and growing interest in synthetic peptides used for serological diagnosis of leishmaniases, and their performances compared to some widely used tests with recombinant proteins.
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Affiliation(s)
- Julie Pagniez
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
| | - Elodie Petitdidier
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
| | | | - Joana Pissarra
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
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Makau-Barasa LK, Ochol D, Yotebieng KA, Adera CB, de Souza DK. Moving from control to elimination of Visceral Leishmaniasis in East Africa. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.965609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Visceral leishmaniasis (VL) is arguably one of the deadliest neglected tropical diseases. People in poverty bear the largest burden of the disease. Today, the largest proportion of persons living with VL reside in the Eastern African countries of Ethiopia, Kenya, Somalia, South Sudan, and Sudan. These East African countries are among the top 10 countries reporting the highest number of cases and deaths. If left undiagnosed and untreated, VL almost always results in death. Subsequently, there is a need for integrated efforts across human, animal, and vector-control programs to address the scourge of VL in East Africa. In the East African region, the challenges including socio-cultural beliefs, poor health system, political instability, and limited epidemiological understanding impede the implementation of effective VL control strategies. The availability of funding, as well as diagnostics and treatment options, are also devastatingly limited. Furthermore, given the realities of climate change and population movement in the region, to effectively address the scourge of visceral leishmaniasis in East Africa, a regional approach is imperative. In this paper, we highlight some of the key challenges and opportunities to effectively move towards an effective control, and eventually elimination, of VL in East Africa. To do this, we underline the need for a fully integrated program in East Africa, inclusive of effective diagnostics and treatment, to effectively reduce and eliminate the burden of VL in the region, subsequently paving the way to achieve global elimination goals.
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Bindroo J, Priyamvada K, Chapman LAC, Mahapatra T, Sinha B, Banerjee I, Mishra PK, Rooj B, Kundan K, Roy N, Gill NK, Hightower A, Sharma MP, Dhingra N, Bern C, Srikantiah S. Optimizing Village-Level Targeting of Active Case Detection to Support Visceral Leishmaniasis Elimination in India. Front Cell Infect Microbiol 2021; 11:648847. [PMID: 33842395 PMCID: PMC8024562 DOI: 10.3389/fcimb.2021.648847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background India has made major progress in improving control of visceral leishmaniasis (VL) in recent years, in part through shortening the time infectious patients remain untreated. Active case detection decreases the time from VL onset to diagnosis and treatment, but requires substantial human resources. Targeting approaches are therefore essential to feasibility. Methods We analyzed data from the Kala-azar Management Information System (KAMIS), using village-level VL cases over specific time intervals to predict risk in subsequent years. We also graphed the time between cases in villages and examined how these patterns track with village-level risk of additional cases across the range of cumulative village case-loads. Finally, we assessed the trade-off between ACD effort and yield. Results In 2013, only 9.3% of all villages reported VL cases; this proportion shrank to 3.9% in 2019. Newly affected villages as a percentage of all affected villages decreased from 54.3% in 2014 to 23.5% in 2019, as more surveillance data accumulated and overall VL incidence declined. The risk of additional cases in a village increased with increasing cumulative incidence, reaching approximately 90% in villages with 12 cases and 100% in villages with 45 cases, but the vast majority of villages had small cumulative case numbers. The time-to-next-case decreased with increasing case-load. Using a 3-year window (2016-2018), a threshold of seven VL cases at the village level selects 329 villages and yields 23% of cases reported in 2019, while a threshold of three cases selects 1,241 villages and yields 46% of cases reported in 2019. Using a 6-year window increases both effort and yield. Conclusion Decisions on targeting must consider the trade-off between number of villages targeted and yield and will depend upon the operational efficiencies of existing programs and the feasibility of specific ACD approaches. The maintenance of a sensitive, comprehensive VL surveillance system will be crucial to preventing future VL resurgence.
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Affiliation(s)
- Joy Bindroo
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Khushbu Priyamvada
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Lloyd A. C. Chapman
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tanmay Mahapatra
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Bikas Sinha
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Indranath Banerjee
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Prabhas Kumar Mishra
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Basab Rooj
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Kumar Kundan
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
| | - Nupur Roy
- National Vector-Borne Disease Control Programme, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | - Naresh Kumar Gill
- National Vector-Borne Disease Control Programme, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | | | | | - Neeraj Dhingra
- National Vector-Borne Disease Control Programme, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco CA, United States
| | - Sridhar Srikantiah
- Bihar Technical Support Program, CARE-India Solutions for Sustainable Development, Patna, India
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