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Piyaraj P, Bualert L, Kalrat A, Leelayoova S, Ruang-areerate T, Theprin N, Naaglor T, Mungthin M. Asymptomatic Leishmania Infection among Blood Donors in a Southern Province of Thailand. Am J Trop Med Hyg 2024; 111:804-813. [PMID: 39137751 PMCID: PMC11448544 DOI: 10.4269/ajtmh.24-0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/22/2024] [Indexed: 08/15/2024] Open
Abstract
Leishmaniasis poses significant public health challenges in endemic regions. Understanding the prevalence of asymptomatic Leishmania infection and identifying risk factors among blood donors is crucial. This study addressed a knowledge gap by evaluating the prevalence of asymptomatic Leishmania infection and pinpointing associated risk factors among blood donors in an endemic area in Thailand and aimed to enhance blood donation safety protocols and reduce the risk of transfusion-transmitted Leishmania infection. A cross-sectional study and a longitudinal follow-up were conducted among 500 blood donors in Trang Province, southern Thailand. A serological test was performed using the direct agglutination test (DAT), and DNA detection was performed using nested polymerase chain reaction (nPCR) to screen for Leishmania infection. Potential risk factors associated with the infection were also assessed. The study identified a 19.0% prevalence of asymptomatic Leishmania infection among blood donors, with nPCR proving more effective in detecting infections (13.0%) than DAT (6.4%). Notably, Leishmania martiniquensis was the predominant species identified, highlighting the local epidemiological profile of Leishmania infection. Furthermore, using multivariate analysis, living in stilt houses was independently associated with Leishmania infection (adjusted odds ratio = 1.85; 95% CI = 1.04-3.28; P = 0.035). A high prevalence of asymptomatic Leishmania infection among blood donors underscores the need for integrating comprehensive Leishmania screening protocols into blood donation processes, particularly in endemic regions. It advocates for using molecular diagnostics to enhance detection accuracy. Furthermore, living in stilt houses as a risk factor emphasizes the importance of environmental management in leishmaniasis control efforts.
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Affiliation(s)
- Phunlerd Piyaraj
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Lertwut Bualert
- HIV Clinic Trang Hospital, Trang Hospital, Trang Province, Thailand
| | - Areerat Kalrat
- Blood Donation Unit, Trang Hospital, Trang Province, Thailand
| | - Saovanee Leelayoova
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Toon Ruang-areerate
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Tawee Naaglor
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
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Kobialka RM, Ceruti A, Roy M, Roy S, Chowdhury R, Ghosh P, Hossain F, Weidmann M, Graf E, Bueno Alvarez J, Moreno J, Truyen U, Mondal D, Chatterjee M, Abd El Wahed A. Portable smartphone-based molecular test for rapid detection of Leishmania spp. Infection 2024; 52:1315-1324. [PMID: 38353873 PMCID: PMC11288998 DOI: 10.1007/s15010-024-02179-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE Leishmaniasis, caused by the parasite of the genus Leishmania, is a neglected tropical disease which is endemic in more than 60 countries. In South-East Asia, Brazil, and East Africa, it mainly occurs as kala-azar (visceral leishmaniasis, VL), and subsequently as post kala-azar dermal leishmaniasis (PKDL) in a smaller portion of cases. As stated per WHO roadmap, accessibility to accurate diagnostic methods is an essential step to achieve elimination. This study aimed to test the accuracy of a portable minoo device, a small battery-driven, multi-use fluorimeter operating with isothermal technology for molecular diagnosis of VL and PKDL. METHODS Fluorescence data measured by the device within 20 min are reported back to the mobile application (or app) via Bluetooth and onward via the internet to a backend. This allows anonymous analysis and storage of the test data. The test result is immediately returned to the app displaying it to the user. RESULTS The limit of detection was 11.2 genome copies (95% CI) as determined by screening a tenfold dilution range of whole Leishmania donovani genomes using isothermal recombinase polymerase amplification (RPA). Pathogens considered for differential diagnosis were tested and no cross-reactivity was observed. For its diagnostic performance, DNA extracted from 170 VL and PKDL cases, comprising peripheral blood samples (VL, n = 96) and skin biopsies (PKDL, n = 74) from India (n = 108) and Bangladesh (n = 62), was screened. Clinical sensitivity and specificity were 88% and 91%, respectively. CONCLUSION Minoo devices can offer a convenient, cheaper alternative to other molecular diagnostics. Its easy handling makes it ideal for use in low-resource settings to identify parasite burden.
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Affiliation(s)
- Rea Maja Kobialka
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany.
| | - Arianna Ceruti
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany
| | - Madhurima Roy
- Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Sutopa Roy
- Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Rajashree Chowdhury
- Nutrition Research Division, International Centre for Diarrheal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Prakash Ghosh
- Nutrition Research Division, International Centre for Diarrheal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Faria Hossain
- Nutrition Research Division, International Centre for Diarrheal Disease Research Bangladesh, Dhaka, Bangladesh
| | | | | | | | - Javier Moreno
- WHO Collaborating Center for Leishmaniasis, National Center for Microbiology, Instituto de Salud Carlos III, CIBER de Enfermedades Infecciosas-CIBERINFEC, Madrid, Spain
| | - Uwe Truyen
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany
| | - Dinesh Mondal
- Nutrition Research Division, International Centre for Diarrheal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Mitali Chatterjee
- Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Ahmed Abd El Wahed
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany
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Messaoudene F, Boukraa S, Boubidi SC, Guerzou A, Ouahabi A. Human Cutaneous Leishmaniasis in North Africa and Its Threats to Public Health: A Statistical Study Focused on Djelfa (Algeria). Microorganisms 2023; 11:2608. [PMID: 37894266 PMCID: PMC10609502 DOI: 10.3390/microorganisms11102608] [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: 08/27/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Cutaneous leishmaniasis, the most common form of leishmaniasis, causes long-term skin lesions on exposed areas of the skin. It is caused by a protozoan parasite belonging to the genus Leishmania and is transmitted via infected phlebotomine sand flies. In North Africa, particularly Algeria, the disease represents a major public health problem. This retrospective study, which focuses on the agropastoral region of Djelfa (central Algeria) during a period of 16 years, from 2006 to 2021, is part of the surveillance of cutaneous leishmaniasis to identify the key factors favouring its probable spread. The analyzed data reveal that this disease is more prevalent in male patients (53.60%) and is highly widespread in this vast area of 66,415 km2 with a total of 3864 CL cases, reaching a peak of 1407 cases in 2006. Statistically, the Pearson correlation validated by the p-value shows, in an original and sometimes unexpected way, that certain factors, such as temperature linked to climate change, are playing a significant role in the probable spread of the disease in Djelfa and its surrounding regions. The concentration of the population in some specific rural areas with limited or nonexistent access to public health services is another potential factor in disease transmission. The results were highlighted by a significant correlation coefficient (r=0.66) with a p-value less than 0.01. While there is currently no vaccine or prophylactic drug available, our research represents a preliminary approach that addresses various epidemiological aspects of the disease. This paves the way for a proactive preventive strategy involving the control of vector-borne diseases.
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Affiliation(s)
- Fatma Messaoudene
- Exploration and Valorization of Steppe Ecosystems Laboratory, Faculty of Nature and Life Science, Ziane Achour University of Djelfa, Djelfa 17000, Algeria
| | - Slimane Boukraa
- Department of Agricultural and Forestry Zoology, Ecole Nationale Supérieure Agronomique, El-Harrach 16004, Algeria
| | - Said Chaouki Boubidi
- Laboratoire d’Eco-Epidémiologie Parasitaire et Génétique des Populations, Institut Pasteur d’Algérie, Dely-Brahim 16047, Algeria
| | - Ahlem Guerzou
- Exploration and Valorization of Steppe Ecosystems Laboratory, Faculty of Nature and Life Science, Ziane Achour University of Djelfa, Djelfa 17000, Algeria
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Sarmadi M, Bagherian Z, Ahmadi-Soleimani SM, Rezaiemanesh MR, Khodamoradi F, Rahimi S, Azizi H. Environmental health risk factors and cutaneous leishmaniasis (CL): A case-control study in northeastern Iran. J Vector Borne Dis 2023; 60:372-381. [PMID: 38174514 DOI: 10.4103/0972-9062.374236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Background & objectives Cutaneous leishmaniasis (CL) is one of the main causes of vector-born diseases in younger population. To evaluate the association of environmental health factors on the odds of CL incidence, a case-control study was conducted in northeastern Iran. Methods This study was conducted within 2020-2021 based on individual and household data from a tertiary referral center. Cases were patients diagnosed with CL by PCR method; controls were selected among the patients' relatives, and information was obtained from a health registry system. Demographic and socioeconomic data of 1871 subjects, included age, sex, household information and environmental health factors. Multivariable models with environmental factors in various conditions and CL were separately fit by univariate and mixed multiple unconditional logistic regression. Results Participants included 617 cases (mean [SD] age, 13.62[13.72] years; 58.20% male) and 1264 controls (mean [SD] age, 16.45[15.44] years; 50.40% male). Results revealed that the use of well-water sources compared to surface water is significantly associated with CL (odds ratio [OR]=0.204; 95%CI, 0.13-0.33;P<0.001). Muddy houses, ruined buildings or wastelands and stagnant water, canals and rivers near the houses were also associated with CL (OR=3.85; 95%CI, 1.66-8.89; P=.002; OR=2.47; 95%CI, 1.76-3.47; P<.001). Besides, existence of pine tree was found to be a risk factor (OR=3.25; 95%CI, 2.12-4.99; P<.001) and similarly for the use of waste collection system (OR=4.43; 95%CI, 3.32-7.51; P<.001). Interpretation & conclusion Environmental factors related to houses were significantly associated with CL and may represent the modifiable risk factors of CL disease.
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Affiliation(s)
- Mohammad Sarmadi
- Department of Environmental Health Engineering, School of Health; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Zahra Bagherian
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - S Mohammad Ahmadi-Soleimani
- Health Sciences Research Center; Department of Physiology, School of Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammad Reza Rezaiemanesh
- Health Sciences Research Center; Department of Laboratory Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Farzad Khodamoradi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sajjad Rahimi
- Department of Environmental Health Engineering, School of Health; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Hakim Azizi
- Department of Medical Parasitology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
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McIntyre-Nolan S, Kumar V, Mark-Carew M, Kumar K, Nightingale ES, Dalla Libera Marchiori G, Rogers ME, Kristan M, Campino S, Medley GF, Das P, Cameron MM. Comparison of collection methods for Phlebotomus argentipes sand flies to use in a molecular xenomonitoring system for the surveillance of visceral leishmaniasis. PLoS Negl Trop Dis 2023; 17:e0011200. [PMID: 37656745 PMCID: PMC10501600 DOI: 10.1371/journal.pntd.0011200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/14/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The kala-azar elimination programme has resulted in a significant reduction in visceral leishmaniasis (VL) cases across the Indian Subcontinent. To detect any resurgence of transmission, a sensitive cost-effective surveillance system is required. Molecular xenomonitoring (MX), detection of pathogen DNA/RNA in vectors, provides a proxy of human infection in the lymphatic filariasis elimination programme. To determine whether MX can be used for VL surveillance in a low transmission setting, large numbers of the sand fly vector Phlebotomus argentipes are required. This study will determine the best method for capturing P. argentipes females for MX. METHODOLOGY/PRINCIPAL FINDINGS The field study was performed in two programmatic and two non-programmatic villages in Bihar, India. A total of 48 households (12/village) were recruited. Centers for Disease Control and Prevention light traps (CDC-LTs) were compared with Improved Prokopack (PKP) and mechanical vacuum aspirators (MVA) using standardised methods. Four 12x12 Latin squares, 576 collections, were attempted (12/house, 144/village,192/method). Molecular analyses of collections were conducted to confirm identification of P. argentipes and to detect human and Leishmania DNA. Operational factors, such as time burden, acceptance to householders and RNA preservation, were also considered. A total of 562 collections (97.7%) were completed with 6,809 sand flies captured. Females comprised 49.0% of captures, of which 1,934 (57.9%) were identified as P. argentipes. CDC-LTs collected 4.04 times more P. argentipes females than MVA and 3.62 times more than PKP (p<0.0001 for each). Of 21,735 mosquitoes in the same collections, no significant differences between collection methods were observed. CDC-LTs took less time to install and collect than to perform aspirations and their greater yield compensated for increased sorting time. No significant differences in Leishmania RNA detection and quantitation between methods were observed in experimentally infected sand flies maintained in conditions simulating field conditions. CDC-LTs were favoured by householders. CONCLUSIONS/SIGNIFICANCE CDC-LTs are the most useful collection tool of those tested for MX surveillance since they collected higher numbers of P. argentipes females without compromising mosquito captures or the preservation of RNA. However, capture rates are still low.
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Affiliation(s)
- Shannon McIntyre-Nolan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Vijay Kumar
- Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | - Miguella Mark-Carew
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kundan Kumar
- Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | - Emily S. Nightingale
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Matthew E. Rogers
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mojca Kristan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Susana Campino
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Graham F. Medley
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Pradeep Das
- Department of Molecular Parasitology, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Mary M. Cameron
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Ullah W, Yen TY, Niaz S, Nasreen N, Tsai YF, Rodriguez-Vivas RI, Khan A, Tsai KH. Distribution and Risk of Cutaneous Leishmaniasis in Khyber Pakhtunkhwa, Pakistan. Trop Med Infect Dis 2023; 8:tropicalmed8020128. [PMID: 36828544 PMCID: PMC9962270 DOI: 10.3390/tropicalmed8020128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Cutaneous leishmaniasis (CL) is a zoonotic infection caused by obligate intracellular protozoa of the genus Leishmania. This study aimed to investigate CL in Khyber Pakhtunkhwa, Pakistan and to estimate the risk of epidemics. Clinico-epidemiological data of 3188 CL patients were collected from health facilities in 2021. Risk factors were analyzed using the chi-square test. ArcGIS V.10.7.1 was applied for spatial analysis. The association between CL occurrence and climatic variables was examined by Bayesian geostatistical analysis. The clinical data revealed males or individuals younger than 20 years old were more affected. Most patients presented with a single lesion, and the face was the most attacked body part. CL was prevalent in the southern region in winter. A proportional symbol map, a choropleth map, and a digital elevation model map were built to show the distribution of CL. Focal transmission was predicted by inverse distance weighting interpolation. Cluster and outlier analysis identified clusters in Bannu, Dir Lower, and Mardan, and hotspot analysis suggested Bannu as a high-risk foci. Bayesian geostatistical analysis indicated that increasing precipitation and temperature as well as low altitudes were associated with CL infection. The study has provided important information for public health sectors to develop intervention strategies for future CL epidemics.
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Affiliation(s)
- Wasia Ullah
- Department of Zoology, Abdul Wali Khan University, Mardan 23300, Khyber Pakhtunkhwa, Pakistan
| | - Tsai-Ying Yen
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan
| | - Sadaf Niaz
- Department of Zoology, Abdul Wali Khan University, Mardan 23300, Khyber Pakhtunkhwa, Pakistan
| | - Nasreen Nasreen
- Department of Zoology, Abdul Wali Khan University, Mardan 23300, Khyber Pakhtunkhwa, Pakistan
| | - Yu-Feng Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan
| | - Roger Ivan Rodriguez-Vivas
- Facultad de Medicina Veterinaria y Zootecnia, Campus de Ciencias Biologicas y Agropecuarias, Universidad Autonoma de Yucatán, Km 15.5 Carretera Mérida–Xmatkuil, Merida 97100, Yucatan, Mexico
| | - Adil Khan
- Department of Botany/Zoology, Bacha Khan University, Charsadda 24420, Khyber Pakhtunkhwa, Pakistan
- Correspondence: (A.K.); (K.-H.T.)
| | - Kun-Hsien Tsai
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei 100025, Taiwan
- Correspondence: (A.K.); (K.-H.T.)
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Ibiapina AB, Batista FMDA, Aguiar BGA, Mendonça VJ, Costa DL, Costa CHN, Abdala CVM. Evidence map of diagnosis, treatment, prognosis, prevention, and control in visceral leishmaniasis. Rev Panam Salud Publica 2022; 46:e89. [PMID: 35875324 PMCID: PMC9299391 DOI: 10.26633/rpsp.2022.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/22/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To develop an evidence map on visceral leishmaniasis prevention, control, diagnosis, treatment, and prognosis. Methods Systematic reviews on visceral leishmaniasis were searched using MEDLINE/PubMed and Virtual Health Library. After selection, each included systematic review was assessed, characterized, and categorized by intervention type and by outcomes, according to the methodology offered by the PAHO/WHO Latin American and Caribbean Center on Health Sciences Information (BIREME). The methodological quality was assessed using the AMSTAR2 tool to determine the confidence level of the evidence obtained. Results Among the prevention and control interventions, insecticide spraying, bednets, dog collars, and dog culling were the most assessed, emphasizing that insecticidal dog collars can reduce visceral leishmaniasis incidence in dogs. Regarding diagnosis, polymerase chain reaction (PCR), rK39 immunochromatographic test (rK39 ICT), and direct agglutination test (DAT) presented high sensitivity and specificity. As for treatment, pentavalent antimonials and amphotericin B were the most analyzed drugs and showed therapeutic success; however, serious adverse events can occur due to their use. The prognostic factors identified were anemia, edema, bleeding, jaundice, age, and HIV coinfection. Conclusions The evidence map developed shows rK39 ICT and DAT as promising diagnostic alternatives and reinforces the efficacy of liposomal amphotericin B and pentavalent antimonials. Insecticide-impregnated dog collars appear as a promising measure for the control of visceral leishmaniasis, but there is also a need for future studies and reviews with higher methodological quality, especially on prevention and control interventions.
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Affiliation(s)
- Andressa Barros Ibiapina
- Intelligence Center in Emerging and Neglected Tropical ConditionsTeresinaPiauíBrazilIntelligence Center in Emerging and Neglected Tropical Conditions, Teresina, Piauí, Brazil
| | - Francisca Miriane de Araújo Batista
- Intelligence Center in Emerging and Neglected Tropical ConditionsTeresinaPiauíBrazilIntelligence Center in Emerging and Neglected Tropical Conditions, Teresina, Piauí, Brazil
| | - Bruno Guedes Alcoforado Aguiar
- Intelligence Center in Emerging and Neglected Tropical ConditionsTeresinaPiauíBrazilIntelligence Center in Emerging and Neglected Tropical Conditions, Teresina, Piauí, Brazil
| | - Vagner José Mendonça
- Intelligence Center in Emerging and Neglected Tropical ConditionsTeresinaPiauíBrazilIntelligence Center in Emerging and Neglected Tropical Conditions, Teresina, Piauí, Brazil
| | - Dorcas Lamounier Costa
- Intelligence Center in Emerging and Neglected Tropical ConditionsTeresinaPiauíBrazilIntelligence Center in Emerging and Neglected Tropical Conditions, Teresina, Piauí, Brazil
| | - Carlos Henrique Nery Costa
- Intelligence Center in Emerging and Neglected Tropical ConditionsTeresinaPiauíBrazilIntelligence Center in Emerging and Neglected Tropical Conditions, Teresina, Piauí, Brazil
| | - Carmen Verônica Mendes Abdala
- PAHO/WHO Latin American and Caribbean Center on Health Sciences Information (BIREME)São PauloBrazilPAHO/WHO Latin American and Caribbean Center on Health Sciences Information (BIREME), São Paulo, Brazil
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Magnitude of visceral leishmaniasis and HIV coinfection and association with social determinants of health in the Northeast region of Brazil: a retrospective, spatiotemporal model (2010-2018). Parasitol Res 2022; 121:1021-1031. [PMID: 35142927 DOI: 10.1007/s00436-022-07450-6] [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: 10/25/2021] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
Abstract
The Northeast region of Brazil (NRB) includes the states with the highest prevalence of visceral leishmaniasis (VL), as well as those with significant increases in HIV cases. This study aims to analyze the spatiotemporal patterns of VL-HIV coinfection and its association with the social determinants of health (SDH) in the NRB. Time trend analysis and Bayesian spatial statistical inferences, Moran's autocorrelation, and retrospective space-time scanning were performed. Spatial regression modelling was used to build an explanatory model for the occurrence of VL-HIV coinfection within NRB. A total of 1550 cases of VL-HIV coinfection were confirmed. We observed a higher prevalence among males (1232; 83%), individuals aged from 20 to 59 years (850; 54.8%), non-white skin color (1,422; 91.7%), and with low education (550; 35.48%). NRB showed an increasing and significant trend in the detection rate of coinfection (APC, 5.3; 95% CI, 1.4 to 9.4). The states of Maranhão and Piauí comprised the high-risk cluster. The SDH that most correlated with the occurrence of coinfection were poor housing, low income, and low education. VL-HIV is dispersed in the NRB but chiefly affects states with greater social vulnerability. Taken together, these findings reinforce the necessity to implement surveillance strategies that will contribute to the reduction of cases in these populations.
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New phosphoramidates containing selenium as leishmanicidal agents. Antimicrob Agents Chemother 2021; 65:e0059021. [PMID: 34339279 DOI: 10.1128/aac.00590-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This work reports the synthesis, characterization by FTIR, 1H, 13C and 79Se NMR, mass spectrometry and elemental analysis techniques as well as the in vitro evaluation of the leishmanicidal activity of thirteen new selenophosphoramidate derivatives. Among the new compounds, four of them (compounds 1f, 1g, 2f and 2g), which exhibited the best profile, were tested against infected macrophages and were selected for further studies related their leishmanicidal mechanism. In this regard, trypanothione redox-system alteration was determined. Compound 1g, under similar conditions, was more effective than the corresponding references. In addition, theoretical calculations showed that this compound also presents most physico-chemical and pharmacokinetic properties within the ranges expected for orally available drugs. It is believed that selenophophoramidate functionalities may represent a scaffold to be explored toward the development of new agents for leishmania treatment.
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Sriwongpan P, Nedsuwan S, Manomat J, Charoensakulchai S, Lacharojana K, Sankwan J, Kobpungton N, Sriwongpun T, Leelayoova S, Mungthin M, Siripattanapipong S, Ruang-areerate T, Naaglor T, Eamchotchawalit T, Piyaraj P. Prevalence and associated risk factors of Leishmania infection among immunocompetent hosts, a community-based study in Chiang Rai, Thailand. PLoS Negl Trop Dis 2021; 15:e0009545. [PMID: 34252099 PMCID: PMC8297947 DOI: 10.1371/journal.pntd.0009545] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 07/22/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background Leishmaniasis is an emerging infectious disease reported in the north and south of Thailand of which patients with HIV/AIDS are a high risk group for acquiring the infection. A lack of information regarding prevalence, and the risk association of Leishmania infection among asymptomatic immunocompetent hosts needs further investigation. Information on potential vectors and animal reservoirs in the affected areas is also important to control disease transmission. Methods An outbreak investigation and a cross-sectional study were conducted following one index case of cutaneous leishmaniasis (CL) caused by L. martiniquensis in an immunocompetent male patient reported in August 2015, Chiang Rai Province, Thailand. From September to November 2015, a total of 392 participants at two study areas who were related to the index case, 130 students at a semi-boarding vocational school and 262 hill tribe villagers in the patient’s hometown, were recruited in this study. The nested internal transcribed spacer 1-PCR (ITS1-PCR) was performed to detect Leishmania DNA in buffy coat, and nucleotide sequencing was used to identify species. Antibody screening in plasma was performed using the Direct Agglutination Test (DAT), and associated risk factors were analyzed using a standardized questionnaire. Captured sandflies within the study areas were identified and detected for Leishmania DNA using nested ITS1-PCR. Moreover, the animal reservoirs in the study areas were also explored for Leishmania infection. Results Of 392 participants, 28 (7.1%) were positive for Leishmania infection of which 1 (4.8%) was L. martiniquensis, 12 (57.1%) were L. orientalis and 8 (38.1%) were Leishmania spp. Of 28, 15 (53.6%) were DAT positive. None showed any symptoms of CL or visceral leishmaniasis. Risk factors were associated with being female (adjusted odds ratio, AOR 2.52, 95%CI 1.01–6.26), increasing age (AOR 1.05, 95%CI 1.02–1.08), having an animal enclosure in a housing area (AOR 3.04, 95%CI 1.13–8.22), being exposed to termite mounds (AOR 3.74, 95%CI 1.11–12.58) and having domestic animals in a housing area (AOR 7.11, 95%CI 2.08–24.37). At the semi-boarding vocational school, six Sergentomyia gemmea samples were PCR positive for DNA of L. orientalis and one S. gemmea was PCR positive for DNA of L. donovani/L. infantum. Additionally, one Phlebotomus stantoni was PCR positive for DNA of L. martiniquensis, and one black rat (Rattus rattus) was PCR positive for DNA of L. martiniquensis. Conclusion This information could be useful for monitoring Leishmania infection among immunocompetent hosts in affected areas and also setting up strategies for prevention and control. A follow-up study of asymptomatic individuals with seropositive results as well as those with positive PCR results is recommended. This is the first community-based study investigating the prevalence and associated risk factors of Leishmania infection among immunocompetent individuals, demonstrating the situation of Leishmania infection in endemic areas of Thailand. An outbreak investigation and a cross-sectional study were conducted following one index case of cutaneous leishmaniasis (CL) caused by L. martiniquensis in an immunocompetent male patient reported in August 2015, Chiang Rai Province, Thailand. Of 392 participants, 28 (7.1%) were positive for Leishmania infection of which 1 (4.8%) was L. martiniquensis, 12 (57.1%) were L. orientalis and 8 (38.1%) were Leishmania spp. The factors associated with Leishmania infection included being female, increasing age, having an animal enclosure in a housing area, being exposed to termite mounds and having domestic animals in a housing area. This information revealed the first burden and risk factors of Leishmania infection among immunocompetent individuals in Thailand and highlighted the urgent need for effective interventions to prevent and control the disease in high risk populations in endemic areas.
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Affiliation(s)
- Pamornsri Sriwongpan
- Department of Public Health, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Supalert Nedsuwan
- Social and Preventive Medicine Department, Chiangrai Prachanukroh Hospital, Ministry of Public Health, Chiang Rai, Thailand
| | - Jidapa Manomat
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | | | | | - Jamnong Sankwan
- Chiangrai Provincial Livestock Office, Ministry of Agriculture and Cooperatives, Chiang Rai, Thailand
| | - Natheeporn Kobpungton
- Anatomical Pathology Department, Chiangrai Prachanukroh Hospital, Ministry of Public Health, Chiang Rai, Thailand
| | | | - Saovanee Leelayoova
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Toon Ruang-areerate
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Tawee Naaglor
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Phunlerd Piyaraj
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
- * E-mail:
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Effectiveness of vector control methods for the control of cutaneous and visceral leishmaniasis: A meta-review. PLoS Negl Trop Dis 2021; 15:e0009309. [PMID: 33983930 PMCID: PMC8118276 DOI: 10.1371/journal.pntd.0009309] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Elimination of visceral leishmaniasis (VL) in Southeast Asia and global control of cutaneous leishmaniasis (CL) and VL are priorities of the World Health Organization (WHO). But is the existing evidence good enough for public health recommendations? This meta-review summarises the available and new evidence for vector control with the aims of establishing what is known about the value of vector control for the control of CL and VL, establishing gaps in knowledge, and particularly focusing on key recommendations for further scientific work. This meta-review follows the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) criteria, including (1) systematic reviews and meta-analyses (SRs/MAs) for (2) vector control methods and strategies and (3) for the control of CL and/or VL. Nine SRs/MAs were included, with different research questions and inclusion/exclusion criteria. The methods analysed for vector control can be broadly classified into (1) indoor residual spraying (IRS); (2) insecticide-treated nets (ITNs; including insecticide-impregnated bednets); (3) insecticide-treated curtains (ITCs; including insecticide-treated house screening); (4) insecticide-treated bedsheets (ITSs) and insecticide-treated fabrics (ITFs; including insecticide-treated clothing) and (5) durable wall lining (treated with insecticides) and other environmental measures to protect the house; (6) control of the reservoir host; and (7) strengthening vector control operations through health education. The existing SRs/MAs include a large variation of different primary studies, even for the same specific research sub-question. Also, the SRs/MAs are outdated, using available information until earlier than 2018 only. Assessing the quality of the SRs/MAs, there is a considerable degree of variation. It is therefore very difficult to summarise the results of the available SRs/MAs, with contradictory results for both vector indices and—if available—human transmission data. Conclusions of this meta-review are that (1) existing SRs/MAs and their results make policy recommendations for evidence-based vector control difficult; (2) further work is needed to establish efficacy and community effectiveness of key vector control methods with specific SRs and MAs (3) including vector and human transmission parameters; and (4) attempting to conclude with recommendations in different transmission scenarios.
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Cytokine saga in visceral leishmaniasis. Cytokine 2020; 147:155322. [PMID: 33127259 DOI: 10.1016/j.cyto.2020.155322] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022]
Abstract
In humans, infection with Leishmania manifests into a spectrum of diseases. The manifestation of the diseases depend on the resultant evasion of the parasite to immune responses namely by macrophages, which is an exclusive host of Leishmania. The B cells valiantly mount antibody responses, however, to no avail as the Leishmania parasites occupy the intracellular niches of the macrophages and subvert the immune response. Extensive studies have been documented on the role of cell-mediated immunity (CMI) in protection and counter survival strategies of the parasites leading to downregulation of CMI. The present review attempts to discuss the cytokines in progression or resolution of visceral form of leishmaniasis or kala-azar, predominantly affecting the Indian subcontinent. The components/cytokine(s) responsible for the regulation of the critical balance of T helper cells and their subsets have been discussed in the perspective. Therefore, any strategy involving the treatment of visceral leishmania (VL) needs to consider the balance and regulation of T cell function.
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Jihene A, Rym E, Ines KJ, Majdi H, Olfa T, Abderrabba M. Antileishmanial Potential of Propolis Essential Oil and Its Synergistic Combination With Amphotericin B. Nat Prod Commun 2020. [DOI: 10.1177/1934578x19899566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The antileishmanial activity of Tunisian propolis essential oil (EO) and its combination with amphotericin B was investigated against 2 local clinical strains of Leishmania: Leishmania major and Leishmania infantum. The cytotoxic potential of this EO was evaluated against macrophage Raw264.7. Combination of propolis EO and amphotericin B was investigated using the checkerboard method. The propolis sample was collected from the region of Beni Khalled, a Tunisian city located west of Cape Bon (Nabeul). Its location is particular since it is near to sea with a steppe climate and the predominance of citrus trees. The EO was obtained by Clevenger-type apparatus. Its chemical composition was identified using gas chromatography with flame ionization detector and gas chromatography-mass spectrometry analysis. Our results demonstrate that Tunisian propolis EO exhibit good antileishmanial activity against L. major and L. infantum promastigotes (IC50 = 5.29 ± 0.31 and 3.67 ± 0.52 µg/mL, respectively) and amastigotes (IC50 = 7.38 ± 0.45 and 4.96 ± 0.24 µg/mL, respectively). Moreover, it reduced significantly the parasite proliferation on a dose-dependent response (95%) with low cytotoxicity (selectivity index = 16.18 and 23.33, respectively). Its combination with amphotericin B showed a synergistic potential (fractional inhibitory concentration = 0.37). Interestingly, the data suggest that propolis EO was involved in macrophage activation by hyperproduction of NO. A total of 51 compounds were identified in the propolis EO. The major compound identified was α-pinene (36.7% ± 2.36%) followed by α-cedrol (6.7% ± 0.10%), totarol (6.6% ± 0.09%), and dehydroabietane (5.2% ± 0.10%). Our findings suggest that Tunisian propolis might constitute a promising source for antileishmanial molecules.
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Affiliation(s)
- Ayari Jihene
- Laboratoire Matériaux Molécules et Applications, Institut Préparatoire des Etudes Scientifiques et Techniques, IPEST, La Marsa, Tunisia
| | - Essid Rym
- Laboratoire des Substances Bioactives, Centre de Biotechnologie `a la Technopole de Borj-Cedria (CBBC), Hammam-Lif, Tunisia
| | - Karoui Jabri Ines
- Laboratoire Matériaux Molécules et Applications, Institut Préparatoire des Etudes Scientifiques et Techniques, IPEST, La Marsa, Tunisia
| | - Hammami Majdi
- Laboratoire des Substances Bioactives, Centre de Biotechnologie `a la Technopole de Borj-Cedria (CBBC), Hammam-Lif, Tunisia
| | - Tabbene Olfa
- Laboratoire des Substances Bioactives, Centre de Biotechnologie `a la Technopole de Borj-Cedria (CBBC), Hammam-Lif, Tunisia
| | - Manef Abderrabba
- Laboratoire Matériaux Molécules et Applications, Institut Préparatoire des Etudes Scientifiques et Techniques, IPEST, La Marsa, Tunisia
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