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Sample records for american tegumentary leishmaniasis

  1. Oral manifestations in the American tegumentary leishmaniasis.

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    Daniel Cesar Silva da Costa

    Full Text Available American tegumentary leishmaniasis (ATL can affect the skin or mucosa (mucocutaneous leishmaniasis - MCL including the oral cavity. MCL oral lesions are often confused with other oral diseases, delaying diagnosis and specific treatment, and increasing the likelihood of sequelae. Thus, increasing the knowledge of the evolution of ATL oral lesions can facilitate its early diagnosis improving the prognosis of healing.Evaluate the frequency of ATL oral lesion and describe its clinical, laboratory and therapeutic peculiarities.A descriptive transversal study was carried out, using data from medical records of 206 patients with MCL examined at the outpatient clinics-IPEC-Fiocruz between 1989 and 2013. Proportions were calculated for the categorical variables and the association among them was assessed by the Pearson's chi-square test. Measures of central tendency and dispersion were used for the continuous variables and their differences were assessed by both parametric (t test and non parametric (Mann-Whitney tests. P-values <0.05 were considered as significant.The most affected site was the nose, followed by the mouth, pharynx and larynx. Seventy eight (37.9% have oral lesions and the disease presented a lower median of the evolution time than in other mucous sites as well as an increased time to heal. The presence of oral lesion was associated with: the presence of lesions in the other three mucosal sites; a smaller median of the leishmanin skin test values; a longer healing time of the mucosal lesions; a higher recurrence frequency; and a smaller frequency of treatment finishing and healing. When the oral lesion was isolated, it was associated with an age 20 years lower than when the oral lesion was associated with other mucosal sites.Considering the worst therapy results associated with the presence of oral lesions, we suggest that lesions in this location represent a factor of worse prognosis for MCL.

  2. Active surveillance of American tegumentary leishmaniasis in endemic areas in rural Bolivia

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    Vladimir Luna Tedesqui

    2012-02-01

    Full Text Available INTRODUCTION: American tegumentary leishmaniasis (ATL, including mucocutaneous leishmaniasis (MCL and localized cutaneous leishmaniasis (LCL, is endemic in Bolivia. We describe the results of active surveillance of ATL from 2001 to 2006 and assess demographic data related to ATL epidemiology in the Yungas valleys. METHODS: Community-based active ATL surveillance was performed by the institutions SERVIR, CÁRITAS, and the Health Services Department of La Paz, whose files were reviewed retrospectively. A cross-sectional survey was carried out to assess demographic data in two communities. RESULTS: Two thousand nine hundred nine cases of ATL were detected from 2001 to 2006: 2,488 (85.5% corresponded to LCL and 421 (14.5% to MCL. A reduction in the proportion of mucosal cases was observed between 2001 and 2006. The proportion of MCL cases increased with age and was higher among males (15.5% versus 12.1%, p=0.018. The rate of positivity via direct observation of the parasite in dermal scrapings and in parasite cultivation was significantly higher for LCL than for MCL (p<0.001 and p=0.009, respectively. The rate of reactivity in the leishmanin skin test was higher in the group with mucosal lesions (p=0.012. The cross-sectional survey showed that 40% of the families had emigrated from the Altiplano. CONCLUSIONS: It is necessary to undertake continuous case detection of ATL in the area, where the disease presents a high rate of mucosal cases. Increasing incidence seems to be associated with immigration and continuous deforestation to expand the crop-growing areas.

  3. Phase 1 study of an inactivated vaccine against American tegumentary leishmaniasis in normal volunteers in Brazil.

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    Marzochi, K B; Marzochi, M A; Silva, A F; Grativol, N; Duarte, R; Confort, E M; Modabber, F

    1998-01-01

    A Phase 1 double-blind placebo-controlled study was performed to evaluate a vaccine against American tegumentary leishmaniasis in 61 healthy male volunteers. Side effects and the immune response to the vaccine were evaluated, with 1- and 2- dose schemes, with intervals of 7 or 21 days, each dose containing 1440 mg of protein N antigen of a single strain of Leishmania amazonensis (PH8) diluted in merthiolated saline (1:10,000). Merthiolated saline and an inert substance were used as placebos. No significant clinical alterations were found following the respective injections in the vaccinated individuals as compared to the placebos, except for local pain, which was associated significantly with injection of the vaccine. The laboratory alterations we observed bore no association with the clinical findings and were unimportant. We observed no differences between the groups with regard to seroconversion of the Montenegro skin test. However, the group that received a single dose of the vaccine and the one that received two doses with a 21-day interval displayed cutaneous induration significantly larger than in the control group, with 100%, 100%, and 66% conversion in the skin test, respectively. We concluded that the vaccine does not present any major side effect that would contraindicate its use in healthy individuals. PMID:9698895

  4. EVOLUTION OF AMERICAN TEGUMENTARY LEISHMANIASIS CASES REPORTED IN PARANÁ STATE, BRAZIL

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    ALCÂNTARA, Léia Regina de Souza; DEMARCHI, Izabel Galhardo; ARISTIDES, Sandra Mara Alessi

    2016-01-01

    SUMMARY Leishmaniases are infectious diseases caused by protozoa of the genus Leishmania. They are widely distributed worldwide and endemic in 88 countries in four continents. The present study analyzed the reported cases of American Tegumentary Leishmaniasis (ATL) in Paraná State (Brazil) from January 2007 to December 2013. The data were grouped according to Regional Health (RH) districts and macroregions, which allowed visualization of the reality in each region in the state. A total of 2,879 ATL cases were reported and distributed among the 22 RH districts, with an average detection rate of 3.9 cases per 100,000 inhabitants. The northwestern region accounted for 50.1% of the total cases, and the northern region accounted for 26.0-76.1% of the reported cases. The 6th RH district did not report any cases. The 7th, 9th, and 18th RH districts had a higher cure rate (> 80%), and lower cure rates were found in the 1st, 4th, and 12th RH districts. Reported unfavorable outcomes included treatment abandonment and death. Overall cure rates are based on the entire country, and unfavorable outcomes require greater attention of managers and health professionals to meet the goals of the Brazilian Ministry of Health. PMID:27680172

  5. Polymerase chain reaction with lesion scrapping for the diagnosis of human American tegumentary leishmaniasis

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    Eneide Aparecida Sabaini Venazzi

    2006-06-01

    Full Text Available The objective of this work was to compare the polymerase chain reaction (PCR using lesion scrapping with other conventional techniques for the diagnosis of the American tegumentary leishmaniasis (ATL. For this, patients with cutaneous lesions suspected to be ATL were studied. The DNA was amplified with the MP1L/MP3H primers. From the 156 studied patients, 79 (50.6% presented positive parasite direct search (PD, 81 (51.9% had positive Montenegro skin test (MST, and 90 (57.7% presented PD and/or MST positive. The PCR was positive in all of the positive-PD patients (100% sensitivity, in 91.1% of the positive PD and/or MST patients, and in 27.3% of the patients that presented negative PD and positive MST. The PCR positivity was similar to the PD (P = 0.2482 and inferior to the MST (P = 0.0455, and to the PD/MST association (P = 0.0133. The high PCR sensitivity, and positivity in those cases where the PD was negative, highlights the importance of this technique as an auxiliary tool for the diagnosis of ATL.

  6. Phase 1 study of an inactivated vaccine against American tegumentary leishmaniasis in normal volunteers in Brazil.

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    Marzochi, K B; Marzochi, M A; Silva, A F; Grativol, N; Duarte, R; Confort, E M; Modabber, F

    1998-01-01

    A Phase 1 double-blind placebo-controlled study was performed to evaluate a vaccine against American tegumentary leishmaniasis in 61 healthy male volunteers. Side effects and the immune response to the vaccine were evaluated, with 1- and 2- dose schemes, with intervals of 7 or 21 days, each dose containing 1440 mg of protein N antigen of a single strain of Leishmania amazonensis (PH8) diluted in merthiolated saline (1:10,000). Merthiolated saline and an inert substance were used as placebos. No significant clinical alterations were found following the respective injections in the vaccinated individuals as compared to the placebos, except for local pain, which was associated significantly with injection of the vaccine. The laboratory alterations we observed bore no association with the clinical findings and were unimportant. We observed no differences between the groups with regard to seroconversion of the Montenegro skin test. However, the group that received a single dose of the vaccine and the one that received two doses with a 21-day interval displayed cutaneous induration significantly larger than in the control group, with 100%, 100%, and 66% conversion in the skin test, respectively. We concluded that the vaccine does not present any major side effect that would contraindicate its use in healthy individuals.

  7. Phlebotomine sandflies (Diptera: Psychodidae in Governador Valadares, a transmission area for American tegumentary leishmaniasis in State of Minas Gerais, Brazil

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    Ricardo Andrade Barata

    2011-04-01

    Full Text Available INTRODUCTION: A study on the phlebotomine sandfly fauna was carried out in an endemic area for American tegumentary leishmaniasis in the municipality of Governador Valadares, in the State of Minas Gerais, Brazil. METHODS: Captures were undertaken using HP light traps in four districts, on three nights per month, for one year (from January to December 2008. Correlations between climatic factors (temperature, relative air humidity and rainfall and the numbers of sandflies collected was observed. RESULTS: 5,413 phlebotomine specimens were caught and were identified as belonging to 12 species. Of these specimens, 2,851 (52% were females and 2,562 (48% were males. CONCLUSIONS: Lutzomyia intermedia predominated (29.9% of the species caught, thus suggesting that they were responsible for transmission of American tegumentary leishmaniasis, together with L. whitmani, which was also found in the area (4.3%. The presence of L. longipalpis (11.9%, the main vector for visceral leishmaniasis in Brazil, is an important finding, which makes rigorous entomological surveillance of the area necessary.

  8. American tegumentary leishmaniasis: effectiveness of an immunohistochemical protocol for the detection of Leishmania in skin.

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    Cibele Fontes Alves

    Full Text Available BACKGROUND: American tegumentary leishmaniasis (ATL is endemic in Latin America, where Brazil has over 27 thousand cases per year. The aim of the present study was to develop an immunohistochemical method (IHC for ATL diagnosis. For this purpose, we used serum from a dog naturally infected with Leishmania (L infantum (canine hyperimmune serum as the primary antibody, followed by a detection system with a secondary biotinylated antibody. METHODOLOGY: Skin samples were obtained from 73 patients in an endemic area of Caratinga, Minas Gerais (MG State, Brazil all testing positive for ATL with the Montenegro skin test, microscopy, and PCR. Canine hyperimmune serum of a dog naturally infected with Leishmania (L. infantum was employed as a primary antibody in an immunohistochemical diagnostic method using streptavidin-biotin peroxidase. To assess the specificity of this reaction, IHC assays employing two monoclonal antibodies were carried out. As the polymer-based technology is less time-consuming and labor intensive than the IHC labeled streptavidin-biotin peroxidase method, we compared the two methods for all samples. RESULTS: The IHC method detected ATL in 67 of the 73 cases (91.8%. Immunolabeled parasites were primarily detected inside macrophages either in the superficial or the deep dermis. Detection was facilitated by the high contrast staining of amastigotes (dark brown against the light blue background. A lower detection rate (71.2% was observed with the both of the monoclonal Leishmania antibodies compared to the canine hyperimmune serum. This may have been due to a non-specific background staining observed in all histological samples rendering positive detection more difficult. The higher efficacy of the canine hyperimmune serum in the IHC method was confirmed by the method using streptavidin-biotin peroxidase as well as that with the polymer-based technology (biotin-avidin-free system. CONCLUSIONS: The data are encouraging with regard to

  9. Leishmaniose Tegumentar Americana: terapêutica com Fluconazol American Tegumentary Leishmaniasis: Fluconazole therapy

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    Vicente Lopes Monte Neto

    2010-11-01

    Full Text Available O tratamento da Leishmaniose Tegumentar Americana (LTA se constitui em um desafio à saúde pública, devido a diversos fatores, dentre eles: a dificuldade de acesso às regiões florestais, a via de administração da droga de primeira escolha ser exclusivamente parenteral e a necessidade de monitoramento de seus efeitos adversos. Este estudo relata três casos de LTA tratados com Fluconazol. Utilizou-se esse medicamento pelos seguintes motivos: existência de alguma contra-indicação, efeitos adversos e resposta parcial ou inexistente ao uso do Antimoniato. Verificou-se a completa reepitelização da lesão nos três casos. Sabe-se, no entanto, da necessidade de estudos clínicos posteriores mais abrangentes, tendo um grupo controle, para confirmação dos resultados aqui obtidos.The treatment of American Tegumentary Leishmaniasis (ATL constitutes a challenge for public health. This is due to a series of factors, amongst them: difficult access to the forest regions, the exclusively parenteral route of administration of the first-choice drug and the need of monitoring adverse effects. This study describes three cases of ATL treated with Fluconazole. This drug was used for the following reasons: existence of some contraindication, adverse effects and only partial or inexistent response to Antimony treatment. Complete reepitheliazation of skin wounds was verified in all three cases. However, further and more extensive clinical studies including control groups will be necessary for confirming the results obtained in the present study.

  10. [Epidemiological aspects of canine American tegumentary leishmaniasis in the Municipality of Paraty, State of Rio de Janeiro, brazil].

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    Barbosa, G M; Marzochi, M C; Massard, C L; Lima, G P; Confort, E M

    1999-01-01

    American tegumentary leishmaniasis (ATL) is endemic in the State of Rio de Janeiro, with the highest incidence observed in the municipalities along the Southern coast. A total of 169 human cases were reported from 1993 to 1995 in the municipality of Paraty, representing 15% of all case reports in the State of Rio de Janeiro during that period. From March to December, 1996, a survey was conducted in endemic american tegumentary leishmaniasis (ATL) areas (Praia Grande, Taquari, Várzea do Machado, and Graúna) in Paraty. 326 households with 215 pet dogs were surveyed. The initial study consisted of taking venous blood samples to perform RIFI and ELISA tests. The canine skin test was performed during the same visit and was positive in 8.8% of dogs. Of the 215 dogs, 5 presented lesions suspected of ATL; biopsies and the vacuum aspiration technique were performed on these cases. Correlating the study areas with the results obtained, some dogs presented sub-clinical infection, highly relevant to studies on canine ATL infection in the State of Rio de Janeiro. PMID:10502161

  11. [Epidemiological aspects of canine American tegumentary leishmaniasis in the Municipality of Paraty, State of Rio de Janeiro, brazil].

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    Barbosa, G M; Marzochi, M C; Massard, C L; Lima, G P; Confort, E M

    1999-01-01

    American tegumentary leishmaniasis (ATL) is endemic in the State of Rio de Janeiro, with the highest incidence observed in the municipalities along the Southern coast. A total of 169 human cases were reported from 1993 to 1995 in the municipality of Paraty, representing 15% of all case reports in the State of Rio de Janeiro during that period. From March to December, 1996, a survey was conducted in endemic american tegumentary leishmaniasis (ATL) areas (Praia Grande, Taquari, Várzea do Machado, and Graúna) in Paraty. 326 households with 215 pet dogs were surveyed. The initial study consisted of taking venous blood samples to perform RIFI and ELISA tests. The canine skin test was performed during the same visit and was positive in 8.8% of dogs. Of the 215 dogs, 5 presented lesions suspected of ATL; biopsies and the vacuum aspiration technique were performed on these cases. Correlating the study areas with the results obtained, some dogs presented sub-clinical infection, highly relevant to studies on canine ATL infection in the State of Rio de Janeiro.

  12. Intestinal helminth coinfection is associated with mucosal lesions and poor response to therapy in American tegumentary leishmaniasis.

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    Azeredo-Coutinho, Rilza Beatriz G; Pimentel, Maria Inês; Zanini, Graziela Maria; Madeira, Maria F; Cataldo, Jamyra Iglesias; Schubach, Armando O; Quintella, Leonardo Pereira; de Mello, Cintia Xavier; Mendonça, Sergio C F

    2016-02-01

    The most severe clinical form of American tegumentary leishmaniasis (ATL) due to Leishmania braziliensis is mucosal leishmaniasis (ML), characterized by destructive lesions in the facial mucosa. We performed a retrospective cohort study of 109 ATL patients from Rio de Janeiro State, Brazil, where ATL is caused by L. braziliensis, to evaluate the influence of intestinal parasite coinfections in the clinical course of ATL. Parasitological stool examination (PSE) was performed with samples from all patients by the sedimentation, Kato-Katz and Baermann-Moraes methods. The diagnosis of ATL was made from lesion biopsies by direct observation of amastigotes in Giemsa-stained imprints, isolation of Leishmania promastigotes or histopathological examination. All patients were treated with meglumine antimoniate. Patients with positive PSE had a frequency of mucosal lesions significantly higher than those with negative PSE (pAscaris lumbricoides (plumbricoides. PMID:26519200

  13. Epidemiology of American Tegumentary Leishmaniasis and Trypanosoma cruzi Infection in the Northwestern Argentina

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    Hoyos, Carlos L.; Cajal, Silvana P.; Juarez, Marisa; Marco, Jorge D.; Alberti D'Amato, Anahí M.; Cayo, Melina; Torrejón, Irma; Cimino, Rubén O.; Diosque, Patricio; Nasser, Julio R.

    2016-01-01

    Background. Endemic areas of tegumentary leishmaniasis (TL) in Salta, Argentina, present some overlap zones with the geographical distribution of Chagas disease, with mixed infection cases being often detected. Objectives. The purpose of this study was to determine the magnitude of Leishmania sp. infection and potential associated risk factors, the serologic prevalence of T. cruzi, and the presence of T. cruzi-Leishmania sp. mixed infection in a region of the northwest of Argentina. Methods. Cross-sectional studies were conducted to detect TL prevalence and T. cruzi seroprevalence. A case-control study was conducted to examine leishmaniasis risk factors. Results. Prevalence of TL was 0.17%, seroprevalence of T. cruzi infection was 9.73%, and mixed infection proportion—within the leishmaniasic patients group—was 16.67%. The risk factors associated with TL transmission were sex, age, exposure to bites at work, staying outdoors more than 10 hours/day, bathing in the river, and living with people who had lesions or were infected during the study. Discussion. The endemic pattern of TL seems to involve exposure of patients to vectors in wild as well as peridomestic environment. Cases of T. cruzi infection are apparently due to migration. Therefore, a careful epidemiological surveillance is necessary due to the contraindication of antimonial administration to chagasic patients. PMID:27777950

  14. Leishmaniose tegumentar americana: apresentação pouco comum American tegumentary leishmaniasis: an unusual presentation

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    Antonio Carlos Martins Guedes

    2008-10-01

    Full Text Available Relata-se caso de leishmaniose tegumentar americana com lesões proeminentes na face. Os critérios diagnósticos incluíram dados clínicos e epidemiológicos, intradermorreação de Montenegro, identificação de Leishmania pela reação em cadeia da polimerase e resposta clínica ao tratamento. A importância do relato se deve ao fato de se tratar de caso incomum de leishmaniose tegumentar americana.We report the case of a patient with American cutaneous leishmaniasis and prominent lesions on the face. Diagnostic criteria included clinical and epidemiological data, Montenegro's skin test, identification of Leishmania by means of polymerase chain reaction and clinical response to treatment. Our report is important to call attention to an unusual presentation of American cutaneous leishmaniasis.

  15. The isolation and molecular characterization of Leishmania spp. from patients with American tegumentary leishmaniasis in northwest Argentina.

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    Locatelli, Fabricio M; Cajal, S Pamela; Barroso, Paola A; Lauthier, Juan J; Mora, María C; Juarez, Marisa; Kato, Hirotomo; Nasser, Julio R; Hashiguchi, Yoshihisa; Korenaga, Masataka; Marco, Jorge D

    2014-03-01

    American tegumentary leishmaniasis (ATL) is a group of zoonotic diseases caused by kinetoplastid flagellates of the genus Leishmania. A total of 66 patients diagnosed as positive ATL cases from northwest Argentina were included in this study. Leishmania stocks were isolated in vitro and analyzed over promastigote cultures sown on FTA through nested PCR and sequence of cytochrome b (cyt b). The molecular analysis resulted in the incrimination of L. (Viannia) braziliensis as the predominant species in the studied area, identifying two genotypes of L. (V.) braziliensis, 24 cases of Ab-1 cyt b and 41 cases of Ab-2 cyt b. One L. (V.) guyanensis strain was obtained from a traveler from the Brazilian Amazon. The prevalence of different genotypes was in agreement with previous studies, suggesting the necessity for new systems to study the genetic diversity in more detail. Most of the cases typified in this study were registered in the area of Zenta Valley (Orán, Hipólito Yrigoyen, and Pichanal cities), pointing a link between genotype and geographical origin of the sample. Sex and age distribution of the patients indicate that the transmission was predominantly associated with rural areas or rural activities, although the results might not exclude the possibility of peri-urban transmission. This work represents, so far, the largest isolation and molecular characterization of ATL cases in Argentina. PMID:24291551

  16. Variability Modeling of Rainfall, Deforestation, and Incidence of American Tegumentary Leishmaniasis in Orán, Argentina, 1985–2007

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    Juan Carlos Rosales

    2014-01-01

    Full Text Available American tegumentary leishmaniasis (ATL is a disease transmitted to humans by the female sandflies of the genus Lutzomyia. Several factors are involved in the disease transmission cycle. In this work only rainfall and deforestation were considered to assess the variability in the incidence of ATL. In order to reach this goal, monthly recorded data of the incidence of ATL in Orán, Salta, Argentina, were used, in the period 1985–2007. The square root of the relative incidence of ATL and the corresponding variance were formulated as time series, and these data were smoothed by moving averages of 12 and 24 months, respectively. The same procedure was applied to the rainfall data. Typical months, which are April, August, and December, were found and allowed us to describe the dynamical behavior of ATL outbreaks. These results were tested at 95% confidence level. We concluded that the variability of rainfall would not be enough to justify the epidemic outbreaks of ATL in the period 1997–2000, but it consistently explains the situation observed in the years 2002 and 2004. Deforestation activities occurred in this region could explain epidemic peaks observed in both years and also during the entire time of observation except in 2005–2007.

  17. Variability Modeling of Rainfall, Deforestation, and Incidence of American Tegumentary Leishmaniasis in Orán, Argentina, 1985–2007

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    Rosales, Juan Carlos; Yang, Hyun Mo; Avila Blas, Orlando José

    2014-01-01

    American tegumentary leishmaniasis (ATL) is a disease transmitted to humans by the female sandflies of the genus Lutzomyia. Several factors are involved in the disease transmission cycle. In this work only rainfall and deforestation were considered to assess the variability in the incidence of ATL. In order to reach this goal, monthly recorded data of the incidence of ATL in Orán, Salta, Argentina, were used, in the period 1985–2007. The square root of the relative incidence of ATL and the corresponding variance were formulated as time series, and these data were smoothed by moving averages of 12 and 24 months, respectively. The same procedure was applied to the rainfall data. Typical months, which are April, August, and December, were found and allowed us to describe the dynamical behavior of ATL outbreaks. These results were tested at 95% confidence level. We concluded that the variability of rainfall would not be enough to justify the epidemic outbreaks of ATL in the period 1997–2000, but it consistently explains the situation observed in the years 2002 and 2004. Deforestation activities occurred in this region could explain epidemic peaks observed in both years and also during the entire time of observation except in 2005–2007. PMID:25580116

  18. APPLICABILITY OF kDNA-PCR FOR ROUTINE DIAGNOSIS OF AMERICAN TEGUMENTARY LEISHMANIASIS IN A TERTIARY REFERENCE HOSPITAL

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    Marcela M. Satow

    2013-12-01

    Full Text Available SUMMARY This study evaluated the applicability of kDNA-PCR as a prospective routine diagnosis method for American tegumentary leishmaniasis (ATL in patients from the Instituto de Infectologia Emílio Ribas (IIER, a reference center for infectious diseases in São Paulo - SP, Brazil. The kDNA-PCR method detected Leishmania DNA in 87.5% (112/128 of the clinically suspected ATL patients, while the traditional methods demonstrated the following percentages of positivity: 62.8% (49/78 for the Montenegro skin test, 61.8% (47/76 for direct investigation, and 19.3% (22/114 for in vitro culture. The molecular method was able to confirm the disease in samples considered negative or inconclusive by traditional laboratory methods, contributing to the final clinical diagnosis and therapy of ATL in this hospital. Thus, we strongly recommend the inclusion of kDNA-PCR amplification as an alternative diagnostic method for ATL, suggesting a new algorithm routine to be followed to help the diagnosis and treatment of ATL in IIER.

  19. Applicability of kDNA-PCR for routine diagnosis of American tegumentary leishmaniasis in a tertiary reference hospital.

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    Satow, Marcela M; Yamashiro-Kanashiro, Edite H; Rocha, Mussya C; Oyafuso, Luiza K; Soler, Rita C; Cotrim, Paulo C; Lindoso, José Angelo L

    2013-01-01

    This study evaluated the applicability of kDNA-PCR as a prospective routine diagnosis method for American tegumentary leishmaniasis (ATL) in patients from the Instituto de Infectologia Emílio Ribas (IIER), a reference center for infectious diseases in São Paulo - SP, Brazil. The kDNA-PCR method detected Leishmania DNA in 87.5% (112/128) of the clinically suspected ATL patients, while the traditional methods demonstrated the following percentages of positivity: 62.8% (49/78) for the Montenegro skin test, 61.8% (47/76) for direct investigation, and 19.3% (22/114) for in vitro culture. The molecular method was able to confirm the disease in samples considered negative or inconclusive by traditional laboratory methods, contributing to the final clinical diagnosis and therapy of ATL in this hospital. Thus, we strongly recommend the inclusion of kDNA-PCR amplification as an alternative diagnostic method for ATL, suggesting a new algorithm routine to be followed to help the diagnosis and treatment of ATL in IIER.

  20. STATUS OF THE AMERICAN TEGUMENTARY LEISHMANIASIS IN THE STATE OF RIO DE JANEIRO , BRAZIL, FROM 2004 TO 2013

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    VITA, Gilmar Ferreira; PEREIRA, Maria Angélica Vieira DA COSTA; FERREIRA, Ildemar; SANAVRIA, Argemiro; BARBOSA, Celso Guimarães; AURNHEIMER, Rita de Cássia Martins; de MELLO, Ericson Ramos; da SILVA, Claudia Bezerra; CABRAL, Rísia Brígida Gonçalves

    2016-01-01

    SUMMARY The aim of the present study was to analyze the status of the American Tegumentary Leishmaniasis (ATL) in the state of Rio de Janeiro, from 2004 to 2013, through its spatiotemporal distribution. We also described variables considered relevant to the epidemiology of the disease, such as the clinical form, gender, ethnic group, age group, and progression of disease. This is a descriptive study, which used notified secondary data from the Brazilian Information System of Notifiable Diseases (SINAN), Ministry of Health, Brazil, regarding confirmed diagnoses. To help the calculation of coefficients of detection and mortality, we used population data from the Brazilian Institute of Geography and Statistics (IBGE). We analyzed 1,470 cases of ATL with the predominance of the cutaneous clinical form (1,292/87.89%). The data has also revealed seven deaths, a predominance of males (922/62.72%), and a higher incidence of ATL in the white ethnic group (731/49.72%). We observed a high incidence of ATL in the group of 20 - 39 years old (477/32.44%). We concluded that there was a decrease in the number of ATL cases in the state of Rio de Janeiro, based on a coefficient of detection of 1.44/100.000 inhabitants in 2004 decreasing to 0.20/100.000 inhabitants in 2013. The localities with the highest occurrences of ATL were the metropolitan region (843 cases) and the municipality of Rio de Janeiro (740 cases). In 2005, the highest incidence of the disease was observed (351 cases) in the study. Among the variables selected to describe the epidemiology of the disease, the following categories: cutaneous clinical form, male patients, white ethnic group, and the age group of 20 - 39 years old were more affected than the others. PMID:27680176

  1. Asociación de sida y leishmaniosis tegumentaria americana en Argentina American tegumentary leishmaniasis associated with AIDS in Argentina

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    Héctor D. Romero

    2004-02-01

    Full Text Available Las migraciones a pequeños municipios y áreas rurales de personas infectadas con HIV contribuye a la diseminación progresiva del sida y a la asociación con otras infecciones prevalentes en áreas endémicas, como las parasitosis. Esta asociación significa un importante desafío para la salud pública, ya que frecuentemente ambas infecciones se potencian. En este trabajo presentamos el primer paciente autóctono con sida asociado a leishmaniosis mucocutánea procedente de la zona de Orán, donde a mediados de los 80 se desarrolló un brote epidémico de leishmaniosis que a la fecha supera más de 2000 casos confirmados parasitológicamente en nuestro Instituto. Recientemente informamos la existencia de 2 especies (Leishmania (V. braziliensis y L. (L. amasonensis como las causantes de leishmaniosis tegumentaria americana en la zona. Queremos llamar la atención de los profesionales de la salud sobre la posibilidad de coinfección HIV-Leishmania, recomendando que en pacientes de áreas endémicas con antecedentes de úlceras cutáneas indoloras o incluso cicatrizales, se investigue, entre otras enfermedades, la leishmaniosis.Migration of HIV infected individuals from cities to small towns and rural areas spreads AIDS among non urban population, superimposing HIV with other endemic or epidemic infections as parasitoses. This situation is a big challenge to public health because in most cases the association between these infections worsens both prognoses. We present here the first case in Argentina of AIDS associated to a mucocutaneous form of American tegumentary leishmaniasis. The patient was from Orán, an area where in the middle eighties, an epidemic outbreak took place. By now more than 2000 cases have been parasitologically confirmed in our Institute and the causing species were identified as Leishmania (V. braziliensis and L. (L. amasonensis. Considering the existence of co-infection of HIV and Leishmania, it is recommended that in

  2. IFNG +874T/A polymorphism is not associated with American tegumentary leishmaniasis susceptibility but can influence Leishmania induced IFN-γ production

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    Sampaio Elizabeth P

    2007-04-01

    Full Text Available Abstract Background Interferon-gamma is a key cytokine in the protective responses against intracellular pathogens. A single nucleotide polymorphism (SNP located in the first intron of the human IFN-γ gene can putatively influence the secretion of cytokine with an impact on infection outcome as demonstrated for tuberculosis and other complex diseases. Our aim was to investigate the putative association of IFNG+874T/A SNP with American tegumentary leishmaniasis (ATL and also the influence of this SNP in the secretion of IFN-γ in vitro. Methods Brazilian ATL patients (78 cutaneous, CL, and 58 mucosal leishmaniasis, ML and 609 healthy volunteers were evaluated. The genotype of +874 region in the IFN-γ gene was carried out by Amplification Refractory Mutational System (ARMS-PCR. Leishmania-induced IFN-γ production on peripheral blood mononuclear cell (PBMC culture supernatants was assessed by ELISA. Results There are no differences between +874T/A SNP frequency in cases and controls or in ML versus CL patients. Cutaneous leishmaniasis cases exhibiting AA genotype produced lower levels of IFN-γ than TA/TT genotypes. In mucosal cases, high and low IFN-γ producers were clearly demonstrated but no differences in the cytokine production was observed among the IFNG +874T or A carriers. Conclusion Our results suggest that +874T/A polymorphism was not associated with either susceptibility or severity to leishmaniasis. Despite this, IFNG +874T/A SNP could be involved in the pathogenesis of leishmaniasis by influencing the amount of cytokine released by CL patients, although it could not prevent disease development. On the other hand, it is possible that in ML cases, other potential polymorphic regulatory genes such as TNF-α and IL-10 are also involved thus interfering with IFN-γ secretion.

  3. [Necessity to adopt and disseminate therapeutic schemes for the treatment of American tegumentary leishmaniasis in Paraná].

    Science.gov (United States)

    Teodoro, U; Spinoza, R P; La Salvia Filho, V; Guilherme, A L; Lima, A P; Junqueira, G M; Misuta, N M; Nerilo Sobrinho, A; de Lima, E M

    1991-01-01

    American cutaneous leishmaniasis has shown an endemic character in areas of North-North-west Paraná State, which were populated in 40's, where residual forests persist with intense modifications. The infection has been found mainly in males, but was found also in females and children and in many individuals of a same family. 513 cases of cutaneous leishmaniasis notified to SUCAM by clinical diagnosis were investigated. Treatment was begun with Glucantime at State Health Centers or at SUCAM. Of 513 treated patients 260 (50.67%) were considered clinically cured. The remaining 253 (49.33%) abandoned treatment. The quantity of Glucantime supplied to the patients varied from 10 vials to more than 200, with or without intervals during the treatment. Two hundred and seventeen (85.46%) patients among 260 received from 10 to 75 vials. The occurrence of leishmaniasis in 163 (31.75%) women and in 34 (6.62%) children, of both sexes, up to 10 years old, suggests domiciliary transmission. It's not known if the 253 (49.33%) individuals who abandoned the treatment recovered. This high number shows the necessity of better knowledge of the consequences that can occur due to incomplete treatment.

  4. AFLP polymorphisms allow high resolution genetic analysis of American Tegumentary Leishmaniasis agents circulating in Panama and other members of the Leishmania genus.

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    Carlos M Restrepo

    Full Text Available American Tegumentary Leishmaniasis is caused by parasites of the genus Leishmania, and causes significant health problems throughout the Americas. In Panama, Leishmania parasites are endemic, causing thousands of new cases every year, mostly of the cutaneous form. In the last years, the burden of the disease has increased, coincident with increasing disturbances in its natural sylvatic environments. The study of genetic variation in parasites is important for a better understanding of the biology, population genetics, and ultimately the evolution and epidemiology of these organisms. Very few attempts have been made to characterize genetic polymorphisms of parasites isolated from Panamanian patients of cutaneous leishmaniasis. Here we present data on the genetic variability of local isolates of Leishmania, as well as specimens from several other species, by means of Amplified Fragment Length Polymorphisms (AFLP, a technique seldom used to study genetic makeup of parasites. We demonstrate that this technique allows detection of very high levels of genetic variability in local isolates of Leishmania panamensis in a highly reproducible manner. The analysis of AFLP fingerprints generated by unique selective primer combinations in L. panamensis suggests a predominant clonal mode of reproduction. Using fluorescently labeled primers, many taxon-specific fragments were identified which may show potential as species diagnostic fragments. The AFLP permitted a high resolution genetic analysis of the Leishmania genus, clearly separating certain groups among L. panamensis specimens and highly related species such as L. panamensis and L. guyanensis. The phylogenetic networks reconstructed from our AFLP data are congruent with established taxonomy for the genus Leishmania, even when using single selective primer combinations. Results of this study demonstrate that AFLP polymorphisms can be informative for genetic characterization in Leishmania parasites, at

  5. Evaluación de un brote de leishmaniasis tegumentaria americana en una comunidad rural del Estado Bolívar, Venezuela Evaluation of an outbreak of American tegumentary leishmaniasis in a rural community in the Bolivar State, Venezuela

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    Ricardo González M.

    2000-02-01

    Full Text Available La presencia de un foco de leishmaniasis tegumentaria americana (LTA en la localidad de San José de Hacha, al sur del Estado Bolívar en Venezuela, motivó la realización de un estudio epidemiológico utilizando la intradermorreacción (IDR de Montenegro. De los 184 habitantes de San José de Hacha, se aplicó la IDR a 121 (65,8%. El 33,9% fueron reactores positivos (44/121. El mayor porcentaje de positividad se observó en personas del sexo masculino con 39,5% (PAn epidemiological survey based on the Montenegro intradermal reaction (IDR was carried out in San Jose de Hacha, south of the Bolivar State, Venezuela, on the occasion of an outbreak of American tegumentary leishmaniasis (LTA in that locality. The IDR was applied to 121 of the 184 local inhabitants (65.8%, with a 33.9 rate of positive reactions (44/121. The highest percentage of positivity was observed among males (39.5% (P < 0.05 and among adults, especially in the 31 to 40 year age group (52.4% (chi2 = 18.28; g.l. = 6. With respect to occupation, agriculturist were the most reactive with 69%. of subjects IDR positive, in 65.9% (27/41 the reaction areas ranging from 5 to 9 mm. Active lesions of LTA were identified in 22 inhabitants and scars were detected in only seven cases. It is suggested that San Jose de Hacha is a recent focus of LTA.

  6. Sandfly fauna in a military training area endemic for American tegumentary leishmaniasis in the Atlantic Rain Forest region of Pernambuco, Brazil Fauna de flebotomíneos em área de treinamento militar endêmica para leishmaniose tegumentar americana, na Zona da Mata de Pernambuco, Brasil

    OpenAIRE

    Maria Sandra Andrade; Hélio França Valença; Amilton Lopes da Silva; Francisco de Assis Almeida; Ericka Lima Almeida; Maria Edileuza Felinto de Brito; Sinval Pinto Brandão Filho

    2005-01-01

    The aim of this study was to characterize the sandfly fauna in a military training area situated in the "Zona da Mata" region of Pernambuco State, Brazil, where human cases of American tegumentary leishmaniasis (ATL) had been observed, caused by Leishmania (Viannia) braziliensis. The occurrence of 16 sandfly species in the Marshall Newton Cavalcanti Military Training Camp (CIMNC) indicates an important diversity of sandfly species in this study area. Lutzomyia complexa was the most common spe...

  7. Pólos de produção de leishmaniose tegumentar americana no norte do Estado do Paraná, Brasil Poles of American tegumentary leishmaniasis production in northern Paraná State, Brazil

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    Wuelton Marcelo Monteiro

    2009-05-01

    Full Text Available No Estado do Paraná, a leishmaniose tegumentar americana é endêmica, com 99,3% dos casos registrados no Sul do Brasil. Verifica-se a distribuição geográfica da doença no norte desse estado, identificando-se as áreas territoriais de maior importância epidemiológica. O estudo foi realizado com dados registrados em fichas epidemiológicas do Laboratório de Ensino e Pesquisa em Análises Clínicas da Universidade Estadual de Maringá, de 1987 a 2004. Consideraram-se apenas os indivíduos que se infectaram nos municípios no norte do Paraná. A identificação das unidades epidemiológicas (pólos e circuitos foi feita com base na densidade espacial dos casos, conforme o modelo da Fundação Nacional de Saúde, considerando-se as localidades mais prováveis de infecção. De 1.933 casos de leishmaniose tegumentar americana registrados, 1.611 se infectaram em áreas no norte do Paraná. A distribuição da endemia no Estado do Paraná sugere a existência de dois circuitos de produção da doença: circuito Paraná-Paranapanema, onde se destacam os pólos Cinzas-Laranjinha, Tibagi, Ivaí-Pirapó, Piquiri e Baixo Iguaçu, e circuito Ribeira, onde se destaca o pólo Alto Ribeira.American tegumentary leishmaniasis is endemic in the State of Paraná, with 99.3% of the cases reported in the South of Brazil. Spatial distribution of the disease in northern Paraná was verified, identifying the most relevant geographic areas in epidemiological terms. The study used data recorded on epidemiological forms from the Teaching and Research Clinical Test Laboratory of the State University in Maringá, from 1987 to 2004. The study only included individuals that were infected in the municipalities (counties in northern Paraná. Identification of the epidemiological units (poles and circuits was based on spatial density of cases, according to the model proposed by the National Health Foundation, considering the most likely infection sites. Considering 1

  8. Phlebotominae spatial distribution asssociated with a focus of tegumentary leishmaniasis in Las Lomitas, Formosa, Argentina, 2002

    OpenAIRE

    Oscar Daniel Salomón; Pablo Wenceslao Orellano; Mario Lamfri; Marcelo Scavuzzo; Lucía Dri; María Isabel Farace; Darío Ozuna Quintana

    2006-01-01

    Las Lomitas, Formosa, Argentina, reported 96 cases of tegumentary leishmaniasis during 2002. The urban transmission was suggested although previous outbreaks were related with floods of the Bermejo river (BR) 50 km from the village. Phlebotomine collections were performed during March 2002 to define the spatial distribution of risk, together with satellite imaginery. The phlebotomine/trap obtained was 1679.5 in the southern BR shore, 1.1 in the periruban-rural environment and 2.3 in the north...

  9. Varicella zoster virus reactivation during or immediately following treatment of tegumentary leishmaniasis with antimony compounds

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    Andrea Barbieri Barros

    2014-07-01

    Full Text Available Antimony compounds are the cornerstone treatments for tegumentary leishmaniasis. The reactivation of herpes virus is a side effect described in few reports. We conducted an observational study to describe the incidence of herpes zoster reactivation during treatment with antimony compounds. The global incidence of herpes zoster is approximately 2.5 cases per 1,000 persons per month (or 30 cases per 1,000 persons per year. The estimated incidence of herpes zoster in patients undergoing antimony therapy is higher than previously reported.

  10. Estimación del número de reproducibilidad basal para la leishmaniasis tegumentar americana en dos localidades del nordeste de la Provincia de Salta, Argentina Estimation of the basic reproducibility number for American tegumentary leishmaniasis in two sitesin northeastern Salta Province, Argentina

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    Juan Carlos Rosales

    2007-11-01

    Full Text Available Un modelo matemático determinístico del tipo SIR para tres hospedadores es aplicado para analizar el proceso de transmisión de la leishmaniasis tegumentar americana, en las localidades Río Blanco y paraje Las Carmelitas, ubicadas en el Nordeste de la Provincia de Salta, Argentina, del mismo se deriva la expresión para el número de reproducibilidad basal Ro. Se implementa el modelo en ambiente MATLAB, en base a datos de las zonas endémicas se realizan simulaciones y se obtienen estimaciones numéricas de Ro. Para el caso de Río Blanco hemos obtenido el valor Ro = 4,689, mientras que para el paraje Las Carmelitas se obtuvo Ro = 1,948. Estudiando numéricamente el modelo también se estima la fuerza de infección, obteniendo para las localidades mencionadas 0,239 y 0,171 (unidad 1/año, respectivamente. Las simulaciones muestran que en la localidad de Río Blanco la fase endémica resulta más sostenida que la fase inter-epidémica presentada en el paraje Las Carmelitas. Las estimaciones obtenidas para estos parámetros epidemiológicos indican donde las instituciones del Ministerio de Salud Pública de la Provincia y de la Nación tendrán más dificultad para el control y la erradicación de la enfermedad.A SIR-type deterministic mathematical model for three hosts is applied to analyze the transmission process for American tegumentary leishmaniasis in Río Blanco and Las Carmelitas, located in northeastern Salta Province, Argentina, and to derive the expression for the baseline reproducibility number Ro. The model is implemented in the MATLAB environment, and based on data from endemic areas, simulations are performed and numerical estimations of Ro are obtained. Río Blanco shows Ro = 4.689 and Las Carmelitas Ro = 1.948. By studying the model numerically, we also estimate the force of infection, namely 0.239 and 0.171 (unit 1/year, respectively. The simulations show that in Río Blanco, the endemic phase was more sustained than the inter

  11. Phlebotomine sandflies (Diptera: Psychodidae in Governador Valadares, a transmission area for American tegumentary leishmaniasis in State of Minas Gerais, Brazil Flebotomíneos (Diptera: Psychodidae em Governador Valadares, área de transmissão de leishmaniose tegumentar americana no Estado de Minas Gerais, Brasil

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    Ricardo Andrade Barata

    2011-04-01

    Full Text Available INTRODUCTION: A study on the phlebotomine sandfly fauna was carried out in an endemic area for American tegumentary leishmaniasis in the municipality of Governador Valadares, in the State of Minas Gerais, Brazil. METHODS: Captures were undertaken using HP light traps in four districts, on three nights per month, for one year (from January to December 2008. Correlations between climatic factors (temperature, relative air humidity and rainfall and the numbers of sandflies collected was observed. RESULTS: 5,413 phlebotomine specimens were caught and were identified as belonging to 12 species. Of these specimens, 2,851 (52% were females and 2,562 (48% were males. CONCLUSIONS: Lutzomyia intermedia predominated (29.9% of the species caught, thus suggesting that they were responsible for transmission of American tegumentary leishmaniasis, together with L. whitmani, which was also found in the area (4.3%. The presence of L. longipalpis (11.9%, the main vector for visceral leishmaniasis in Brazil, is an important finding, which makes rigorous entomological surveillance of the area necessary.INTRODUÇÃO: Um estudo da fauna de flebotomíneos foi realizado em uma área endêmica para leishmaniose tegumentar americana no município de Governador Valadares, no Estado de Minas Gerais, Brasil. MÉTODOS: Capturas foram feitas com armadilhas luminosas HP em quatro bairros, três noites por mês, durante o período de janeiro a dezembro de 2008. A correlação entre fatores climáticos (temperatura, umidade relativa do ar e pluviosidade e o número de flebotomíneos coletados foi avaliada. RESULTADOS: Foram capturados 5.413 espécimes de flebotomíneos, distribuídos em 12 espécies, sendo 2.851 (52% fêmeas e 2.562 (48% machos. CONCLUSÕES: Lutzomyia intermedia foi predominante com 29,9% das espécies capturadas, sugerindo ser a responsável pela transmissão de LTA, juntamente com L. whitmani, que também foi encontrada na região (4,3%. A presença de L

  12. Distribuição geográfica e características epidemiológicas da leishmaniose tegumentar americana em áreas de colonização antiga do Estado do Paraná, Sul do Brasil Geographic distribution and epidemiological features of American tegumentary leishmaniasis in old rural settlements in Paraná State, Southern Brazil

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    Wuelton Marcelo Monteiro

    2008-06-01

    Full Text Available Analisa-se a epidemiologia da leishmaniose tegumentar americana em municípios das mesorregiões norte central, centro ocidental e noroeste do Estado do Paraná, Brasil. O diagnóstico dos casos de leishmaniose tegumentar americana foi realizado na Universidade Estadual de Maringá, de 1987 a 2004. Conforme o provável local de infecção, os casos foram divididos em autóctones (infectaram-se no domínio doméstico ou alóctones (infectaram-se fora do domínio doméstico. Observou-se que em todos os anos do período houve atendimento de casos provenientes das mesorregiões supracitadas. Os municípios com maior número de casos notificados foram Maringá (458, Doutor Camargo (126, São Jorge do Ivaí (121, Terra Boa (114, Cianorte (98 e Colorado (95. De 1.938 casos, 66,9% eram do sexo masculino. Entre 667 casos autóctones, o número de mulheres afetadas pela doença foi semelhante ao de homens, com casos em menores de cinco anos de idade, fatos que não ocorreram entre os 794 casos alóctones. As condições necessárias à produção da leishmaniose tegumentar americana foram criadas no processo de construção do espaço rural das mesorregiões em pauta, particularmente no modelo de colonização e na crise da monocultura cafeeira.This study analyzes the epidemiology of American tegumentary leishmaniasis in the municipalities of the Central North, Central West, and Northwest mesoregions of Paraná State, Brazil. Diagnosis of American tegumentary leishmaniasis cases was performed at the State University in Maringá from 1987 to 2004. According to the probable site of infection, cases were classified as autochthonous (infection inside the household domain or allochthonous (outside the household domain. Municipalities with the most cases were Maringá (458, Doutor Camargo (126, São Jorge do Ivaí (121, Terra Boa (114, Cianorte (98, and Colorado (95. Of the total of 1,938 cases, 66.9% were male. Among the 667 autochthonous cases, similar

  13. Cross-protective efficacy from a immunogen firstly identified in Leishmania infantum against tegumentary leishmaniasis.

    Science.gov (United States)

    Martins, V T; Lage, D P; Duarte, M C; Costa, L E; Chávez-Fumagalli, M A; Roatt, B M; Menezes-Souza, D; Tavares, C A P; Coelho, E A F

    2016-02-01

    Experimental vaccine candidates have been evaluated to prevent leishmaniasis, but no commercial vaccine has been proved to be effective against more than one parasite species. LiHyT is a Leishmania-specific protein that was firstly identified as protective against Leishmania infantum. In this study, LiHyT was evaluated as a vaccine to against two Leishmania species causing tegumentary leishmaniasis (TL): Leishmania major and Leishmania braziliensis. BALB/c mice were immunized with rLiHyT plus saponin and lately challenged with promastigotes of the two parasite species. The immune response generated was evaluated before and 10 weeks after infection, as well as the parasite burden at this time after infection. The vaccination induced a Th1 response, which was characterized by the production of IFN-γ, IL-12 and GM-CSF, as well as by high levels of IgG2a antibodies, after in vitro stimulation using both the protein and parasite extracts. After challenge, vaccinated mice showed significant reductions in their infected footpads, as well as in the parasite burden in the tissue and organs evaluated, when compared to the control groups. The anti-Leishmania Th1 response was maintained after infection, being the IFN-γ production based mainly on CD4(+) T cells. We described one conserved Leishmania-specific protein that could compose a pan-Leishmania vaccine.

  14. Phlebotominae spatial distribution asssociated with a focus of tegumentary leishmaniasis in Las Lomitas, Formosa, Argentina, 2002

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    Oscar Daniel Salomón

    2006-05-01

    Full Text Available Las Lomitas, Formosa, Argentina, reported 96 cases of tegumentary leishmaniasis during 2002. The urban transmission was suggested although previous outbreaks were related with floods of the Bermejo river (BR 50 km from the village. Phlebotomine collections were performed during March 2002 to define the spatial distribution of risk, together with satellite imaginery. The phlebotomine/trap obtained was 1679.5 in the southern BR shore, 1.1 in the periruban-rural environment and 2.3 in the northern Pilcomayo river marshes. Lutzomyia neivai was the prevalent species (91.1% among the 2393 phlebotomine captured, and it was only found in the BR traps. The other species were L. migonei (7.9%, L. cortelezzii (0.9%, and Brumptomyia guimaraesi (0.1%. The satellite images analysis indicates that the fishing spots at the BR were significantlyoverflowed during the transmission peak, consistent with fishermen recollections. This spatial restricted flood might concentrate vectors, reservoirs, and humans in high places. Therefore, both the spatial distribution of vectors and the sensor remoting data suggests that in Las Lomitas area the higher transmission risk it is still related with the gallery forest of the BR, despite of the urban residence of the cases. The surveillance and control implications of these results are discussed.

  15. Towards a more precise serological diagnosis of human tegumentary leishmaniasis using Leishmania recombinant proteins.

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    Ana Paula Souza

    Full Text Available BACKGROUND: Exposure to Leishmania induces a humoral immune response that can be used as a marker of parasite exposure. METHODOLOGY/PRINCIPAL FINDINGS: Herein, ELISA was used to screen sera from patients with Tegumentary Leishmaniasis (TL against different L. infantum-chagasi-derived recombinant proteins (rHSP70, rH2A, rH2B, rH3, rH4 and rKMP11. Among the recombinant proteins, rHSP70 and rH2A showed the best reactivity against human sera obtained from endemic areas of TL. Receiver-Operator Characteristics (ROC curve analysis was used to identify the effectiveness of these proteins for serodiagnosis of TL. ROC curves confirmed the superior performance of rHSP70 and rH2A, in comparison to the other tested recombinant proteins. Additionally, we evaluated the specificity of the response to rHSP70 and rH2A by testing sera obtained from patients with Chagas' disease, Tuberculosis, Leprosy or Systemic Lupus Erythematosus. In this case, rHSP70 displayed an increased ability to discriminate diseases, in comparison to SLA. CONCLUSION: Our results raise possibility of using rHSP70 for the serodiagnosis of TL.

  16. Aspectos epidemiológicos da leishmaniose tegumentar americana em cães, no Município de Paraty, Estado do Rio de Janeiro, Brasil Epidemiological aspects of canine american tegumentary leishmaniasis in the Municipality of Paraty, State of Rio de Janeiro, Brazil

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    Gilda Maria Sales Barbosa

    1999-09-01

    Full Text Available A leishmaniose tegumentar americana (LTA é de ocorrência endêmica no Estado do Rio de Janeiro, sendo a maior incidência observada nos municípios do litoral sul. No período de 1993 a 1995, foram registrados, no Município de Paraty, extremo sul do Estado, 169 casos humanos, o que corresponde a 15% das notificações no estado. Neste trabalho, realizou-se estudo em áreas endêmicas (Praia Grande, Taquari, Várzea do Machado e Graúna de LTA, com cães residentes no Município de Paraty, entre março e dezembro de 1996. Foram visitadas 315 residências, compreendendo uma população de 1.282 habitantes, com 215 cães estudados. O trabalho inicial consistiu na coleta de sangue venoso, para realização das técnicas sorológicas: Reação de Imunofluorescência Indireta (RIFI e Enzyme Linked Immunossorbent Assay (ELISA. O resultado da sorologia foi de 3,2% de positividade para a técnica de Rifi e 10,2% para a de Elisa. A prova intradérmica canina foi realizada na mesma ocasião da coleta de sangue e sua positividade foi de 8,8%. Dos 215 cães, cinco deles apresentaram lesões suspeitas, nos quais realizou-se biópsia e técnica de aspirado a vácuo.American tegumentary leishmaniasis (ATL is endemic in the State of Rio de Janeiro, with the highest incidence observed in the municipalities along the Southern coast. A total of 169 human cases were reported from 1993 to 1995 in the municipality of Paraty, representing 15% of all case reports in the State of Rio de Janeiro during that period. From March to December, 1996, a survey was conducted in endemic american tegumentary leishmaniasis (ATL areas (Praia Grande, Taquari, Várzea do Machado, and Graúna in Paraty. 326 households with 215 pet dogs were surveyed. The initial study consisted of taking venous blood samples to perform Rifi and Elisa tests. The canine skin test was performed during the same visit and was positive in 8.8% of dogs. Of the 215 dogs, 5 presented lesions suspected of ATL

  17. Clinical epidemiological profile of American tegumentary leishmaniasis at the Pinto Sugar Mill in Moreno Municipality, Greater Metropolitan Recife, Pernambuco State, Brazil Perfil clínico-epidemiológico da leishmaniose tegumentar americana no Engenho Pinto, Município de Moreno, Região Metropolitana do Recife, Pernambuco, Brasil

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    Maria Edileuza Felinto de Brito

    2008-10-01

    Full Text Available American tegumentary leishmaniasis (ATL is present in all regions of Pernambuco State, Brazil, where it is spreading, with the emergence of foci in new areas like the Municipality (County of Moreno in Greater Metropolitan Recife. The objective of the current study was to assess the prevalence of infection and identify autochthonous cases of ATL. In April 2006 a population survey was performed using a questionnaire and the Montenegro skin test (MST in 481 individuals from the Pinto Sugar Mill, of whom 47% were males and 74% were younger than 30 years. One hundred forty-four individuals (30% showed a positive MST. Of these, five presented active lesions, 41 were cured after meglumine antimoniate treatment, and one showed a spontaneous cure. Indirect immunofluorescence (IIF was performed on sera from 89 individuals and showed a 36% positive rate. The high ATL prevalence demonstrates the epidemiological spread of the disease in Greater Metropolitan Recife, a worrisome development since there are no effective measures for ATL control except ecological awareness raising to minimize the risk of infection.A leishmaniose tegumentar americana incide em todas as regiões do Estado de Pernambuco, Brasil, onde se apresenta em expansão, com o surgimento de focos em novas áreas, como o Município de Moreno, na região metropolitana do Recife. O objetivo deste estudo foi avaliar a prevalência da infecção e identificar os casos autóctones de leishmaniose tegumentar americana. Em abril de 2006, realizou-se um inquérito populacional por meio da aplicação de um questionário e do teste de intradermoreação de Montenegro a 481 indivíduos do Engenho Pinto, dos quais 47% eram do sexo masculino e 74% menores de 30 anos. Cento e quarenta e quatro (30% indivíduos apresentaram reação positiva ao teste. Dentre estes, cinco apresentaram lesões ativas, 41 foram curados após quimioterapia e um curado espontaneamente. A RIFI realizada nos soros de 89 indiv

  18. Detecção de DNA de Leishmania braziliensis em pacientes de leishmaniose tegumentar americana Detección de DNA de Leishmania braziliensis en pacientes de leishmaniose tegumentaria americana Detection of Leishmania braziliensis DNA in American tegumentary leishmaniasis patients

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    Leila Martins

    2010-06-01

    Full Text Available Foi realizado diagnóstico para leishmaniose tegumentar americana a partir de sangue de pacientes residentes em dois municípios endêmicos do estado de Pernambuco. O DNA de 119 amostras de sangue foi extraído e submetido a reação em cadeia da polimerase. Utilizaram-se primers do minicírculo do DNA do cinetoplasto (kDNA de Leishmania braziliensis, circulante em Pernambuco, cuja seqüência-alvo gera um fragmento de 750 pares de bases. No total 58 (48,7% indivíduos apresentaram amplificação positiva e 61 (51,3% negativa. Das amostras positivas para a PCR, 37 (≅ 64% pertenciam a indivíduos tratados e sem lesão. Conclui-se que a técnica de PCR é eficaz para identificar o DNA de leishmânia em material de biópsias e em sangue venoso.Fue realizado diagnóstico para leishmaniosis tegumentaria americana a partir de sangre de pacientes residentes en dos municipios endémicos del estado de Pernambuco (Noreste de Brasil. El DNA de 119 muestras de sangre fue extraído y sometido a la reacción en cadena de la polimerasa. Se utilizaron primers del minicírculo del DNA del cinetoplasto (kDNA de Leishmania braziliensis, circulante en Pernambuco, cuya secuencia blanco genera un fragmento de 750 pares de bases. En total 58 (48,7% individuos presentaron amplificación positiva y 61 (51,3% negativa. De las muestras positivas para la PCR, 37 (≅64% pertenecían a individuos tratados y sin lesión. Se concluyó que la técnica de la PCR es eficaz para identificar el DNA de Leishmania en material de biopsias y en sangre venosa.Diagnostic tests for American tegumentary leishmaniasis were performed on blood samples of patients living in two endemic municipalities in the state of Pernambuco, Northeastern Brazil. DNA was extracted from 119 samples and used as template for polymerase chain reaction (PCR analysis. The tests used primers specific for the kinetoplast mini-circle DNA (kDNA of Leishmania braziliensis, a species circulating in Pernambuco, which

  19. The use of radionuclide DNA probe technology for epidemiological studies of tegumentary leishmaniasis in Mato Grosso state, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Antero Silva Ribeiro de [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN), Belo Horizonte, MG (Brazil); Fernandes, Octavio [Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ (Brazil). Dept. de Medicina Tropical; Heub, Marcia; Fontes, Cor Jesus [Universidade Federal do Mato Grosso, Cuiaba, MT (Brazil). Hospital Universitario Julio Muller; Carvalho, Maria de Lourdes Ribeiro; Melo, Maria Norma de [Universidade Federal de Minas Gerais, Belo Horizonte, MG (Brazil). Dept. de Parasitologia

    2005-10-15

    DNA hybridisation, using probes labelled with 32 P, was used to type Leishmania samples isolated from patients living in endemic areas of Mato Grosso State (Brazil), and clinically diagnosed as having tegumentary leishmaniasis. k DNA cloned mini-circle probes specific for the Leishmania mexicana and Leishmania braziliensis complexes were used. The results showed that L. braziliensis is the predominant group infecting human patients in the state. Sixty-eight samples were typed, 64 samples (94.1%) belonging to the L. braziliensis complex and only four (5.9%) belonging to the L. mexicana complex. Accurate identification of the Leishmania permits better orientation of the medical follow-up, since clinical manifestations may vary depending on the complex to which the parasite belongs. The epidemiological information furnished by the identification of the Leishmania in given endemic area is also essential for the design of appropriate control measures. (author)

  20. OX40+ T lymphocytes and IFN-γ are associated with American tegumentary leishmaniasis pathogenesis Linfócitos T OX40+ e IFN-γ estão associados com a patogênese da leishmaniose tegumentar americana

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    Patrícia Luciana Batista Domingos

    2012-12-01

    Full Text Available BACKGROUND: Leishmaniases are zoonoses considered a public health problem, representing a complex group of diseases with a broad clinical spectrum and epidemiological diversity. Leishmaniasis is caused by several species of protozoa of the genus Leishmania. The evolution of the pathology and the resolution of the leishmaniasis are dependent mainly on the Leishmania species involved, although the cytokine profile plays an important role in the development of the immune response. OBJECTIVES: The purpose of our study was to evaluate the immune response of patients affected by lesions of cutaneous leishmaniasis by immunostaining of the OX40, CD20, IFN-γ and IL-4 proteins. METHODS: The tissue samples were collected from indolent skin ulcers confirmed as cutaneous leishmaniasis of 41 patients aged between six and 90 years. The lesions were submitted to OX40, CD20, INF-γ and IL-4 immunolabeling. RESULTS: We observed a statistically significant higher expression of IFN-γ compared with IL-4 (p=0.009. Besides, OX40 had higher expression when compared with CD20 (pFUNDAMENTOS: As leishmanioses são zoonoses consideradas um problema de saúde pública, representando um grupo de doenças complexas, com uma diversidade de amplo espectro clínico e epidemiológico. A leishmaniose é uma doença causada por várias espécies de protozoários do gênero Leishmania spp. A evolução da patologia e a resolução da leishmaniose são dependentes principalmente da espécie de Leishmania envolvida; embora o perfil das citocinas tenha um importante papel no desenvolvimento da resposta imune. OBJETIVOS: Proporcionar mais conhecimentos sobre os eventos inflamatórios na leishmaniose tegumentar através da avaliação da imunoexpressão de OX40, CD20, IFN-γ e IL-4. MÉTODOS: Foram coletadas amostras de tecido de 41 pacientes, com idade variando entre 6 a 90 anos, com úlceras indolentes na pele confirmados através de exames de diagnóstico como leishmaniose

  1. A FRET-based real-time PCR assay to identify the main causal agents of New World tegumentary leishmaniasis.

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    Pablo Tsukayama

    Full Text Available In South America, various species of Leishmania are endemic and cause New World tegumentary leishmaniasis (NWTL. The correct identification of these species is critical for adequate clinical management and surveillance activities. We developed a real-time polymerase chain reaction (PCR assay and evaluated its diagnostic performance using 64 archived parasite isolates and 192 prospectively identified samples collected from individuals with suspected leishmaniasis enrolled at two reference clinics in Lima, Peru. The real-time PCR assay was able to detect a single parasite and provided unambiguous melting peaks for five Leishmania species of the Viannia subgenus that are highly prevalent in South America: L. (V. braziliensis, L. (V. panamensis, L. (V. guyanensis, L. (V. peruviana and L. (V. lainsoni. Using kinetoplastid DNA-based PCR as a gold standard, the real-time PCR had sensitivity and specificity values of 92% and 77%, respectively, which were significantly higher than those of conventional tests such as microscopy, culture and the leishmanin skin test (LST. In addition, the real-time PCR identified 147 different clinical samples at the species level, providing an overall agreement of 100% when compared to multilocus sequence typing (MLST data performed on a subset of these samples. Furthermore, the real-time PCR was three times faster and five times less expensive when compared to PCR - MLST for species identification from clinical specimens. In summary, this new assay represents a cost-effective and reliable alternative for the identification of the main species causing NWTL in South America.

  2. Identification and Biological Characterization of Leishmania (Viannia guyanensis Isolated from a Patient with Tegumentary Leishmaniasis in Goiás, a Nonendemic Area for This Species in Brazil

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    Alause da Silva Pires

    2015-01-01

    Full Text Available The aim of this study was to characterize clinical field isolates of Leishmania spp. obtained from patients with American Tegumentary Leishmaniasis (ATL who live in Goiás state, Brazil. The presumed areas of infection were in Goiás, Tocantins, and Pará states. Three isolates of parasites were identified as L. (Viannia braziliensis and one as L. (V. guyanensis. The in vitro growth profiles were found to be similar for all parasites. Nevertheless, in C57BL/6 mice, L. (V. guyanensis infection was better controlled than L. (V. braziliensis. Yet in C57BL/6 mice deficient in interferon gamma, L. (V. guyanensis lesions developed faster than those caused by L. (V. braziliensis isolates. In BALB/c mice, the development of lesions was similar for isolates from both species; however, on the 11th week of infection, amastigotes could not be observed in macrophages from L. (V. guyanensis-infected mice. Thus, L. (V. guyanensis can be circulating in Goiás, a state where autochthonous cases of this species had not yet been reported. Considering the difficulties to differentiate L. (V. guyanensis from L. (V. braziliensis at the molecular, morphological, and clinical (human and murine models levels, the presence of L. (V. guyanensis infections is possibly underestimated in several regions of Brazil.

  3. Ecological Aspects of Phebotomine (Diptera, Psychodidae in an Endemic Area of Tegumentary Leishmaniasis in the Northeastern Argentina, 1993-1998

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    Oscar D Salomón

    2002-03-01

    Full Text Available The first epidemic tegumentary leishmaniasis´ outbreak in the province of Misiones was recorded in 1998, in the locality of Puerto Esperanza. Phlebotominae collected in the region, previously or simultaneously to the outbreak (September 1993-December 1998 showed that the species Lutzomyia intermedia s. l. was prevalent (94%, n 6,150 at all the sites sampled with miniature light trap (10 and Shannon trap (3. L. pessoai, L. whitmani, L. migonei, L. shannoni, L. fischeri, L. misionensis, Brumptomyia avellari and B. guimaraesi were also captured. Sand fly distribution in time and space suggests that in the province of Misiones (1 the species already present before 1990 could give rise to the epidemic by the density/dispersion fluctuation of their local populations; (2 the abundance of L. intermedia s. l. was associated with environments with ecotones of primary-secondary vegetation, close to water bodies and with moderate human disturbance; (3 this species showed, towards the end of 1997, peaks of exceptional abundance, subsequent to rainfall peaks in 1996. This increase in abundance of potential vector sand fly populations close to houses with colonizable surroundings could have generated the 1998 epidemic outbreak.

  4. Evaluation of myofibroblasts and its association with TGF-β and IFN-γ in lesions of patients with american tegumentary leishmaniasis Avaliação de miofibroblastos e sua associação com TGF-β e IFN-γ em lesões de pacientes com leishmaniose tegumentar americana

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    Agostinho Gonçalves Viana

    2012-08-01

    Full Text Available BACKGROUND: Leishmaniasis is caused by protozoa of Leishmania spp. genus. It is transmitted by the bite of the sand fly insect. It is believed that 12 million people are infected with this disease and that its annual incidence is 2 million; this number is increasing. OBJECTIVES: The present study aimed to evaluate the expression of myofibroblasts through alpha smooth muscle actin labeling, and to analyze their relationship with the expression of the cytokines Interferon gama (IFN-γ and Transforming growth factor beta (TGF-β1 in lesions of American tegumentary leishmaniasis (ATL. METHODS: For this retrospective study, we gathered 28 patients diagnosed with ATL between 2002 and 2006. We verified α-SMA positivity and performed IFN-γ and TGF-β1 immunolabeling to identify the profile of these cytokines in both positive and negative cases for myofibroblasts, via immunohistochemistry, in order to assess the presence of myofibroblasts,. RESULTS: We observed that out of the 28 cases, 17 (60.71% were positive for alpha smooth muscle actin, while 11 (39.29% were negative, and IFN-γ was more expressed than TGF-β1 (p=0.007. The mean percentages of expression of IFN-γ and TGF-β1 in the group negative for alpha smooth muscle actin were different, with an increased expression of IFN-γ (p=0.047. However, in the group positive for alpha smooth muscle actin, there was no difference in cytokine labeling (p>0.05. CONCLUSION: We verified the presence of positive α-SMA stromal cells in the majority of the cases of ATL, indicating the presence of myofibroblasts. In cases negative for alpha smooth muscle actin, an increased expression of IFN-γ compared to TGF-β1 was observed, revealing an inflammatory phase progressing to a healing process.FUNDAMENTOS: A leishmaniose é causada pelo protozoário do gênero Leishmania spp., sendo transmitida via picada do inseto flebotomíneo. Estima-se que 12 milhões de indivíduos estejam infectados com a doença, sendo a

  5. Occupationally Acquired American Cutaneous Leishmaniasis

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    Maria Edileuza Felinto de Brito

    2012-01-01

    Full Text Available We report two occupationally acquired cases of American cutaneous leishmaniasis (ACL: one accidental laboratory autoinoculation by contaminated needlestick while handling an ACL lesion sample, and one acquired during field studies on bird biology. Polymerase chain reaction (PCR assays of patient lesions were positive for Leishmania, subgenus Viannia. One isolate was obtained by culture (from patient 2 biopsy samples and characterized as Leishmania (Viannia naiffi through an indirect immunofluorescence assay (IFA with species-specific monoclonal antibodies (mAbs and by multilocus enzyme electrophoresis (MLEE. Patients were successfully treated with N-methyl-glucamine. These two cases highlight the potential risks of laboratory and field work and the need to comply with strict biosafety procedures in daily routines. The swab collection method, coupled with PCR detection, has greatly improved ACL laboratory diagnosis.

  6. American Visceral Leishmaniasis in Chiapas, Mexico

    OpenAIRE

    Pastor-Santiago, Jorge A.; Chávez-López, Susana; Guzmán-Bracho, Carmen; Flisser, Ana; Olivo-Díaz, Angélica

    2012-01-01

    We report the results of a study conducted during 1990–2006 with 89 cases of American visceral leishmaniasis in Chiapas State in southeastern Mexico and a seroprevalence study performed with 726 persons and 224 dogs that lived near cases of American visceral leishmaniasis. Clinical aspects, epidemiologic profiles, and risk factors are described. Most cases were in children ≤ 5 years of age, the prevalence of seropositive persons was 77%. The main risk factors associated with this disease were...

  7. The use of radionuclide DNA probe technology for epidemiological studies of tegumentary leishmaniasis in Mato Grosso state

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    Antero Silva Ribeiro de Andrade

    2005-10-01

    Full Text Available DNA hybridisation, using probes labelled with 32P, was used to type Leishmania samples isolated from patients living in endemic areas of Mato Grosso State (Brazil, and clinically diagnosed as having tegumentary leishmaniasis. kDNA cloned mini-circle probes specific for the Leishmania mexicana and Leishmania braziliensis complexes were used. The results showed that L. braziliensis is the predominant group infecting human patients in the state. Sixty-eight samples were typed, 64 samples (94.1% belonging to the L. braziliensis complex and only four (5.9% belonging to the L. mexicana complex. Accurate identification of the Leishmania permits better orientation of the medical follow-up, since clinical manifestations may vary depending on the complex to which the parasite belongs. The epidemiological information furnished by the identification of the Leishmania in given endemic area is also essential for the design of appropriate control measuresHibridização, utilizando sondas de DNA marcadas com 32P, foi utilizada para a tipagem de amostras de Leishmania isoladas de pacientes do estado do Mato Grosso (Brasil, diagnosticados clinicamente como portadores de leishmaniose tegumentar. Sondas de minicírculos clonados de kDNA, específicas para os complexos Leishmania mexicana e Leishmania braziliensis, foram utilizadas. Os resultados demonstraram que o complexo L. brasiliensis é o grupo predominante infectando pacientes humanos no estado do Mato Grosso. Foram tipadas 68 amostras: 64 (94,1% foram identificadas como pertencentes ao complexo L. brasiliensis e somente 4 (5,9% como pertencentes ao complexo L. mexicana. A tipagem de Leishmania é importante para um melhor acompanhamento médico, uma vez que as manifestações clínicas podem variar em função do complexo ao qual o parasita pertence. A informação fornecida pela identificação também é essencial para a definição das medidas de controle mais adequadas e compreensão da epidemiologia da

  8. American visceral leishmaniasis in Chiapas, Mexico.

    Science.gov (United States)

    Pastor-Santiago, Jorge A; Chávez-López, Susana; Guzmán-Bracho, Carmen; Flisser, Ana; Olivo-Díaz, Angélica

    2012-01-01

    We report the results of a study conducted during 1990-2006 with 89 cases of American visceral leishmaniasis in Chiapas State in southeastern Mexico and a seroprevalence study performed with 726 persons and 224 dogs that lived near cases of American visceral leishmaniasis. Clinical aspects, epidemiologic profiles, and risk factors are described. Most cases were in children ≤ 5 years of age, the prevalence of seropositive persons was 77%. The main risk factors associated with this disease were having 1-3 rooms in a house compared with ≥ 4 rooms, having a roof that was not made of cement, and having domestic animals. In contrast, only 19% of dogs were seropositive, suggesting that this species is not important in the transmission cycle of Leishmania. These data indicate that active transmission is taking place in the central valley of Chiapas State, Mexico, in communities located < 1,000 meters above sea level near the Grijalva River. PMID:22232459

  9. Mapping B-cell epitopes for the peroxidoxin of Leishmania (Viannia braziliensis and its potential for the clinical diagnosis of tegumentary and visceral leishmaniasis.

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    Daniel Menezes-Souza

    Full Text Available The search toward the establishment of novel serological tests for the diagnosis of leishmaniasis and proper differential diagnosis may represent one alternative to the invasive parasitological methods currently used to identify infected individuals. In the present work, we investigated the potential use of recombinant peroxidoxin (rPeroxidoxin of Leishmania (Viannia braziliensis as a potential antigen for the immunodiagnosis of human tegumentary (TL and visceral leishmaniasis (VL and canine visceral leishmaniasis (CVL. Linear B-cell epitope mapping was performed to identify polymorphic epitopes when comparing orthologous sequences present in Trypanosoma cruzi, the agent for Chagas disease (CD, and the Homo sapiens and Canis familiaris hosts. The serological assay (ELISA demonstrated that TL, VL and CVL individuals showed high levels of antibodies against rPeroxidoxin, allowing identification of infected ones with considerable sensitivity and great ability to discriminate (specificity between non-infected and CD individuals (98.46% and 100%; 98.18% and 95.71%; 95.79% and 100%, respectively. An rPeroxidoxin ELISA also showed a greater ability to discriminate between vaccinated and infected animals, which is an important requirement for the public campaign control of CVL. A depletion ELISA assay using soluble peptides of this B-cell epitope confirmed the recognition of these sites only by Leishmania-infected individuals. Moreover, this work identifies two antigenic polymorphic linear B-cell epitopes of L. braziliensis. Specific recognition of TL and VL patients was confirmed by significantly decreased IgG reactivity against rPeroxidoxin after depletion of peptide-1- and peptide-2-specific antibodies (peptide 1: reduced by 32%, 42% and 5% for CL, ML and VL, respectively; peptide-2: reduced by 24%, 22% and 13% for CL, ML and VL, respectively and only peptide-2 for CVL (reduced 9%. Overall, rPeroxidoxin may be a potential antigen for the

  10. Evaluation of myofibroblasts and its association with TGF-β and IFN-γ in lesions of patients with american tegumentary leishmaniasis Avaliação de miofibroblastos e sua associação com TGF-β e IFN-γ em lesões de pacientes com leishmaniose tegumentar americana

    OpenAIRE

    Agostinho Gonçalves Viana; Carlos Alberto de Carvalho Fraga; Paulo Rogério Ferreti Bonan

    2012-01-01

    BACKGROUND: Leishmaniasis is caused by protozoa of Leishmania spp. genus. It is transmitted by the bite of the sand fly insect. It is believed that 12 million people are infected with this disease and that its annual incidence is 2 million; this number is increasing. OBJECTIVES: The present study aimed to evaluate the expression of myofibroblasts through alpha smooth muscle actin labeling, and to analyze their relationship with the expression of the cytokines Interferon gama (IFN-γ) and ...

  11. Evaluation of the histopathological classifications of American cutaneous and mucocutaneous leishmaniasis

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    A. L. Bittencourt

    1991-03-01

    Full Text Available In order to evaluate the reliability of histopathological classifications of cutaneous and mucocutaneous leishmaniasis the authors compared the histopathological patterns of two biopsies taken simultaneously from the same patient, and classified the material according to Ridley et al. (1980, to Magalhães et al. (1986a, and to a more simplified classification with only three patterns. District histopathological aspects, were observed in different lesions or even in the same lesion. The authors concluded that histopathological patterns do not represent a stage of tegumentary leishmaniasis, thus they can not be correlated with prognosis and therapeutical response as suggested in the literature.

  12. American visceral Leishmaniasis: a case report

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    H. Langoni

    2005-09-01

    Full Text Available Visceral leishmaniasis is a zoonotic disease caused by parasites of the Leishmania genus. Dog is the major source of infection to man, especially in urban areas. The authors report a case of visceral leishmaniasis in a pit bull female dog from Bocaina, São Paulo, Brazil. The animal presented clinical signs compatible with leishmaniasis, including skin lesions in the body and partial damage of the external ears. The indirect fluorescent antibody test (IFAT demonstrated a titer of 1280, and promastigote forms of Leishmania sp were isolated by the culture of bone marrow puncture. Cytological analysis of the lymph node and smear of the bone marrow puncture revealed macrophages containing amastigote forms of Leishmania sp in their inner region. The test of Polymerase Chain Reaction (PCR utilized the primers LINR4 and LIN19, which amplify 720 base pairs, specific for Leishmania sp. The authors discuss the importance of techniques for a quick and precise diagnosis to this serious zoonosis with great impact in animal and public health.

  13. Asymptomatic infection with American cutaneous leishmaniasis: epidemiological and immunological studies

    Science.gov (United States)

    Andrade-Narvaez, Fernando J; Loría-Cervera, Elsy Nalleli; Sosa-Bibiano, Erika I; Van Wynsberghe, Nicole R

    2016-01-01

    American cutaneous leishmaniasis (ACL) is a major public health problem caused by vector-borne protozoan intracellular parasites from the genus Leishmania, subgenera Viannia and Leishmania. Asymptomatic infection is the most common outcome after Leishmania inoculation. There is incomplete knowledge of the biological processes explaining the absence of signs or symptoms in most cases while other cases present a variety of clinical findings. Most studies of asymptomatic infection have been conducted in areas of endemic visceral leishmaniasis. In contrast, asymptomatic ACL infection has been neglected. This review is focused on the following: (1) epidemiological studies supporting the existence of asymptomatic ACL infection and (2) immunological studies conducted to understand the mechanisms responsible for controlling the parasite and avoiding tissue damage. PMID:27759762

  14. Leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, M; Theander, T G

    2000-01-01

    Leishmania parasites are obligate intracellular protozoa, that produce clinical pictures, ranging from localised, self-healing ulcers to systemic, lethal diseases. The diseases caused by the parasites can be divided into cutaneous, mucocutaneous, and visceral leishmaniasis. Recovery from the infe......Leishmania parasites are obligate intracellular protozoa, that produce clinical pictures, ranging from localised, self-healing ulcers to systemic, lethal diseases. The diseases caused by the parasites can be divided into cutaneous, mucocutaneous, and visceral leishmaniasis. Recovery from...... the infection often leaves lifelong immunity. Leishmaniasis may occur in individuals who have been to the Mediterranean countries, the countries on the Horn of Africa, the Arabian Peninsula, parts of Asia, and South and Central America. Co-infection of Leishmania parasites and HIV is a special problem....... Leishmaniasis can be treated with pentavalent compounds of antimony, but other drugs, including amphotericin B, are also affective. Udgivelsesdato: 2000-Nov-13...

  15. American cutaneous leishmaniasis: presentation and problems of patient management

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    Jeffrey D. Chulay

    1988-12-01

    Full Text Available We report our experience with the diagnosis and treatment of 60 patients with American cutaneous leishmaniasis. They were infected in Panama (55, Brazil (4 or Colombia (I. Among 35 patients with a 3 week exposure in Panama, the mean maximum incubation period was 33 days (range 4-81 days. Diagnosis was delayed an average of 93 days after onset of skin lesions, due to the patient's delay in seeking medical attention (31 days, medical personnel's delay in considering the diagnosis (45 days, and the laboratory's delay in confirming the diagnosis (17 days. Forty-four patients (73% developed ulcers typical of cutaneous leishmaniasis. Sixteen additional patients (27% had atypical macular, papular, squamous, verrucous or acneiform skin lesions that were diagnosed only because leishmanial cultures were obtained. Of the 59 patients treated with pentavalent antimonial drugs, only 34 (58% were cured after the first course of treatment. Lesions which were at least 2 cm in diameter, ulcerated, or caused by Leishmania braziliensis were less likely to be cured after a single course of treatment than were lesions smaller than 2 cm, nonulcerated or caused by Leishmania mexicana or Leishmania donovani.

  16. An optimized nanoparticle delivery system based on chitosan and chondroitin sulfate molecules reduces the toxicity of amphotericin B and is effective in treating tegumentary leishmaniasis

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    Ribeiro TG

    2014-11-01

    Full Text Available Tatiana G Ribeiro,1 Juçara R Franca,1 Leonardo L Fuscaldi,1 Mara L Santos,2 Mariana C Duarte,3 Paula S Lage,3 Vivian T Martins,4 Lourena E Costa,3 Simone OA Fernandes,1,5 Valbert N Cardoso,1,5 Rachel O Castilho,1,6 Manuel Soto,7 Carlos AP Tavares,4 André AG Faraco,1,6 Eduardo AF Coelho,3,8,* Miguel A Chávez-Fumagalli3,* 1Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, 2Departamento de Morfologia, Instituto de Ciências Biológicas, 3Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, 4Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, 5Departamento de Análises Clínicas e Toxicológicas, 6Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; 7Centro de Biología Molecular Severo Ochoa (CSIC-UAM, Departamento de Biología Molecular, Universidad Autónoma de Madrid, Madrid, Spain; 8Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil *These authors contributed equally to this work Abstract: Amphotericin B (AmpB is active against leishmaniasis, but its use is hampered due to its high toxicity observed in patients. In this study, a nanoparticles-delivery system for AmpB (NQC-AmpB, containing chitosan and chondroitin sulfate molecules, was evaluated in BALB/c mice against Leishmania amazonensis. An in vivo biodistribution study, including biochemical and toxicological evaluations, was performed to evaluate the toxicity of AmpB. Nanoparticles were radiolabeled with technetium-99m and injected in mice. The products presented a similar biodistribution in the liver, spleen, and kidneys of the animals. Free AmpB induced alterations in the body weight of the mice, which, in the biochemical analysis, indicated hepatic and renal injury, as well as morphological damage to the kidneys of

  17. FIRST REPORT OF CUTANEOUS LEISHMANIASIS CAUSED BYLeishmania (Leishmania) infantum chagasi IN AN URBAN AREA OF RIO DE JANEIRO, BRAZIL

    Science.gov (United States)

    LYRA, Marcelo Rosandiski; PIMENTEL, Maria Inês Fernandes; MADEIRA, Maria de Fátima; ANTONIO, Liliane de Fátima; LYRA, Janine Pontes de Miranda; FAGUNDES, Aline; SCHUBACH, Armando de Oliveira

    2015-01-01

    SUMMARY American tegumentary leishmaniasis (ATL) is an infectious disease caused by protozoa of the genus Leishmania, and transmitted by sandflies. In the state of Rio de Janeiro, almost all of the cases of American tegumentary leishmaniasis (ATL) are caused by Leishmania (Viannia) braziliensis, while cases of visceral leishmaniasis (VL) are caused by Leishmania (Leishmania) infantum chagasi. The resurgence of autochthonous VL cases in Rio de Janeiro is related to the geographic expansion of the vector Lutzomyia longipalpis and its ability to adapt to urban areas. We report the first case of leishmaniasis with exclusively cutaneous manifestations caused by L. (L.) infantum chagasi in an urban area of Rio de Janeiro. An eighty-one-year-old woman presented three pleomorphic skin lesions that were not associated with systemic symptoms or visceromegalies. Multilocus enzyme electrophoresis identified L. (L.) infantum chagasi, but direct smear and PCR of bone narrow were negative for Leishmania sp. (suggesting exclusively cutaneous involvement). We discuss the different dermatological presentations of viscerotropic leishmaniasis of the New and Old World, and the clinical and epidemiological importance of the case. Etiologic diagnosis of ATL based upon exclusive clinical criteria may lead to incorrect conclusions. We should be aware of the constant changes in epidemiological patterns related to leishmaniases. PMID:26603237

  18. FIRST REPORT OF CUTANEOUS LEISHMANIASIS CAUSED BY Leishmania (Leishmania infantum chagasi IN AN URBAN AREA OF RIO DE JANEIRO, BRAZIL

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    Marcelo Rosandiski LYRA

    2015-10-01

    Full Text Available SUMMARY American tegumentary leishmaniasis (ATL is an infectious disease caused by protozoa of the genus Leishmania, and transmitted by sandflies. In the state of Rio de Janeiro, almost all of the cases of American tegumentary leishmaniasis (ATL are caused by Leishmania (Viannia braziliensis, while cases of visceral leishmaniasis (VL are caused by Leishmania (Leishmania infantum chagasi. The resurgence of autochthonous VL cases in Rio de Janeiro is related to the geographic expansion of the vector Lutzomyia longipalpis and its ability to adapt to urban areas. We report the first case of leishmaniasis with exclusively cutaneous manifestations caused by L. (L. infantum chagasi in an urban area of Rio de Janeiro. An eighty-one-year-old woman presented three pleomorphic skin lesions that were not associated with systemic symptoms or visceromegalies. Multilocus enzyme electrophoresis identified L. (L. infantum chagasi, but direct smear and PCR of bone narrow were negative for Leishmania sp. (suggesting exclusively cutaneous involvement. We discuss the different dermatological presentations of viscerotropic leishmaniasis of the New and Old World, and the clinical and epidemiological importance of the case. Etiologic diagnosis of ATL based upon exclusive clinical criteria may lead to incorrect conclusions. We should be aware of the constant changes in epidemiological patterns related to leishmaniases.

  19. Distribuição da leishmaniose tegumentar por imagens de sensoreamento remoto orbital, no Estado do Paraná, Brasil Tegumentary leishmaniasis distribution by satellite remote sensing imagery, in Paraná State, Brazil

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    Airton Pereira Lima

    2002-12-01

    Full Text Available FUNDAMENTOS: A leishmaniose tegumentar (LT tem sua epidemiologia pouco conhecida no Estado do Paraná. OBJETIVOS: Verificar a distribuição geográfica dos casos de LT em quatro municípios do Paraná, usando imagens por sensoriamento remoto orbital (ISRO, correlacionando-a com a presença de vegetação remanescente e cursos d'água. MÉTODOS: A distribuição de 4.416 casos no Paraná, de 1993 a 1998, foi feita com informações da ficha de notificação da Secretaria de Saúde do Estado do Paraná. Por ISRO verificou-se a distribuição de 231 casos de LT e a correlação destes com as matas residuais e o grau de antropia nos municípios de Cianorte, Japurá, Jussara e São Tomé. RESULTADOS: Houve concentração de casos no Norte e Oeste do Paraná. As ISRO mostram que há relação muito íntima da LT com as áreas de mata nativa modificada, pequenas matas ciliares ou resquícios destas, nos municípios de Cianorte, Japurá, Jussara e São Tomé. CONCLUSÃO: Em Cianorte, Japurá, Jussara e São Tomé a LT tem íntima relação com áreas de mata nativa modificada, pequenas matas ciliares ou resquícios de ambas. Possivelmente, as áreas onde há mais casos de LT no Paraná guardam semelhanças com as desses municípios.BACKGROUND: The epidemiology of tegumentary Leishmaniasis (TL is poorly known in the State of Paraná. OBJECTIVES: To verify the geographical distribution of TL cases in four municipalities in the State of Paraná and correlate the notified TL cases with the presence of the remaining vegetation and water streams, using images by satellite monitoring. METHODS: The distribution of 4,416 cases of TL in the State of Paraná, from 1993 to 1998, was done according to the notification records used by the State of Paraná Health Secretariat. The distribution of 231 cases of TL and the correlation between these cases and the remaining forest, as well as the extent to which man has influenced the environment in Cianorte, Japur

  20. American cutaneous leishmaniasis: presentation and problems of patient management

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    Jeffrey D. Chulay

    1988-12-01

    Full Text Available We report our experience with the diagnosis and treatment of 60 patients with American cutaneous leishmaniasis. They were infected in Panama (55, Brazil (4 or Colombia (I. Among 35 patients with a 3 week exposure in Panama, the mean maximum incubation period was 33 days (range 4-81 days. Diagnosis was delayed an average of 93 days after onset of skin lesions, due to the patient's delay in seeking medical attention (31 days, medical personnel's delay in considering the diagnosis (45 days, and the laboratory's delay in confirming the diagnosis (17 days. Forty-four patients (73% developed ulcers typical of cutaneous leishmaniasis. Sixteen additional patients (27% had atypical macular, papular, squamous, verrucous or acneiform skin lesions that were diagnosed only because leishmanial cultures were obtained. Of the 59 patients treated with pentavalent antimonial drugs, only 34 (58% were cured after the first course of treatment. Lesions which were at least 2 cm in diameter, ulcerated, or caused by Leishmania braziliensis were less likely to be cured after a single course of treatment than were lesions smaller than 2 cm, nonulcerated or caused by Leishmania mexicana or Leishmania donovani.Relatamos nossa experiência em 60 pacientes com leishmaniose tegumentar americana diagnosticada e tratada entre 1977 e 1982. Cinqüenta e cinco pacientes foram infectados no Panamá, 4 no Brasil, e 1 na Colômbia. Entre 35 pacientes com uma exposição de 3 semanas no Panamá, a média do período de incubação foi 33 dias (limite sobre 4 e 81 dias. O diagnóstico foi feito, em média, 93 dias depois do início das lesões de pele, devido a demora do paciente em procurar o serviço médico (31 dias, a demora do médico em considerar o diagnóstico (45 dias, e a demora do laboratório em confirmar o diagnóstico (17 dias. Quarenta e quatro pacientes (73% desenvolveram úlceras típicas de leishmaniose cutânea. Porém, 16 pacientes (27% tiveram lesões de pele at

  1. Thermotherapy. An alternative for the treatment of American cutaneous leishmaniasis.

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    López Liliana

    2012-05-01

    Full Text Available Abstract Background Pentavalent antimonials (Sb5 and miltefosine are the first-line drugs for treating cutaneous leishmaniasis in Colombia; however, toxicity and treatment duration negatively impact compliance and cost, justifying an active search for better therapeutic options. We compared the efficacy and safety of thermotherapy and meglumine antimoniate for the treatment of cutaneous leishmaniasis in Colombia. Method An open randomized Phase III clinical trial was performed in five military health centres. located in northwestern, central and southern Colombia. Volunteers with parasitological positive diagnosis (Giemsa-stained smears of cutaneous leishmaniasis were included. A single thermotherapy session involving the application of 50°C at the center and active edge of each lesion. Meglumine antimoniate was administered intramuscularly at a dose of 20 mg Sb5/kg weight/day for 20 days. Results Both groups were comparable. The efficacy of thermotherapy was 64% (86/134 patients by protocol and 58% (86/149 by intention-to-treat. For the meglumine antimoniate group, efficacy by protocol was 85% (103/121 patients and 72% (103/143 by intention-to-treat, The efficacy between the treatments was statistically significant (p 0.01 and Leishmania species responsible for infection. The side effects of meglumine antimoniate included myalgia, arthralgia, headache and fever. Regarding thermotherapy, the only side effect was pain at the lesion area four days after the initiation of treatment. Conclusion Although the efficacy rate of meglumine antimoniate was greater than that of thermotherapy for the treatment of cutaneous leishmaniasis, the side effects were also greater. Those factors, added to the increased costs, the treatment adherence problems and the progressive lack of therapeutic response, make us consider thermotherapy as a first line treatment for cutaneous leishmaniasis. Registered ClinicalTrials.gov NCT00471705

  2. SOUTH AMERICAN COLLABORATION IN SCIENTIFIC PUBLICATIONS ON LEISHMANIASIS: BIBLIOMETRIC ANALYSIS IN SCOPUS (2000-2011

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    Charles Huamaní

    2014-09-01

    Full Text Available Objectives: Evaluate the production and the research collaborative network on Leishmaniasis in South America. Methods: A bibliometric research was carried out using SCOPUS database. The analysis unit was original research articles published from 2000 to 2011, that dealt with leishmaniasis and that included at least one South American author. The following items were obtained for each article: journal name, language, year of publication, number of authors, institutions, countries, and others variables. Results: 3,174 articles were published, 2,272 of them were original articles. 1,160 different institutional signatures, 58 different countries and 398 scientific journals were identified. Brazil was the country with more articles (60.7% and Oswaldo Cruz Foundation (FIOCRUZ had 18% of Brazilian production, which is the South American nucleus of the major scientific network in Leishmaniasis. Conclusions: South American scientific production on Leishmaniasis published in journals indexed in SCOPUS is focused on Brazilian research activity. It is necessary to strengthen the collaboration networks. The first step is to identify the institutions with higher production, in order to perform collaborative research according to the priorities of each country.

  3. Interventions for American cutaneous and mucocutaneous leishmaniasis: a systematic review update.

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    Ludovic Reveiz

    Full Text Available INTRODUCTION: Leishmaniasis is an important public health problem in the Americas. A Cochrane review published in 2009 analyzed 38 randomized controlled trials (RCT. We conducted a systematic review to evaluate the effects of therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis. METHODS: All studies were extracted from PubMed, Embase, Lilacs (2009 to July, 2012 respectively, the Cochrane Central Register of Controlled Trials (6-2012 and references of identified publications. RCTs' risk of bias was assessed. RESULTS: We identified 1865 references of interest; we finally included 10 new RCTs. The risk of bias scored low or unclear for most domains. Miltefosine was not significantly different from meglumine antimoniate in the complete cure rate at 6 months (4 RCT; 584 participants; ITT; RR: 1.12; 95%CI: 0.85 to 1.47; I2 78%. However a significant difference in the rate of complete cure favoring miltefosine at 6 months was found in L. panamensis and L. guyanensis (2 RCTs, 206 participants; ITT; RR: 1.22; 95%CI: 1.02 to 1.46; I2 0%. One RCT found that meglumine antimoniate was superior to pentamidine in the rate of complete cure for L. braziliensis (80 participants, ITT; RR: 2.21; 95%CI: 1.41 to 3.49, while another RCT assessing L. guyanensis did not find any significant difference. Although meta-analysis of three studies found a significant difference in the rate of complete cure at 3 months favoring imiquimod versus placebo (134 participants; ITT; RR: 1.45; 95%CI: 1.12 to 1.88; I2 0%, no significant differences were found at 6 and 12 months. Thermotherapy and nitric oxide were not superior to meglumine antimoniate. CONCLUSION: Therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis are varied and should be decided according to the context. Since mucosal disease is the more neglected form of leishmaniasis a multicentric trial should be urgently considered.

  4. Chemokines and chemokine receptors expression in the lesions of patients with American cutaneous leishmaniasis

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    Nilka Luisa Diaz

    2013-06-01

    Full Text Available American cutaneous leishmaniasis (ACL presents distinct active clinical forms with different grades of severity, known as localised (LCL, intermediate (ICL and diffuse (DCL cutaneous leishmaniasis. LCL and DCL are associated with a polarised T-helper (Th1 and Th2 immune response, respectively, whereas ICL, or chronic cutaneous leishmaniasis, is associated with an exacerbated immune response and a mixed cytokine expression profile. Chemokines and chemokine receptors are involved in cellular migration and are critical in the inflammatory response. Therefore, we evaluated the expression of the chemokines CXCL10, CCL4, CCL8, CCL11 and CXCL8 and the chemokine receptors CCR3, CXCR3, CCR5 and CCR7 in the lesions of patients with different clinical forms of ACL using immunohistochemistry. LCL patients exhibited a high density of CXCL10+, CCL4+ and CCL8+ cells, indicating an important role for these chemokines in the local Th1 immune response and the migration of CXCR3+ cells. LCL patients showed a higher density of CCR7+ cells than ICL or DCL patients, suggesting major dendritic cell (DC migration to lymph nodes. Furthermore, DCL was associated with low expression levels of Th1-associated chemokines and CCL11+ epidermal DCs, which contribute to the recruitment of CCR3+ cells. Our findings also suggest an important role for epidermal cells in the induction of skin immune responses through the production of chemokines, such as CXCL10, by keratinocytes.

  5. EPIDEMIOLOGICAL SURVEY ON CANINE POPULATION WITH THE USE OF IMMUNOLEISH SKIN TEST IN ENDEMIC AREAS OF HUMAN AMERICAN CUTANEOUS LEISHMANIASIS IN THE STATE OF RIO DE JANEIRO, BRAZIL

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    Elizabeth Gloria O. Barbosa Santos

    1998-01-01

    Full Text Available A survey for canine tegumentary leishmaniasis (CTL has been carried out between 1986 and 1993 in seven endemic localities for American cutaneous leishmaniasis in the State of Rio de Janeiro. 270 dogs have been examined for their clinical aspects, the development of delayed hypersensitivity (DHS with Immunoleish antigen and with immunofluorescent antibody research of IgG (IF. 28.2% of them had ulcer lesions and 3.3% had scars. The lesions consisted of single (39.5% and mucocutaneous lesions (31.6%, multiple cutaneous (25.0% and mucocutaneous lesions associated with cutaneous ulcers (4.0%. Twelve (15.8% isolates from biopsies were analyzed by zimodeme and schizodeme and identified as L. (V. braziliensis. The overall prevalence of canine infection that was evaluated with the skin test was of 40.5% and with IF it was of 25.5%. Both tests showed a high positive rate with relation to the animals with mucosal lesions, as in the case of human mucocutaneous leishmaniasis. The comparison of the two tests showed the skin test to have a better performance although there was no statistical difference (p>0.05 between them. The proportional sensitivity and specificity was of 84.0% and 74.0%, respectively. The Immunoleish skin test and IF are useful tools to be employed in CTL field epidemiological surveys.Um inquérito epidemiológico em população canina foi realizado em 7 localidades endêmicas de Leishmaniose Tegumentar Americana (LTA entre os anos de 1986 a 1993, no Estado do Rio de Janeiro. Duzentos e setenta cães foram examinados, segundo os parâmetros: clínicos, desenvolvimento de hipersensibilidade tardia e dosagem de anticorpos por imunofluorescência indireta (IFI. 28,2% dos animais possuíam lesões e 3,3% eram portadores de cicatrizes compatíveis com infecção prévia de Leishmania sp. De um total de 98 lesões ulceradas detectadas, 39,5% eram cutâneas únicas, 25,0% lesões cutâneas múltiplas, 31,6% lesões de mucosa e 4,0% lesões de

  6. Association between HLA-C*04 and American cutaneous leishmaniasis in endemic region of southern Brazil.

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    Ribas-Silva, R C; Ribas, A D; Ferreira, E C; Silveira, T G V; Borelli, S D

    2015-11-23

    Leishmaniasis is a parasitic infectious disease with global repercussions. American cutaneous leishmaniasis (ACL) is endemic in southern Brazil and its pathogenesis varies according to parasite species, immune response, and host genetics. In terms of immunogenetics, many host genes, including HLA (human leukocyte antigen), could be involved in susceptibility to and protection against ACL. Accordingly, the aim of this study was to investigate the association between HLA class I genes (HLA-A, -B, and -C) and ACL in an endemic region of southern Brazil. The allele frequencies of 186 patients diagnosed with ACL and 278 healthy individuals were compared. HLA class I (HLA-A, -B, and -C) typing was carried out by PCR-SSO using Luminex technology. The results revealed an association between the HLA-C*04 allele and the patient study group, in which it appeared more frequently than in the control group [21.5 vs 13.49% (P = 0.0016 and Pc = 0.0258; OR = 1.7560; 95%CI = 1.2227-2.5240)], thereby suggesting an increased susceptibility to ACL. Additional allelic groups such as HLA-A*02, HLA-B*35, HLA-B*45, HLA-C*01, and HLA-C*15 were also implicated; however, further investigation is necessary to confirm their association with ACL. Therefore, the results obtained in this study demonstrate the involvement of HLA class I genes in the susceptibility or resistance to ACL, with significant association between HLA-C*04 and ACL susceptibility.

  7. Evaluation of different diagnostic methods of American Cutaneous Leishmaniasis in the Brazilian Amazon.

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    Espir, Thais Tibery; Guerreiro, Thayanne Sá; Naiff, Maricleide de Farias; Figueira, Luanda de Paula; Soares, Fabiane Veloso; da Silva, Susi Simas; Franco, Antonia Maria Ramos

    2016-08-01

    Epidemiological studies have been conducted to better understand the dynamics of American Cutaneous Leishmaniasis (ACL) in the Amazon region where distinct species of Leishmania circulate. In endemic areas, the optimal diagnosis must be made in the earlier clinical presentation to avoid the complications of chronic disease. The scarcity of financial support, laboratory infrastructure and trained persons are the major obstacles in this reality. This paper describes the result of performing different diagnostic methods for ACL in Amazonas State between the years 2010 and 2011. The tests used were the intradermal skin test (Montenegro's skin test), ELISA (Enzyme-Linked Immunosorbent Assay), direct examination, culture isolation and identification of Leishmania species. A total of 38 suspected human cases of ACL were diagnosed by different methods, of which 71.0% (n = 27) were positive by direct examination, 75.6% (n = 28) had positivity in the culture isolates and, of these, 54.0% (n = 19) had infection with Leishmania (Viannia) guyanensis. The positivity of the intradermal skin test with the leishmanin solution was observed in 77.0% of cases analyzed and the serology with detection of IgG and IgM showed the presence of antibodies in 100% of exams realized results, showing variation in the titles of antibodies. The success of Leishmaniasis treatment depends on an effective and early diagnosis. Parasitological diagnosis is highly specific, but sensitivity is subject to variation because the tissue distribution of parasites generally is not homogeneous and depends on the specie of parasite. Moreover, parasitological tests require invasive procedures and depend on restrictive conditions for the collection of biological sample, which limit their use in large-scale for epidemiological studies. ELISA has been the most widely used serological method for the diagnosis of Visceral Leishmaniasis (VL) as it is easy to perform and has a low cost. However, flaws in

  8. Epidemiologic aspects of American visceral leishmaniasis in an endemic focus in Eastern Venezuela.

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    Zulueta, A M; Villarroel, E; Rodriguez, N; Feliciangeli, M D; Mazzarri, M; Reyes, O; Rodriguez, V; Centeno, M; Barrios, R M; Ulrich, M

    1999-12-01

    An endemic focus of American visceral leishmaniasis (AVL) in eastern Venezuela has been evaluated in terms of patients (n = 48), immunologic reactivity to Leishmania in household contacts (n = 187) and neighborhood controls (n = 170), detection of Leishmania (L. donovani complex) in dogs and wild animals by the polymerase chain reaction (PCR) and characteristics of the sandfly population. The male:female ratio of patients was 1.18:1; 89.6% were Didelphis marsupialis), and a black rat (Rattus rattus). Lutzomyia longipalpis and Lu. evansi, both implicated in the transmission of AVL, were identified among the 386 sand flies examined. These observations provide the bases for an active control program as well as further studies of reservoirs and vector-host relationships in this area. PMID:10674675

  9. Renal function evaluation in patients with American Cutaneous Leishmaniasis after specific treatment with pentavalent antimonial

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    Oliveira Rodrigo A

    2012-06-01

    Full Text Available Abstract Background Renal evaluation studies are rare in American Cutaneous Leishmaniasis (ACL. The aim of this study is to investigate whether specific treatment reverts ACL-associated renal dysfunction. Methods A prospective study was conducted with 37 patients with ACL. Urinary concentrating and acidification ability was assessed before and after treatment with pentavalent antimonial. Results The patients mean age was 35.6 ± 12 years and 19 were male. Before treatment, urinary concentrating defect (U/Posm Conclusion As previously described, urinary concentrating and acidification defects were found in an important number of patients with ACL. Present results demonstrate that only some patients recover urinary acidification capacity, while no one returned to normal urinary concentration capacity.

  10. El rol de tres pruebas de ELISA con antígenos de promastigotes de Leishmania braziliensis, L. amazonensis y L. guyanensis en el diagnóstico de leishmaniasis tegumentaria Role of three ELISA tests using promastigote homogenates of Leishmania braziliensis, L. amazonensis and L. guyanensis in the diagnosis of tegumentary leishmaniasis

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    José F. Gil

    2011-10-01

    Full Text Available Es importante conocer si la variabilidad de especies de Leishmania circulantes en una región afecta la performance de las pruebas de ELISA estandarizadas para el diagnostico de la leishmaniasis. El objetivo de este trabajo fue analizar la reactividad de la prueba de ELISA utilizando homogenados de promastigotes de Leishmania (V. braziliensis (ELISAb, L (L amazonensis (ELISAa y L (V. guyanensis (ELISAg frente a distintos grupos de sueros. Se estudiaron muestras de personas con leishmaniasis cutánea (n = 37, leishmaniasis mucocutánea (n = 8, no infectados (n = 52, infectadas por Trypanosoma cruzi (n = 11 e infecciones mixtas (n = 14. Se calcularon las sensibilidades, especificidades, cut off, valores predictivos, y se compararon las tres pruebas usando ANOVA, índice de concordancia kappa, comparación de curvas ROC e intervalos de confianza construidos por el método de bootstrap. Se encontraron diferencias significativas al comparar los niveles de DO de los sueros de pacientes con leishmaniasis cutánea respecto a los controles negativos, pero no se encontraron diferencias entre pruebas. Las sensibilidades calculadas fueron de 84.6% para ELISAb y ELISAa y de 88.5 para ELISAg, mientras que el valor de especificidad para las tres pruebas fue de 96.2. El índice de concordancia kappa y la comparación de curvas ROC mostraron performances similares para las tres pruebas (p = 0.225. La elevada reactividad obtenida para estas ELISAs frente a sueros de pacientes con leishmaniasis mucocutánea indica un importante potencial de esta técnica como complemento en el diagnóstico de la enfermedad.It is important to know whether the variability of species of Leishmania parasites circulating in a region affects the performance of the ELISA test for the diagnosis of leishmaniasis. Therefore, the aim of this study was to analyze the reactivity of the ELISA using homogenates of promastigotes of Leishmania (V. braziliensis (ELISAb, Leishmania (L amazonensis

  11. American Cutaneous Leishmaniasis in Panama: a historical review of entomological studies on anthropophilic Lutzomyia sand fly species

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    Dutari, Larissa C.; Loaiza, Jose R.

    2014-01-01

    We review existing information on the epidemiology of American Cutaneous Leishmaniasis (ACL) in Panama, with emphasis on the bionomics of anthropophilic Lutzomyia sand fly species. Evidence from Panamanian studies suggests that there are six anthropophilic species in the country: Lutzomyia trapidoi, Lu. panamensis, Lu. gomezi, Lu. ylephiletor, Lu. sanguinaria and Lu. pessoana (Henceforth Lu. carrerai thula). In general, these taxa are abundant, widespread and feed opportunistically on their h...

  12. Macroecological patterns of American Cutaneous Leishmaniasis transmission across the health areas of Panamá (1980–2012)

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    Yamada, Koji; Valderrama, Anayansi; Gottdenker, Nicole; Cerezo, Lizbeth; MINAKAWA, NOBORU; Saldaña, Azael; Calzada, José E.; Chaves, Luis Fernando

    2016-01-01

    American Cutaneous Leishmaniasis (ACL) is a neglected vector-borne zoonosis that persists despite increasing socio-economic development and urbanization in Panamá. Here, we investigate the association between environmental changes and spatio-temporal ACL transmission in the Republic of Panamá (1980–2012). We employ a macroecological approach, where patterns of variation in ACL incidence at the spatially coarse-grained scale of health areas are studied considering factors linked to the ecology...

  13. QBC® for the diagnosis of human and canine american visceral leishmaniasis: preliminary data

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    Liarte Daniel B.

    2001-01-01

    Full Text Available "Quantitative Buffy Coat" (QBC® is a direct and fast fluorescent method used for the identification of blood parasites. Since Leishmania chagasi circulates in blood, we decided to test it in American visceral leishmaniasis (AVL. Bone marrow (BM and peripheral blood (PB of 49 persons and PB of 31 dogs were analyzed. QBC® was positive in BM of 11/11 patients with AVL and in 1/6 patients with other diseases. Amastigotes were identified in PB of 18/22 patients with AVL and in none without AVL. The test was positive in 30 out of the 31 seropositive dogs and in 28/28 dogs with Leishmania identified in other tissues. QBC® is a promising method for diagnosis of human AVL, and possibly for the exam of PB of patients with AVL/AIDS, for the control of the cure and for the identification of asymptomatic carriers. Because it is fast and easy to collect and execute, QBC® should be evaluated for programs of reservoir control.

  14. [American cutaneous leishmaniasis on the northern coastline of the State of São Paulo, 1993 to 2005].

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    Condino, Maria Lúcia Fadel; Galati, Eunice Aparecida Bianchi; Holcman, Márcia Moreira; Salum, Maria Rafaela Braga; Silva, Diogo Correa da; Novaes Júnior, René Antonio

    2008-01-01

    American cutaneous leishmaniasis acquired epidemic characteristics on the northern coastline of the State of São Paulo beginning in the 1990s. From secondary data, a descriptive study of the disease in the four municipalities making up this region over the period from 1993 to 2005 was conducted. The frequency of phlebotomine capture in the probable transmission locations was analyzed. 689 autochthonous cases of cutaneous leishmaniasis were notified, with single and grouped cases, thus determining that the spatial distribution was heterogenous. There was synchronism and cyclicity of disease manifestation, at intervals of six to eight years. All ages were affected, with slight predominance among males, without association with any specific occupation. Among the 2,758 phlebotomines captured, Nyssomyia intermedia predominated (80.4%) inside homes and in areas surrounding them. The disease presented a transmission profile inside homes and in areas surrounding them, between the urban fringe and forests, and inside forests. In such cases, transmission would be more related to enzootic foci.

  15. American Cutaneous Leishmaniasis in Panama: a historical review of entomological studies on anthropophilic Lutzomyia sand fly species.

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    Dutari, Larissa C; Loaiza, Jose R

    2014-01-01

    We review existing information on the epidemiology of American Cutaneous Leishmaniasis (ACL) in Panama, with emphasis on the bionomics of anthropophilic Lutzomyia sand fly species. Evidence from Panamanian studies suggests that there are six anthropophilic species in the country: Lutzomyia trapidoi, Lu. panamensis, Lu. gomezi, Lu. ylephiletor, Lu. sanguinaria and Lu. pessoana (Henceforth Lu. carrerai thula). In general, these taxa are abundant, widespread and feed opportunistically on their hosts, which make them potential transmitters of pathogens to a broad range of wildlife, domesticated animals and humans. Furthermore, nearly all man-biting species in Panama (with the exception of Lu. gomezi) expand demographically during the rainy season when transmission is likely higher due to elevated Leishmania infection rates in vector populations. Despite this, data on the distribution and prevalence of ACL suggest little influence of vector density on transmission intensity. Apart from Lu. trapidoi, anthropophilic species seem to be most active in the understory, but vertical stratification, as well as their opportunistic feeding behavior, could vary geographically. This in turn seems related to variation in host species composition and relative abundance across sites that have experienced different degrees of human alteration (e.g., deforestation) in leishmaniasis endemic regions of Panama. PMID:24886629

  16. Immunotherapy, immunochemotherapy and chemotherapy for American cutaneous leishmaniasis treatment Imunoterapia, imunoquimioterapia e quimioterapia no tratamento da leishmaniose tegumentar americana

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    Wilson Mayrink

    2006-02-01

    Full Text Available The first choice of treatment for American cutaneous leishmaniasis is the pentavalent antimonial drug. Although it has been shown that this treatment is mostly effective and indicated, some disadvantages should be taken into account such as side effects, long term treatment inconveniences and counter-indication for patients suffering from cardiopathy, nephropathy; yet, aging, pregnancy and other conditions. With the advent of the vaccine anti-American cutaneous leishmaniasis as a prophylactic measure, studies on therapy using the vaccine associated or not with other drugs have been performed by many investigators and it is currently among the alternative treatments and prevention measures for American cutaneous leishmaniasis. In conclusion, the association between antimony and vaccine (immunochemotherapy showed the same cure rate when compared with the standard treatment (100% and it was also able to reduce the salt volume in 17.9% and treatment length from 87 to 62 days, decreasing side effects.O tratamento de primeira escolha para leishmaniose tegumentar americana é o antimonial pentavalente. Embora este tratamento seja na maioria das vezes efetivo e indicado, devem ser consideradas as desvantagens tais como efeitos colaterais, longa duração do tratamento e contra-indicação para cardiopatas, nefropatas, idosos, grávidas e outras condições. Com o advento da vacina antileishmaniose tegumentar americana para fins profiláticos e terapêuticos, associando-a ou não a outros fármacos, muitas pesquisas têm sido desenvolvidas, sendo a vacina a principal entre os atuais recursos no tratamento e prevenção da leishmaniose tegumentar americana. Em conclusão, a associação do antimônio com a vacina (imunoquimioterapia apresentou o mesmo índice de cura em relação ao tratamento padrão (100%, e ainda reduziu o volume do sal em 17,9% e o tempo de cura significativamente, de 87 para 62 dias; conseqüentemente, reduzindo os efeitos colaterais.

  17. Comparative evaluation of phenol and thimerosal as preservatives for a candidate vaccine against American cutaneous leishmaniasis.

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    Mayrink, Wilson; Tavares, Carlos Alberto Pereira; Deus, Rosangela Barbosa de; Pinheiro, Melina Barros; Guimarães, Tânia Mara Pinto Dabés; Andrade, Hélida Monteiro de; Costa, Carlos Alberto da; Toledo, Vicente de Paulo Coelho Peixoto da

    2010-02-01

    For decades thimerosal has been used as a preservative in the candidate vaccine for cutaneous leishmaniasis, which was developed by Mayrink et al. The use of thimerosal in humans has been banned due to its mercury content. This study addresses the standardization of phenol as a new candidate vaccine preservative. We have found that the proteolytic activity was abolished when the test was conducted using the candidate vaccine added to merthiolate (MtVac) as well as to phenol (PhVac). The Montenegro's skin test conversion rates induced by MtVac and by PhVac was 68.06% and 85.9%, respectively, and these values were statistically significant (p leishmaniasis.

  18. Host preferences of the sand fly Lutzomyia longipalpis at an endemic focus of American visceral leishmaniasis in Colombia.

    Science.gov (United States)

    Morrison, A C; Ferro, C; Tesh, R B

    1993-07-01

    Blood meals from 579 Lutzomyia longipalpis (Diptera:Psychodidae), collected in an endemic focus of American visceral leishmaniasis in Colombia, were identified by precipitin test. Sand fly collections were made during a 16-month period from the inside walls of two houses, a pigpen, and rock crevices in a small community (El Callejon) within the endemic area. Feeding patterns of the sand flies varied with locality and date of collection. Overall, bovine feedings predominated, but feedings were also recorded on pigs, equines, humans, dogs, opossums, birds, and reptiles. Calculation of the forage ratios for each host species indicated that cows and pigs were the preferred hosts of Lu. longipalpis in El Callejon. Results of this study suggest that Lu. longipalpis is an opportunistic feeder and is not highly anthropophilic nor strongly attracted to dogs.

  19. American cutaneous leishmaniasis in dogs from an endemic urban area in Cianorte municipality, Paraná State, Brazil

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    DA Cerino

    2010-01-01

    Full Text Available American cutaneous leishmaniasis (ACL was investigated in dogs from an urban endemic area in Cianorte, Paraná state, Brazil. Of 169 studied dogs, none presented suspected ACL lesions. Eleven animals (6.6% had anti-Leishmania braziliensis antibodies (titers > 40 detected by the immunofluorescent antibody test (IFAT while four (2.4% showed L. braziliensis-complex DNA by the polymerase chain reaction (PCR. Although no associations were found between IFAT or PCR results and age, sex, origin, free-roaming animals or length of residence at the address, the majority of IFAT- or PCR-positive dogs were from the urban area of the city and were allowed to roam freely beyond their neighborhood. The presence of anti-Leishmania braziliensis antibodies and L. braziliensis-complex DNA in dogs from this urban area near a native-forest park indicates the importance of following up on these dogs to confirm the ACL diagnosis.

  20. Integrated Tools for American Cutaneous Leishmaniasis Surveillance and Control: Intervention in an Endemic Area in Rio de Janeiro, RJ, Brazil

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    Cheryl Gouveia

    2012-01-01

    Full Text Available American cutaneous leishmaniasis (ACL is a focal disease whose surveillance and control require complex actions. The present study aimed to apply integrated tools related to entomological surveillance, environmental management, and health education practices in an ACL-endemic area in Rio de Janeiro city, RJ, Brazil. The distribution of the disease, the particular characteristics of the localities, and entomological data were used as additional information about ACL determinants. Environmental management actions were evaluated after health education practices. The frequency of ACL vectors Lutzomyia (N. intermedia and L. migonei inside and outside houses varied according to environment characteristics, probably influenced by the way of life of the popular groups. In this kind of situation environmental management and community mobilization become essential, as they help both specialists and residents create strategies that can interfere in the dynamics of vector’s population and the contact between man and vectors.

  1. Infecções experimentaes na Leishmaniose visceral americana Experimental infections in american visceral leishmaniasis

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    Aristides Marques da Cunha

    1938-01-01

    sôro-agglutinação, conforme mostramos em trabalho anterior, não permite a separação das especies do genero Leishmania, pois todas ellas, quando recentemente isoladas, possuem identica constituição antigenica, que se modifica depois, pela conservação longo tempo em cultura. É esse facto, que deu logar ás conclusões contradictorias a que chegaram os autores que se ocuparam do assumpto bem como os primeiros resultados que obtivemos. Deante de todos esses factos, nos julgamos autorizados a concluir como já fizemos anteriormente, que o agente da Leishmaniose visceral americana é identico á Leishmania infantum. Ao terminar, queremos deixar consignados nossos agradecimentos ao Dr. E. chagas, por ter posto a nossa disposição as culturas de Leishmania por elle isoladas, tornando possivel deste modo, a execução do presente trabalho.With cultures isolated from cases of american visceral leishmaniasis we succeeded in obtaining experimental infections in hamsters (Cricetus cricetus, rhesus monkeys (Macaca mullata and dogs. Hamsters were infected with strains obtained from man and dogs, the intraperitoneal way having been always employed. When cultures recently isolated are used, infection is obtained practically in 100% of the animals inoculated. The first negative results obtained by us may be explained by the use of cultures isolated some time before (about 7 months 0 and which had lost already their virulence. In some cases external lesions are observed represented by alterations of the skin and swelling of the paws. The skin lesions are observed on the ventral surface and consist in depilation, erythema and exudation. The skin thus affected shows to be extremely friable, rupturing at the movements of the animal when hold. On post-mortem examination, besides the lesions pointed out, the animals present enlargement of the spleen. The parasites are very numerous in the spleen, liver, bone marrow, etc. The changed skin shows considerable hypertrophy of the

  2. Comparative evaluation of phenol and thimerosal as preservatives for a candidate vaccine against American cutaneous leishmaniasis

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    Wilson Mayrink

    2010-02-01

    Full Text Available For decades thimerosal has been used as a preservative in the candidate vaccine for cutaneous leishmaniasis, which was developed by Mayrink et al. The use of thimerosal in humans has been banned due to its mercury content. This study addresses the standardization of phenol as a new candidate vaccine preservative. We have found that the proteolytic activity was abolished when the test was conducted using the candidate vaccine added to merthiolate (MtVac as well as to phenol (PhVac. The Montenegro's skin test conversion rates induced by MtVac and by PhVac was 68.06% and 85.9%, respectively, and these values were statistically significant (p < 0.05. The proliferative response of peripheral mononuclear blood cells shows that the stimulation index of mice immunized with both candidate vaccines was higher than the one in control animals (p < 0.05. The ability of the candidate vaccines to induce protection in C57BL/10 mice against a challenge with infective Leishmania amazonensis promastigotes was tested and the mice immunized with PhVac developed smaller lesions than the mice immunized with MtVac. Electrophoresis of phenol-preserved antigen revealed a number of proteins, which were better preserved in PhVac. These results do in fact encourage the use of phenol for preserving the immunogenic and biochemical properties of the candidate vaccine for cutaneous leishmaniasis.

  3. American cutaneous leishmaniasis cases in the metropolitan region of Manaus, Brazil: association with climate variables over time.

    Science.gov (United States)

    Ferreira de Souza, Rodrigo Augusto; Andreoli, Rita Valéria; Toshie Kayano, Mary; Lima Carvalho, Afrânio

    2015-05-18

    A temporal series of the normalized difference vegetation index (NDVI) and other environmental parameters covering the years 2002- 2009 was used for the study of the potential association between the climate and the number of cases of American cutaneous leishmaniasis (CL) in Manaus Metropolitan Region (MMR), State of Amazonas, Brazil. The results show that CL has a marked seasonality and a strong linkage with local climate conditions. Dry and warm conditions favor the vector, while the maximum number of CL cases occurs during the following wet season. This has a clear relation to the El Niño/La Niña Southern Oscillation (ENSO) and the results presented here show that uncharacteristic dry conditions in the MMR follow El Niño after a lag period of 3 months, while wet conditions follow La Niña, again after a lag period of 3 months. El Niño brings dry conditions with warming of the land surface leading to increased growth of trees and bushes as indicated by rising NDVI values, eventually producing increased numbers of CL cases, with a peak of new cases occurring 4 to 5 months later. La Niña, on the other hand, produces wet and cool weather, which is less favorable for the leishmaniasis vector and therefore results in comparatively lower number of CL cases. Since these seasonal climate changes affect the dynamics of the CL vector, and thus the number of CL cases, a close watch of the ENSO phenomenon and the weather type it brings should be useful for monitoring and control of CL in the MMR.

  4. PANCREATIC TOXICITY AS AN ADVERSE EFFECT INDUCED BY MEGLUMINE ANTIMONIATE THERAPY IN A CLINICAL TRIAL FOR CUTANEOUS LEISHMANIASIS

    Science.gov (United States)

    LYRA, Marcelo Rosandiski; PASSOS, Sonia Regina Lambert; PIMENTEL, Maria Inês Fernandes; BEDOYA-PACHECO, Sandro Javier; VALETE-ROSALINO, Cláudia Maria; VASCONCELLOS, Erica Camargo Ferreira; ANTONIO, Liliane Fatima; SAHEKI, Mauricio Naoto; SALGUEIRO, Mariza Mattos; SANTOS, Ginelza Peres Lima; RIBEIRO, Madelon Noato; CONCEIÇÃO-SILVA, Fatima; MADEIRA, Maria Fatima; SILVA, Jorge Luiz Nunes; FAGUNDES, Aline; SCHUBACH, Armando Oliveria

    2016-01-01

    SUMMARY American tegumentary leishmaniasis is an infectious disease caused by a protozoan of the genus Leishmania. Pentavalent antimonials are the first choice drugs for cutaneous leishmaniasis (CL), although doses are controversial. In a clinical trial for CL we investigated the occurrence of pancreatic toxicity with different schedules of treatment with meglumine antimoniate (MA). Seventy-two patients were allocated in two different therapeutic groups: 20 or 5 mg of pentavalent antimony (Sb5+)/kg/day for 20 or 30 days, respectively. Looking for adverse effects, patients were asked about abdominal pain, nausea, vomiting or anorexia in each medical visit. We performed physical examinations and collected blood to evaluate serum amylase and lipase in the pre-treatment period, and every 10 days during treatment and one month post-treatment. Hyperlipasemia occurred in 54.8% and hyperamylasemia in 19.4% patients. Patients treated with MA 20 mg Sb5+ presented a higher risk of hyperlipasemia (p = 0.023). Besides, higher MA doses were associated with a 2.05 higher risk ratio (p = 0.003) of developing more serious (moderate to severe) hyperlipasemia. The attributable fraction was 51% in this group. Thirty-six patients presented abdominal pain, nausea, vomiting or anorexia but only 47.2% of those had hyperlipasemia and/ or hyperamylasemia. These findings suggest the importance of the search for less toxic therapeutic regimens for the treatment of CL. PMID:27680173

  5. Study of sand fly fauna in an endemic area of American cutaneous leishmaniasis and canine visceral leishmaniasis in the municipality of Espírito Santo do Pinhal, São Paulo, Brazil.

    Science.gov (United States)

    Colla-Jacques, Fernanda Elisa; Casanova, Cláudio; Prado, Angelo Pires do

    2010-03-01

    Canine American visceral leishmaniasis and American cutaneous leishmaniasis (ACL) cases have been recorded in Espírito Santo do Pinhal. The aim of this study was to gather knowledge of the sand fly community and its population ecology within the municipality. Captures were made weekly over a period of 15 months in the urban, periurban and rural areas of the municipality, using automatic light traps. A total of 5,562 sand flies were collected, comprising 17 species. The most abundant species were Nyssomyia whitmani and Pintomyia pessoai in the rural area, Lutzomyia longipalpis and Ny. whitmani in the periurban area and Lu. longipalpis in the urban area. The highest species richness and greatest index species diversity were found in the rural area. The similarity index showed that urban and periurban areas were most alike. Lu. longipalpis was found in great numbers during both dry and humid periods. The presence of dogs infected with Leishmania infantum chagasi in the urban area indicates a high risk for the establishment of the disease in the region. A high abundance of Ny. whitmani and Pi. pessoai in the rural and periurban areas indicates the possibility of new cases of ACL occurring in and spreading to the periurban area of Espírito Santo do Pinhal.

  6. Study of sand fly fauna in an endemic area of American cutaneous leishmaniasis and canine visceral leishmaniasis in the municipality of Espírito Santo do Pinhal, São Paulo, Brazil

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    Fernanda Elisa Colla-Jacques

    2010-03-01

    Full Text Available Canine American visceral leishmaniasis and American cutaneous leishmaniasis (ACL cases have been recorded in Espírito Santo do Pinhal. The aim of this study was to gather knowledge of the sand fly community and its population ecology within the municipality. Captures were made weekly over a period of 15 months in the urban, periurban and rural areas of the municipality, using automatic light traps. A total of 5,562 sand flies were collected, comprising 17 species. The most abundant species were Nyssomyia whitmani and Pintomyia pessoai in the rural area, Lutzomyia longipalpis and Ny. whitmani in the periurban area and Lu. longipalpis in the urban area. The highest species richness and greatest index species diversity were found in the rural area. The similarity index showed that urban and periurban areas were most alike. Lu. longipalpis was found in great numbers during both dry and humid periods. The presence of dogs infected with Leishmania infantum chagasi in the urban area indicates a high risk for the establishment of the disease in the region. A high abundance of Ny. whitmani and Pi. pessoai in the rural and periurban areas indicates the possibility of new cases of ACL occurring in and spreading to the periurban area of Espírito Santo do Pinhal.

  7. Lutzomyia longipalpis and the eco-epidemiology of American visceral leishmaniasis, with particular reference to Brazil: a review

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    Ralph Lainson

    2005-12-01

    Full Text Available An historical review is given of American visceral leishmaniasis (AVL, with particular reference to the eco-epidemiology of the disease in Brazil. Following the first records of AVL in this country, in 1934, the sandfly Lutzomyia longipalpis (Lutz and Neiva, 1912 was incriminated as the principal vector. It is now generally accepted, however, that there exist a number of cryptic species under the name of Lu. longipalpis s.l. and that variations in the quantity of the vasodilatory peptide maxadilan in the saliva of flies from different populations of Lu. longipalpis s.l., may account for the variable clinical manifestations of AVL seen in different geographic regions. Distribution of AVL has been shown to extend throughout most of South and Central America, with the domestic dog serving as the principal reservoir of infection for man. However, while one hypothesis suggests that the causative parasite is Leishmania infantum, imported from Europe with the Portuguese and Spanish colonists, the demonstration of a high rate of benign, inapparent infection in foxes in Amazonian Brazil raised an opposing suggestion that the parasite is indigenous to the Americas. Recent reports of similar infections in native marsupials, and possibly rodents, tend to support this view, particularly as Lu. longipalpis is primordially a silvatic sandfly. Although effective control measures in foci of the disease will diminish the number of canine and human infections, the presence of such an enzootic in a variety of native animals will render the total eradication of AVL unlikely.

  8. Phlebotomine sand flies in Porteirinha, an area of American visceral leishmaniasis transmission in the State of Minas Gerais, Brazil

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    Ricardo Andrade Barata

    2004-08-01

    Full Text Available A study of the phlebotomine sand fly fauna was carried out in an endemic area of American visceral leishmaniasis (AVL in the municipality of Porteirinha, in the Brazilian state of Minas Gerais. Captures were performed with CDC light traps in 7 districts, 5 days per month, during 2 consecutive years (January 2000 to December 2001. A total of 3240 sand flies were captured and identified. Sixteen species were found, among which 15 belonged to the genus Lutzomyia and one to the genus Brumptomyia. Lutzomyia longipalpis, a proven vector of AVL, was the predominant species (71.85% throughout the time period. The interference of climatic factors (temperature, humidity, and rainfall over the populational dynamics of the sand flies was determined. Statistical analysis of the data showed a significant correlation among the number of phlebotomine sand flies collected, rainfall, and humidity, whereas the effect of temperature was negligible, in that particular region. The amount of collected phlebotomine, the number of human cases, and the prevalence of canine AVL in the districts of Porteirinha are discussed.

  9. Studies on the sandfly fauna (Diptera: Psychodidae: Phlebotominae from transmission areas of American Cutaneous Leishmaniasis in state of Acre, Brazil

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    Alfredo CR Azevedo

    2008-12-01

    Full Text Available Studies were undertaken on the phlebotomines in the municipalities of Bujari, Xapuri and Rio Branco in the state of Acre. The abundance of species on the ground and in the tree canopy was estimated by Standardized Index of Species Abundance. Of the 52 species identified, Lutzomyia (N. antunesi, Lutzomyia (N. whitmani, Lutzomyia (P. davisi, Lutzomyia migonei, Lutzomyia (N. umbratilis, Lutzomyia (N. flaviscutellata, Lutzomyia (T. ubiqui-talis, Lutzomyia (P. hirsuta hirsuta, Lutzomyia (P. paraensis and Lutzomyia (P. ayrozai are known to be vectors of Leishmania, the causative agent of American cutaneous leishmaniasis. Lutzomyia (T. auraensis, Lu. (N. antunesi, Lu. (N. whitmani and Lu. (P. davisi accounted for 66.95% of the specimens collected. Lu. (N. whitmani was the most abundant species, followed by Lu. (N. antunesi and Lu. (P. davisi. Lu. (N. antunesi was the most abundant species in the soil as well as in the canopy. Lu. (N. umbratilis occurred in all three municipalities and was the fifth most abundant species in the Chico Mendes Municipal Park in Rio Branco. It was collected on both the ground level as well as in the canopy; however, it was more frequently collected in the tree canopy. The present study suggests the existence of three transmission cycles of Leishmania in Acre, including the transmission of Leishmania (V. guyanensis by Lu. (N. umbratilis south of the Amazon River.

  10. Immunopathology of american cutaneous leishmaniasis. Modulation of MHC class II gene products by Keratinocytes before and after glucantime therapy

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    Claude Pirmez

    1990-06-01

    Full Text Available Epidermal changes from 32 cutaneous and 3 mucosal American leishmaniasis (ACL active lesions were studied for HLA-DR, -DP expression, Lanerhans cells and lymphocyte infiltration. In addition to a DR and DQ positivity at the surface of the cells of the inflammatory infiltrate, a strong reaction for DR antigens was detected on keratinocytes. Hyperplasia of Langerhans cells was present in al cutaneous lesions and epidermis was infiltrated by T lymphocytes. When healed lesions of 14 of these subjects were re-biopsied 1 to 12 months after the end of pentavalent antimonial therapy, MHC class antigens could no longer be seen on keratinocytes. Our data represrn evidence for hhe reversibility of the abnormal HLA-DR expression by keratinocytes in ACL after Glucantime therapy or spontaneous scar formation, demonstrating that this expresion is restricted to the period of active lesions. The present findings can be regarded as an indirect evidence that keratinocytes may be involved in the immunopathology of ACL.

  11. MOLECULAR CHARACTERIZATION OF AMERICAN CUTANEOUS LEISHMANIASIS IN THE TRI‑BORDER AREA OF ASSIS BRASIL, ACRE STATE, BRAZIL

    Science.gov (United States)

    TELES, Carolina Bioni Garcia; MEDEIROS, Jansen Fernandes; dos SANTOS, Ana Paula de Azevedo; de FREITAS, Luís Antônio Rodrigues; KATSURAGAWA, Tony Hiroshi; CANTANHÊDE, Lilian Motta; FERREIRA, Ricardo de Godoi Mattos; CAMARG, Luís Marcelo Aranha

    2015-01-01

    SUMMARY In this study, Leishmaniaspecies were identified by Polymerase Chain Reaction (PCR). The epidemiology of patients suspected of having American Cutaneous Leishmaniasis in the municipality of Assis Brasil, Acre State, located in the Brazil/Peru/Bolivia triborder was also investigated. By PCR, the DNA of Leishmaniawas detected in 100% of the cases (37 samples) and a PCR-Restriction Fragment Length Polymorphism (RFLP) of the hsp 70gene identified the species in 32 samples: Leishmania (Viannia) braziliensis (65.6%) , L. (V.) shawi (28.1%) , L. (V.) guyanensis (3.1%) and mixed infection L. (V.) guyanensis and L. (Leishmania) amazonensis (3.1%)This is the first report of L. (V.) shawiand L. (L.) amazonensis in Acre. The two predominant species were found in patients living in urban and rural areas. Most cases were found in males living in rural areas for at least three years and involved in rural work. This suggests, in most cases, a possible transmission of the disease from a rural/forest source, although some patients had not engaged in activities associated with permanence in forestall areas, which indicate a possible sandflies adaptation to the periurban setting. PMID:26422160

  12. Validity of the polymerase chain reaction in the diagnosis of clinically suspected cases of American visceral leishmaniasis.

    Science.gov (United States)

    Pedrosa, Celia Maria Silva; Ximenes, Ricardo Arraes de Alencar; Almeida, Wendell Alexandre Pinheiro de; Rocha, Eliana Maria Mauricio da

    2013-01-01

    To test the validity of the polymerase chain reaction for diagnosing American visceral leishmaniasis, 88 suspected cases were studied. Diagnosis was confirmed in 47 (53.5%) and ruled out in 41 (46.5%) patients. Samples of bone marrow and peripheral blood were processed by polymerase chain reaction to evaluate the sensitivity and specificity of the test and its agreement beyond chance with microscopy examination. The polymerase chain reaction was positive in bone marrow of 100% of the patients with amastigotes seen with microscopy examination, and in 59.5% in those where no parasite were seen. Agreement beyond chance between visualization of the parasite in bone marrow aspirates and polymerase chain reaction was considered weak (Kappa=0.41). Concordance between polymerase chain reaction of bone marrow aspirates and of peripheral blood was considered excellent (Kappa=0.88). The test turned out positive in all bone marrow aspirates of those with the disease and whereas the positivity rate was 58.5% among those without the disease, with specificity rate of 41.5%.

  13. Epidemiological aspects of American Cutaneous Leishmaniasis in a periurban area of the metropolitan region of Belo Horizonte, Minas Gerais, Brazil

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    V. M. A. Passos

    1993-03-01

    Full Text Available In order to characterize the epidemiology of American Cutaneous Leishmaniasis (ACL in a periurban area of the municipality of Sabará in the metropolitan region of Belo Horizonte (MRBH, an area until then considered free of the disease, a cross sectional survey was undertaken in 1990. The survey of the population consisted of 1119 interviews and 881 clinical examinations using Montenegro's skin test (MST. A low prevalence (3.7% of positive MST was encountered. The disease had been occuring in the area for about 20 years in the form of sporadic cases. The predominant species of sandfly both in domestic areas and nearby areas of secondary vegetation was Lutzomyia whitmani. A canine survey of delayed hypersensitivity to the antigen P10,000 identified only one dog with a positive reaction out of 113 examined. The transmission of ACL in MRBH was confirmed. The occurrence of the disease in women, children and individuals with no contact with forest areas as well as the presence of potential vector species in the domiciliar environment, suggests the transmission of the disease in this environment.

  14. Host genetic factors in American cutaneous leishmaniasis: a critical appraisal of studies conducted in an endemic area of Brazil

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    Léa Cristina Castellucci

    2014-06-01

    Full Text Available American cutaneous leishmaniasis (ACL is a vector-transmitted infectious disease with an estimated 1.5 million new cases per year. In Brazil, ACL represents a significant public health problem, with approximately 30,000 new reported cases annually, representing an incidence of 18.5 cases per 100,000 inhabitants. Corte de Pedra is in a region endemic for ACL in the state of Bahia (BA, northeastern Brazil, with 500-1,300 patients treated annually. Over the last decade, population and family-based candidate gene studies were conducted in Corte de Pedra, founded on previous knowledge from studies on mice and humans. Notwithstanding limitations related to sample size and power, these studies contribute important genetic biomarkers that identify novel pathways of disease pathogenesis and possible new therapeutic targets. The present paper is a narrative review about ACL immunogenetics in BA, highlighting in particular the interacting roles of the wound healing gene FLI1 with interleukin-6 and genes SMAD2 and SMAD3 of the transforming growth factor beta signalling pathway. This research highlights the need for well-powered genetic and functional studies on Leishmania braziliensis infection as essential to define and validate the role of host genes in determining resistance/susceptibility regarding this disease.

  15. Predictors of an unsatisfactory response to pentavalent antimony in the treatment of American visceral leishmaniasis

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    Santos Mácia A.

    2002-01-01

    Full Text Available Although treatment of visceral leishmaniasis with pentavalent antimony is usually successful, some patients require second-line drug therapy, most commonly with amphotericin B. To identify the clinical characteristics that predict an inadequate response to pentavalent antimony, a case-control study was undertaken in Teresina, Piaui, Brazil. Over a two-year period, there were 19 cases of VL in which the staff physicians of a hospital prescribed second-line therapy with amphotericin B after determining that treatment with pentavalent antimony had failed. The control group consisted of 97 patients that were successfully treated with pentavalent antimony. A chart review using univariate and multivariate analysis was performed. The cure rate was 90% with amphotericin B. The odds ratio for the prescription of amphotericin B was 10.2 for children less than one year old, compared with individuals aged over 10 years. Patients who presented coinfection had an OR of 7.1 while those on antibiotics had an OR of 2.8. These data support either undertaking a longer course of therapy with pentavalent antimony for children or using amphotericin B as a first-line agent for children and individuals with coinfections. It also suggests that chemoprophylaxis directed toward bacterial coinfection in small children with VL may be indicated.

  16. Environmental factors associated with American cutaneous leishmaniasis in a new Andean focus in Colombia

    Science.gov (United States)

    Ocampo, C. B.; Ferro, M. C.; Cadena, H.; Gongora, R.; Pérez, M.; Valderrama-Ardila, C. H.; Quinnell, R. J.; Alexander, N.

    2016-01-01

    OBJECTIVE To evaluate the environmental and ecological factors associated with Leishmania transmission and vector abundance in Chaparral, Tolima-Colombia. METHODS First, we compared the ecological characteristics, abundance of phlebotomies and potential reservoir hosts in the peridomestic environment (100 m radius) of randomly selected houses, between two townships with high and low cutaneous leishmaniasis incidence. Second, we examined peridomestic correlates of phlebotomine abundance in all 43 houses in the higher risk township. RESULTS The high transmission township had higher coverage of forest (23% vs. 8.4%) and shade coffee (30.7% vs. 11%), and less coffee monoculture (16.8% vs. 26.2%) and pasture (6.3% vs. 12.3%), compared to the low transmission township. Lutzomyia were more abundant in the high transmission township 2.5 vs. 0.2/trap/night. Lutzomyia longiflocosa was the most common species in both townships: 1021/1450 (70%) and 39/80 (49%). Numbers of potential wild mammal reservoirs were small, although four species were found to be infected with Leishmania (Viannia) spp. In the high transmission township, the overall peridomiciliary capture rate of L. longiflocosa was 1.5/trap/night, and the abundance was higher in houses located nearer to forest (ρ = −0.30, P = 0.05). CONCLUSION The findings are consistent with a domestic transmission cycle with the phlebotomies dependent on dense vegetation near the house. PMID:22882595

  17. [Traditional treatments in an endemic area of american cutaneous Leishmaniasis in Peru].

    Science.gov (United States)

    Pineda-Reyes, Roberto; Llanos-Cuentas, Alejandro; Dancuart, Mauricio

    2015-10-01

    In order to know the first-choice treatment by villagers of an endemic area of Cutaneous Leishmaniasis (CL) prior to medical attention in a health care center, a cross sectional study was realized in Pichupampa town. A census was made in order to collect demographic data and previous history of CL. 254 participants were surveyed. 41.7% (106/254) of the village had CL at least once in their lives and only half of them went to a health center to seek for primary care. 76/106 (71.7%) used some traditional treatment as their first choice and only 23.6% (25/106) subjects went to a health-care center without manipulation of their lesions. It's evident that a high percentage (71.7%) of people potentially infected by CL manipulate and treat their lesions with traditional treatments prior to professional health-care, actions that could interfere with the diagnosis and effectiveness of the program implemented by the Health Ministry. PMID:26732927

  18. American Visceral Leishmaniasis: Factors Associated with Lethality in the State of São Paulo, Brazil

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    Geraldine Madalosso

    2012-01-01

    Full Text Available Objectives. To identify factors associated with death in visceral leishmaniasis (VL cases. Patients and Methodology. We evaluated prognostic factors for death from VL in São Paulo state, Brazil, from 1999 to 2005. A prognostic study nested in a clinical cohort was carried out by data analysis of 376 medical files. A comparison between VL fatal cases and survivors was performed for clinical, laboratory, and biological features. Association between variables and death was assessed by univariate analysis, and the multiple logistic regression model was used to determine adjusted odds ratio for death, controlling confounding factors. Results. Data analysis identified 53 fatal cases out of 376 patients, between 1999 and 2005 in São Paulo state. Lethality was 14.1% (53/376, being higher in patients older than fifty years. The main causes of death were sepsis, bleeding, liver failure, and cardiotoxicity due to treatment. Variables significantly associated with death were severe anemia, bleeding, heart failure, jaundice, diarrhea, fever for more than sixty days, age older than fifty years, and antibiotic use. Conclusion. Educational health measures are needed for the general population and continuing education programs for health professionals working in the affected areas with the purpose of identifying and treating early cases, thus preventing the disease evolution towards death.

  19. Clinical and Parasitological Features of Patients with American Cutaneous Leishmaniasis that Did Not Respond to Treatment with Meglumine Antimoniate

    Science.gov (United States)

    Robayo, Marta L.; Lopez, Myriam C.; Daza, Carlos D.; Bedoya, Angela; Mariño, Maria L.; Saavedra, Carlos H.

    2016-01-01

    Background American cutaneous leishmaniasis (ACL) is a complicated disease producing about 67.000 new cases per year. The severity of the disease depends on the parasite species; however in the vast majority of cases species confirmation is not feasible. WHO suggestion for ACL produced by Leishmania braziliensis, as first line treatment, are pentavalent antimonial derivatives (Glucantime or Sodium Stibogluconate) under systemic administration. According to different authors, pentavalent antimonial derivatives as treatment for ACL show a healing rate of about 75% and reasons for treatment failure are not well known. Methods In order to characterise the clinical and parasitological features of patients with ACL that did not respond to Glucantime, a cross-sectional observational study was carried out in a cohort of 43 patients recruited in three of the Colombian Army National reference centers for complicated ACL. Clinical and paraclinical examination, and epidemiological and geographic information were recorded for each patient. Parasitological, histopathological and PCR infection confirmation were performed. Glucantime IC50 and in vitro infectivity for the isolated parasites were estimated. Results Predominant infecting Leishmania species corresponds to L. braziliensis (95.4%) and 35% of the parasites isolated showed a significant decrease in in vitro Glucanatime susceptibility associated with previous administration of the medicament. Lesion size and in vitro infectivity of the parasite are negatively correlated with decline in Glucantime susceptibility (Spearman: r = (-)0,548 and r = (-)0,726; respectively). Conclusion A negative correlation between lesion size and parasite resistance is documented. L. braziliensis was found as the main parasite species associated to lesion of patients that underwent treatment failure or relapse. The indication of a second round of treatment in therapeutic failure of ACL, produced by L. braziliensis, with pentavalent antimonial

  20. Spatial analysis of areas likely to harbor American cutaneous leishmaniasis in Seropédica, Rio de Janeiro State, Brazil

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    Isabela Pereira de Oliveira

    2016-02-01

    Full Text Available The goal of the present study was to evaluate the spatial distribution of American cutaneous leishmaniasis (ACL in Seropédica, Rio de Janeiro State, Brazil according to the favorability of occurrence. The Vista-SAGA Geo-environmental Analysis System (Sistema de Análise Geoambiental Vista-SAGA was used to create a database (theme maps and perform environmental analyses, signatures and combinations. The degrees of likelihood were obtained by evaluating soil use and plant cover; soil type and geomorphology (geo-environmental factors; and altitude and slope (topographic factors. The factors used in the analyses were selected based on results from the literature and according to the technical feasibility of their inclusion in the databases. Weights and grades were attributed to the factors and their categories, respectively, according to their relevance to the life cycle of parasites from genus Leishmania and parasite vectors. Based on the results of the environmental analyses, areas were classified and grouped to represent the spatial distribution of favorability. Areas were classified as very unfavorable, unfavorable, somewhat favorable, favorable and very favorable for ACL occurrence. The results of the signature analyses showed that the municipality included 6.81% very favorable areas, 65.14% favorable areas, 17.98% somewhat favorable areas, 2.39% unfavorable areas and 0.07% very unfavorable areas for ACL occurrence. The signature analyses of the results and theme maps were able to locate and characterize the ecosystem profiles in terms of risk of ACL occurrence, indicating that rural, peri-urban and urban areas of the municipality of Seropédica may be classified as favorable for the occurrence of this disease. The results of the present study may be used to support management decisions made by authorities responsible for ACL control and prevention in Seropédica. In addition, geoprocessing was found to be a low-cost alternative for data

  1. Sustained Presence of Cutaneous Leishmaniasis in Urban Manaus, the Largest Human Settlement in the Amazon.

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    Benício, Ednelza; Cordeiro, Mayara; Monteiro, Hannah; Saboia Moura, Marco Antônio; Oliveira, Cintia; Nunes Gadelha, Ellen Pricilla; Chrusciak-Talhari, Anette; Talhari, Carolina; de Lima Ferreira, Luiz Carlos; Mira, Marcelo Távora; Lima Machado, Paulo Roberto; Talhari, Sinésio; Schriefer, Albert

    2015-12-01

    The Amazon is responsible for approximately 40% of the American tegumentary leishmaniasis (ATL) in Brazil. Herein the sustained presence of ATL in Manaus, the largest settlement in the Amazon, was investigated. Records of notification of historic cases, and data from cases prospectively enrolled in the Tropical Medicine Foundation of the Amazonas State were used. Geographic coordinates of prospective patients' living sites were used to detect inner-city clusters of ATL. Infecting Leishmania species was determined by polymerase chain reaction. Among prospectively enrolled subjects, 94.8% were infected with Leishmania (Viannia) guyanensis, 76.7% were male, 30.2% were 0-20 years old, and 69.8% had an urban residence. Historic cases showed a profile similar to that of prospectively enrolled subjects. Several clusters of ATL, widely distributed within the city of Manaus, could be detected. In conclusion, there was a high frequency of disease in young age groups and cases clustered in urban neighborhoods. It cannot be determined from these data whether transmission of these cases occurred within or outside the city of Manaus. PMID:26483119

  2. Leishmaniasis FAQs

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    ... have become infected in various countries, such as Iraq and Afghanistan Back To Top Is leishmaniasis found ... source: Global Health - Division of Parasitic Diseases and Malaria Notice: Linking to a non-federal site does ...

  3. Cutaneous Leishmaniasis

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    Mehmet Harman

    2015-12-01

    Full Text Available Leishmaniasis is used to describe a spectrum of diseases caused by the parasitic protozoa leishmania spp. and transmitted by infected female sandflies. There are three main forms of the disease; cutaneous, mucocutaneous, and visceral. According to the World Health Organization, almost 12 million people from 98 countries worldwide are currently infected with leishmaniasis, while 350 million people are at risk. It was reported that 2 million new cases are diagnosed every year, with three-fourth are cutaneous leishmaniasis (CL cases. The scientific and medical communities have learnt a lot about CL during the 20th and early 21st centuries. However, the management and control of the disease remains a difficult task. This article was focused on the most common form of the disease, cutaneous leishmaniasis, and especially its epidemiological aspects and treatment.

  4. The use of different concentrations of leishmanial antigen in skin testing to evaluate delayed hypersensitivity in american cutaneous leishmaniasis

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    César A. Cuba Cuba

    1985-12-01

    Full Text Available Three concentrations of Leishmania mexicana amazonensis sonicated whole promastigote antigen (30, 9.6 and 3 ug N in 0.1 ml wereprepared and 0.1 ml of each inoculated intradermally intopatients who live in one endemic leishmaniasis region in Brazil. Patients were divided into groups with active cutaneous leishmaniasis (ACL, healed cutaneous leishmaniasis (HCL, mucosal leishmaniasis (ML, and Controls (C. Skin reactions were recorded by measuring induration 48 hours after inoculation. Skin tests using 9.6 ugN/0.1 mlyielded the best diagnostic resultssince 97% of 30 patients with active lesions (cutaneous or mucosal and 83% with HCL showed reactions of 5 mm orgreater as compared with 4% Controls. Tests using 30ug N/O. 1 ml causedan unacceptable levei of skin reactions with necrosis (10% of ACL patients tested and 17% of HCL, respectively. Tests using 3 ug N/O. 1 ml were less sensitive since only 87% of patients with active lesions and 68% with HCL had reactions of 5mm orgreater. The 3 ug N/O. 1 ml dose was utilized to ask the questions whether skin delayed hypersensitivity decreased with time after the initial lesion and whether mucosal involvement is associated with enhaced hypersensitivity to leishmanial antigen. Decreased delayed hypersensitivity was noted only in those patients who had an initial lesion more than 30 years ago. The mean induration of the reaction in 10 patients with ML was 11.3 mm ± 7.15, in 41 patients with HCL, 9.27 mm ± 6.78 and in 20patients with ACL 10. 7 mm ± 6.10 mm. The percent of patients with 5 mm orgreater induration was ML 80%, HCL 71%, ACL 90%. Thus, we could not confirm an association between enhanced delayed hypersensitivity and mucosal involvement in leishmaniasis.

  5. Eclectic feeding behavior of Lutzomyia (Nyssomyia intermedia (Diptera, Psychodidae, Phlebotominae in the transmission area of American cutaneous leishmaniasis, state of Paraná, Brazil

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    Mauricio Baum

    2013-10-01

    Full Text Available Introduction The blood meal source of sandflies provides valuable information about the vector/host interaction and allows for an understanding of American cutaneous leishmaniasis (ACL transmission mechanisms. The aim of this study was to identify the blood meal sources of Lutzomyia (Nyssomyia intermedia in an endemic area of leishmaniasis in Brazil's State of Paraná using a precipitin test. Methods Sandflies were collected in the rural locality of Epitácio Pessoa within the City of Adrianópolis, State of Paraná, in southern Brazil. A total of 864 female sandflies were captured, and 862 (99.8% were identified as L. intermedia species. However, two unidentified specimens were considered to be part of the genus Lutzomyia. Results Among the females examined, 396 specimens presented reactions to a certain type of tested antiserum, and most (67.9% reacted to the simple type. These sandflies fed mainly on the blood of birds, opossums, and rodents, but specimens that fed on the blood of humans, dogs, horses, cattle, and cats were also found. Among the cross-reactions found (32.1%, bird/rodent, bird/opossum, bird/dog, bird/human, and horse/dog cross-reactions were the most common. Conclusions These results demonstrate a tendency in the eclectic feeding behavior of L. intermedia and support its potential role as a vector for ACL in the study area.

  6. Molecular detection of the blood meal source of sand flies (Diptera: Psychodidae) in a transmission area of American cutaneous leishmaniasis, Paraná State, Brazil.

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    Baum, Maurício; de Castro, Edilene Alcântara; Pinto, Mara Cristina; Goulart, Thais Marchi; Baura, Walter; Klisiowicz, Débora do Rocio; Vieira da Costa-Ribeiro, Magda Clara

    2015-03-01

    The feeding behavior of sand flies provides valuable information about the vector/host interactions and elucidates the epidemiological patterns of American cutaneous leishmaniasis (ACL) transmission. The aim of this study was to identify the blood meal sources of sand flies in endemic areas of leishmaniasis in Paraná State through polymerase chain reaction (PCR) amplification of a prepronociceptin (PNOC) gene fragment and its subsequent DNA sequencing. Moreover, molecular assays were conducted to evaluate the sensitivity and reproducibility of the PNOC gene amplification. Besides that, a time-course digestion test of the blood using sand flies that fed artificially on BALB/c mice was performed. Of 1263 female sand flies collected in the field, 93 (3.6%) specimens were engorged and 27 allowed efficient amplification of the PNOC gene. These flies had fed on equine (Equus caballus), porcine (Sus scrofa) and canine (Canis lupus familiaris) species. The results also showed that the identification of the blood meal sources of the sand flies using the molecular method was directly linked to the level of digestion of the blood (time-course) and not to the amount of blood that had been ingested or to the presence of inhibitors in the blood.

  7. Laryngeal Leishmaniasis

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    Moraes, Bruno Teixeira de

    2012-01-01

    Full Text Available Introduction: Leishmaniasis is classified into three clinical presentations: visceral, coetaneous and mucocutaneous. The latter is usually secondary to hematogenous spread after months or years of skin infection and can manifest as infiltrative lesions, ulcerated or vegetating in nose, pharynx, larynx and mouth, associated or not with ganglionics infarction. Laryngeal involvement is part of the differential diagnosis of lesions in this topography as nonspecific chronic laryngitis, granulomatosis and even tumors of the upper aerodigestive tract presenting atypical evolution. Sometimes it is difficult for the correct diagnosis of Leishmaniasis, with description of cases in the literature were conducted improperly. Objective: The objective of this study is to report a case of laryngeal Leishmaniasis addressing the difficulty of diagnosis, complications and treatment applied. Case Report: A patient with pain throat, dysphagia, odynophagia, dysphonia and weight loss, with no improvement with symptomatic medication. At telelaringoscopy, infiltrative lesion showed nodular supraglottis. He underwent a tracheotomy for airway obstruction and biopsy with immunohistochemical study for a definitive diagnosis of laryngeal Leishmaniasis. The patient was referred to the infectious diseases that initiated treatment with N-methylglucamine antimoniate with satisfactory response to therapy. Final Comments: Faced with a clinical suspicion of granulomatous diseases, it is essential to follow protocol laboratory evaluation associated with histological injury, to get a precise definition etiological without prolonging the time of diagnosis. Medical treatment for mucosal Leishmaniasis, recommended by the World Health Organization, was adequate in the case of laryngeal disorders, with complete resolution of symptoms.

  8. Leishmaniasis as a Manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV-Infected Patients: A Literature Review

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    Badaró, Roberto; Gonçalves, Larissa O.; Gois, Luana L.; Maia, Zuinara Pereira Gusmão; Benson, Constance; Grassi, Maria Fernanda Rios

    2016-01-01

    Introduction After the onset of highly active antiretroviral therapy (HAART), some HIV-infected patients present a severe inflammation in response to a latent or a previously treated opportunistic pathogen termed immune reconstitution inflammatory syndrome (IRIS). Few reports of tegumentary and visceral leishmaniasis have been described in association with IRIS. Methods A systematic literature review of IRIS in association with leishmaniasis identified 34 reported cases. Results and Discussion The majority of these occurred in males 4 months following the onset of HAART. The mean CD4 count before HAART was 94 ± 77 cells/mm3, increasing to 5 times the initial value between the onset of HAART and IRIS presentation. Visceral leishmaniasis and post–kala-azar dermal leishmaniasis were the most commonly reported clinical manifestations, followed by tegumentary leishmaniasis and uveitis. Conclusions Commonly found characteristics included cutaneous involvement, regardless of Leishmania species; appearance of lesions unrelated to time of probable Leishmania infection; rapid recovery of CD4 count following HAART; and rapid progression. PMID:25331225

  9. Therapeutic options for old world cutaneous leishmaniasis and new world cutaneous and mucocutaneous leishmaniasis.

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    Monge-Maillo, Begoña; López-Vélez, Rogelio

    2013-11-01

    Estimated worldwide incidence of tegumentary leishmaniasis (cutaneous leishmaniasis [CL] and mucocutaneous leishmaniasis [MCL]) is over 1.5 million cases per year in 82 countries, with 90 % of cases occurring in Afghanistan, Brazil, Iran, Peru, Saudi Arabia and Syria. Current treatments of CL are poorly justified and have sub-optimal effectiveness. Treatment can be based on topical or systemic regimens. These different options must be based on Leishmania species, geographic regions, and clinical presentations. In certain cases of Old World CL (OWCL), lesions can spontaneously heal without any need for therapeutic intervention. Local therapies (thermotherapy, cryotherapy, paromomycin ointment, local infiltration with antimonials) are good options with less systemic toxicity, reserving systemic treatments (azole drugs, miltefosine, antimonials, amphotericin B formulations) mainly for complex cases. The majority of New World CL (NWCL) types require systemic treatment (mainly with pentavalent antimonials), either to speed the healing or to prevent dissemination to oral-nasal mucosa as MCL (NWMCL). These types of lesions are potentially serious and always require systemic-based regimens, mainly antimonials and pentamidine; however, the associated immunotherapy is promising. This paper is an exhaustive review of the published literature on the treatment of OWCL, NWCL and NWMCL, and provides treatment recommendations stratified according to their level of evidence regarding the species of Leishmania implicated and the geographical location of the infection. PMID:24170665

  10. Association of Lutzomyia longipalpis (Diptera: Psychodidae population density with climate variables in Montes Claros, an area of American visceral leishmaniasis transmission in the state of Minas Gerais, Brazil

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    Érika Monteiro Michalsky

    2009-12-01

    Full Text Available In the present paper, we evaluate the relationship between climate variables and population density of Lutzomyia longipalpis in Montes Claros, an area of active transmission of American visceral leishmaniasis (AVL in Brazil. Entomological captures were performed in 10 selected districts of the city, between September 2002-August 2003. A total of 773 specimens of L. longipalpiswere captured in the period and the population density could be associated with local climate variables (cumulative rainfall, average temperature and relative humidity through a mathematical linear model with a determination coefficient (Rsqr of 0.752. Although based on an oversimplified statistical analysis, as far as the vector is concerned, this approach showed to be potentially useful as a starting point to guide control measures for AVL in Montes Claros.

  11. Association of Lutzomyia longipalpis (Diptera: Psychodidae) population density with climate variables in Montes Claros, an area of American visceral leishmaniasis transmission in the state of Minas Gerais, Brazil.

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    Michalsky, Erika Monteiro; Fortes-Dias, Consuelo Latorre; França-Silva, João Carlos; Rocha, Marilia Fonseca; Barata, Ricardo Andrade; Dias, Edelberto Santos

    2009-12-01

    In the present paper, we evaluate the relationship between climate variables and population density of Lutzomyia longipalpis in Montes Claros, an area of active transmission of American visceral leishmaniasis (AVL) in Brazil. Entomological captures were performed in 10 selected districts of the city, between September 2002-August 2003. A total of 773 specimens of L. longipalpiswere captured in the period and the population density could be associated with local climate variables (cumulative rainfall, average temperature and relative humidity) through a mathematical linear model with a determination coefficient (Rsqr) of 0.752. Although based on an oversimplified statistical analysis, as far as the vector is concerned, this approach showed to be potentially useful as a starting point to guide control measures for AVL in Montes Claros.

  12. Effects of azadirachtin on the biology of Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae) adult female, the main vector of American visceral leishmaniasis.

    Science.gov (United States)

    De Andrade-Coelho, Cláudia Alves; De Souza, Nataly Araujo; Silva, Vanderlei Campos; Souza, Adelson A; Gonzalez, Marcelo Salabert; Rangel, Elizabeth Ferreira

    2014-07-01

    The effects of azadirachtin A added to the sucrose diet of the adult females on the mortality, oviposition, and hatching of the sand fly vector of American visceral leishmaniasis Lutzomyia longipalpis (Lutz & Neiva, 1912) were investigated. Concentrations of 0.1, 1.0, and 10.0 microg/mg of azadirachtin significantly increased insect mortality in comparison with control insects. The same dose also significantly reduced oviposition but not hatching. After a long development period, significantly fewer adult insects were obtained from eggs hatching by azadirachtin-treated females in a dose-response manner. These results indicate that azadirachtin is a potent sterilizer that could be used against the development of Lu. longipalpis populations and as a tool for studying physiological and biochemical processes in phlebotomine species. PMID:25118426

  13. An analysis of the spatiotemporal distribution of American cutaneous leishmaniasis in counties located along road and railway corridors in the State of Maranhao, Brazil

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    Vicente Silva Goncalves Neto

    2013-06-01

    Full Text Available Introduction The incidence of American cutaneous leishmaniasis (ACL is increasing in Latin America, especially in Brazil, where 256,587 cases were confirmed in the last decade. Methods This study used a Bayesian model to examine the spatial and temporal distribution of ACL cases between 2000 and 2009 in 61 counties of State of Maranhão located along the three main road and railway corridors. Results During the study period, 13,818 cases of ACL were recorded. There was a significant decrease in the incidence of ACL in the ten study years. The recorded incidence rate ranged from 7.36 to 241.45 per 100,000 inhabitants. The relative risk increased in 77% of the counties, decreased in 18% and was maintained in only five counties. Conclusions Although there was a decreased incidence of the disease, ACL was present in all of the examined municipalities, thus maintaining the risk of contracting this illness.

  14. Studies on the Feeding Habits of Lutzomyia (Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera: Psychodidae: Phlebotominae Populations from Endemic Areas of American Visceral Leishmaniasis in Northeastern Brazil

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    Margarete Martins dos Santos Afonso

    2012-01-01

    Full Text Available The aim of this study was to identify potential blood feeding sources of L. (L. longipalpis specimens from populations in Northeastern Brazil, endemic areas of American Visceral Leishmaniasis (AVL and its correlation with the transmission of L. (L. i. chagasi. The ELISA technique was applied using bird, dog, goat, opossum, equine, feline, human, sheep, and rodent antisera to analyze 609 females, resulting in an overall positivity of 60%. In all municipalities, females showed higher positivity for bird followed by dog antiserum and sand fly specimens were also positive for equine, feline, human, sheep, goat, opossum, and rodent antisera. The finding for 17 combinations of two or three types of blood in some females corroborates the opportunistic habit of this sand fly species. The results demonstrating the association between L. (L. longipalpis and opossum suggest the need for further evaluation of the real role of this synanthropic mammal in the eco-epidemiology of AVL.

  15. Moonlight and blood-feeding behaviour of Lutzomyia intermedia and Lutzomyia whitmani (Diptera:Psychodidae:Phlebotominae, vectors of American cutaneous leishmaniasis in Brazil

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    Nataly A Souza

    2005-02-01

    Full Text Available Lutzomyia intermedia (Lutz & Neiva, 1912 and L. whitmani (Antunes & Coutinho, 1939 (Diptera: Psychodidae: Phlebotominae, two important vectors of American cutaneous leishmaniasis in Brazil, occur in sympatry in the locality of Posse county, Petrópolis municipality, state of Rio de Janeiro, Brazil. We investigated the influence of the lunar cycle on the frequency of specimens of the two species caught while attempting to bite the collectors and in CDC light traps. Analysis of the numbers of sand flies captured in different lunar phases for two consecutive years in the peridomestic site and forest shows that there is a significant positive correlation between moonlight intensity and the numbers of L. intermedia and L. whitmani females collected while blood-feeding, whereas the opposite was observed for the CDC traps.

  16. Fauna of phlebotomine sand flies (Diptera, Psychodidae in areas with endemic American cutaneous leishmaniasis in the State of Mato Grosso do Sul, Brazil

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    Paulo Silva de Almeida

    2013-03-01

    Full Text Available Fauna of phlebotomine sand flies (Diptera, Psychodidae in areas with endemic American cutaneous leishmaniasis in the State of Mato Grosso do Sul, Brazil. The aim of this study was to investigate the ecological aspects of the main vectors of American cutaneous leishmaniasis (ACL in four monitoring stations situated in the municipalities of Naviraí, Nova Andradina, Novo Horizonte do Sul and Rio Verde de Mato Grosso. For each monitoring station, the captures of sand flies were undertaken each month from July 2008 to June 2010 using CDC and Shannon traps. The CDC traps were installed simultaneously for three consecutive nights in three collection sites: intradomicile, peridomicile and edge of the forest. A Shannon trap was installed from dusk to 10 pm, inside the forest, one night per month. A total of 7,651 sand flies belonging to nine genera and twenty-nine species were captured. Nyssomyia neivai (52.95%, Psathyromyia hermanlenti (10.91%, Psathyromyia runoides (9.16%, Nyssomyia whitmani (7.95%, Psathyromyia aragaoi (4. 89%, Nyssomyia antunesi (3.14% and Evandromyia bourrouli (2.20% were the most frequent species. Approximately 65% of the sand flies were collected in the forest environment. The municipalities presented significantly different indexes of species diversity. Naviraí presented the lowest species diversity index, however, it showed the highest abundance. Novo Horizonte do Sul had the highest species diversity index, but the lowest abundance (< 5%. It is noteworthy the occurrence of vector species of Leishmania in the areas studied, especially in Naviraí, where Ny. neivai presented high frequencies which may explain the increased number of ACL cases in this municipality.

  17. Phlebotomine fauna (Diptera: Psychodidae and species abundance in an endemic area of American cutaneous leishmaniasis in southeastern Minas Gerais, Brazil

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    Carlos Frederico Loiola

    2007-08-01

    Full Text Available This study was undertaken to identify the phlebotomine fauna and species abundance in domiciliary and peridomiciliary (hen-house and guava-tree environments, on a lake shore, a cultivated area of coffee and banana, and a forested area of Conceição da Aparecida municipality, southeastern the state of Minas Gerais, to provide information for the control and epidemiological surveillance of leishmaniasis in this area. The captures were carried out monthly between May 2001 and November 2002, with automatic light and Shannon traps. A total of 1444 sand flies were captured, 951 (76.5% with automatic light traps and 493 (23.5% with the Shannon trap. Thirteen species were captured, the most frequent being Nyssomyia whitmani (62.7%, Migonemyia migonei (21.4%, Pintomyia fischeri (6.9%, and Evandromyia lenti (3.6%. Species abundance was determined using the automatic light traps installed in the six environments. The most abundant species according to the standardized index of species abundance were Ny. whitmani (1.0 and Mg. migonei (0.82. In view of the dominance of these two species, known vectors of cutaneous leishmaniasis in other Brazilian areas, their participation in the transmission of the disease in this county is suggested. The diversity and evenness indexes in the domicile were the lowest due to the high frequency (83% of Ny. whitmani. The capture of Lutzomyia longipalpis, rarely recorded in the south-eastern and southern regions of Minas Gerais, is also noteworthy.

  18. Leishmaniose mucosa: considerações epidemiológicas e de tratamento Mucosal leishmaniasis: epidemiological and treatment considerations Leishmaniasis mucosa: consideraciones epidemiológicas y de tratamiento

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    Letícia Ziggiotti de Oliveira

    2011-06-01

    Full Text Available Na região Sul do Brasil, a leishmaniose tegumentar americana predomina no Estado do Paraná, especialmente ao Norte e Oeste, onde um dos circuitos de produção da doença é localizado. Estima-se que 3 a 5% dos casos de leishmaniose cutânea desenvolvam lesão mucosa, e que cerca de 1% destas podem evoluir para óbito. De longa data, as drogas de escolha para tratamento da doença são os compostos antimoniais sob a forma de sais pentavalentes. O objetivo deste estudo foi descrever características epidemiológicas e de tratamento dos pacientes com leishmaniose mucosa, diagnosticados no período de 2001 a 2007, em municípios localizados na área de abrangência da 13ª Regional de Saúde, com sede no município de Cianorte, no Paraná. As informações foram coletadas do prontuário ambulatorial e das fichas de investigação epidemiológicas do Sistema de Notificação e Informação de Agravos. No período estudado, foram notificados 505 casos de leishmaniose tegumentar americana, 30 deles (6% na forma mucosa. Foram incluídos no estudo pacientes com diagnóstico de leishmaniose mucosa, que apresentavam exames complementares realizados antes e durante o tratamento. Os resultados evidenciaram a necessidade de acompanhamento cuidadoso dos doentes nas equipes de saúde, dado a possível evolução e presença de efeitos medicamentosos indesejáveis nos pacientes afetados pela condição. In South Brazil, American tegumentary leishmaniasis is predominant at Paraná, specially on the North and West areas, where it is localized one of the disease’s production circuits. It is believed that 3 to 5% of the cases evolve to the mucosal form, and that 1% of these can evolve to death. There is a long time that first choice drugs to treat this disease are the antimony compounds as pentavalent salts. The purpose of this study was to describe epidemiological and treatment characteristics of patients with mucosal leishmaniasis, who were diagnosed during

  19. Development and validation of PCR-based assays for diagnosis of American cutaneous leishmaniasis and identificatio nof the parasite species

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    Grazielle Cardoso da Graça

    2012-08-01

    Full Text Available In this study, PCR assays targeting different Leishmania heat-shock protein 70 gene (hsp70 regions, producing fragments ranging in size from 230-390 bp were developed and evaluated to determine their potential as a tool for the specific molecular diagnosis of cutaneous leishmaniasis (CL. A total of 70 Leishmania strains were analysed, including seven reference strains (RS and 63 previously typed strains. Analysis of the RS indicated a specific region of 234 bp in the hsp70 gene as a valid target that was highly sensitive for detection of Leishmania species DNA with capacity of distinguishing all analyzed species, after polymerase chain reaction-restriction fragment length polymorfism (PCR-RFLP. This PCR assay was compared with other PCR targets used for the molecular diagnosis of leishmaniasis: hsp70 (1400-bp region, internal transcribed spacer (ITS1 and glucose-6-phosphate dehydrogenase (G6pd. A good agreement among the methods was observed concerning the Leishmania species identification. Moreover, to evaluate the potential for molecular diagnosis, we compared the PCR targets hsp70-234 bp, ITS1, G6pd and mkDNA using a panel of 99 DNA samples from tissue fragments collected from patients with confirmed CL. Both PCR-hsp70-234 bp and PCR-ITS1 detected Leishmania DNA in more than 70% of the samples. However, using hsp70-234 bp PCR-RFLP, identification of all of the Leishmania species associated with CL in Brazil can be achieved employing a simpler and cheaper electrophoresis protocol.

  20. Force of infection and evolution of lesions of canine tegumentary leishmaniasis in Northwestern Argentina

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    Jorge Diego Marco

    2001-07-01

    Full Text Available A clinical-serological follow-up was carried out in a canine population in endemic foci of Leishmania braziliensis spread in northwestern Argentina. Each dog was studied in at least two visits, 309±15 days (X±SE apart. Some initially healthy dogs (n=52 developed seroconversion or lesions. The clinical evolution of the disease in dogs resembles in many aspects the human disease. Similarities include the long duration of most ulcers with occasional healing or appearance of new ones and the late appearance of erosive snout lesions in some animals. Yearly incidence rates of 22.7% for seroconversion and of 13.5% for disease were calculated as indicators of the force of infection by this parasite upon the canine population.

  1. Sand fly vectors (Diptera, Psychodidae) of American visceral leishmaniasis areas in the Atlantic Forest, State of Espírito Santo, southeastern Brazil.

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    Pinto, Israel de Souza; Ferreira, Adelson Luiz; Valim, Valéria; Carvalho, Felipe dos Santos; da Silva, Giovana Marques; Falcão, Alda Lima; Dietze, Reynaldo; Falqueto, Aloísio

    2012-06-01

    The aim of this study was to evaluate the sand fly fauna of American visceral leishmaniasis (AVL) endemic areas within the Central Atlantic Forest Biodiversity Corridor, State of Espírito Santo, southeastern Brazil. The sand fly captures were performed between January, 1989 and December, 2003 in localities where autochthonous cases of AVL were recorded, as well as in their boundary areas. Sand flies were collected from surrounding houses and domestic animal shelters using two to five CDC automatic light traps, and manual captures were also performed using mouth aspirators in one illuminated Shannon trap during the first four hours of the night. We used cladistic analysis to determine the geographic relationships among the collected sand fly species as well as the index species for the occurrence of other sand flies. A total of 62,469 sand flies belonging to 17 species and eight genera was collected in 164 localities from nine municipalities with AVL records. The richness (S=17) and diversity (H=0.971) of sand flies were lower than in conservation areas and similar to modified environments in the Atlantic Forest of Espírito Santo. Lutzomyia longipalpis was identified in 79 localities. The cladistic analysis identified Evandromyia lenti as the index species for Lutzomyia longipalpis. The latter seems to be the main vector of AVL in the Central Atlantic Forest Biodiversity Corridor due to its high abundance and distribution matching the disease occurrence. Therefore, Evandromyia lenti may be used as an index species for the occurrence of Lutzomyia longipalpis.

  2. Natural Leishmania (Viannia) spp. infections in phlebotomine sand flies (Diptera: Psychodidae) from the Brazilian Amazon region reveal new putative transmission cycles of American cutaneous leishmaniasis.

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    de Souza, Adelson Alcimar Almeida; Dos Santos, Thiago Vasconcelos; Jennings, Yara Lúcia Lins; Ishikawa, Edna Aoba Yassui; Barata, Iorlando da Rocha; Silva, Maria das Graças Soares; Lima, José Aprígio Nunes; Shaw, Jeffrey; Lainson, Ralph; Silveira, Fernando Tobias

    2016-01-01

    In Amazonian Brazil the etiological agents of American cutaneous leishmaniasis (ACL) belong to at least seven Leishmania species but little is known about the putative phlebotomine sand fly vectors in different biomes. In 2002-2003 a survey of the phlebotomine fauna was undertaken in the "Floresta Nacional do Tapajós", Belterra municipality, in the lower Amazon region, western Pará State, Brazil, where we recently confirmed the presence of a putative hybrid parasite, L. (V.) guyanensis × L. (V.) shawi shawi. Sand flies were collected from Centers for Disease Control (CDC) light traps, Shannon traps and by aspiration on tree bases. Females were dissected and attempts to isolate any flagellate infections were made by inoculating homogenized midguts into Difco B(45) medium. Isolates were characterized by monoclonal antibodies and isoenzyme electrophoresis. A total of 9,704 sand flies, belonging to 68 species or subspecies, were collected. Infections were found in the following sand flies: L. (V.) naiffi with Psychodopygus hirsutus hirsutus (1) and Ps. davisi (2); and L. (V.) shawi shawi with Nyssomyia whitmani (3) and Lutzomyia gomezi (1). These results provide strong evidence of new putative transmission cycles for L. (V.) naiffi and L. (V.) s. shawi.

  3. Spatial epidemiology of American cutaneous leishmaniasis in a municipality of west São Paulo State, Brazil

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    Elivelton da Silva Fonseca

    2014-12-01

    Full Text Available Background & objectives: In the last decade, in the state of São Paulo, 5898 cases of cutaneous leishmaniasis (CL were reported. This study was undertaken to analyze the epidemiology of CL in the municipality of Teodoro Sampaio, in São Paulo State, Brazil, based on a geographic approach, as very little is known of the relationship between CL and the spatial transformation process. Methods: This is a population-based quantitative, descriptive and cross-sectional case study. Surveys of the official notifications in the healthcare center and official sources from 1998 to 2011 were analysed. The data were described based on statistics and the Kernel method to detect hotspots of transmission. Results: The age group between 21 and 40 yr was most affected, with 24 cases (57.9%. Of the 41 cases reported between 1998 and 2011, 33 cases were having low education status and 31 cases (75.6% were males. The spatial and temporal distribution was aggregated in three-year periods which permitted the identification of two microfoci, in periods I (1998–2000 and III (2005–2007. Interpretation & conclusion: The disease has presented, in recent years, a pattern of sporadic transmission or microfoci, and continues to maintain enzootic cycles of Leishmania in a sylvatic environment, ensuring the perpetuation of the pathogen in nature, and the risk of emergence of new cases of CL in domestic animals and humans.

  4. Prevalência da infecção canina em áreas endêmicas de leishmaniose tegumentar americana, do município de Paracambi, Estado do Rio de Janeiro, no período entre 1992 e 1993 Prevalence of canine infection from endemic areas of American cutaneous leishmaniasis in Paracambi District, Rio de Janeiro State, between 1992 and 1993

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    Ginelza Peres Lima dos Santos

    2005-04-01

    Full Text Available No município de Paracambi, Estado do Rio de Janeiro, foi realizado um inquérito epidemiológico sobre a leishmaniose tegumentar americana na população canina residente em áreas endêmicas rural e semiurbana. Foram cadastrados 179 cães e 138 (77,1% foram examinados, segundo seus aspectos clínicos e desenvolvimento de hipersensibilidade tardia ao antígeno Imunoleish® e respostas sorológicas à reação de imunofluorescência indireta e ao ensaio imunoenzimático. Dos 9 (6,5.% animais portadores de lesões/cicatrizes suspeitas, 66,7% foram causadas por Leishmania sp; 44,4% produziram infecção em hamsters e apresentaram crescimento em meio de cultura, compatíveis com o comportamento de Leishmania do complexo braziliensis. A caracterização molecular (análises isoenzimáticas e do perfil de restrição do KDNA identificou 2 amostras como similares à Leishmania (Viannia braziliensis. A prevalência da infecção canina observada através do teste cutâneo, RIFI e ELISA foi, respectivamente, 10,1%, 16,7% e 27,8%. A presença das formas clínica/subclínica da LTA na população canina associada à infecção humana sugere que o cão pode atuar como possível fonte de infecção, assim como na disseminação da doença.In the district of Paracambi, State of Rio de Janeiro an epidemiological survey for American tegumentary leishmaniasis in canine population was carried out in endemic localities. A total of 179 dogs was registered and 138 (77.1% examined for their clinical aspects, development of delayed hypersensitivity (DHS with Imunoleish® antigen and serological responses by indirect immunofluorescent reaction and enzyme-linked immunosorbent assay. In 9 (6.5% dogs with active cutaneous lesions or suspect scars, 66.7% were caused by Leishmania sp; 44.4% produced infection in hamsters and showed growth in culture media, which was considered to be compatible with the species of Leishmania braziliensis complex. The molecular

  5. Neutrophil Extracellular Traps Identification in Tegumentary Lesions of Patients with Paracoccidioidomycosis and Different Patterns of NETs Generation In Vitro.

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    Amanda Manoel Della Coletta

    Full Text Available Paracoccidioidomycosis (PCM is a systemic mycosis, endemic in most Latin American countries, especially in Brazil. It is caused by the thermo-dimorphic fungus of the genus Paracoccidioides (Paracoccidioides brasiliensis and Paracoccidioides lutzii. Innate immune response plays a crucial role in host defense against fungal infections, and neutrophils (PMNs are able to combat microorganisms with three different mechanisms: phagocytosis, secretion of granular proteins, which have antimicrobial properties, and the most recent described mechanism called NETosis. This new process is characterized by the release of net-like structures called Neutrophil Extracellular Traps (NETs, which is composed of nuclear (decondensed DNA and histones and granular material such as elastase. Several microorganisms have the ability of inducing NETs formation, including gram-positive and gram-negative bacteria, viruses and some fungi. We proposed to identify NETs in tegumentary lesions of patients with PCM and to analyze the interaction between two strains of P. brasiliensis and human PMNs by NETs formation in vitro. In this context, the presence of NETs in vivo was evidenced in tegumentary lesions of patients with PCM by confocal spectrum analyzer. Furthermore, we showed that the high virulent P. brasiliensis strain 18 (Pb18 and the lower virulent strain Pb265 are able to induce different patterns of NETs formation in vitro. The quantification of extracellular DNA corroborates the idea of the ability of P. brasiliensis in inducing NETs release. In conclusion, our data show for the first time the identification of NETs in lesions of patients with PCM and demonstrate distinct patterns of NETs in cultures challenged with fungi in vitro. The presence of NETs components both in vivo and in vitro open new possibilities for the detailed investigation of immunity in PCM.

  6. Histopathology of human American cutaneous leishmaniasis before and after treatment Histopatologia de leishmaniose tegumentar americana humana, antes e após o tratamento

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    A.C.C. Botelho

    1998-02-01

    Full Text Available Chemical therapy for the treatment of leishmaniasis is still inadequate, and a number of drugs and therapeutic programs are being tested. Besides treatment, the ultimate goal is an effective cure, and histopathological analyses of the lesion cicatrices constitute an important measure of treatment success, or otherwise, in this respect. In this paper, we describe histopathological patterns in cases of American cutaneous leishmaniasis in 32 patients from the municipality of Caratinga, Minas Gerais, Brazil, before and after treatment with the following therapeutic methodos: l leishvacin + glucantime; 2 leishvacin + BCG associated with glucantime; 3 glucantime; 4 leishvacin + BCG. Lesion fragments were collected from all patients by biopsy prior to, and approximately 30 days after, each treatment which resulted in a clinical diagnosis of cure. Following the analysis of slides, the preparations were described from a histopathological point of view and grouped taking into account the prevalence or significance of the characteristic elements. This process resulted in the following classification: 1. exsudative reaction (ER; 2. exsudative giant cell reaction (EGCR; 3. exsudative productive reaction (EPR; 4. exsudative productive giant cell reaction (EPGCR; 5. exsudative productive necrotic reaction (EPNR; 6. necrotic exsudative reaction (NER; 7. productive exsudative reaction (PER, 8. productive giant cell reaction (PGCR; 9. productive exsudative giant cell reaction (PEGCR; 10. productive exsudative giant cell granulomatous reaction (PEGCGR; 11. productive reaction (PR and 12. productive cicatricial (cure reaction (PCR. After this analysis, it was noted that clinical cure did not always coincide with histopathological cure.A quimioterapia para a leishmaniose não é satisfatória e existem hoje, várias drogas e esquemas terapêuticos em teste. Além do tratamento ideal, busca-se um critério de cura efetivo, onde a análise da histopatologia da

  7. Impact of leishmaniasis on public health

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    L. B Camargo

    2006-01-01

    Full Text Available Leishmaniasis is a parasitic zoonosis caused by protozoans of the genus Leishmania transmitted by insects known as phlebotomines, which are found in wild or urban environments. It affects domestic and wild animals and transmission to man happens by accident. The disease occurs in tropical and sub-tropical areas, mainly in Asia, Europe, Africa, and the Americas. There are two forms that affect man: American cutaneous leishmaniasis (ACL and American visceral leishmaniasis (AVL. The latter is caused by three species of Leishmania: Leishmania (Leishmania donovani, Leishmania (Leishmania infantum, and Leishmania (Leishmania chagasi, which are grouped in the Leishmania (Leishmania donovani complex. Wild reservoir hosts of L. chagasi known so far are foxes and marsupials. In domestic environment, dogs are the most important reservoir hosts and sources of infection to the vectors Lutzomyia longipalpis. Leishmaniasis is difficult to control, causing epidemic outbreaks, thus being an important public health problem. Due to lesions caused by the mucocutaneous type and the severity of those caused by the visceral type in humans, visceral leishmaniasis is one of the main public health concerns. This paper is part of the monograph presented at the end of the residency program in the field of Zoonosis and Public Health at the School of Veterinary Sciences and Animal Husbandry, São Paulo State University, UNESP, Botucatu, São Paulo State, Brazil, in 2005.

  8. Vaccines for Canine Leishmaniasis

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    Faeze Foroughi-Parvar

    2014-01-01

    Full Text Available Leishmania infantum is the obligatory intracellular parasite of mammalian macrophages and causes zoonotic visceral leishmaniasis (ZVL. The presence of infected dogs as the main reservoir host of ZVL is regarded as the most important potential risk for human infection. Thus the prevention of canine visceral leishmaniasis (CVL is essential to stop the current increase of the Mediterranean visceral leishmaniasis. Recently considerable advances in achieving protective immunization of dogs and several important attempts for achieving an effective vaccine against CVL lead to attracting the scientists trust in its important role for eradication of ZVL. This paper highlights the recent advances in vaccination against canine visceral leishmaniasis from 2007 until now.

  9. Laryngeal leishmaniasis in Malta.

    Science.gov (United States)

    Fsadni, C; Fsadni, P; Piscopo, T; Mallia Azzopardi, C

    2007-02-01

    The localization of Leishmania spp. in the larynx is rare especially when not associated with immunosuppression or with visceral or cutaneous leishmaniasis. We present a case of isolated laryngeal leishmaniasis, the first of its kind documented in Malta and infrequently reported from the Mediterranean basin.

  10. Cloning and characterization of a V-ATPase subunit C from the American visceral leishmaniasis vector Lutzomyia longipalpis modulated during development and blood ingestion

    OpenAIRE

    Ramalho-Ortigão JM; AN Pitaluga; EL Telleria; Marques, C.; Souza AA de; YM Traub-Cseko

    2007-01-01

    Visceral leishmaniasis (VL) is a serious tropical disease that affects approximately 500 thousand people worldwide every year. In the Americas, VL is caused by the parasite Leishmania (Leishmania) infantum chagasi mainly transmitted by the bite of the sand fly vector Lutzomyia longipalpis. Despite recent advances in the study of interaction between Leishmania and sand flies, very little is known about sand fly protein expression profiles. Understanding how the expression of proteins may be af...

  11. Leishmaniose tegumentar americana: histórico, epidemiologia e perspectivas de controle American cutaneous leishmaniasis: history, epidemiology and prospects for control

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    Sergio de Almeida Basano

    2004-09-01

    Full Text Available A Leishmaniose Tegumentar Americana (LTA é uma doença causada por protozoários do gênero Leishmania, transmitida ao homem pela picada de mosquitos flebotomíneos (Ordem Diptera; Família Psychodidae; Sub-Família Phlebotominae. No Brasil existem atualmente 6 espécies de Leishmania responsáveis pela doença humana, e mais de 200 espécies de flebotomíneos implicados em sua transmissão. Trata-se de uma doença que acompanha o homem desde tempos remotos e que tem apresentado, nos últimos 20 anos, um aumento do número de casos e ampliação de sua ocorrência geográfica, sendo encontrada atualmente em todos os Estados brasileiros, sob diferentes perfis epidemiológicos. Estima-se que, entre 1985 e 2003, ocorreram 523.975 casos autóctones, a sua maior parte nas regiões Nordeste e Norte do Brasil. Neste estudo, são discutidos aspectos relacionados ao tratamento e ao controle dessa doença, assim como também as dificuldades para a implementação dessas medidas. São apontadas alternativas que passam pela estruturação dos serviços de saúde, com respeito ao diagnóstico, no desenvolvimento de drogas de aplicação tópica ou por via oral, no desenvolvimento de vacinas, no controle diferenciado de vetores e no aprofundamento de estudos relacionados à biologia celular do parasita.American Cutaneous Leishmaniasis (ACL is an infectious disease transmitted by the bite of phlebotomines mosquitos (Order Diptera: Family Psychodidae: Sub-Family Phlebotominae and caused by protozoa from the genus Leishmania (ROSS 1903. In Brazil, there are six different species of Leishmania and more than 200 different species of phlebotomines. It's a disease that has been afflicting human beings for many centuries, and in Brazil, in the past two decades, there has been an important increase in the number of cases and also in its geographical distribution. Presently, ACL cases are registered in all Brazilian states under three different epidemiological

  12. Busca ativa de casos de leishmaniose cutânea em humanos e cães em área periférica do município de Campo Mourão - PR, Brasil Active search of cutaneous leishmaniasis in humans and canines in the peripherical area of Campo Mourão - PR - Brazil

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    Luís Antonio Sangioni

    2007-10-01

    Full Text Available Foi realizada uma busca ativa de casos de leishmaniose cutânea em humanos e cães, em área periférica da cidade de Campo Mourão - PR. No período de 01 a 30 de junho de 2004, uma equipe multidisciplinar visitou todas as residências e estabelecimentos comerciais situadas até 150m da margem superior e inferior do rio 119, que delimita o município. Todos os casos humanos suspeitos de Leishmaniose Tegumentar Americana (LTA foram encaminhados para o Posto de Saúde de referência para receberem os devidos tratamentos e orientação profilática. Foram encontrados 6 (seis casos de pessoas suspeitas de LTA, sendo que 04 (quatro resultaram em diagnóstico negativo e 02 (dois em diagnóstico positivo. Nenhum cão apresentou lesão suspeita de LTA.An active search was done to identify cases of leishmaniasis in humans and dogs in a peripherical area of Campo Mourão, PR, Brazil. From the first to thirtieth June of 2004, a multidisciplinary professional team visited all residences located within 150 meters from the superior and inferior margins of the river 119, which delimits the city. All human cases of American Tegumentary Leishmaniasis (ATL were directed to reference health care center for the appropriated treatment and prophylactic orientation. Six cases of persons suspected of ATL were found; four patients resulted in a negative diagnosis while two cases were positive. No dogs demonstrated lesions that were suggestive of ATL.

  13. American cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis resistant to meglumine antimoniate, but with good response to pentamidine: a case report.

    Science.gov (United States)

    Pimentel, Maria Inês Fernandes; Baptista, Cibele; Rubin, Evelyn Figueiredo; Vasconcellos, Erica de Camargo Ferreira e; Lyra, Marcelo Rosandiski; Salgueiro, Mariza de Matos; Saheki, Maurício Naoto; Rosalino, Cláudia Maria Valete; Madeira, Maria de Fátima; Silva, Aline Fagundes da; Confort, Eliame Mouta; Schubach, Armando de Oliveira

    2011-01-01

    This is a case report of a Brazilian soldier with cutaneous leishmaniasis. The lesion relapsed following two systemic treatments with meglumine antimoniate. The patient was treated with amphotericin B, which was interrupted due to poor tolerance. Following isolation of Leishmania sp., six intralesional infiltrations of meglumine antimoniate resulted in no response. Leishmania sp promastigotes were again isolated. The patient was submitted to intramuscular 4 mg/kg pentamidine. Parasites from the first and second biopsies were identified as Leishmania (Viannia) braziliensis; those isolated from the first biopsy were more sensitive to meglumine antimoniate in vitro than those isolated from the second biopsy. No relapse was observed. PMID:21552747

  14. American cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis resistant to meglumine antimoniate, but with good response to pentamidine: a case report.

    Science.gov (United States)

    Pimentel, Maria Inês Fernandes; Baptista, Cibele; Rubin, Evelyn Figueiredo; Vasconcellos, Erica de Camargo Ferreira e; Lyra, Marcelo Rosandiski; Salgueiro, Mariza de Matos; Saheki, Maurício Naoto; Rosalino, Cláudia Maria Valete; Madeira, Maria de Fátima; Silva, Aline Fagundes da; Confort, Eliame Mouta; Schubach, Armando de Oliveira

    2011-01-01

    This is a case report of a Brazilian soldier with cutaneous leishmaniasis. The lesion relapsed following two systemic treatments with meglumine antimoniate. The patient was treated with amphotericin B, which was interrupted due to poor tolerance. Following isolation of Leishmania sp., six intralesional infiltrations of meglumine antimoniate resulted in no response. Leishmania sp promastigotes were again isolated. The patient was submitted to intramuscular 4 mg/kg pentamidine. Parasites from the first and second biopsies were identified as Leishmania (Viannia) braziliensis; those isolated from the first biopsy were more sensitive to meglumine antimoniate in vitro than those isolated from the second biopsy. No relapse was observed.

  15. [Penile sporotrichoid cutaneous leishmaniasis].

    Science.gov (United States)

    Masmoudi, A; Boudaya, S; Bouzid, L; Frigui, F; Meziou, T J; Akrout, F; Turki, H; Zahaf, A

    2005-12-01

    The localisation of the cutaneous leishmaniasis of L. major at the penis level is rare, we report here a new observation. Mr K. R aged of 41, without known pathological background presented for 20 days a nodular lesion of the anterior face of the neck, 2 juxtaposed ulcerated nodular lesions of the left wrist. He presented also subcutaneous nodules ranged linearly and extended to the root of the penis. Theses lesions were covered by an erythematous or ulcerated skin. The smear made from the genital lesions of the penis confirmed the diagnosis of a cutaneous leishmaniasis. The evolution was favourable after a 21 days treatment by doxycyclin after an interval of one week. Our observation was specific by the localisation of the cutaneous leishmaniasis and by the clinical form. This shows that in our region cutaneous leishmaniasis is characterised by different clinical symptoms. PMID:16425718

  16. Cloning and characterization of a V-ATPase subunit C from the American visceral leishmaniasis vector Lutzomyia longipalpis modulated during development and blood ingestion

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    JM Ramalho-Ortigão

    2007-06-01

    Full Text Available Visceral leishmaniasis (VL is a serious tropical disease that affects approximately 500 thousand people worldwide every year. In the Americas, VL is caused by the parasite Leishmania (Leishmania infantum chagasi mainly transmitted by the bite of the sand fly vector Lutzomyia longipalpis. Despite recent advances in the study of interaction between Leishmania and sand flies, very little is known about sand fly protein expression profiles. Understanding how the expression of proteins may be affected by blood feeding and/or presence of parasite in the vector's midgut might allow us to devise new strategies for controlling the spread of leishmaniasis. In this work, we report the characterization of a vacuolar ATPase subunit C from L. longipalpis by screening of a midgut cDNA library with a 220 bp fragment identified by means of differential display reverse transcriptase-polymerase chain reaction analysis. The expression of the gene varies along insect development and is upregulated in males and bloodfed L. longipalpis, compared to unfed flies.

  17. Cloning and characterization of a V-ATPase subunit C from the American visceral leishmaniasis vector Lutzomyia longipalpis modulated during development and blood ingestion.

    Science.gov (United States)

    Ramalho-Ortigão, J M; Pitaluga, A N; Telleria, E L; Marques, C; Souza, A A; Traub-Cseko, Y M

    2007-06-01

    Visceral leishmaniasis (VL) is a serious tropical disease that affects approximately 500 thousand people worldwide every year. In the Americas, VL is caused by the parasite Leishmania (Leishmania) infantum chagasi mainly transmitted by the bite of the sand fly vector Lutzomyia longipalpis. Despite recent advances in the study of interaction between Leishmania and sand flies, very little is known about sand fly protein expression profiles. Understanding how the expression of proteins may be affected by blood feeding and/or presence of parasite in the vector's midgut might allow us to devise new strategies for controlling the spread of leishmaniasis. In this work, we report the characterization of a vacuolar ATPase subunit C from L. longipalpis by screening of a midgut cDNA library with a 220 bp fragment identified by means of differential display reverse transcriptase-polymerase chain reaction analysis. The expression of the gene varies along insect development and is upregulated in males and bloodfed L. longipalpis, compared to unfed flies. PMID:17607496

  18. Mucosal Leishmaniasis: An Underestimated Presentation of a Neglected Disease

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    Alessio Strazzulla

    2013-01-01

    Full Text Available We present a review of current knowledge about mucosal leishmaniasis (ML. Although involvement of mucous membranes is classically admitted in New World leishmaniasis, particularly occurring in infection by Leishmania (L. braziliensis species complex, ML is also a possible presentation of Old World leishmaniasis, in either L. donovani or L. major species complex infections. Thus, ML has to be considered not only as a Latin American disease but as an Old and New World disease. We describe ML epidemiology, pathogenesis, clinics, diagnosis, and therapy. Considering both its highly disfiguring lesions and its possible lethal outcome, ML should not be underestimated by physicians. Moreover, leishmaniasis is expected to increase its burden in many countries as sandfly vector distribution is widespreading towards non-endemic areas. Finally, the lack of clear understanding of ML pathogenesis and the absence of effective human vaccines strongly claim for more research.

  19. Ecological aspects of the sandfly fauna (Diptera, Psychodidae in an American cutaneous leishmaniasis endemic area under the influence of hydroelectric plants in Paranapanema river, State of Paraná, Brazil

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    Mariza Fordellone Rosa Cruz

    2012-08-01

    Full Text Available INTRODUCTION: An epidemiological study was undertaken to identify determinant factors in the occurrence of American cutaneous leishmaniasis in areas under the influence of hydroelectric plants in Paranapanema river, State of Paraná, Brazil. The ecological aspects of the phlebotomine fauna were investigated. METHODS: Sandflies were sampled with automatic light traps from February 2004 to June 2006 at 25 sites in the urban and rural areas of Itambaracá, and in Porto Almeida and São Joaquim do Pontal. RESULTS: A total of 3,187 sandflies of 15 species were captured. Nyssomyia neivai predominated (34.4%, followed by Pintomyia pessoai (32.6%, Migonemyia migonei (11.6%, Nyssomyia whitmani (8.8%, and Pintomyia fischeri (2.7%, all implicated in the transmission of Leishmania. Males predominated for Ny. neivai, and females for the other vector species, with significant statistical differences (p < 0.001. Nyssomyia neivai, Pi. pessoai, Ny. whitmani, Brumptomyia brumpti, Mg. migonei, and Pi. fischeri presented the highest values for the Standardized Species Abundance Index (SSAI. The highest frequencies and diversities were found in the preserved forest in Porto Almeida, followed by forests with degradation in São Joaquim do Pontal and Vila Rural. CONCLUSIONS: Sandflies were captured in all localities, with the five vectors predominating. Ny. neivai had its highest frequencies in nearby peridomestic environments and Pi. pessoai in areas of preserved forests. The highest SSAI values of Ny. neivai and Pi. pessoai reflect their wider dispersion and higher frequencies compared with other species, which seems to indicate that these two species may be transmitting leishmaniasis in the area.

  20. [Occurrence of sand flies (Diptera, Psychodidae) in leishmaniasis foci in an ecotourism area around the Lençóis Maranhenses National Park, Brazil].

    Science.gov (United States)

    Rebêlo, José Manuel Macário; Assunção Júnior, Antonildes Nascimento; Silva, Orleans; Moraes, Jorge Luiz Pinto

    2010-01-01

    The distribution and relative abundance of sand fly species were studied in the municipality of Barreirinhas, Maranhão State, Brazil, around the Lençóis Maranhenses National Park, from January to June 2005, August 2004, July 2005, and September/2008. A total of 6,658 specimens were captured. The most frequent species were Lutzomyia whitmani (46.6%), L. longipalpis (29.9%), L. evandroi (17.1%), and L. lenti (4.8%), while L. termitophila, L. flaviscutellata, L. migonei, L. infraspinosa, L. sordellii, L. wellcomei, L. antunesi, and L. trinidadensis represented 1.6%. The presence of Leishmania vector species explains the high detection rate for tegumentary leishmaniasis in 2000 (308.2), 2001 (310.9), 2002 (338.2), and 2005 (313.6) and active foci of human visceral leishmaniasis in the municipality of Barreirinhas.

  1. Leishmaniasis in the knee area

    Institute of Scientific and Technical Information of China (English)

    Bava Amadeo Javier; Rossi Maria Laura; Seley Celeste; Troncoso Alcides

    2010-01-01

    Leishmaniasis is a parasitic infection caused by species leishmaniae, which can produce two types of manifestations: visceral and cutaneous. In south America cutaneous leishmaniasis is more common than visceral leishmaniasis. A case of primary cutaneous leishmaniasis from Bolivia is presented for its rarity. The patient of our case showed an ulcerated lesion of the knee. Montenegro's intradermal test was positive. Giemsa-stained touch preparation of the skin biopsy revealed amastigotes inside macrophages, consistent with leishmaniasis. The patient was treated with meglumine antimoniate intramuscular (20 mg of Sb+/kg/day) three weeks, with complete cicatrization of the lesion.

  2. Leishmaniasis in HIV infection.

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    Paredes R

    2003-01-01

    Full Text Available Herein we review the particular aspects of leishmaniasis associated with HIV infection. The data in this review are mainly from papers identified from PubMed searches and from papers in reference lists of reviewed articles and from the authors′ personal archives. Epidemiological data of HIV/Leishmania co-infection is discussed, with special focus on the influence of Highly Active Antiretroviral Therapy (HAART on incidence of leishmaniasis and transmission modalities. Microbiological characteristics, pathogenesis, clinical presentation and specific treatment of the co-infection are also presented.

  3. The phlebotomine fauna (Diptera: Psychodidae of Guaraí, state of Tocantins, with an emphasis on the putative vectors of American cutaneous leishmaniasis in rural settlement and periurban areas

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    Maurício Luiz Vilela

    2013-08-01

    Full Text Available Phlebotomine sandflies were captured in rural settlement and periurban areas of the municipality of Guaraí in the state of Tocantins (TO, an endemic area of American cutaneous leishmaniasis (ACL. Forty-three phlebotomine species were identified, nine of which have already been recognised as ACL vectors. Eleven species were recorded for the first time in TO. Nyssomyia whitmani was the most abundant species, followed by Evandromyia bourrouli, Nyssomyia antunesi and Psychodopygus complexus. The Shannon-Wiener diversity index and the evenness index were higher in the rural settlement area than in the periurban area. The evaluation of different ecotopes within the rural area showed the highest frequencies of Ev. bourrouli and Ny. antunesi in chicken coops, whereas Ny. whitmani predominated in this ecotope in the periurban area. In the rural settlement area, Ev. bourrouli was the most frequently captured species in automatic light traps and Ps. complexus was the most prevalent in Shannon trap captures. The rural settlement environment exhibited greater phlebotomine biodiversity than the periurban area. Ps. complexus and Psychodopygus ayrozai naturally infected with Leishmania (Viannia braziliensis were identified. The data identified Ny. whitmani as a potential ACL vector in the periurban area, whereas Ps. complexus was more prevalent in the rural environment associated with settlements.

  4. Phlebotominae sand flies (Diptera: Psychodidae: potential vectors of American cutaneous leishmaniasis agents in the area associated with the Santo Antônio Hydroelectric System in Western Amazonian Brazil

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    Allan Kardec Ribeiro Galardo

    2015-06-01

    Full Text Available INTRODUCTION: An entomological study was conducted as part of a vector-monitoring program in the area associated with the Santo Antônio hydroelectric system in State of Rondônia, Western Amazonian Brazil. METHODS: Fourteen sampling sites were surveyed to obtain data on the potential vectors of Leishmania spp. in the area. Sand flies were collected from 2011 to 2014 during the months of January/February (rainy season, May/June (dry season, and September/October (intermediary season using light traps arranged in three vertical strata (0.5, 1, and 20m. RESULTS : A total of 7,575 individuals belonging to 62 species/subspecies were collected. The five most frequently collected sand flies were Psychodopygus davisi (Root (36.67%, Trichophoromyia ubiquitalis (Mangabeira (8.51%, Nyssomyia umbratilis (Ward & Fraiha (6.14%, Bichromomyia flaviscutellata (Mangabeira (5.74%, and Psychodopygus complexus (Mangabeira (5.25%. These species have been implicated in the transmission of American cutaneous leishmaniasis agents in the Brazilian Amazon region and described as potential vectors of this disease in the study area. CONCLUSIONS: Additional surveillance is needed, especially in areas where these five species of sand fly are found.

  5. Leishmaniose tegumentar americana em centro de treinamento militar localizado na Zona da Mata de Pernambuco, Brasil American cutaneous leishmaniasis in military training unit localized in Zona da Mata of Pernambuco State, Brazil

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    Sinval P. Brandão-Filho

    1998-12-01

    Full Text Available Um surto de leishmaniose tegumentar americana ocorreu em 1996 em unidade de treinamento militar situada na Zona da Mata de Pernambuco, com o registro de 26 casos humanos. Um inquérito epidemiológico foi realizado através da realização de levantamento entomológico e da aplicação do Teste de Montenegro. Lutzomyia choti apresentou predominância de 89,9% dos flebótomos identificados. De 545 homens que participaram de treinamentos no período, 24,1% (incluindo os casos clínicos foram positivo para o Teste de Montenegro.An outbreak of American cutaneous leishmaniasis has been occurred in military training unit localized in 'Zona da Mata' of Pernambuco State, Brazil, where were registered 26 human cases. An epidemiological survey was carried out by entomological investigation and Montenegro skin test (MST. Lutzomyia choti presents predominance (89.9% in sandflies identified. Out of 545 men who realized training activities were 24.12% positive to MST.

  6. Cutaneous Leishmaniasis, Sri Lanka

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    Sujeevi S. K. Nawaratna; Weilgama, Danister J.; Wijekoon, Chandana J.; Dissanayake, Manel; Rajapaksha, Kosala

    2007-01-01

    Cutaneous leishmaniasis (CL) is an emerging disease in Sri Lanka. Of 116 patients with clinical symptoms suggestive of CL, 86 were confirmed positive for Leishmania donovani. Most patients had single dry lesions, usually on the face. Patients were from 5 of the 7 agroclimatic zones in Sri Lanka.

  7. Aspectos eco-epidemiológicos da leishmaniose tegumentar americana no Município de Campinas Eco-epidemiological aspects of American cutaneous leishmaniasis in the Municipality of Campinas, São Paulo, Brazil

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    Antônio Ângelo Corte

    1996-12-01

    Full Text Available Os autores descrevem um surto de leishmaniose tegumentar americana ocorrido no período de fevereiro de 1993 a setembro de 1994, nos Distritos de Sousas e Joaquim Egídio, Município de Campinas, SP. Ocorreram 25 casos, sete na área rural, nove na área peri-urbana e nove na urbana. Verifica-se uma mobilidade da ocorrência dos casos em direção rural-urbana. Em relação ao sexo, houve predomínio do masculino (60% sobre o feminino (40%, com 44% dos casos concentrados na faixa etária de 11 e trinta anos. Quanto à ocupação, 48% correspondem a estudantes, empregadas domésticas e donas-de-casa. Em 92% dos casos, a doença manifestou-se com lesão única, predominantemente localizadas nos membros inferiores e superiores. O surgimento desses casos na área está provavelmente associado à expansão urbana ocorrida nas décadas de 70-80 e acelerada mais recentemente.The authors describe an outbreak of American cutaneous leishmaniasis from February 1993 to September 1994 in the districts of Sousas and Joaquim Egídio, Campinas, São Paulo State. Out of a total of 25 cases, seven occurred in the countryside, nine in the periurban area, and nine in the urban area. The authors observed a shift in the occurrence of leishmaniasis cases from rural to urban areas. Cases in males predominated over females (60%/40%. Some 44% of the cases occurred in individuals ranging from 11 to 30 years of age. Some 48% of cases occurred in students, domestic workers, and housewives. In 90% of the cases, the disease presented as a single lesion, located predominantly on the upper and lower limbs. The appearance of cases in the region is probably related to the expansion of urban areas occurring in the 1970s and 1980s, a trend which intensified further more recently.

  8. Human immunodeficiency virus/Leishmania infantum in the first foci of urban American visceral leishmaniasis: clinical presentation from 1994 to 2010

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    Iúri Paz Lima

    2013-04-01

    Full Text Available INTRODUCTION: Human immunodeficiency virus (HIV coinfection with Leishmania infantum or Leishmania donovani, the agents of visceral leishmaniasis (or kala-azar, has become a fatal public health problem in the tropics where kala-azar is endemic. METHODS: The clinical presentation of patients with HIV and L. infantum coinfection is described using two unique databases that together produce the largest case series of patients with kala-azar infected with HIV in South America. First, a retrospective study paired the list of all patients with kala-azar from 1994 to 2004 with another of all patients with HIV/AIDS from the reference hospital for both diseases in the City of Teresina, State of Piauí, Brazil. Beginning in 2005 through to 2010 this information was prospectively collected at the moment of hospitalization. RESULTS: During the study, 256 admissions related to 224 patients with HIV/L. infantum coinfection were registered and most of them were males between 20-40 years of age. Most of the 224 patients were males between 20-40 years of age. HIV contraction was principally sexual. The most common symptoms and signs were pallor, fever, asthenia and hepatosplenomegaly. 16.8% of the cohort died. The primary risk factors associated to death were kidney or respiratory failure, somnolence, hemorrhagic manifestations and a syndrome of systemic inflammation. The diagnosis of HIV and kala-azar was made simultaneously in 124 patients. CONCLUSIONS: The urban association between HIV and kala-azar coinfection in South America is worrisome due to difficulty in establishing the diagnosis and higher mortality among the coinfected then those with either disease independently. HIV/L. infantum coinfection exhibits some singular characteristics and due to its higher mortality it requires immediate assistance to patients and greater research on appropriate combination therapy.

  9. Human immunodeficiency virus/Leishmania infantum in the first foci of urban American visceral leishmaniasis: clinical presentation from 1994 to 2010

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    Iúri Paz Lima

    2013-09-01

    Full Text Available INTRODUCTION: Human immunodeficiency virus (HIV coinfection with Leishmania infantum or Leishmania donovani, the agents of visceral leishmaniasis (or kala-azar, has become a fatal public health problem in the tropics where kala-azar is endemic. METHODS: The clinical presentation of patients with HIV and L. infantum coinfection is described using two unique databases that together produce the largest case series of patients with kala-azar infected with HIV in South America. First, a retrospective study paired the list of all patients with kala-azar from 1994 to 2004 with another of all patients with HIV/AIDS from the reference hospital for both diseases in the City of Teresina, State of Piauí, Brazil. Beginning in 2005 through to 2010 this information was prospectively collected at the moment of hospitalization. RESULTS: During the study, 256 admissions related to 224 patients with HIV/L. infantum coinfection were registered and most of them were males between 20-40 years of age. Most of the 224 patients were males between 20-40 years of age. HIV contraction was principally sexual. The most common symptoms and signs were pallor, fever, asthenia and hepatosplenomegaly. 16.8% of the cohort died. The primary risk factors associated to death were kidney or respiratory failure, somnolence, hemorrhagic manifestations and a syndrome of systemic inflammation. The diagnosis of HIV and kala-azar was made simultaneously in 124 patients. CONCLUSIONS: The urban association between HIV and kala-azar coinfection in South America is worrisome due to difficulty in establishing the diagnosis and higher mortality among the coinfected then those with either disease independently. HIV/L. infantum coinfection exhibits some singular characteristics and due to its higher mortality it requires immediate assistance to patients and greater research on appropriate combination therapy.

  10. Vaccines for canine leishmaniasis

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    Clarisa B. Palatnik-De-Sousa

    2012-04-01

    Full Text Available Leishmaniasis is the third most important vector-borne disease worldwide. Visceral leishmaniasis (VL is a severe and frequently lethal protozoan disease of increasing incidence and severity due to infected human and dog migration, new geographical distribution of the insect due to global-warming, co-infection with immunosuppressive diseases and poverty. The disease is an anthroponosis in India and Central Africa and a canid zoonosis (ZVL in the Americas, the Middle East, Central Asia, China and the Mediterranean. The ZVL epidemic has been controlled by one or more measures including the culling of infected dogs, treatment of human cases and insecticidal treatment of homes and dogs. However, the use of vaccines is considered the most cost-effective control tool for human and canine disease. Since the severity of the disease is related to the generation of T-cell immunosuppression, effective vaccines should be capable of sustaining or enhancing the T-cell immunity. In this review we summarize the clinical and parasitological characteristics of ZVL with special focus on the cellular and humoral canine immune response and review state-of-the-art vaccine development against human and canine visceral leishmaniasis. Experimental vaccination against leishmaniasis has evolved from the practice of leishmanization with living parasites to vaccination with crude lysates, native parasite extracts to recombinant and DNA vaccination. Although more than 30 defined vaccines have been studied in laboratory models no human formulation has been licensed so far; however three second-generation canine vaccines have already been registered. As expected for a zoonotic disease, the recent preventive vaccination of dogs in Brazil has led to a reduction in the incidence of canine and human disease. The recent identification of several Leishmania proteins with T-cell epitopes anticipates development of a multiprotein vaccine that will be capable of protecting both humans

  11. Clinical, epidemiological and laboratory aspects of patients with American cutaneous leishmaniasis in the State of Pernambuco Aspectos clínicos, epidemiológicos e laboratoriais de pacientes com leishmaniose cutânea americana no Estado de Pernambuco

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    Luiza de Campos Reis

    2008-10-01

    Full Text Available The diagnosis for American cutaneous leishmaniasis is based on an association of clinical, epidemiological and laboratory characteristics. The present study identified the circulating species of Leishmania in the State of Pernambuco, described its clinical-epidemiological characteristics and diagnosed the disease. Nineteen patients presenting active lesions who had been diagnosed through clinical evaluation and laboratory tests were selected. The tests included direct investigation, in vitro culturing, Montenegro skin test, indirect immunofluorescence and polymerase chain reaction. The Montenegro Skin Test showed positive results in 89% of the patients; indirect immunofluorescence, in 79%; direct investigation, in 58%; and polymerase chain reaction in 75%. Seven Leishmania (Viannia braziliensis samples were isolated from these patients and were characterized by means of specific monoclonal antibodies. These data confirm that a combination of different diagnosis techniques is needed in order to obtain efficient results and that, so far, Leishmania (Viannia braziliensis is the only species responsible for American cutaneous leishmaniasis infection in Pernambuco. Thus, it is essential to identify the parasite species involved in cases of human disease in an endemic area in order to determine the clinical and epidemiological characteristics, especially with regard to diagnosis, therapy development and disease prognosis.O diagnóstico da leishmaniose cutânea americana é baseado na associação dos aspectos clínicos, epidemiológicos e laboratoriais. O presente estudo identificou a espécie de Leishmania circulante no Estado de Pernambuco, descreveu os aspectos clínico-epidemiológicos e diagnosticou a doença. Foram selecionados 19 pacientes apresentando lesão ativa e diagnosticados através de avaliação clínica e pelos exames laboratoriais que incluíram a pesquisa direta, cultivo in vitro, intradermorreação de Montenegro, imunofluoresc

  12. American cutaneous leishmaniasis in the Pontal of Paranapanema - SP, Brazil: ecological and entomological aspects Leishmaniose cutânea americana no Pontal do Paranapanema, SP, Brasil: aspectos ecológicos e entomológicos

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    Claudia Álvares Calvo Alessi

    2009-10-01

    Full Text Available American cutaneous leishmaniasis (ACL occurs in epidemic outbreaks and in sporadic cases with small annual variation in the Pontal of Paranapanema, SP. There is little research on the sandfly fauna of this region. The last outbreaks were related to the Movement of the Landless Workers (MST and with the ecological tourism in preserved forest of the Parque Estadual do Morro do Diabo (PEMD. AIM: identification of the sandfly fauna within the PEMD, mainly anthropophilic species already incriminated as vectors of ACL, as well as their seasonality, hourly frequency and data of the behavior. M&M: The captures were undertaken with CDC light and Shannon traps from 6:00 pm to 10:00 pm, monthly from May 2000 to December 2001. The temperature and relative humidity data were registered at hourly intervals. RESULTS: The captured species were: Brumptomyia brumpti, Nyssomyia neivai, Nyssomyia whitmani, Pintomyia fischeri and Pintomyia pessoai. The P. pessoai predominated (34.39% and N. neivai was less found (0.74%, only being captured in CDC traps. Shannon trap captured more sandflies (63.01% than the CDC traps (36.99%. Despite the environmental degradation anthropophilic species, indicates favorable bioecological conditions for persistence of vectors and potential transmission of leishmaniasis.LCA ocorre em surtos epidêmicos e casos esporádicos com pequena variação anual no Pontal do Paranapanema, SP. Há pouca pesquisa sobre a fauna flebotomínea na região. Os últimos surtos estão relacionados ao MST e turismo ecológico na floresta do Parque Estadual do Morro do Diabo (PEMD. OBJETIVO: identificar a fauna flebotomínea no PEMD, principalmente as espécies antropofílicas já incriminadas como vetores da LCA, também, sua sazonalidade, horários e dados de comportamento. M&M: As capturas foram feitas com armadilhas CDC e Shannon das 18 às 22h, mensalmente de maio de 2000 a dezembro de 2001. Dados de temperatura e umidade relativa foram registrados com

  13. A review of Leishmaniasis in Eastern Africa

    Institute of Scientific and Technical Information of China (English)

    Peter K. Ngure; Albert Kimutai; Zipporah W. Ng'ang'a; Geoffrey Rukunga; Willy K. Tonui

    2009-01-01

    The review presents the epidemiology of leishmaniasis in the Eastern Africa region. We searched PUB MED and MEDLINE with several key words-namely,"leishmaniasis";"cutaneous"," diffuse cutaneous"," mucosal", and "visceral leishmaniasis";"kala azar" and "post kala azar dermal leishmaniasis"-for recont clinical and basic science articles related to leishmaniasis in countries in the Eastern Africa region. Poverty, wars, conflicts and migration have significantly aggravated leishmaniases in Eastern Africa. Of particular concern is the increasing incidence of Leishmania-HIV co-infection in Ethiopia where 20--40% of the persons affected by visceral leishmaniasis are HIV-co-infected. Sudan has the highest prevalence rate of post kala-azar dermal leishmaniasis(PKDL) in the world, a skin complication of visceral leishmaniasis(VL) that mainly afflicts children below age ten. In view of its spread to previously non-endemic areas and an increase in imported cases, leishmaniasis in Eastern Africa should be considered a health emergency.

  14. A canine leishmaniasis pilot survey in an emerging focus of visceral leishmaniasis: Posadas (Misiones, Argentina

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    Deschutter Jorge

    2010-12-01

    Full Text Available Abstract Background An increasing number of reports are calling our attention to the worldwide spread of leishmaniasis. The urbanization of zoonotic visceral leishmaniasis (VL has been observed in different South American countries, due to changes in demographic and ecological factors. In May 2006, VL was detected for the first time in the city of Posadas (Misiones, Argentina. This event encouraged us to conduct a clinical and parasitological pilot survey on domestic dogs from Posadas to identify their potential role as reservoirs for the disease. Methods One hundred and ten dogs from the city of Posadas were included in the study. They were selected based on convenience and availability. All dogs underwent clinical examination. Symptomatology related to canine leishmaniasis was recorded, and peripheral blood and lymph node aspirates were collected. Anti-Leishmania antibodies were detected using rK39-immunocromatographic tests and IFAT. Parasite detection was based on peripheral blood and lymph node aspirate PCR targeting the SSUrRNA gene. Molecular typing was addressed by DNA sequence analysis of the PCR products obtained by SSUrRNA and ITS-1 PCR. Results According to clinical examination, 69.1% (76/110 of the dogs presented symptoms compatible with canine leishmaniasis. Serological analyses were positive for 43.6% (48/110 of the dogs and parasite DNA was detected in 47.3% (52/110. A total of 63 dogs (57.3% were positive by serology and/or PCR. Molecular typing identified Leishmania infantum (syn. Leishmania chagasi as the causative agent. Conclusions This work confirms recent findings which revealed the presence of Lutzomyia longipalpis, the vector of L. infantum in this area of South America. This new VL focus could be well established, and further work is needed to ascertain its magnitude and to prevent further human VL cases.

  15. Periungual leishmaniasis Leishmaniose periungueal

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    Ciro Martins Gomes

    2012-02-01

    Full Text Available The vast majority of cases of cutaneous leishmaniasis are represented by limb injuries. A female patient, white, presented an ulcer with infiltrated borders located on the fourth finger of the left hand following occupational exposure in an area of native forest. Diagnosis of cutaneous leishmaniasis caused by Leishmania of the subgenus Viannia was confirmed. The patient failed to respond to treatment with antimony, but achieved clinical cure after this was associated with pentoxifylline. The case highlights the rarity of the periungual location of the leishmanial lesion and the difficulties encountered in therapy.A grande maioria dos casos de leishmaniose tegumentar é representada por lesões nos membros. Paciente feminina, branca, diabética, apresentou úlcera com bordas infiltradas, localizada no quarto quirodáctilo esquerdo, após exposição ocupacional em área de mata nativa. Foi confirmado o diagnóstico de leishmaniose tegumentar por Leishmania do subgênero Viannia. Não respondeu ao tratamento com antimonial, mas obteve cura clínica após associação com a pentoxifilina. O caso destaca-se pela raridade da localização periungueal da lesão leishmaniótica e pela dificuldade terapêutica.

  16. Cutaneous leishmaniasis: an overview.

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    Hepburn N

    2003-01-01

    Full Text Available Leishmaniasis is a major world health problem, which is increasing in incidence. In Northern Europe it is seen in travellers returning from endemic areas. The protozoa is transmitted by sandflies and may produce a variety of clinical syndromes varying from a simple ulcer to fatal systemic disease. This review considers the management of simple cutaneous leishmaniasis. Patients usually have a single ulcer that may heal spontaneously, requiring only topical, or no treatment at all. Lesions caused by Leishmania braziliensis may evolve into the mucocutaneous form, ′espundia′, and should be treated with systemic antimony. Sodium stibogluconate 20mg/kg/day i.v. for 20 days is the appropriate first line treatment in these cases. Although it may cause transient bone marrow suppression, liver damage, a chemical pancreatitis, and disturbances in the electrocardiogram, it appears safe. The success of treatment should be assessed 6 weeks after it has been completed and patients should be followed up for 6 months.

  17. Linear B-cell epitope mapping of MAPK3 and MAPK4 from Leishmania braziliensis: implications for the serodiagnosis of human and canine leishmaniasis.

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    Menezes-Souza, Daniel; de Oliveira Mendes, Tiago Antônio; de Araújo Leão, Ana Carolina; de Souza Gomes, Matheus; Fujiwara, Ricardo Toshio; Bartholomeu, Daniella Castanheira

    2015-02-01

    The correct and early identification of humans and dogs infected with Leishmania are key steps in the control of leishmaniasis. Additionally, a method with high sensitivity and specificity at low cost that allows the screening of a large number of samples would be extremely valuable. In this study, we analyzed the potential of mitogen-activated protein kinase 3 (MAPK3) and mitogen-activated protein kinase 4 (MAPK4) proteins from Leishmania braziliensis to serve as antigen candidates for the serodiagnosis of human visceral and tegumentary leishmaniasis, as well as canine visceral disease. Moreover, we mapped linear B-cell epitopes in these proteins and selected those epitopes with sequences that were divergent in the corresponding orthologs in Homo sapiens, in Canis familiaris, and in Trypanosoma cruzi. We compared the performance of these peptides with the recombinant protein using ELISA. Both MAPK3 and MAPK4 recombinant proteins showed better specificity in the immunodiagnosis of human and canine leishmaniasis than soluble parasite antigens and the EIE-leishmaniose-visceral-canina-bio-manguinhos (EIE-LVC) kit. Furthermore, the performance of this serodiagnosis assay was improved using synthetic peptides corresponding to B-cell epitopes derived from both proteins.

  18. Cutaneous Leishmaniasis with HIV.

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    Talat, Humaira; Attarwala, Sharmeen; Saleem, Mubasshir

    2014-05-01

    Cutaneous Leishmaniasis (CL) is a vector borne disease caused by various species of the Leishmania parasite. CL is endemic in the province of Balochistan in Pakistan. In certain instances a Human Immunodeficiency Virus (HIV)-related immunocompromised is associated with atypical clinical presentation and occurrence of reactivated lesions of CL. Such presentations respond poorly to the standard treatment and frequent relapses are noted. We are reporting three cases of localized and disseminated CL due to Leishmania tropica which responded to meglumine antimoniate. Due to the fact that CL is endemic in Balochistan, we did not consider HIV infection as a causative organism. It was their presentation with history of weight loss and fever that prompted Enzyme-linked Immunosorbent Assay (ELISA) tests for HIV, which turned out to be positive. CL is becoming visible as an opportunistic infection associated with HIV/AIDS and may even be the first symptom in HIV positive patients in an endemic area.

  19. Epidemiology of visceral leishmaniasis

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    Ready PD

    2014-05-01

    Full Text Available Paul D ReadyDisease Control Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UKAbstract: Leishmania species are the causative agents of leishmaniasis, a neglected tropical disease. These parasitic protozoans are usually transmitted between vertebrate hosts by the bite of blood sucking female phlebotomine sand flies. This review focuses on the two parasites causing most human visceral leishmaniasis (VL, which leads to substantial health problems or death for up to 400,000 people per year. Except for travel cases, Leishmania donovani infections are restricted to the (sub-tropics of Asia and Africa, where transmission is mostly anthroponotic, while Leishmania infantum occurs in the drier parts of Latin America as well as in the Mediterranean climate regions of the Old World, with the domestic dog serving as the main reservoir host. The prevalence of VL caused by L. infantum has been declining where living standards have improved. In contrast, infections of L. donovani continue to cause VL epidemics in rural areas on the Indian subcontinent and in East Africa. The current review compares and contrasts these continental differences and suggests priorities for basic and applied research that might improve VL control. Transmission cycles, pathogenesis, diagnosis, treatment and prognosis, prevention (including vector control, surveillance, transmission modeling, and international control efforts are all reviewed. Most case detection is passive, and so routine surveillance does not usually permit accurate assessments of any changes in the incidence of VL. Also, it is not usually possible to estimate the human inoculation rate of parasites by the sand fly vectors because of the limitations of survey methods. Consequently, transmission modeling rarely passes beyond the proof of principle stage, and yet it is required to help develop risk factor analysis for control programs. Anthroponotic VL

  20. Many faces of cutaneous leishmaniasis

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    Bari Arfan Ul

    2008-01-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is known for its clinical diversity and increasing numbers of new and rare variants of the disease are being reported these days. Aim: The aim of this descriptive study was to look for and report the atypical presentations of this common disease occurring in Pakistan. Methods: The study was carried out in three hospitals (MH, Rawalpindi; PAF Hospital, Sargodha; and CMH, Muzaffarabad from 2002 to 2006. Military and civilian patients of all ages, both males and females, belonging to central and north Punjab province and Kashmir were included in the study. Clinical as well as parasitological features of cutaneous leishmaniasis were studied. The unusual lesions were photographed and categorized accordingly using simple descriptive statistics. Results: Out of 718 patients of cutaneous leishmaniasis, 41 (5.7% had unusual presentations. The commonest among unusual morphologies was lupoid leishmaniasis 14 (34.1%, followed by sporotrichoid 5 (12.1%, paronychial 3 (7.3%, lid leishmaniasis 2 (4.9%, psoriasiform 2 (4.9%, mycetoma-like 2 (4.9%, erysipeloid 2 (4.9%, chancriform 2 (4.9%, whitlow 1 (2.4%, scar leishmaniasis 1 (2.4%, DLE-like 1 (2.4%, ′squamous cell carcinoma′-like 1 (2.4%, zosteriform 1 (2.4%, eczematous 1 (2.4%, verrucous 1 (2.4%, palmar/plantar 1 (2.4% and mucocutaneous 1 (2.4%. Conclusion: In Pakistan, an endemic country for CL, the possibility of CL should be kept in mind while diagnosing common dermatological diseases like erysipelas, chronic eczema, herpes zoster, paronychia; and uncommon disorders like lupus vulgaris, squamous cell carcinoma, sporotrichosis, mycetoma and other deep mycoses.

  1. Voice disorders in mucosal leishmaniasis.

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    Ana Cristina Nunes Ruas

    Full Text Available INTRODUCTION: Leishmaniasis is considered as one of the six most important infectious diseases because of its high detection coefficient and ability to produce deformities. In most cases, mucosal leishmaniasis (ML occurs as a consequence of cutaneous leishmaniasis. If left untreated, mucosal lesions can leave sequelae, interfering in the swallowing, breathing, voice and speech processes and requiring rehabilitation. OBJECTIVE: To describe the anatomical characteristics and voice quality of ML patients. MATERIALS AND METHODS: A descriptive transversal study was conducted in a cohort of ML patients treated at the Laboratory for Leishmaniasis Surveillance of the Evandro Chagas National Institute of Infectious Diseases-Fiocruz, between 2010 and 2013. The patients were submitted to otorhinolaryngologic clinical examination by endoscopy of the upper airways and digestive tract and to speech-language assessment through directed anamnesis, auditory perception, phonation times and vocal acoustic analysis. The variables of interest were epidemiologic (sex and age and clinic (lesion location, associated symptoms and voice quality. RESULTS: 26 patients under ML treatment and monitored by speech therapists were studied. 21 (81% were male and five (19% female, with ages ranging from 15 to 78 years (54.5+15.0 years. The lesions were distributed in the following structures 88.5% nasal, 38.5% oral, 34.6% pharyngeal and 19.2% laryngeal, with some patients presenting lesions in more than one anatomic site. The main complaint was nasal obstruction (73.1%, followed by dysphonia (38.5%, odynophagia (30.8% and dysphagia (26.9%. 23 patients (84.6% presented voice quality perturbations. Dysphonia was significantly associated to lesions in the larynx, pharynx and oral cavity. CONCLUSION: We observed that vocal quality perturbations are frequent in patients with mucosal leishmaniasis, even without laryngeal lesions; they are probably associated to disorders of some

  2. Treatment of visceral leishmaniasis

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    E M Moore

    2010-01-01

    Full Text Available The available treatment options for visceral leishmaniasis (VL have problems relating to efficacy, adverse effects and cost, making treatment a complex issue. We review the evidence relating to the different methods of treatment in relation to - efficacy and toxicity of the drugs in different areas of the world; ability to monitor side effects, length of treatment; ability of patients to pay for and stay safe during treatment, ability of the healthcare services to give intramuscular, intravenous or oral therapy; the sex and child-bearing potential of the patient and the immune status of the patient. The high mortality of untreated/ poorly treated VL infection makes the decisions paramount, but a unified and coordinated response by each area is likely to be more effective and informative to future policies than an ad hoc response. For patients in resource-rich countries, liposomal amphotericin B appears to be the optimal treatment. In South Asia, miltefosine is being used; the combination of single dose liposomal amphotericin B and short course miltefosine looks encouraging but has the problem of potential reproductive toxicities in females. In Africa, the evidence to switch from SSG is not yet compelling. The need to monitor and plan for evolving drug failure, secondary to leishmania parasite resistance, is paramount. With a few drugs the options may be limited; however, we await key ongoing trials in both Africa and India to explore the effects of combination treatment. If safe and reliable combinations are revealed by the ongoing studies, it is far from clear as to whether this will avoid leishmania parasite resistance. The development of new drugs to add to the armamentarium is paramount. Lessons can be learnt from the management of diseases such as tuberculosis and malaria in terms of planning the switch to combination treatment. As important as establishing the best choice for specific antileishmanial agent is ensuring treatment centers

  3. Visceral Leishmaniasis In A Native Kashmiri Boy

    Directory of Open Access Journals (Sweden)

    Deepti Mahajan, M.L. Bhat

    2009-07-01

    Full Text Available Leishmaniasis, though widely prevalent in South Asia, is not seen in the Kashmir valley where the coldclimatic conditions create a hostile environment for the growth of the parasite or its vector, the sandfly.However, a few cases of cutaneous leishmaniasis have been documented from the hot and arid Uri belt ofKashmir. We present a case of visceral leishmaniasis in a boy hailing from Uri, a rarity in this region.

  4. Development of Vaccines against Visceral Leishmaniasis

    OpenAIRE

    Krystal J. Evans; Lukasz Kedzierski

    2011-01-01

    Leishmaniasis is a neglected disease resulting in a global morbidity of 2,090 thousand Disability-Adjusted Life Years and a mortality rate of approximately 60,000 per year. Among the three clinical forms of leishmaniasis (cutaneous, mucosal, and visceral), visceral leishmaniasis (VL) accounts for the majority of mortality, as if left untreated VL is almost always fatal. Caused by infection with Leishmania donovani or L. infantum, VL represents a serious public health problem in endemic region...

  5. Visceral Leishmaniasis In A Native Kashmiri Boy

    OpenAIRE

    Deepti Mahajan, M.L. Bhat; Singh, J B.; Deepa Hans

    2009-01-01

    Leishmaniasis, though widely prevalent in South Asia, is not seen in the Kashmir valley where the coldclimatic conditions create a hostile environment for the growth of the parasite or its vector, the sandfly.However, a few cases of cutaneous leishmaniasis have been documented from the hot and arid Uri belt ofKashmir. We present a case of visceral leishmaniasis in a boy hailing from Uri, a rarity in this region.

  6. Diagnóstico molecular para Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Ysabel Montoya

    1997-01-01

    Full Text Available El potencial diagnóstico de epitopes inmunodominantes seleccionados fue ensayado satisfactoriamente a fin de obtener una prueba serodiagnóstica alternativa para la Leishmaniasis Tegumentaria Americana. Dos proteínas recombinantes prometedoras de L. (v. peruviana referidas como T-26-U2/T26-U4 fueron reconocidas por sueros individuales de pacientes con Leishmaniasis Tegumentaria Americana usando Western Blot. La sensibilidad de la prueba fue de 86% con sueros permanentes con Leishmaniasis peruana.

  7. A Rare Presentation of Leishmaniasis.

    Science.gov (United States)

    Prajapati, Ritesh; Kumar, Ashish; Sharma, Praveen; Singla, Vikas; Bansal, Naresh; Dhawan, Shashi; Arora, Anil

    2016-06-01

    Leishmaniasis or kala-azar is a protozoan disease that can present as cutaneous, mucocutaneous, visceral, and disseminated disease. In India, it is usually localized in distinct areas of Bihar, Jharkhand, West Bengal, and parts of Eastern Uttar Pradesh. Visceral leishmaniasis (VL) involves the visceral organs, mainly the liver, the spleen and bone marrow. VL is characterized by prolonged fever, massive splenomegaly, weight loss, progressive anemia, pancytopenia, and hypergammaglobulinemia, and can be complicated by serious infections. In most of the patient the diagnosis is made on bone marrow biopsy or splenic aspirate. We hereby present an unusual case of kala-azar in a 52-year-old patient non-resident of endemic area presenting with pyrexia of unknown origin, in whom bone marrow biopsy was negative for Leishmanin Donovan (LD) bodies, and diagnosis was made by liver biopsy in which LD bodies were seen. PMID:27493461

  8. Diffuse cutaneous leishmaniasis in Mexico.

    Science.gov (United States)

    Velasco, O; Savarino, S J; Walton, B C; Gam, A A; Neva, F A

    1989-09-01

    In Mexico, 6 cases of diffuse cutaneous leishmaniasis (DCL) were found in widely separated geographic regions. Information was also available on 2 other cases. In addition to the typical clinical features, half of the patients had evidence of nasopharyngeal mucosal involvement. All isolates from the DCL patients were identified as Leishmania mexicana mexicana by isoenzyme analysis and monoclonal antibody typing. In 1 region of Tabasco state where DCL was found, uncomplicated cutaneous leishmaniasis appeared to be highly endemic, and isolates from a few such patients were identified as L. mexicana mexicana. An incidental finding was the recovery of an isolate of L. braziliensis braziliensis from a patient with chiclero ulcer in Oaxaca state. The clinical and epidemiological significance of the reported cases are discussed. PMID:2802018

  9. Leishmaniose tegumentar americana: estudo clínico, epidemiológico e laboratorial realizado no Hospital Universitário de Campo Grande, Mato Grosso do Sul, Brasil American cutaneous leishmaniasis: clinical, epidemiological and laboratory studies conducted at a university teaching hospital in Campo Grande, Mato Grosso do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Nathalia Dias Negrão Murback

    2011-02-01

    Full Text Available FUNDAMENTOS: Leishmaniose Tegumentar Americana é zoonose de manifestações clínicas variadas, em expansão no Brasil, sendo o estado de Mato Grosso do Sul importante área endêmica. OBJETIVOS: Avaliar clínica, epidemiológica e laboratorialmente pacientes com Leishmaniose Tegumentar Americana , atendidos no Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal de Mato Grosso do Sul, Brasil (HU/UFMS. MÉTODOS: Trata-se de um estudo observacional do tipo transversal com abordagem descritiva e analítica. Foram avaliados, retrospectivamente, dados de pacientes suspeitos de Leishmaniose Tegumentar Americana , atendidos no HU/UFMS de 1998 a 2008, e encaminhados ao Laboratório de Parasitologia/UFMS para complementação diagnóstica. Para a inclusão neste estudo foram considerados critérios clínicos e laboratoriais. RESULTADOS: Quarenta e sete pacientes foram incluídos no estudo. Houve predominância de homens de 45 a 59 anos, com a forma cutânea, lesão única, ulcerada, em áreas expostas do corpo e com duração menor que seis meses. O comprometimento de mucosas foi crescente com o aumento da idade e maior em pacientes que procuraram atendimento tardiamente. Intradermorreação de Montenegro foi o exame de maior sensibilidade e o encontro do parasito mostrou-se mais difícil em lesões antigas. CONCLUSÃO: Suspeição diagnóstica precoce é de extrema importância para diagnóstico preciso. Associação de exame parasitológico e imunológico torna mais seguro o diagnóstico laboratorial.BACKGROUND: American cutaneous leishmaniasis is a disease with a wide variety of clinical manifestations that is expanding throughout Brazil, the state of Mato Grosso do Sul constituting a significant endemic area. OBJECTIVES: To evaluate the clinical, epidemiological and laboratory characteristics of patients with American cutaneous leishmaniasis. Patients were recruited among those attending the Maria Aparecida Pedrossian Teaching

  10. Leishmaniasis cutis:report of two cases

    Institute of Scientific and Technical Information of China (English)

    XU Ke-jian; LIU Yue-hua; FANG Kai

    2005-01-01

    @@ Leishmaniasis cutis is a chronic dermatosis resulting from infestation by Leishmania of the skin.The diagnosis could not be established until a biopsy specimen revealed Leishman-Donovan(LD)bodies.We report two cases of leishmaniasis cutis diagnosed and treated recently in our department.

  11. Oral mucosal involvement in visceral leishmaniasis

    Institute of Scientific and Technical Information of China (English)

    Sunny Garg; Richik Tripathi; Kamlakar Tripathi

    2013-01-01

    Leishmaniasis affects both the visceral and cutaneous tissues in body.OralMucosal involvement in leishmaniasis is rare and is often overlooked.We present a case17 year old boy from the north east region ofBihar who has a history of visceral leishmaniasis one year back, came to the department of oral surgery for treatment of persistent oral ulcers.Oral examination did not give any diagnostic information while systemic examination revealed enlarged spleen and low grade fever.Patient was screened for leishmaniasis by rK39 based immunochromatographic strip test which came to be positive.Biopsy of the ulcer as well as splenic and bone marrow aspirate confirmed the presence of leishmaniasis.Patient was administeredAmphotericinB for20 days following which significant clinical and haematological improvement followed.

  12. Leishmaniasis in the genital area

    Directory of Open Access Journals (Sweden)

    CABELLO Ismery

    2002-01-01

    Full Text Available Two patients from the gold mines of Bolivar State, Venezuela, presenting cutaneous leishmaniasis in the genital region, an unusual location, are described. The first patient showed an ulcerated lesion of the glans penis. Leishmanin skin test was positive. A biopsy specimen revealed a granulomatous infiltrate containing Leishmania parasites. In the second patient, Leishmanin skin test was positive, HIV and VDRL were negative. Leishmania parasites were present in a biopsy of an ulcerated lesion in the scrotum, with an indurated base, infiltrative borders with an yellowish exudate. Patients were treated with meglumine antimoniate and the lesions healed.

  13. Cutaneous Leishmaniasis with Unusual Presentation

    Directory of Open Access Journals (Sweden)

    N Bagherani

    2009-05-01

    Full Text Available "nThis case report states a 25-year-old woman, residing in the city of Dezfool, Khuzestan Province, south of Iran with the diagnosis of cutaneous leishmaniasis in June 2008. Her skin lesion had de­veloped from 8 months earlier as a nodule on her left arm, 1×3 cm in diameter. Because of sever­ity of the lesion, we prescribed meglumine antimoniate intralesionally with giving up her breast feeding. After 6 months follow-up, no recurrence was seen.

  14. Vaccine candidates for leishmaniasis: a review.

    Science.gov (United States)

    Nagill, Rajeev; Kaur, Sukhbir

    2011-10-01

    Leishmaniasis is a diverse group of clinical syndromes caused by protozoan parasites of the genus Leishmania. The clinical manifestation of the disease varies from self-limiting cutaneous lesions to progressive visceral disease. It is estimated that 350 million people are at risk in 88 countries, with a global incidence of 1-1.5 million cases of cutaneous and 500,000 cases of visceral leishmaniasis. The key control measures mainly rely on early case detection and chemotherapy which has been hampered by the toxicity of drugs, side-effects and by the emergence of drug resistance in parasites. Control of reservoir host and vector is difficult due to operational difficulties and frequent relapses in the host. Therefore, the development of effective and affordable vaccine against leishmaniasis is highly desirable. Although considerable progress has been made over the last decade in understanding immune mechanisms underlying potential candidate antigens, including killed, live attenuated parasites, crude parasites, pure or recombinant Leishmania proteins or DNA encoding leishmanial proteins, as well as immunomodulators from sand fly saliva, very few candidate vaccines have progressed beyond the experimental stage. As such there is no vaccine against any form of human leishmaniasis. In recent years, however, much interest has been stimulated towards vaccination against leishmaniasis focused mainly on cutaneous leishmaniasis with fewer attempts against visceral leishmaniasis.

  15. Ecological Aspects of Phlebotomine Sand Flies (Diptera, Psychodidae, Phlebotominae) in Areas of American Cutaneous Leishmaniasis, in the Municipality of Paraty, Rio de Janeiro, Brazil. I-Index of Abundance by Location and Type of Capture.

    Science.gov (United States)

    Vieira, V R; Azevedo, A C R; Alves, J R C; Guimarães, A E; Aguiar, G M

    2015-09-01

    The description of the first and autochthonous case of diffuse cutaneous leishmaniasis in the municipality of Paraty, State of Rio de Janeiro, brought the interest of this study. Sand flies were captured over a 3-yr period. Using manual suction tubes, sand flies were collected from the inner and outer walls of homes, in the living spaces of domestic animals, and in Shannon light traps, which were set up outside homes and in the forest. CDC light traps were installed inside homes, around the exterior of the houses, and along the divide and within the forest. A total of 102,937 sand flies were collected, representing 23 species--three from the genus Brumptomyia and 20 from the genus Lutzomyia. Of these, six species, Lutzomyia intermedia, Lutzomyia fischeri, Lutzomyia migonei, Lutzomyia whitmani, and Lutzomyia pessoai have already been recorded as being naturally infected by Leishmania braziliensis, and one species, Lutzomyia ayrozai, by Leishmania naiffi. Lu. intermedia is the vector of Le. braziliensis in the study area, particularly inside the homes and on the exterior of the houses. Lu. fischeri can also act as vector of Le. braziliensis in domestic environments and particularly in the wild. The third-ranked Lu. migonei was the most abundant in kennels, suggesting its canine affinity. Lu. whitmani, ranked fourth, still has characteristics indicative of the wild, but with a significant number located on the edge of the forest, suggesting a selection process of adaptation to the anthropic environment.

  16. Leishmaniasis in dogs: Case study

    Directory of Open Access Journals (Sweden)

    Aleksić Jelena

    2009-01-01

    Full Text Available The paper presents a case of leishmaniasis in a 2.5-month-old dog imported from France. The clinical examination established a generally poor state of health, expressed cachexia, atrophy of the temporal musculature, weakness of movement, as well as abnormally long and brittle nails. There was also hyperkeratosis of the nose tip and paws. A histological examination of biopsy sections of the altered skin parts showed inflammatory changes in the area of the dermis, together with infiltration of macrophages and a smaller number of lymphocytes, plasmocytes and neutrophil granulocytes in the area around the sebaceous glands and hair follicles. The determined changes correspond to superficial dermatitis. Edema followed by partial degeneration of connective-tissue fibers is observed in connective tissue. A smaller number of intracellular parasitic forms was established in mononuclear cells. A smaller number of oval amastigotes with round dark red nucleis were observed in sections stained using the Gimza method in the cytoplasm of macrophages located in the dermis, but also extracellularly. It was concluded that the dog was diseased with leishmaniasis on the grounds of the clinical picture and the microscopic findings.

  17. Leishmaniose tegumentar americana: flebotomíneos de área de transmissão no Norte do Paraná, Brasil American cutaneous leishmaniasis: phlebotominae of the area of transmission in the North of Parana, Brazil

    Directory of Open Access Journals (Sweden)

    Ueslei Teodoro

    1991-04-01

    Full Text Available Dos casos de leishmaniose tegumentar diagnosticados no Laboratório de Ensino e Pesquisa de Análises Clínicas da Universidade Estadual de Maringá-PR (Brasil, a maioria está relacionada a áreas, no Norte do Paraná, que vem sendo ocupadas desde a década de 1940, quando se iniciou extenso desmatamento naquela Região. A vegetação nativa, já em grande parte destruída, é constituída por mata densa do tipo tropical de transição para subtropical. A paisagem no seu conjunto é de planalto, com clima tropical de transição para subtropical, temperaturas médias anuais entre 20°C e 22°C e média do mês mais quente superior a 22°C. Das florestas nativas restam poucas e esparsas manchas de vegetação, geralmente modificadas, ao longo das bacias dos rios Ivaí, Paranapanema e Paraná, e seus afluentes. Neste ambiente foram feitas 24 capturas de flebotomíneos, 2 por mês, de outubro de 1986 a setembro de 1987, das 18 horas à l hora do dia seguinte. As capturas, com armadilhas de Shannon, foram realizadas às margens de mata modificada, tendo sido classificados 16.496 flebotomíneos, pertencentes na sua quase totalidade a 13 espécies. Observou-se prevalência de Lutzomyia whitmani com 11.188 (67,82% exemplares, seguido por Lutzomyia intermedia com 2.900 (17,58% e Lutzomyia migonei com 1.491 (9,03%. Lutzomyia whitmani e Lutzomyia intermedia vêm mostrando grande capacidade de adaptação nos ambientes antrópicos, onde têm destacado papel na transmissão de leishmaniose.Most of the cases of cutaneous leishmaniasis diagnosed in the laboratory of the State University of Maringá, Paraná, Brazil, are related to areas of northern Paraná State, which have been settled since 40 years age, when the destructions of vast areas of forest in this region was begun. The native vegetation, already, in large part, destroyed is constituted of dense forest of the type found in the transition from tropical to subtropical regions. The landscape is

  18. T-cell response in human leishmaniasis

    DEFF Research Database (Denmark)

    Kharazmi, A; Kemp, K; Ismail, A;

    1999-01-01

    In the present communication we provide evidence for the existence of a Th1/Th2 dichotomy in the T-cell response to Leishmania antigens in human leishmaniasis. Our data suggest that the pattern of IL-4 and IFN-gamma response is polarised in these patients. Lymphocytes from individuals recovered...... from cutaneous leishmaniasis (CL) responded by IFN-gamma production following stimulation with Leishmania antigens whereas cells from patients recovered from visceral leishmaniasis (VL) showed a mixed pattern of IFN-gamma and IL-4 responses. The cells producing these cytokines were predominantly CD4......+. Furthermore, IL-10 plays an important role in the development of post kala azar dermal leishmaniasis (PKDL) from VL. The balance between the parasitic-specific T-cell response plays an important regulatory role in determining the outcome of Leishmania infections in humans....

  19. Development of Vaccines against Visceral Leishmaniasis.

    Science.gov (United States)

    Evans, Krystal J; Kedzierski, Lukasz

    2012-01-01

    Leishmaniasis is a neglected disease resulting in a global morbidity of 2,090 thousand Disability-Adjusted Life Years and a mortality rate of approximately 60,000 per year. Among the three clinical forms of leishmaniasis (cutaneous, mucosal, and visceral), visceral leishmaniasis (VL) accounts for the majority of mortality, as if left untreated VL is almost always fatal. Caused by infection with Leishmania donovani or L. infantum, VL represents a serious public health problem in endemic regions and is rapidly emerging as an opportunistic infection in HIV patients. To date, no vaccine exists for VL or any other form of leishmaniasis. In endemic areas, the majority of those infected do not develop clinical symptoms and past infection leads to robust immunity against reinfection. Thus the development of vaccine for Leishmania is a realistic public health goal, and this paper summarizes advances in vaccination strategies against VL. PMID:21912561

  20. Development of Vaccines against Visceral Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Krystal J. Evans

    2012-01-01

    Full Text Available Leishmaniasis is a neglected disease resulting in a global morbidity of 2,090 thousand Disability-Adjusted Life Years and a mortality rate of approximately 60,000 per year. Among the three clinical forms of leishmaniasis (cutaneous, mucosal, and visceral, visceral leishmaniasis (VL accounts for the majority of mortality, as if left untreated VL is almost always fatal. Caused by infection with Leishmania donovani or L. infantum, VL represents a serious public health problem in endemic regions and is rapidly emerging as an opportunistic infection in HIV patients. To date, no vaccine exists for VL or any other form of leishmaniasis. In endemic areas, the majority of those infected do not develop clinical symptoms and past infection leads to robust immunity against reinfection. Thus the development of vaccine for Leishmania is a realistic public health goal, and this paper summarizes advances in vaccination strategies against VL.

  1. Leishmaniasis in refugee and local Pakistani populations.

    Science.gov (United States)

    Brooker, Simon; Mohammed, Nasir; Adil, Khaksar; Agha, Said; Reithinger, Richard; Rowland, Mark; Ali, Iftikhar; Kolaczinski, Jan

    2004-09-01

    The epidemiology of anthroponotic cutaneous leishmaniasis was investigated in northwest Pakistan. Results suggested similar patterns of endemicity in both Afghan refugee and Pakistani populations and highlighted risk factors and household clustering of disease. PMID:15498178

  2. Case study for a vaccine against leishmaniasis.

    Science.gov (United States)

    Alvar, Jorge; Croft, Simon L; Kaye, Paul; Khamesipour, Ali; Sundar, Shyam; Reed, Steven G

    2013-04-18

    Leishmaniasis in many ways offers a unique vaccine case study. Two reasons for this are that leishmaniasis is a disease complex caused by several different species of parasite that are highly related, thus raising the possibility of developing a single vaccine to protect against multiple diseases. Another reason is the demonstration that a leishmaniasis vaccine may be used therapeutically as well as prophylactically. Although there is no registered human leishmaniasis vaccine today, immunization approaches using live or killed organisms, as well as defined vaccine candidates, have demonstrated at least some degree of efficacy in humans to prevent and to treat some forms of leishmaniasis, and there is a vigorous pipeline of candidates in development. Current approaches include using individual or combined antigens of the parasite or of salivary gland extract of the parasites' insect vector, administered with or without formulation in adjuvant. Animal data obtained with several vaccine candidates are promising and some have been or will be entered into clinical testing in the near future. There is sufficient scientific and epidemiological justification to continue to invest in the development of vaccines against leishmaniasis.

  3. Leishmaniasis: vaccine candidates and perspectives.

    Science.gov (United States)

    Singh, Bhawana; Sundar, Shyam

    2012-06-01

    Leishmania is a protozoan parasite and a causative agent of the various clinical forms of leishmaniasis. High cost, resistance and toxic side effects of traditional drugs entail identification and development of therapeutic alternatives. The sound understanding of parasite biology is key for identifying novel drug targets, that can induce the cell mediated immunity (mainly CD4+ and CD8+ IFN-gamma mediated responses) polarized towards a Th1 response. These aspects are important in designing a new vaccine along with the consideration of the candidates with respect to their ability to raise memory response in order to improve the vaccine performance. This review is an effort to identify molecules according to their homology with the host and their ability to be used as potent vaccine candidates.

  4. Treatment Approaches for Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Sema Aytekin

    2009-06-01

    Full Text Available Cutaneous leishmaniasis (CL is a widespread tropical infection caused by numerous different species of Leishmania protozoa. In our country, CL is due frequently to L. major and L. tropica. Its clinical presentation is extremely diverse. Treatment of CL aims to prevent mucosal invasion, to accelerate the healing of skin lesions, and avoid disfiguring scar. Local and physical treatment modalities including topical paromomycin, cryotherapy, localized controlled heat, carbon dioxide laser therapy, or pentavalant antimonals can be effective against. Intralesional antimonals are still the drug of choice may patients. WHO recommends an injection of drug under edges of the lesions and the entire lesion until the surface has blanched. Parenteral antimonials are useful for large, persistent or recurrent lesions. Combinations with other drugs such as allopurinol, pentoxifylline must be used for antimony unresponsive lesions.

  5. Comportamento de Lutzomyia longipalpis, vetor principal da leishmaniose visceral americana, em Campo Grande, Estado do Mato Grosso do Sul Behavior of Lutzomyia longipalpis, the main vector of American visceral leishmaniasis, in Campo Grande, State of Mato Grosso do Sul

    Directory of Open Access Journals (Sweden)

    Elaine Araujo e Silva

    2007-08-01

    Full Text Available O município de Campo Grande, Estado de Mato Grosso do Sul, Brasil, apresenta ocorrência de casos humanos e caninos de leishmaniose visceral desde 2002 e é classificado como área com transmissão intensa. O estudo foi realizado no período de maio de 2003 a abril de 2005, em parceria com a Fundação Nacional de Saúde e a Secretaria de Saúde do Estado, com o objetivo de conhecer o comportamento e a sazonalidade da espécie Lutzomyia longipalpis. As capturas foram realizadas com armadilhas luminosas, tipo CDC, em doze estações distribuídas na zona urbana. As estações com maior densidade situam-se na parte sul da cidade e a abundância relativa aumentou durante, ou logo após, as precipitações pluviométricas. Nos meses frios e secos a quantidade foi reduzida e a abundância relativa foi maior no peridomicílio. A borrifação com alphacypermetrina, em intervalos de quatro meses, contribuiu para a diminuição do vetor em três das quatro estações borrifadas e, das oito que não sofreram intervenção química, cinco tiveram aumento.The municipality of Campo Grande, State of Mato Grosso do Sul, Brazil, has presented cases of canine and human visceral leishmaniasis since 2002, and is classified as an area of intense transmission. This study was carried out from May 2003 to April 2005, in partnership with the National Health Foundation and the State Health Department, with the objective of determining the behavior and seasonality of the species Lutzomyia longipalpis. Captures were accomplished using luminous traps of CDC type, at twelve stations distributed in the urban zone. The stations with the highest population densities were situated in the southern part of the city and the relative abundance increased during or immediately after rainfall. During the cold and dry months, the number of specimens was reduced and the relative abundance was higher in habitats surrounding homes. Spraying with alpha-cypermethrin at four-month intervals

  6. Estudo clínico, epidemiológico e terapêutico de 402 pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Brasília, DF, Brasil Clinical, epidemiological and therapeuthic study of 402 patients with american cutaneous leishmaniasis attended at University Hospital of Brasilia, DF, Brazil

    Directory of Open Access Journals (Sweden)

    Roberto Querido Name

    2005-06-01

    Full Text Available FUNDAMENTOS: A leishmaniose tegumentar americana é doença em expansão no Brasil. A região Centro-Oeste é hoje a terceira em incidência e a primeira em crescimento da doença. OBJETIVOS: Avaliar pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Brasília, quanto a aspectos clinicoepidemiológicos e resposta ao tratamento com antimonial pentavalente. MÉTODOS: Estudo do tipo série de casos de 402 pacientes, segundo sexo, idade, ocupação, procedência, formas clínicas, métodos de diagnóstico, tratamento com antimonial pentavalente e efeitos colaterais, no período de 1/1/1994 a 28/2/2003. O acompanhamento foi de um ano pós-tratamento. RESULTADOS: Predomínio de homens, lavradores, de 20 a 39 anos, com a forma cutânea. A eficácia do antimonial foi maior em pacientes com forma cutânea tratados até seis meses depois do início dos sintomas, e em pacientes do sexo feminino (diferenças estatisticamente significativas na análise multivariada. O mesmo ocorreu para pacientes com forma mucocutânea, mas sem diferença estatística significante. Alterações eletrocardiográficas foram mais freqüentes no grupo tratado com 20mg SbV/kg/dia por 30 dias em relação ao tratado por 20 dias. Eosinofilia ocorreu em 17,5% dos casos. CONCLUSÕES: Tratamento precoce, sexo feminino e a forma cutânea apresentaram índices mais elevados de cura. Alterações do eletrocardiograma aumentaram com o tempo de tratamento com antimoniais. A eosinofilia como efeito colateral ao uso do antimonial merece maior investigação.BACKGROUND: American cutaneous leishmaniasis is a disease with high prevalence and incidence in Brazil. The Brazilian Central-Western Region currently holds the third largest incidence and the first growth rate of this disease in the country. OBJECTIVES: To evaluate clinical, epidemiological and treatment features of patients with American cutaneous leishmaniasis seen at the University Hospital of Bras

  7. Leishmaniasis

    Science.gov (United States)

    ... culture Montenegro skin test (not approved in the United States) Skin biopsy and culture Other tests that may be done include: Complete blood count Serologic testing Serum albumin Serum immunoglobulin levels ...

  8. Canine visceral leishmaniasis on Margarita Island (Nueva Esparta, Venezuela).

    Science.gov (United States)

    Zerpa, O; Ulrich, M; Negrón, E; Rodríguez, N; Centeno, M; Rodríguez, V; Barrios, R M; Belizario, D; Reed, S; Convit, J

    2000-01-01

    The frequency of American visceral leishmaniasis affecting humans on Margarita Island, Venezuela, has increased in recent years, and infected dogs appear to constitute the principal source of infection. ELISA tests with Leishmania donovani promastigotes and rK39 antigen from L. chagasi in serum from 541 dogs were positive in 33.1% and 21.6% of the samples, respectively. A second blood sample taken from 50 animals after 8-10 months revealed an increase from 24% to 40% of ELISA positivity to both antigens, suggesting high susceptibility and transmission in the canine population. Among 42 serologically positive dogs, 33% of which showed clinical signs of disease, 79% were positive in polymerase chain reactions using primers specific for the L. donovani complex. Control measures including epidemiological hypersurveillance, the humane sacrifice of infected dogs, and rapid diagnosis and treatment of human cases have been initiated. PMID:11132371

  9. Association of the Endobiont Double-Stranded RNA Virus LRV1 With Treatment Failure for Human Leishmaniasis Caused by Leishmania braziliensis in Peru and Bolivia.

    Science.gov (United States)

    Adaui, Vanessa; Lye, Lon-Fye; Akopyants, Natalia S; Zimic, Mirko; Llanos-Cuentas, Alejandro; Garcia, Lineth; Maes, Ilse; De Doncker, Simonne; Dobson, Deborah E; Arevalo, Jorge; Dujardin, Jean-Claude; Beverley, Stephen M

    2016-01-01

    Cutaneous and mucosal leishmaniasis, caused in South America by Leishmania braziliensis, is difficult to cure by chemotherapy (primarily pentavalent antimonials [Sb(V)]). Treatment failure does not correlate well with resistance in vitro, and the factors responsible for treatment failure in patients are not well understood. Many isolates of L. braziliensis (>25%) contain a double-stranded RNA virus named Leishmaniavirus 1 (LRV1), which has also been reported in Leishmania guyanensis, for which an association with increased pathology, metastasis, and parasite replication was found in murine models. Here we probed the relationship of LRV1 to drug treatment success and disease in 97 L. braziliensis-infected patients from Peru and Bolivia. In vitro cultures were established, parasites were typed as L. braziliensis, and the presence of LRV1 was determined by reverse transcription-polymerase chain reaction, followed by sequence analysis. LRV1 was associated significantly with an increased risk of treatment failure (odds ratio, 3.99; P = .04). There was no significant association with intrinsic Sb(V) resistance among parasites, suggesting that treatment failure arises from LRV1-mediated effects on host metabolism and/or parasite survival. The association of LRV1 with clinical drug treatment failure could serve to guide more-effective treatment of tegumentary disease caused by L. braziliensis.

  10. Vaccines for visceral leishmaniasis: A review.

    Science.gov (United States)

    Jain, Keerti; Jain, N K

    2015-07-01

    Visceral leishmaniasis, which is also known as Kala-Azar, is one of the most severely neglected tropical diseases recognized by the World Health Organization (WHO). The threat of this debilitating disease continues due to unavailability of promising drug therapy or human vaccine. An extensive research is undergoing to develop a promising vaccine to prevent this devastating disease. In this review we compiled the findings of recent research with a view to facilitate knowledge on experimental vaccinology for visceral leishmaniasis. Various killed or attenuated parasite based first generation vaccines, second generation vaccines based on antigenic protein or recombinant protein, and third generation vaccines derived from antigen-encoding DNA plasmids including heterologous prime-boost Leishmania vaccine have been examined for control and prevention of visceral leishmaniasis. Vaccines based on recombinant protein and antigen-encoding DNA plasmids have given promising results and few vaccines including Leishmune®, Leishtec, and CaniLeish® have been licensed for canine visceral leishmaniasis. A systematic investigation of these vaccine candidates can lead to development of promising vaccine for human visceral leishmaniasis, most probably in the near future.

  11. Aetiology of visceral leishmaniasis in Mexico.

    Science.gov (United States)

    Monroy-Ostria, A; Hernandez-Montes, O; Barker, D C

    2000-03-25

    Two children with visceral leishmaniasis (VL), were studied by DNA analysis. DNA from liver biopsy samples from both patients, was amplified by PCR with broad primers specific for the Leishmania subgenus. DNA from the patient from Chiapas was also amplified with primers specific for the Leismania donovani complex and hybridised with a probe specific for L. donovani complex. The second patient, who is the first reported case of visceral leishmaniasis in the Mexican state of Tabasco, where localised cutaneous leishmaniasis and DCL predominate, had a co-infection with Toxoplasma gondii. The DNA from this patient was not amplified with primers specific for the L. donovani complex, did not hybridise with a probe specific for the L. donovani complex, but did hybridise with kDNA from a Mexican Leishmania mexicana strain used as a probe. We therefore, suggest that members of the L. donovani or L. mexicana complexes cause VL in Mexico. PMID:10708655

  12. Leishmaniasis vaccines: past, present and future.

    Science.gov (United States)

    Modabber, Farrokh

    2010-11-01

    No vaccine exists against any form of leishmaniasis. Because recovery from infection is usually accompanied by a strong immunity and because it is possible to protect experimental animals against live challenge, hope for the development of a vaccine for humans has been high. However, leishmaniasis is a disease of the poor and the market for a vaccine is very limited. Until a few years ago, with minimal resources, only a pragmatic approach was possible for testing the first-generation vaccines (i.e. killed whole parasites). Recently, funding has become available for developing defined second-generation vaccines, including recombinant proteins and DNA constructs. With new adjuvants also being developed there is new hope, and several new vaccines are in development against leishmaniasis.

  13. Molecular Epidemiology for Vector Research on Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Hirotomo Kato

    2010-03-01

    Full Text Available Leishmaniasis is a protozoan disease caused by the genus Leishmania transmitted by female phlebotomine sand flies. Surveillance of the prevalence of Leishmania and responsive vector species in endemic and surrounding areas is important for predicting the risk and expansion of the disease. Molecular biological methods are now widely applied to epidemiological studies of infectious diseases including leishmaniasis. These techniques are used to detect natural infections of sand fly vectors with Leishmania protozoa and are becoming powerful tools due to their sensitivity and specificity. Recently, genetic analyses have been performed on sand fly species and genotyping using PCR-RFLP has been applied to the sand fly taxonomy. In addition, a molecular mass screening method has been established that enables both sand fly species and natural leishmanial infections to be identified simultaneously in hundreds of sand flies with limited effort. This paper reviews recent advances in the study of sand flies, vectors of leishmaniasis, using molecular biological approaches.

  14. Hemophagocytic lymphohistiocytosis in children with visceral leishmaniasis.

    Science.gov (United States)

    Blázquez-Gamero, Daniel; Domínguez-Pinilla, Nerea; Chicharro, Carmen; Negreira, Sagrario; Galán, Pilar; Pérez-Gorricho, Beatriz; Calvo, Cristina; Prieto, Luis; De la Parte, María; Otheo, Enrique; Vivanco, Jose Luis; Ruiz-Contreras, Jesús

    2015-06-01

    Acquired hemophagocytic lymphohistiocitosis (HLH) syndrome can be a complication of visceral leishmaniasis (VL). A multicenter prospective study was conducted to determine the frequency of HLH syndrome in children with VL. Twenty-four children with VL were identified, and 10 (41%) developed HLH syndrome. VL should be ruled out in all children with HLH criteria living in or coming from endemic areas.

  15. [Cutaneous leishmaniasis--an import from Belize].

    Science.gov (United States)

    Schnedl, Jakob; Auer, Herbert; Fischer, Marcellus; Tomaso, Herbert; Pustelnik, Tom; Mooseder, Gerhard

    2007-01-01

    Cutaneous leishmaniasis of the New World, in particular when caused by Leishmania (L.) braziliensis, harbours the risk of lymphogenic as well as hematogenic dissemination. This may result in mucocutaneous leishmaniasis causing severe destruction of orofacial structures. Dissemination may occur years after the disappearance of the skin lesions. In contrast, cutaneous leishmaniasis of the old world, is typically restricted to the site of inoculation. Therefore, a conservative diagnostic and therapeutic approach is usually sufficient. Infections acquired in the new world should be treated systemically, if infection with Leishmania (Viannia) braziliensis complex cannot be excluded. Here we report on three Austrian soldiers, who, weeks after having participated in an international jungle patrol course in Belize, presented themselves with multiple ulcers on the upper limbs. Diagnosis of cutaneous leishmaniasis was made based upon histological evaluation of biopsies taken from several ulcers revealing the presence of leishmanial bodies, and detection of amastigote leishmania in smears of material obtained from the ulcers. As species phenotyping could not be performed, infection with L. brasiliensis as well as progression into a mucocutaneous form were possible, demanding systemic therapy. Several treatment options including local cryotherapy with liquid nitrogen, paromomycin (Humatis Pulvis, Parke-Davis) 15% topically or oral fluconazole (Diflucan, Pfizer) 200 mg/d were applied, but showed no effect. Hence, a systemic therapy with intravenous pentamidine (Pentacarinat, Gerot), three times in total, 3-4 mg/kg body weight each, led to a complete regression of the lesions within four weeks. PMID:17987367

  16. Vectors control importance on leishmaniasis transmission

    OpenAIRE

    Alfredo M. Oliveira Filho; Marli T. V. Melo

    1994-01-01

    We reviewed the control of transmission of leishmaniasis regarding chemotherapy, reservoirs elimination, vaccination and insect control through the use of chemical insecticides. We also discussed complementary measures like monitoring traps, impregnated bednets and curtains, repelents, pheromones, biological control, etc. A cost comparison of insecticide interventions through the use of products belonging to the four main chemical groups was also alone, comparing together conventional formula...

  17. Social and Economic Burden of Human Leishmaniasis.

    Science.gov (United States)

    Okwor, Ifeoma; Uzonna, Jude

    2016-03-01

    Leishmaniasis continues to pose a major public health problem worldwide. With new epidemics occurring in endemic areas and the spread of the disease to previously free areas because of migration, tourism, and military activities, there is a great need for the development of an effective vaccine. Leishmaniasis is a disease of the poor, occurring mostly in remote rural villages with poor housing and little or no access to modern health-care facilities. In endemic areas, diagnosis of any form of leishmaniasis puts a huge financial strain on an already meagre financial resource at both the individual and community levels. Most often families need to sell their assets (land and livestock) or take loans from informal financial outfits with heavy interest rates to pay for the diagnosis and treatment of leishmaniasis. Here, we discuss the disease with special emphasis on its socioeconomic impact on the affected individual and community. In addition, we highlight the reasons why continued research aimed at developing an effective Leishmania vaccine is necessary.

  18. Mefloquine in the treatment of cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Correia Dalmo

    1999-01-01

    Full Text Available Three cases of cutaneous leishmaniasis were treated orally with a mefloquine dose of 4.2mg/kg/day for six days in the Teaching Hospital of the Faculdade de Medicina do Triângulo Mineiro, Uberaba, MG, Brazil. Three weeks later a new series was repeated. No patient was cured.

  19. [Visceral leishmaniasis: not only a tropical disease].

    NARCIS (Netherlands)

    Cuperus, F.J.C.; Oosterwijk, P.R.; Vos, A.; Remijn, J.A.; Dobbenburgh, A. van; Bisseling, T.M.

    2013-01-01

    We report 2 cases of visceral leishmaniasis in Dutch patients after a stay in Greece and the former Yugoslavia, respectively. Patient A, a 69-year-old woman, was referred to our department with abdominal pain. Additional examinations were suggestive of chronic liver disease. After a liver biopsy, wh

  20. Social and Economic Burden of Human Leishmaniasis.

    Science.gov (United States)

    Okwor, Ifeoma; Uzonna, Jude

    2016-03-01

    Leishmaniasis continues to pose a major public health problem worldwide. With new epidemics occurring in endemic areas and the spread of the disease to previously free areas because of migration, tourism, and military activities, there is a great need for the development of an effective vaccine. Leishmaniasis is a disease of the poor, occurring mostly in remote rural villages with poor housing and little or no access to modern health-care facilities. In endemic areas, diagnosis of any form of leishmaniasis puts a huge financial strain on an already meagre financial resource at both the individual and community levels. Most often families need to sell their assets (land and livestock) or take loans from informal financial outfits with heavy interest rates to pay for the diagnosis and treatment of leishmaniasis. Here, we discuss the disease with special emphasis on its socioeconomic impact on the affected individual and community. In addition, we highlight the reasons why continued research aimed at developing an effective Leishmania vaccine is necessary. PMID:26787156

  1. Monoclonal gammopathy associated with visceral leishmaniasis

    Directory of Open Access Journals (Sweden)

    Vishal Sharma

    2010-06-01

    Full Text Available Monoclonal gammopathy can accompany diverse conditions and is usually benign. It should be distinguished from monoclonal gammopathy of undetermined significance (MGUS which can rarely turn malignant. Visceral leishmaniasis has only rarely been associated with monoclonal gammopathy. We describe the case of a 55-year-old male who had monoclonal gammopathy associated with visceral leishmanisais, which reversed with stibogluconate therapy.

  2. Topical and Intradermal Efficacy of Photodynamic Therapy with Methylene Blue and Light-Emitting Diode in the Treatment of Cutaneous Leishmaniasis Caused by Leishmania braziliensis

    OpenAIRE

    Sbeghen, Mônica Raquel; Voltarelli, Evandra Maria; Campois, Tácito Graminha; Kimura, Elza; Aristides, Sandra Mara Alessi; Hernandes, Luzmarina; Caetano, Wilker; Hioka, Noboru; Lonardoni, Maria Valdrinez Campana; Silveira, Thaís Gomes Verzignassi

    2015-01-01

    Introduction: The topical and intradermal photodynamic therapy (PDT) effect of methylene blue (MB) using light-emitting diode (LED) as light source (MB/LED-PDT) in the treatment of lesions of American cutaneous leishmaniasis (ACL) caused by Leishmania braziliensis in hamsters were investigated.

  3. [Visceral leishmaniasis in an HIV positive patient].

    Science.gov (United States)

    Rossiere-Echazarreta, Natalia Lorena; Rodríguez-Campos, Esther Alicia; Morales-Esponda, Mario; Domínguez-Moreno, Rogelio; Cruz-Ortiz, Margarita; Rodríguez-Guzmán, Leoncio Miguel

    2013-01-01

    Introducción: la leishmaniasis visceral o kala azar es la presentación clínica más grave. En México, es una enfermedad rara por lo que su diagnóstico es tardío y generalmente culmina en la muerte del paciente. Se describe a un paciente VIH positivo que desarrolló leishmaniasis visceral. El objetivo es explicar sus características fisiopatológicas y de su tratamiento. Caso clínico: hombre de 45 años de edad, quien ingresó al hospital por cuadro crónico de diarrea sanguinolenta, distensión abdominal, dolor tipo cólico, pérdida de peso y fiebre. A la exploración física se identificó paciente febril con dolor en fosa iliaca derecha y hepatoesplenomegalia. La prueba ELISA para VIH resultó positiva y el ultrasonido hizo evidente una tumoración en ciego, por lo que se realizó biopsia. El informe histopatológico indicó que se trataba de leishmaniasis. Conclusiones: en los pacientes con leishmaniasis e infección por VIH existe pobre respuesta al tratamiento y la mortalidad es alta, causada por la menor respuesta inmune del huésped. En la literatura especializada se sugiere el tratamiento establecido para la infección por VIH combinado con miltefosine y anfotericina B liposomal para la leishmaniasis.

  4. Canine visceral leishmaniasis in Sicily.

    Science.gov (United States)

    Orndorff, G R; Cooper, B A; Smith, W; Ryan, J R

    2000-01-01

    The Sicilian province of Catania is an active foci for human visceral leishmaniasis (VL) in the Mediterranean area. Approximately 10 to 15 cases of VL are diagnosed via hospital admissions each year in this community. Recently, an increase in VL case reporting by Sicilian physicians was noted, with 38 and 37 VL cases in 1996 and 1997, respectively. Before 1995, there were no reported VL cases among U.S. military personnel or their family members living in Sicily. However, since 1996, there have been four cases referred to Walter Reed Army Medical Center for diagnosis and treatment, all involving the children of personnel assigned to Naval Air Station Sigonella. Exposure histories for all infected individuals excluded exposure to Leishmania parasites outside of Sicily. All patients lived in areas where vectoring sandflies are present. All had dogs as family pets. To evaluate the level of infection among dogs owned by Navy personnel and their families, U.S. Navy Environmental and Preventive Medicine Unit 7, in a collaborative study with the U.S. Army Veterinary Clinic, Naval Air Station Sigonella, and the Walter Reed Army Institute of Research, performed clinical evaluation and serological testing of 50 dogs residing with U.S. personnel assigned to Naval Air Station Sigonella. The data indicate a high exposure rate to Leishmania (60% of the animals tested had elevated immunoglobulin M antibody levels) in the study population, suggesting that they were infected with Leishmania infantum. Distribution of seropositive dogs by sex was equal. Most of the dogs studied appeared to be in good health. However, inapparent infection of dogs, seen by Italian veterinarians, has been observed throughout all areas of Catania. Sandflies responsible for vectoring L. infantum were trapped in the same locations as the dogs sampled in this study. The level of subclinical infection was 75% among seropositive dogs. The overall level of canine infection observed was higher than expected

  5. Infectivity of seropositive dogs, showing different clinical forms of leishmaniasis, to Lutzomyia longipalpis phlebotomine sand flies.

    Science.gov (United States)

    Michalsky, Erika Monteiro; Rocha, Marília Fonseca; da Rocha Lima, Ana Cristina Vianna Mariano; França-Silva, João Carlos; Pires, Marize Quinhone; Oliveira, Fernanda Santos; Pacheco, Raquel Silva; dos Santos, Sara Lopes; Barata, Ricardo Andrade; Romanha, Alvaro José; Fortes-Dias, Consuelo Latorre; Dias, Edelberto Santos

    2007-06-20

    Visceral leishmaniasis (VL) is a growing zoonosis with an increasing number of new cases and a rapid geographical spreading of the disease. In the present study, a canine survey was carried out in the city of Montes Claros (320,000 inhabitants), an endemic area of American visceral leishmaniasis in the state of Minas Gerais, Brazil. A total number of 4795 dogs were examined by serology, which showed a rate of seropositivity of 5%. Isoenzymatic analysis confirmed Leishmania infantum chagasi as the local aetiological agent of CVL. Canine tissues were assayed for the presence of Leishmania parasite DNA using different techniques. The infectivity of asymptomatic, oligosymptomatic and symptomatic seropositive dogs was tested by xenodiagnosis using laboratory reared Lutzomyia longipalpis. Rates of infection of 5.4%, 5.1% and 28.4% were found for the phlebotomine sand flies that fed in asymptomatic, oligosymptomatic and symptomatic dogs, respectively. Our results indicate that, under experimental conditions, symptomatic dogs are about four times more infective to VL vectors than oligosymptomatic or asymptomatic animals. The lower infectivity rates of dogs displaying any of the last two clinical forms of leishmaniasis, however, must be taken into account in the epidemiology of CVL.

  6. Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia

    Directory of Open Access Journals (Sweden)

    Liliana López

    2013-06-01

    Full Text Available In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems, cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145 or a thermotherapy (Thermomed® application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149. Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients and 69% (85/145 patients, respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol between the two treatments. ClinicalTrials.gov: NCT00471705.

  7. Bone marrow leishmaniasis: a review of situation in Thailand.

    Science.gov (United States)

    Wiwanitkit, Viroj

    2011-10-01

    Leishmaniasis is an important tropical vector-borne disease. This infection can be seen in tropical area and it is considered to be one of the most important vector-borne infections at present. The general situation of the leishmaniasis in Thailand is hereby reviewed. Although Thailand is a tropical country, the leishmaniasis is not endemic but sporadic. The imported cases are documented in some literatures. The serious form of leishmaniasis, the visceral leishmaniasis is also detectable in Thailand. Also, the author performed an in depth literature review of the reports of bone marrow leishmaniasis, a specific kind of visceral leishmaniasis, in Thailand in order to summarize the characteristics of this infection among Thai patients. According to this review, there have been at least 5 reports in the literature of 6 cases of bone marrow leishmaniasis in the Thai population, of which no case was lethal. Concerning the clinical manifestations, all except had prolonged fever with unknown origin. From physical examination, all had hepatosplenomegaly. The striking findings were active hemophagocytosis with increased proliferation of lymphoidplasma cell line in the bone marrow and amastigotes of Leishmania donovani was demonstrated. Considering the treatment, pantavalent antimony compound was used and the excellent improvement and complete recovery. Finally, the author also discussed on the importance of leishmaniasis in Thailand relating to the present globalization and good traveling system.

  8. Visceral leishmaniasis diagnosed in a patient with MALT lymphoma

    DEFF Research Database (Denmark)

    Kaae, Jeanette; Nørgaard, Peter; Himmelstrup, B

    2007-01-01

    We report a case of visceral leishmaniasis in a 66-year-old female with a history of MALT lymphoma in the gastrointestinal tract. The patient presented with major hemorrhage per rectum and perforation of the small intestine. Due to unexplained decreasing platelets, lymphoma bone marrow involvement...... was suspected and bone marrow examination was performed. Surprisingly, Leishman-Donovan bodies were detected. The low platelet count, caused by the combination of MALT lymphoma and visceral leishmaniasis, appears to have aggravated the symptoms of the intestinal lymphoma. Leishmaniasis should be suspected even...... among asymptomatic patients with immune compromising illnesses and a travel history to areas where leishmaniasis is endemic....

  9. Role of Co-stimulation in Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Rashmi Tuladhar, Gayathri Natarajan, Abhay R Satoskar

    2011-01-01

    Full Text Available Leishmania are obligate intracellular parasites that cause a wide spectrum of diseases ranging from cutaneous, mucocutaneous and the visceral kind. Persistence or resolution of leishmaniasis is governed by host immune response. Co-stimulation is an important secondary signal that governs the extent, strength and direction of the immune response that follows. Co-stimulation by CD40, B7 and OX40 family has been shown to influence the outcome following Leishmania infection and manipulation of these pathways has shown promise for use in immune therapy of leishmaniasis. In this review, we discuss the roles of CD40, B7 and OX40 co-stimulatory pathways in regulating immunity to Leishmania and their implications in the treatment of this disease.

  10. Primary laryngeal leishmaniasis: A rare case report

    Directory of Open Access Journals (Sweden)

    Kumar Bipin

    2009-01-01

    Full Text Available Laryngeal leishmaniasis is extremely rare. We report a case of primary laryngeal leishmaniasis in a 70-year-old male who was admitted with complaints of gradual progressive hoarseness of the voice, dyspnea, cough for the past 3 months and noisy breathing for the past 5 days. An X-ray of the soft tissue of the neck showed a prevertebral soft tissue mass causing narrowing of the airway at the C6-C7 vertebral level. A computerized tomography (CT scan showed a soft tissue mass in the subglottic region causing significant narrowing of the airway. A direct laryngoscopy showed a pinkish-white, friable mass involving the subglottic region and the anterior half of the vocal cords. With the clinical suspicion of malignancy, an endoscopic biopsy was done. A histopathological examination showed diffuse mixed inflammatory cell infiltrate in subepithelium with numerous Leishmania donovani bodies in the cytoplasm of histiocytes.

  11. Visceral leishmaniasis: Experimental models for drug discovery

    OpenAIRE

    Gupta, Suman; Nishi

    2011-01-01

    Visceral leishmaniasis (VL) or kala-azar is a chronic protozoan infection in humans associated with significant global morbidity and mortality. The causative agent is a haemoflagellate protozoan Leishmania donovani, an obligate intracellular parasite that resides and multiplies within macrophages of the reticulo-endothelial system. Most of the existing anti-leishmanial drugs have serious side effects that limit their clinical application. As an alternate strategy, vaccination is also under ex...

  12. Recent advances in the diagnosis of leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Singh S

    2003-01-01

    Full Text Available Leishmaniasis is a parasitic disease caused by a haemoflagellate Leishmania. There are more than 21 species causing human infection. The infection is transmitted to humans through the bites of female sandflies belonging to 30 species. The disease manifests mainly in 3 forms: the visceral, the cutaneous and the mucocutaneous leishmaniasis. The diagnosis of visceral form is conventionally made by the demonstration of amastigotes of the parasite in the aspirated fluid from the bone marrow, the spleen, and rarely from the lymph nodes, or the liver. The parasite demonstration and isolation rates are rather poor from cutaneous and mucocutaneous lesions due to low parasite load and high rate of culture contamination. Recently several recombinant proteins have been developed to accomplish accurate diagnosis. Recombinant kinesin protein of 39 kDa called rK 39 is the most promising of these molecules. The antigen used in various test formats has been proved highly sensitive and specific for visceral leishmaniasis. It is useful in the diagnosis of HIV-Leishmania co-infection and as a prognostic marker. Molecular techniques targeting various genes of the parasite have also been reported, the PCR being the most common molecular technique successfully used for diagnosis and for differentiation of species.

  13. Cutaneous Leishmaniasis – Dermoscopic Findings And Cryotherapy

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    Dobrev Hristo P.

    2015-03-01

    Full Text Available We present a 60-year-old male patient who, three months after a holiday in Southern Greece, found a small ‘pimple’ on his back, which gradually got as big as a small walnut, the central part becoming ulcerated and scabby. Dermatological examination found an erythematous-to-livid nodular lesion on the right shoulder; it was 16 mm in diameter with central ulceration, covered with brownish crust which discharged pus-like secretion upon pressure. Microscope examination of Romanowsky-Giemsa stained lesion material detected amastigote forms of Leishmania tropica. The culture investigation and serological tests for leishmaniasis were negative. Dermoscopy of the lesion found the following features: erythema, hyperkeratosis, central ulceration covered with brownish crust, “yellow tears-like” structures and “white starburst-like” patterns, and various vascular structures (including dotted vessels, comma-shaped vessels, hairpin- and glomerular-like vessels. The patient was diagnosed with cutaneous leishmaniasis and underwent four cryotherapy sessions every other week with excellent therapeutic results - complete resolution of infiltrate with subsequent gentle hypopigmented scarring. In conclusion, dermoscopy is an easily accessible non-invasive method which can be useful for the diagnosis of cutaneous leishmaniasis. Cryotherapy is the treatment of choice for single skin lesions.

  14. Genetically modified organisms and visceral leishmaniasis.

    Science.gov (United States)

    Chhajer, Rudra; Ali, Nahid

    2014-01-01

    Vaccination is the most effective method of preventing infectious diseases. Since the eradication of small pox in 1976, many other potentially life compromising if not threatening diseases have been dealt with subsequently. This event was a major leap not only in the scientific world already burdened with many diseases but also in the mindset of the common man who became more receptive to novel treatment options. Among the many protozoan diseases, the leishmaniases have emerged as one of the largest parasite killers of the world, second only to malaria. There are three types of leishmaniasis namely cutaneous (CL), mucocutaneous (ML), and visceral (VL), caused by a group of more than 20 species of Leishmania parasites. Visceral leishmaniasis, also known as kala-azar is the most severe form and almost fatal if untreated. Since the first attempts at leishmanization, we have killed parasite vaccines, subunit protein, or DNA vaccines, and now we have live recombinant carrier vaccines and live attenuated parasite vaccines under various stages of development. Although some research has shown promising results, many more potential genes need to be evaluated as live attenuated vaccine candidates. This mini-review attempts to summarize the success and failures of genetically modified organisms used in vaccination against some of major parasitic diseases for their application in leishmaniasis.

  15. Canine cutaneous leishmaniasis by Leishmania (Viannia braziliensis in an agricultural settlement, endemic area for leishmaniasis

    Directory of Open Access Journals (Sweden)

    A.F. Brilhante

    2016-08-01

    Full Text Available ABSTRACT Cutaneous leishmaniasis has several species of Leishmania as agents, and a wide variety of wild and domestic animals as hosts and different species of phlebotomines as vectors. A case of cutaneous leishmaniasis in a dog coming from an agricultural settlement is described. This is the first report of parasitism in a dog by Le. (Viannia braziliensis in Mato Grosso do Sul State. Attention is called to the importance of including this protozoonosis in the differential diagnosis of dermopathies in dogs as also the need to assess the importance of the domestic dog as a possible reservoir of Le. braziliensis.

  16. Cutaneous leishmaniasis with lymphadenopathy due to Leishmania donovani

    NARCIS (Netherlands)

    W.R. Faber; J. Wonders; A.J. Jensema; E. Chocholova; P.A. Kager

    2009-01-01

    Summary We describe a case of cutaneous leishmaniasis with lymphadenopathy due to Leishmania donovani, which was successfully treated with oral miltefosine. Given the increased prevalence of travelling, patients presenting with lymph-node enlargement should have leishmaniasis included in the differe

  17. Localised Leishmaniasis of Oral Mucosa: Report of an Unusual Clinicopathological Entity

    Directory of Open Access Journals (Sweden)

    Deepak Passi

    2014-01-01

    Full Text Available The term leishmaniasis comprises of a group of diseases caused by different species of a protozoan called Leishmania. There are three main clinical forms of leishmaniasis: visceral leishmaniasis, cutaneous leishmaniasis, and mucocutaneous leishmaniasis. Exclusive involvement of the mucosa is very rare. We present a case of mucosal leishmaniasis located in the oral cavity. The only manifestation of leishmaniasis disease in the described case was the appearance of an oral lesion. Treatment was provided in the form of antimoniates (oral miltefosine and systemic sodium stibogluconate. A review of literature is made on the subject.

  18. A urbanização da leishmaniose tegumentar americana no município de Campinas - São Paulo (SP e região: magnitude do problema e desafios Urbanization of American Cutaneous Leishmaniasis in Campinas - Sao Paulo (SP and region: problems and challenges

    Directory of Open Access Journals (Sweden)

    Lúcia Mensato Rebello da Silva

    2007-12-01

    Full Text Available FUNDAMENTOS - A leishmaniose tegumentar americana ocupa o segundo lugar entre as protozoonoses por vetores no Brasil. OBJETIVOS - Descrever a distribuição da doença na macrorregião de Campinas-SP e identificar as principais dificuldades em sua prevenção. MÉTODOS - A área estudada abrange 42 municípios. Os dados foram coletados no Sistema Nacional de Agravos e de Notificação do Grupo de Vigilância Epidemiológica, de 1998 a 2004, da Superintendência de Controle de Endemias, do Centro de Zoonoses e foi feita revisão da literatura. RESULTADOS - Foram registrados 458 casos, de caráter endêmico e com maior ocorrência em Campinas e Jundiaí. A doença predominava na área urbana (57%, no sexo masculino (62% e acometia todas as faixas etárias. As espécies vetoras encontradas foram Lutzomyia intermedia sl, L. neivai, L. migonei, L. whitmani, L. fisheri, e L. pessoai. CONCLUSÕES - A leishmaniose tegumentar está distribuída amplamente na região (81% dos municípios estudados e predominava na área urbana (57%. As dificuldades encontradas em seu controle foram a crescente adaptação do vetor ao peridomicílio, a multiplicidade dos fatores envolvidos na transmissão e a resposta insuficiente às medidas de controle atuais. O acompanhamento do ambiente e da doença, o diagnóstico e o tratamento precoces, a notificação compulsória e o seguimento dos casos, além de investimento em pesquisas, campanhas e ações diretas junto aos pacientes são importantes para o controle da doença.BACKGROUND - American cutaneous leishmaniasis (ACL is ranked second among vector-transmitted zoonoses in Brazil. OBJECTIVES - This paper aims at verifying the distribution of this disease in Campinas-SP and surrounding region and to identify the main difficulties for preventive actions to this illness. METHODS - The Campinas area encloses 42 counties. Data from 1998 to 2004 were collected from the National System of Injuries and Notification in Campinas

  19. Leishmania braziliensis: isolation of carbohydrate-containing antigen and possibility of its use in the immunodiagnosis of American Cutaneous Leishmaniasis Leishmania braziliensis: isolamento de antígeno contendo carboidrato e a possibilidade de sua aplicação no imunodiagnóstico da Leishmaniose Tegumentar Americana

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    T. G. V. Silveira

    1995-06-01

    Full Text Available Leishmania braziliensis is a causative agent of American Cutaneous Leishmaniasis (ACL. The 034-JCG strain, isolated from a patient from the northern region of Paraná State, Brazil, was cultivated in Blood Agar Base medium, lyophilized and submitted to phenol-water extraction. The extract was treated with RNase I. The carbohydrate containing-antigen (Ag-CHO was immunogenic to rabbits and showed at least a fraction with some negative charge at pH 8.2. This antigen showed cross-reactivity with the phenol-water extract of the growth medium used for the culture of promastigotes and with the surface antigens of promastigotes. Its composition is: 24.3% of total sugars, from which 11.2% of galactose, 7.5% of mannose and 5.6% of ribose. Protein content was 5.4% and phosphate 18.5%. The antigenic activity was maintained after: repeated freezing-thawing; lyophilization; heating at 100ºC for 30 minutes; treatment with RNase, trichloroacetic acid and sodium metaperiodate. The precipitin line obtained is Periodic Acid Schiff positive. The application of the Ag-CHO in counterimmunoelectrophoresis reaction for the immunodiagnosis of ACL showed 60% sensitivity, and no cross-reaction with the five sera of Chagas' disease patients tested. The use of this antigen in a more sensitive technique, with more samples of sera, may improve these results.A Leishmania braziliensis é um dos agentes causadores da Leishmaniose Tegumentar Americana (LTA. A cepa 034-JCG, isolada de paciente da região norte do estado do Paraná, Brasil, foi cultivada em meio Blood Agar Base, liofilizada e submetida a extração com fenol-água e o extrato obtido foi tratado com RNase I. O antígeno contendo carboidrato (Ag-CHO mostrou-se imunogênico para coelhos e apresentou pelo menos uma fração com poucas cargas negativas em pH 8,2. Este antígeno apresenta reação cruzada com extrato fenólico do meio de cultura usado para o cultivo de promastigotas e com antígenos de superfície de

  20. An outbreak of american cutaneous leishmaniasis (Leishmania braziliensis braziliensis in a periurban area of Rio de Janeiro city, Brazil: clinical and epidemiological studies Um surto de leishmaniose cutânea americana (Leishmania braziliensis braziliensis numa área periurbana da cidade do Rio de Janeiro, Brasil: estudos clínicos e epidemiológicos

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    Manoel P. Oliveira-Neto

    1988-12-01

    Full Text Available From July 1984 to September 1986, 105 cases of American cutaneous leishmaniasis were studied in a locality closely situated to an urbanized area of the city of Rio de Janeiro, Brazil. Settement in this area was established at least 20 years ago but the first cases were noted six months prior to the beginning of this study. Cases were almost exlusively cutaneous and ulcerated, with one to six months of evolution. Montenegro's skin tests were positive in all cases and anti-Leishmania antibodies were detected by indirect immunofluorescence test in 74.3% of the patients. Parasites were demonstrated in 69.5% of cases. Domestic animals were easily found infected; 32% of the examined dogs and 30.8% of the examined equines were positive to the presence of Leishmania in cutaneous ulcerated lesions. Parasite isolates from human, dog andequines were immunologically characterized and identified as L. b. braziliensis. 73,0% of the sandfly population were Lutzomyia intermedia mainly caught on human baits and on domestic animals. Our observations suggest that this is an area of recent established L. b. braziliensis infection and that transmission probably occurs indoors or outdoors close to the houses.De julho de 1984 a setembro de 1986, 105 casos de leishmaniose cutânea foram estudados numa localidade situada na imediata vizinhança da área urbanizada da região metropolitana da cidade do Rio de Janeiro. A ocupação do sítio deu-se aproximadamente há 20 anos, mas os primeiros casos foram registrados somente seis meses antes do início de nosso estudo. Os casos eram quase que exclusivamente cutâneos, da forma clínica ulcerada com um e seis meses de evolução. O teste de Montenegro foi positivo em todos os casos e anticorpos antileishmania foram detectados por imunofluorescência indireta em 74,3% dos pacientes. A demonstração do parasito foi obtida em 69,5%. Animais domésticos infectados foram facilmente encontrados: 32% dos cães examinados e 30

  1. Leishmaniasis Gone Viral: Social Media and an Outbreak of Cutaneous Leishmaniasis.

    Science.gov (United States)

    Mongkolrattanothai, Kanokporn; Nadipuram, Santhosh M; Krakowski, Andrew C; Stone, Margaret M; Krogstad, Paul; Lehman, Deborah

    2016-09-01

    This report details how social media communication was used in a group of teens to diagnose cutaneous leishmaniasis that they acquired during a trip to Israel. Their posts quickly brought the cluster to the attention of the teens and their parents, leading to prompt recognition of the true etiology of their lesions and appropriate treatment. PMID:27469423

  2. Urban distribution of Phlebotominae in a cutaneous leishmaniasis focus, Argentina

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    Oscar D Salomón

    2008-05-01

    Full Text Available Urbanization and vector domestication are currently proposed as factors that contributed to the recent increase of American cutaneous leishmaniasis (ACL. Is likely also urban transmission? Oran is the main city in the Argentinean hyper-endemic area of ACL, and human cases in urban residences are usually reported. In order to assess the spatial distribution of risk, phlebotomine traps were located in different environments of Oran. A total of 7,787 sand flies were captured: Lutzomyia neivai (98.1%, Lutzomyia migonei (1.2%, Lutzomyia cortelezzii (0.7%, and one Lutzomyia shannoni. During the season of transmission (April-May a single sand fly was obtained in one out of five urban sites, while a trap in a peri-urban pigsty captured up to 2,985 Lu. neivai/night. Captures performed in the other season of vector activity (September-October revealed that small-scale changes in the pigsty environment resulted in noticeable changes in the abundance of Lu. neivai. In addition, in a new neighbourhood, on the fringe of the city, 1,073 Lu. neivai/site were captured in the forested edge but one in the yard of the houses. Therefore, in this urban ACL focus the human-vector effective contact risk is still associated with peri-urban vegetation and ecotone modifications despite the urban residence of the cases.

  3. Immune regulation during chronic visceral leishmaniasis.

    Science.gov (United States)

    Faleiro, Rebecca J; Kumar, Rajiv; Hafner, Louise M; Engwerda, Christian R

    2014-07-01

    Visceral leishmaniasis is a chronic parasitic disease associated with severe immune dysfunction. Treatment options are limited to relatively toxic drugs, and there is no vaccine for humans available. Hence, there is an urgent need to better understand immune responses following infection with Leishmania species by studying animal models of disease and clinical samples from patients. Here, we review recent discoveries in these areas and highlight shortcomings in our knowledge that need to be addressed if better treatment options are to be developed and effective vaccines designed.

  4. Prevalence of Cutaneous Leishmaniasis in Ramshir, Iran; an Epidemiological Study

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    Vazirianzadeh B.* PhD,

    2014-08-01

    Full Text Available Aims Cutaneous leishmaniasis is a prevalent parasitological disease with diverse clinical manifestations in Iran. Therefore, the present retrospective study carried out to describe the demographic features of cutaneous leishmaniasis in Ramshir, Iran. Materials & Methods This descriptive study was performed on 136 cutaneous leishmaniasis patients whose data were recorded in the Ramshir health center during 2006-9. Demographic information of patients including age, sex, habitat and sites of lesions, month and years of incidence were recorded. The data were analyzed by SPSS 16 software. Findings Totally 79 patients (58.1% resided in urban areas and the born to 9 years (49.3% was recognized as the most infected age group. Hands (41.2% had the highest rates of cutaneous leishmaniasis lesions followed by face (36.0% and foot (22.8%. The maximum number of cutaneous leishmaniasis lesions was reported in March. Conclusion As cutaneous leishmaniasis in Ramshir seemed to be an endemic rural type, the appropriate preventing measures regarding to the rural cutaneous leishmaniasis should be considered to decrease incidence of the disease in the region.

  5. Genetically Modified Organisms and Visceral Leishmaniasis

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    NAHID eALI

    2014-05-01

    Full Text Available Vaccination is the most effective method of preventing infectious diseases. Since the eradication of small pox in 1976, many other potentially life compromising if not threatening diseases have been dealt with subsequently. This event was a major leap not only in the scientific world already burdened with many diseases but also in the mindset of the common man who became more receptive to novel treatment options. Among the many protozoan diseases, the leishmaniases have emerged as one of the largest parasite killers of the world, second only to malaria. There are three types of leishmaniases namely cutaneous (CL, mucocutaneous (ML and visceral (VL, caused by a group of more than 20 species of Leishmania parasites. Visceral leishmaniasis, also known as kala-azar is the most severe form and almost fatal if untreated. Since the first attempts at leishmanization, we have killed parasite vaccines, subunit protein or DNA vaccines, and now we have live recombinant carrier vaccines and live attenuated parasite vaccines under various stages of development. Although some research has shown promising results, many more potential genes need to be evaluated as live attenuated vaccine candidates. This mini-review attempts to summarize the success and failures of genetically modified organisms used in vaccination against some of major parasitic diseases for their application in leishmaniasis.

  6. Leishmaniasis–HIV coinfection: current challenges

    Science.gov (United States)

    Lindoso, José Angelo Lauletta; Cunha, Mirella Alves; Queiroz, Igor Thiago; Moreira, Carlos Henrique Valente

    2016-01-01

    Leishmaniasis – human immunodeficiency virus (HIV) coinfection can manifest itself as tegumentary or visceral leishmaniasis. Almost 35 countries have reported autochthonous coinfections. Visceral leishmaniasis is more frequently described. However, usual and unusual manifestations of tegumentary leishmaniasis have been reported mainly in the Americas, but the real prevalence of Leishmania infection in HIV-infected patients is not clear. Regarding the clinical manifestations, there are some reports showing unusual manifestations in visceral leishmaniasis and tegumentary leishmaniasis in HIV-infected patients; yet, the usual manifestations are more frequent. Leishmaniasis diagnosis relies on clinical methods, but serological tests are used to diagnose visceral leishmaniasis despite them having a low sensitivity to tegumentary leishmaniasis. The search for the parasite is used to diagnose both visceral leishmaniasis and tegumentary leishmaniasis. Nevertheless, in HIV-infected patients, the sensitivity of serology is very low. Drugs available to treat leishmaniasis are more restricted and cause severe side effects. Furthermore, in HIV-infected patients, these side effects are more prominent and relapses and lethality are more recurrent. In this article, we discuss the current challenges of tegumentary leishmaniasis and visceral leishmaniasis–HIV infection, focusing mainly on the clinical manifestations, diagnosis, and treatment of leishmaniasis. PMID:27785103

  7. Cutaneous leishmaniasis in germfree, gnotobiotic, and conventional mice

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    Enio Cardillo Vieira

    1987-12-01

    Full Text Available Cutaneous leishmaniasis was much more severe in conventional than in gnotobiotic mice as revealed by macro and microscopic examination. An inoculum of Leishmania mexicana amazonensis was used.

  8. First generation leishmaniasis vaccines: a review of field efficacy trials.

    Science.gov (United States)

    Noazin, Sassan; Modabber, Farrokh; Khamesipour, Ali; Smith, Peter G; Moulton, Lawrence H; Nasseri, Kiumarss; Sharifi, Iraj; Khalil, Eltahir A G; Bernal, Ivan Dario Velez; Antunes, Carlos M F; Kieny, Marie Paule; Tanner, Marcel

    2008-12-01

    First generation candidate vaccines against leishmaniasis, prepared using inactivated whole parasites as their main ingredient, were considered as promising because of their relative ease of production and low cost. These vaccines have been the subject of many investigations over several decades and are the only leishmaniasis vaccine candidates which have undergone phase 3 clinical trial evaluation. Although the studies demonstrated the safety of the vaccines and several studies showed reasonable immunogenicity and some indication of protection, an efficacious prophylactic vaccine is yet to be identified. Despite this overall failure, these trials contributed significantly to increasing knowledge on human leishmaniasis immunology. To provide a collective view, this review discusses the methods and findings of field efficacy trials of first generation leishmaniasis vaccine clinical trials conducted in the Old and New Worlds.

  9. Post-kala-azar dermal leishmaniasis associated with AIDS

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    Bittencourt Achiléa

    2002-01-01

    Full Text Available Post-kala-azar dermal leishmaniasis (PKDL is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

  10. Post-kala-azar dermal leishmaniasis associated with AIDS

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    Bittencourt Achiléa

    2003-01-01

    Full Text Available Post-kala-azar dermal leishmaniasis (PKDL is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

  11. Sex Hormones and Modulation of Immunity against Leishmaniasis

    OpenAIRE

    Snider, Heidi; Lezama-Davila, Claudio; Alexander, James; Satoskar, Abhay R.

    2009-01-01

    Sex-associated hormones such as estradiol, testosterone and progesterone have all been shown to modulate immune responses, which can result in differential disease outcomes between males and females, as well as between pregnant and nonpregnant females. Most parasitic diseases, including leishmaniasis, usually result in more severe disease in males compared with females. This review highlights our current knowledge concerning the role of sex hormones in modulating leishmaniasis in both clinica...

  12. Liver transplant recipient with concomitant cutaneous and visceral leishmaniasis.

    Science.gov (United States)

    Ozcan, Deren; Seçkin, Deniz; Allahverdiyev, Adil M; Weina, Peter J; Aydin, Hakan; Ozçay, Figen; Haberal, Mehmet

    2007-03-01

    Diagnosis of leishmaniasis in immunosuppressed patients may be a serious challenge for physicians because of the major clinical and laboratory differences with immunocompetent patients. In immunosuppressed patients, the disease is characterized usually by disseminated visceral involvement, atypical cutaneous lesions and persistent negativity of diagnostic tests. Here, we report an eight-yr-old liver transplant recipient with concomitant cutaneous and visceral leishmaniasis in whom the cutaneous lesion led to the diagnosis of systemic involvement. PMID:17300508

  13. First Case of Visceral Leishmaniasis Caused by Leishmania martiniquensis

    OpenAIRE

    Liautaud, Bernard; Vignier, Nicolas; Miossec, Charline; Plumelle, Yves; Kone, Moumini; Delta, Delphine; Ravel, Christophe; Cabié, André; Desbois, Nicole

    2015-01-01

    We report the first case of visceral leishmaniasis (VL) caused by Leishmania martiniquensis in the Caribbean, which until now, was known only to cause cutaneous leishmaniasis. The disease presented with fatigue, anemia, and hepatosplenomegaly in a 61-year-old man with human immunodeficiency virus (HIV) infection who was receiving antiretroviral therapy. Diagnosis was made by bone marrow biopsy. VL is life-threatening, and its emergence in the Caribbean is of concern.

  14. First case of visceral leishmaniasis caused by Leishmania martiniquensis.

    Science.gov (United States)

    Liautaud, Bernard; Vignier, Nicolas; Miossec, Charline; Plumelle, Yves; Kone, Moumini; Delta, Delphine; Ravel, Christophe; Cabié, André; Desbois, Nicole

    2015-02-01

    We report the first case of visceral leishmaniasis (VL) caused by Leishmania martiniquensis in the Caribbean, which until now, was known only to cause cutaneous leishmaniasis. The disease presented with fatigue, anemia, and hepatosplenomegaly in a 61-year-old man with human immunodeficiency virus (HIV) infection who was receiving antiretroviral therapy. Diagnosis was made by bone marrow biopsy. VL is life-threatening, and its emergence in the Caribbean is of concern. PMID:25404076

  15. Post-kala-azar dermal leishmaniasis associated with AIDS

    OpenAIRE

    Bittencourt Achiléa; Silva Nancy; Straatmann Andréa; Nunes Victor Luiz Correia; Follador Ivonise; Badaró Roberto

    2003-01-01

    Post-kala-azar dermal leishmaniasis (PKDL) is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area) presented with clinical manifestations of visceral leishm...

  16. Plant-derived compounds in treatment of leishmaniasis

    OpenAIRE

    Oryan, A.

    2015-01-01

    Leishmaniasis is a neglected public health problem caused by the protozoan species belonging to the genus Leishmania affecting mostly the poor populations of developing countries. The causative organism is transmitted by female sandflies. Cutaneous, mucocutaneous, and visceral clinical manifestations are the most frequent forms of leishmaniasis. Chemotherapy still relies on the use of pentavalent antimonials, amphotericin B, paromomycin, miltefosin and liposomal amphotericin B. However, the a...

  17. Epidemiology of visceral leishmaniasis in Georgia.

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    Giorgi Babuadze

    2014-03-01

    Full Text Available This study investigated the transmission and prevalence of Leishmania parasite infection of humans in two foci of Visceral Leishmaniasis (VL in Georgia, the well known focus in Tbilisi in the East, and in Kutaisi, a new focus in the West of the country. The seroprevalence of canine leishmaniasis was investigated in order to understand the zoonotic transmission. Blood samples of 1575 dogs (stray and pet and 77 wild canids were tested for VL by Kalazar Detect rK39 rapid diagnostic tests. Three districts were investigated in Tbilisi and one in Kutaisi. The highest proportions of seropositive pet dogs were present in District #2 (28.1%, 82/292 and District #1 (26.9%, 24/89 in Tbilisi, compared to 17.3% (26/150 of pet dogs in Kutaisi. The percentage of seropositive stray dogs was also twice as high in Tbilisi (16.1%, n = 670 than in Kutaisi (8%, n = 50; only 2/58 wild animals screened were seropositive (2. 6%. A total of 873 Phlebotomine sand flies were collected, with 5 different species identified in Tbilisi and 3 species in Kutaisi; 2.3% of the females were positive for Leishmania parasites. The Leishmanin Skin Test (LST was performed on 981 human subjects in VL foci in urban areas in Tbilisi and Kutaisi. A particularly high prevalence of LST positives was observed in Tbilisi District #1 (22.2%, 37.5% and 19.5% for ages 5-9, 15-24 and 25-59, respectively; lower prevalence was observed in Kutaisi (0%, 3.2% and 5.2%, respectively; P<0.05. This study shows that Tbilisi is an active focus for leishmaniasis and that the infection prevalence is very high in dogs and in humans. Although exposure is as yet not as high in Kutaisi, this is a new VL focus. The overall situation in the country is alarming and new control measures are urgently needed.

  18. The epidemiology and control of leishmaniasis in Andean countries

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    Davies Clive Richard

    2000-01-01

    Full Text Available This paper reviews the current knowledge of leishmaniasis epidemiology in Venezuela, Colombia, Ecuador, Peru, and Bolivia. In all 5 countries leishmaniasis is endemic in both the Andean highlands and the Amazon basin. The sandfly vectors belong to subgenera Helcocyrtomyia, Nyssomiya, Lutzomyia, and Psychodopygus, and the Verrucarum group. Most human infections are caused by Leishmania in the Viannia subgenus. Human Leishmania infections cause cutaneous lesions, with a minority of L. (Viannia infections leading to mucocutaneous leishmaniasis. Visceral leishmaniasis and diffuse cutaneous leishmaniasis are both rare. In each country a significant proportion of Leishmania transmission is in or around houses, often close to coffee or cacao plantations. Reservoir hosts for domestic transmission cycles are uncertain. The paper first addresses the burden of disease caused by leishmaniasis, focusing on both incidence rates and on the variability in symptoms. Such information should provide a rational basis for prioritizing control resources, and for selecting therapy regimes. Secondly, we describe the variation in transmission ecology, outlining those variables which might affect the prevention strategies. Finally, we look at the current control strategies and review the recent studies on control.

  19. The epidemiology and control of leishmaniasis in Andean countries

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    Clive Richard Davies

    2000-12-01

    Full Text Available This paper reviews the current knowledge of leishmaniasis epidemiology in Venezuela, Colombia, Ecuador, Peru, and Bolivia. In all 5 countries leishmaniasis is endemic in both the Andean highlands and the Amazon basin. The sandfly vectors belong to subgenera Helcocyrtomyia, Nyssomiya, Lutzomyia, and Psychodopygus, and the Verrucarum group. Most human infections are caused by Leishmania in the Viannia subgenus. Human Leishmania infections cause cutaneous lesions, with a minority of L. (Viannia infections leading to mucocutaneous leishmaniasis. Visceral leishmaniasis and diffuse cutaneous leishmaniasis are both rare. In each country a significant proportion of Leishmania transmission is in or around houses, often close to coffee or cacao plantations. Reservoir hosts for domestic transmission cycles are uncertain. The paper first addresses the burden of disease caused by leishmaniasis, focusing on both incidence rates and on the variability in symptoms. Such information should provide a rational basis for prioritizing control resources, and for selecting therapy regimes. Secondly, we describe the variation in transmission ecology, outlining those variables which might affect the prevention strategies. Finally, we look at the current control strategies and review the recent studies on control.

  20. Status of vaccine research and development of vaccines for leishmaniasis.

    Science.gov (United States)

    Gillespie, Portia M; Beaumier, Coreen M; Strych, Ulrich; Hayward, Tara; Hotez, Peter J; Bottazzi, Maria Elena

    2016-06-01

    A number of leishmaniasis vaccine candidates are at various stages of pre-clinical and clinical development. Leishmaniasis is a vector-borne neglected tropical disease (NTD) caused by a protozoan parasite of the genus Leishmania and transmitted to humans by the bite of a sand fly. Visceral leishmaniasis (VL, kala-azar) is a high mortality NTD found mostly in South Asia and East Africa, while cutaneous leishmaniasis (CL) is a disfiguring NTD highly endemic in the Middle East, Central Asia, North Africa, and the Americas. Estimates attribute 50,000 annual deaths and 3.3 million disability-adjusted life years to leishmaniasis. There are only a few approved drug treatments, no prophylactic drug and no vaccine. Ideally, an effective vaccine against leishmaniasis will elicit long-lasting immunity and protect broadly against VL and CL. Vaccines such as Leish-F1, F2 and F3, developed at IDRI and designed based on selected Leishmania antigen epitopes, have been in clinical trials. Other groups, including the Sabin Vaccine Institute in collaboration with the National Institutes of Health are investigating recombinant Leishmania antigens in combination with selected sand fly salivary gland antigens in order to augment host immunity. To date, both VL and CL vaccines have been shown to be cost-effective in economic modeling studies. PMID:26973063

  1. Cutaneous leishmaniasis of the Old World.

    Science.gov (United States)

    Alrajhi, A A

    2003-02-01

    Cutaneous Leishmaniasis is a vector-borne protozoal infection of the skin. Several species of Leishmania cause this disease in the Old World. It is manifested as chronic nodular to ulcerative lesions of the skin, which last for many months and may be disfiguring. They eventually heal leaving a scar. Local care of the lesion and treatment of secondary bacterial infection are essential for healing. Antileishmania therapy is indicated in immunocompromised hosts, patients with progressive, multiple, or critically located lesions. Pentavalent antimony compounds remain the main therapeutic option for all species. They are given intravenously (i.v.), intramuscularly (i.m.), or intralesionally. Cryotherapy, and some systemic antifungal agents have been used successfully. Oral azoles are promising new treatments for lesions caused by L. Major. Several other alternatives and their evidence are also presented. PMID:12728282

  2. CANINE VISCERAL LEISHMANIASIS CASE INVESTIGATION IN THE JACARE REGION OF NITEROI, RIO DE JANEIRO, BRAZIL.

    Science.gov (United States)

    Oliveira, Amanda Codeço de; Figueiredo, Fabiano Borges; Silva, Valmir Laurentino; Santos, Fernanda Nunes; Souza, Marcos Barbosa de; Madeira, Maria de Fátima; Abrantes, Tuanne Rotti; Périssé, André Reynaldo Santos

    2015-01-01

    American visceral leishmaniasis is a vector-borne zoonosis in expansion in Brazil. Dogs are the main urban reservoir. Departing from a case of canine visceral leishmaniasis (CVL) in Jacaré, Niterói, Rio de Janeiro State, an epidemiological canine and entomological study was performed to assess the extension of the disease at the location. Sample was collected around the case and the dogs identified by serological tests (rapid double platform immunochromatographic exams, immunoenzymatic assay/ELISA, indirect immunofluorescence/IFAT). The parasitological diagnosis was performed in animals positive in at least one of these tests. The entomological study was carried out by using light traps and manual collection. The associations between canine variables and outcome (ELISA and IFAT reagents) were assessed by the chi-square test and adjusted by multivariate logistic regression for those associations with p < 0.1 in the bivariate analysis. Seventeen cases of CVL were detected among 110 evaluated dogs (prevalence of 15.5%). Presence of ectoparasites (OR 6.5; 95% CI 1.1-37.4), animals with clinical signs (OR 9.5; 95% CI 1.2-76.6), and previous cases of CVL in the same house (OR 17.9; 95% CI 2.2-147.1) were associated with the outcome. Lutzomyia longipalpis was not detected. Our results are indicative of an ongoing transmission in the area.

  3. Phlebotominae: Vectores de Leishmaniasis en las provincias de Santa Fe y Entre Ríos, Argentina Phlebotominae: vectors of leishmaniasis in the provinces of Santa Fe and Entre Ríos, Argentina

    Directory of Open Access Journals (Sweden)

    Oscar D. Salomón

    2006-06-01

    Full Text Available La transmisión de leishmaniasis tegumentaria (LT se incrementó desde 1985 en 9 provincias argentinas. Santa Fe y Entre Ríos en dicho período no notificaron casos de transmisión autóctona comprobada, sin embargo en el año 2003 ocurrió un brote epidémico en Bella Vista, Corrientes, localidad que se encuentra en un área con continuidad ecológica y contigüidad geográfica con ambas provincias. Por ello, para determinar el riesgo potencial de transmisión de LT en las áreas próximas y al sur de Bella Vista se realizaron capturas de Phlebotominae en febrero del 2004, colectándose sobre las márgenes del río Paraná en Santa Fe (El Rabón, Villa Ocampo, Cayastá y en Entre Ríos (La Paz, La Celina-Villa Urquiza 860 ejemplares de Lutzomyia neivai (99.5% y Lu. migonei (0.5 %, ambas especies con capacidad vectorial para Leishmania (V. braziliensis. En Tartagal, Santa Fe, las capturas fueron consistentes con el paisaje de «chaco» residual: 7 ejemplares de Lu. nerivai, Lu. migonei y Lu. cortelezzii. Se destaca el riesgo potencial de transmisión epidémica de LT en estas provincias, especialmente por la tropicalización progresiva hacia el sur de la selva en galeria paranaense. Se recomiendan actividades de vigilancia clínica y vectorial.The transmission of tegumentary leishmaniasis (TL has increased in 9 provinces of Argentina since 1985. Santa Fe and Entre Ríos did not record in this period autochtonous probed cases: however, an epidemic outbreak took place in 2003 in Bella Vista, Corrientes, located in an area with ecological continuity and contiguous to both provinces. In order to evaluate the potential risk of transmission of LT, Phlebotominae were captured at locations close to and southern from Bella Vista during February 2004. The traps located on the shores of Parana river in Santa Fe (El Rabón, Villa Ocampo, Cayastá, and Entre Ríos (La Paz. La Celina-Villa Urquiza captured 860 individuals of Lutzomyia neivai (99.5% and Lu

  4. LeishMan recommendations for treatment of cutaneous and mucosal leishmaniasis in travelers, 2014

    NARCIS (Netherlands)

    Blum, Johannes; Buffet, Pierre; Visser, Leo; Harms, Gundel; Bailey, Mark S; Caumes, Eric; Clerinx, Jan; van Thiel, Pieter P A M; Morizot, Gloria; Hatz, Christoph; Dorlo, Thomas P C; Lockwood, Diana N J

    2014-01-01

    BACKGROUND: Treatment of cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) in travelers is still controversial. Over the last decade, national and international consortia have published recommendations for treating CL in travelers. These guidelines harmonize many issues, but there are some

  5. Visceral kala-azar associated with post-kala-azar dermal leishmaniasis.

    Science.gov (United States)

    Singh, N K; Agrawal, S K; Jha, T K

    1989-02-01

    Visceral leishmaniasis associated with post-kala-azar dermal leishmaniasis (PKDL) is very rare. We are reporting one such case which incidentally is the seventh case so far reported from Indian sub-continent. PMID:2808294

  6. [Chronic lupoid leishmaniasis. A rare differential diagnosis in Germany for erythematous infiltrative facial plaques].

    Science.gov (United States)

    Herrmann, A; Wohlrab, J; Sudeck, H; Burchard, G-D; Marsch, W C

    2007-03-01

    Lupoid leishmaniasis is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and a chronic relapsing course. Clinically and histologically it is similar to lupus vulgaris, which is thus the most important differential diagnostic consideration. All patients with granulomatous facial lesions coming from endemic areas or with a positive travel history should be suspected of having leishmaniasis. We describe a 59-year-old woman with facial lupoid leishmaniasis. PMID:16670926

  7. Leishmaniasis, An Emerging Disease Found in Companion Animals in the United States

    OpenAIRE

    Petersen, Christine A.

    2009-01-01

    This review discusses leishmaniasis in cats and dogs in the United States. Leishmaniasis is endemic in Foxhound populations in the United States and is still being characterized in this group. Pathophysiology, clinical signs, transmission, immunology, and treatment are examined in this review. Leishmaniasis is an emergent zoonosis of great public health significance.

  8. Visceral leishmaniasis and HIV coinfection in Latin America.

    Science.gov (United States)

    Lindoso, José Angelo; Cota, Gláucia Fernandes; da Cruz, Alda Maria; Goto, Hiro; Maia-Elkhoury, Ana Nilce Silveira; Romero, Gustavo Adolfo Sierra; de Sousa-Gomes, Márcia Leite; Santos-Oliveira, Joanna Reis; Rabello, Ana

    2014-09-01

    Visceral leishmaniasis (VL) is an endemic zoonotic disease in Latin America caused by Leishmania (Leishmania) infantum, which is transmitted by sand flies from the genus Lutzomyia. VL occurs in 12 countries of Latin America, with 96% of cases reported in Brazil. Recently, an increase in VL, primarily affecting children and young adults, has been observed in urban areas of Latin America. The area in which this spread of VL is occurring overlaps regions with individuals living with HIV, the number of whom is estimated to be 1.4 million people by the World Health Organization. This overlap is suggested to be a leading cause of the increased number of reported VL-HIV coinfections. The clinical progression of HIV and L. infantum infections are both highly dependent on the specific immune response of an individual. Furthermore, the impact on the immune system caused by either pathogen and by VL-HIV coinfection can contribute to an accelerated progression of the diseases. Clinical presentation of VL in HIV positive patients is similar to patients without HIV, with symptoms characterized by fever, splenomegaly, and hepatomegaly, but diarrhea appears to be more common in coinfected patients. In addition, VL relapses are higher in coinfected patients, affecting 10% to 56.5% of cases and with a lethality ranging from 8.7% to 23.5% in Latin America, depending on the study. With regards to the diagnosis of VL, parasitological tests of bone marrow aspirates have proven to be the most sensitive test in HIV-infected patients. Serologic tests have demonstrated a variable sensitivity according to the method and antigens used, with the standard tests used for diagnosing VL in Latin America displaying lower sensitivity. For this review, few articles were identified that related to VL-HIV coinfections and originated from Latin America, highlighting the need for improving research within the regions most greatly affected. We strongly support the formation of a Latin American network for

  9. The first canine visceral leishmaniasis outbreak in Campinas, State of São Paulo Southeastern Brazil

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    Andrea Paula Bruno von Zuben

    2014-06-01

    Full Text Available Introduction Early detection of American visceral leishmaniasis (AVL outbreak in animals is crucial for controlling this disease in non-endemic areas. Methods Epidemiological surveillance (2009-2012 was performed in Campinas, State of São Paulo, Brazil. Results In 2009, Leishmania chagasi was positively identified in four dogs. Entomological research and three serological studies (2010-2012 were undertaken as monitoring measures; these approaches revealed a moderate prevalence of Leishmania present in 4% of the canine population. Nyssomyia whitmani and Lutzomyia longipalpis were the predominant species identified. Conclusions Detection of an AVL outbreak in dogs in an area with an evolving natural landscape containing sand flies is crucial for control programs.

  10. [The impact of climate change on leishmaniasis in Brazil].

    Science.gov (United States)

    Mendes, Chrystian Soares; Coelho, Alexandre Bragança; Féres, José Gustavo; Souza, Elvanio Costa de; Cunha, Dênis Antônio da

    2016-01-01

    This paper sought to assess how climate change will affect the proliferation of leishmaniasis in Brazil in three time frames: 2010-2039, 2040-2079 and 2080-2100, and with two climate change scenarios. The relation of temperature, precipitation and the number of hospital admissions due to leishmaniasis was estimated and projections were made using these results. Results show that precipitation has a strong relation with leishmaniasis incidence and projections show that by the end of the twenty-first century there will be a 15% growth in the annual number of hospital admissions due to leishmaniasis in Brazil, compared to the base scenario (1992-2002). In regional terms, projections indicate growth in every region, with the exception of the Mid-West. The highest relative growth will be in the South of the country, while the highest increase in absolute terms will be observed in the Northeast region. In general, the incidence of leishmaniasis will grow in Brazil due to climate change.

  11. [Approaches and problems in vaccine development against leishmaniasis].

    Science.gov (United States)

    Allahverdiyev, Adil; Bağirova, Melahat; Cakir Koç, Rabia; Oztel, Olga Nehir; Elçıçek, Serhat; Ateş, Sezen Canım; Karaca, Tuğçe Deniz

    2010-01-01

    Leishmaniasis is a major public health problem of the world and Turkey. Recently there has been increasing interest in vaccine studies among strategies for control of leishmaniasis. Recently the increase of interest in vaccine studies among leishmaniasis control strategies makes the subject more up to date. So the aim of this review is to present information about recent vaccine studies, problems and new strategies for vaccine development studies. There are 3 generations of vaccine against leishmaniasis. First-generation vaccines are killed or live attenuated parasites; second-generation vaccines are recombinant or native antigens and live genetically modified parasites (knock out and suicidal cassettes), third generation vaccines are DNA vaccines. Also vector salivary proteins, dendritic cells and non-pathogenic L. tarentolae have been used as vaccine candidates. However there is still no effective vaccine against leishmaniasis. Since polymer conjugates considerably increase immunogenicity, polymer based vaccine studies have gained importance in recent years. However, there has not been such a study for an antileishmanial vaccine yet. LPG, surface antigen of Leishmania promastigotes, and polymer conjugates may be promising in antileishmanial vaccine studies so we are carrying out a TUBITAK Project on this subject which has been given the number, 1085170SBAG-4007. PMID:20597059

  12. Regulation of PKC mediated signaling by calcium during visceral leishmaniasis.

    Science.gov (United States)

    Roy, Nivedita; Chakraborty, Supriya; Paul Chowdhury, Bidisha; Banerjee, Sayantan; Halder, Kuntal; Majumder, Saikat; Majumdar, Subrata; Sen, Parimal C

    2014-01-01

    Calcium is an ubiquitous cellular signaling molecule that controls a variety of cellular processes and is strictly maintained in the cellular compartments by the coordination of various Ca2+ pumps and channels. Two such fundamental calcium pumps are plasma membrane calcium ATPase (PMCA) and Sarco/endoplasmic reticulum calcium ATPase (SERCA) which play a pivotal role in maintaining intracellular calcium homeostasis. This intracellular Ca2+ homeostasis is often disturbed by the protozoan parasite Leishmania donovani, the causative organism of visceral leishmaniasis. In the present study we have dileneated the involvement of PMCA4 and SERCA3 during leishmaniasis. We have observed that during leishmaniasis, intracellular Ca2+ concentration was up-regulated and was further controlled by both PMCA4 and SERCA3. Inhibition of these two Ca2+-ATPases resulted in decreased parasite burden within the host macrophages due to enhanced intracellular Ca2+. Contrastingly, on the other hand, activation of PMCA4 was found to enhance the parasite burden. Our findings also highlighted the importance of Ca2+ in the modulation of cytokine balance during leishmaniasis. These results thus cumulatively suggests that these two Ca2+-ATPases play prominent roles during visceral leishmaniasis. PMID:25329062

  13. Regulation of PKC mediated signaling by calcium during visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Nivedita Roy

    Full Text Available Calcium is an ubiquitous cellular signaling molecule that controls a variety of cellular processes and is strictly maintained in the cellular compartments by the coordination of various Ca2+ pumps and channels. Two such fundamental calcium pumps are plasma membrane calcium ATPase (PMCA and Sarco/endoplasmic reticulum calcium ATPase (SERCA which play a pivotal role in maintaining intracellular calcium homeostasis. This intracellular Ca2+ homeostasis is often disturbed by the protozoan parasite Leishmania donovani, the causative organism of visceral leishmaniasis. In the present study we have dileneated the involvement of PMCA4 and SERCA3 during leishmaniasis. We have observed that during leishmaniasis, intracellular Ca2+ concentration was up-regulated and was further controlled by both PMCA4 and SERCA3. Inhibition of these two Ca2+-ATPases resulted in decreased parasite burden within the host macrophages due to enhanced intracellular Ca2+. Contrastingly, on the other hand, activation of PMCA4 was found to enhance the parasite burden. Our findings also highlighted the importance of Ca2+ in the modulation of cytokine balance during leishmaniasis. These results thus cumulatively suggests that these two Ca2+-ATPases play prominent roles during visceral leishmaniasis.

  14. A century of leishmaniasis in Alpes-Maritimes, France.

    Science.gov (United States)

    Marty, P; Izri, A; Ozon, C; Haas, P; Rosenthal, E; Del Giudice, P; Godenir, J; Coulibaly, E; Gari-Toussaint, M; Delaunay, P; Ferrua, B; Haas, H; Pratlong, F; Le Fichoux, Y

    2007-10-01

    A century of publications on leishmaniasis in Alpes-Maritimes, in southern France, is here reviewed. Autochtonous human and canine leishmaniasis were first recognised in this département, which lies by the Mediterranean Sea and near the Italian border, in 1918 and 1925, respectively. The parasite responsible for the leishmaniasis, Leishmania infantum, is transmitted by Phlebotomus perniciosus and P. ariasi. The human leishmaniasis is zoonotic, with domestic dogs acting as the main 'reservoir' hosts. In prospective surveys over the last two decades, a mean of 12% of the domestic dogs checked in Alpes-Maritimes have been found seropositive for L. infantum but only about 50% of the seropositive animals showed any clinical signs of infection at the time of the surveys. During the last 30 years, 178 cases of human visceral leishmaniasis have been recorded in the area. Such cases are sporadic and often opportunistic, occurring predominantly in children (29% of the 178 cases) or HIV-positive subjects (31%). Recently, it has been demonstrated that, in Alpes-Maritimes, approximately 20% of those found seropositive in leishmanin skin tests are asymptomatic carriers, with amastigotes in their peripheral blood. PMID:17877875

  15. Misdiagnosis and Mistreatment of Post-Kala-Azar Dermal Leishmaniasis

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    Ahmed Mohamed El Hassan

    2013-01-01

    Full Text Available Post-kala-azar dermal leishmaniasis (PKDL is a known complication of visceral leishmaniasis (VL caused by L. donovani. It is rare in VL caused by L. infantum and L. chagasi. In Sudan, it occurs with a frequency of 58% among successfully treated VL patients. In the majority of cases, PKDL can be diagnosed on the basis of clinical appearance, distribution of the lesions, and past history of treated VL. The ideal diagnostic method is to demonstrate the parasite in smears, by culture or PCR. Diagnosis is particularly difficult in patients who develop PKDL in the absence of previous history of visceral leishmaniasis. We describe a case of cutaneous leishmaniasis misdiagnosed as PKDL and 3 cases of PKDL who were either misdiagnosed or mistreated as other dermatoses. This caused exacerbation of their disease leading to high parasite loads in the lesions and dissemination to internal organs in one of the patients, who was also diabetic. The latter patient had L. major infection. A fourth patient with papulonodular lesions on the face and arms of 17-year duration and who was misdiagnosed as having PKDL is also described. He turned out to have cutaneous leishmaniasis due to L. major. Fortunately, he was not treated with steroids. He was cured with intravenous sodium stibogluconate.

  16. Leishmanization revisited: immunization with a naturally attenuated cutaneous Leishmania donovani isolate from Sri Lanka protects against visceral leishmaniasis.

    Science.gov (United States)

    McCall, Laura-Isobel; Zhang, Wen-Wei; Ranasinghe, Shanlindra; Matlashewski, Greg

    2013-02-27

    Leishmaniasis is a neglected tropical disease caused by Leishmania protozoa and associated with three main clinical presentations: cutaneous, mucocutaneous and visceral leishmaniasis. Visceral leishmaniasis is the second most lethal parasitic disease after malaria and there is so far no human vaccine. Leishmania donovani is a causative agent of visceral leishmaniasis in South East Asia and Eastern Africa. However, in Sri Lanka, L. donovani causes mainly cutaneous leishmaniasis, while visceral leishmaniasis is rare. We investigate here the possibility that the cutaneous form of L. donovani can provide immunological protection against the visceral form of the disease, as a potential explanation for why visceral leishmaniasis is rare in Sri Lanka. Subcutaneous immunization with a cutaneous clinical isolate from Sri Lanka was significantly protective against visceral leishmaniasis in BALB/c mice. Protection was associated with a mixed Th1/Th2 response. These results provide a possible rationale for the scarcity of visceral leishmaniasis in Sri Lanka and could guide leishmaniasis vaccine development efforts.

  17. Geographical distribution of cutaneous leishmaniasis and sand flies in Pakistan.

    Science.gov (United States)

    Shakila, Ashraf; Bilqees, Fatima Mujib; Salim, Azra; Moinuddin, Moinuddin

    2006-01-01

    Cutaneous leishmaniasis is found in all the four provinces of Pakistan; these are NWFP, Balochistan, Sindh and Punjab. In Balochistan the areas from where the patients came are Uthal, Quetta and Ormara. The highest number of patients came from Quetta and least from Ormara. The patients included in this study were from the Mangopir and Chakewara, areas of Karachi. The infection is endemic in this country and the recent epidemics in the Dadu District and Nawabshah indicate its importance in the locality. The sand fly vector is found in all four provinces of Pakistan that are listed here. It is quite obvious that presence of leishmaniasis indicates the presence of sand flies and cutaneous leishmaniasis is more common.

  18. Tuberous sclerosis with visceral leishmaniasis: a case report

    Directory of Open Access Journals (Sweden)

    Pandey Krishna

    2009-09-01

    Full Text Available Abstract Introduction Visceral leishmaniasis, a tropical infectious disease, is a major public health problem in India. Tuberous sclerosis, a congenital neuro-ectodermosis, is an uncommon disease which requires life long treatment. Case presentation A 15-year-old Indian patient, presented to the outpatient department of our institute with a high-grade fever for two months, splenomegaly and a history of generalized tonic-clonic convulsions since childhood. The clinical and laboratory findings suggested visceral leishmaniasis with tuberous sclerosis. The patient was treated with miltefosine and antiepileptics. Conclusion The patient responded well and in a follow up six months after presentation, she was found free of visceral leishmaniasis and seizures. Diagnosis and treatment of this rare combination of diseases is difficult.

  19. Reactivation of Cutaneous Leishmaniasis after Renal Transplantation: A Case Report

    Directory of Open Access Journals (Sweden)

    Hossein Mortazavi

    2014-01-01

    Full Text Available A 45-year-old man with reactivation of previously existing and subsiding cutaneous leishmaniasis on his wrist and lower leg (shin after renal transplantation was admitted to our dermatology service on March 2008. He presented to us with two huge tumoral and cauliflower-like lesions. Skin smear and histopathology of skin showed leishman bodies and confirmed the diagnosis. After renal transplantation, he received cyclosporine plus prednisolone to induce immunosuppression and reduce the probability of transplant rejection. After immunosuppressive therapy, reactivation of cutaneous leishmaniasis with the above presentation took place. The patient responded to 800 mg/day intravenous sodium stibogluconate for 3 weeks plus local cryotherapy. Systemic plus local therapy along with reducing the doses of immunosuppressive drugs led to improvement of lesions. Reactivation of leishmaniasis after immunosuppression has been rarely reported.

  20. Maiden Visit of Visceral Leishmaniasis to Malwa Region

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    Shirish S Nandedkar, Kamal Malukani, Amit Varma

    2013-01-01

    Full Text Available Visceral Leishmaniasis is a well known public health problem in eastern parts of India. So far the cases have not been reported from Malwa plateu of Madhya Pradesh, to the best of our knowledge and available literature. We report here two cases of Visceral Leishmaniasis first time from the Malwa region. Both the cases are from the migratory population of Bihar. The diseases like Leishmaniasis which were previously restricted to endemic areas of the country are spreading to non endemic areas along with the large migratory population, which is seen with the development of the country.. The cases are reported to inform the National health authorities to take proper steps to curb the spread of the disease to non -endemic areas and to emphasize the need of vector surveys in these areas.

  1. Mucocutaneous Leishmaniasis/HIV Coinfection Presented as a Diffuse Desquamative Rash

    Directory of Open Access Journals (Sweden)

    Guilherme Almeida Rosa da Silva

    2014-01-01

    Full Text Available Leishmaniasis is an infectious disease that is endemic in tropical areas and in the Mediterranean. This condition spreads to 98 countries in four continents, surpassing 12 million infected individuals, with 350 million people at risk of infection. This disease is characterized by a wide spectrum of clinical syndromes, caused by protozoa of the genus Leishmania, with various animal reservoirs, such as rodents, dogs, wolves, foxes, and even humans. Transmission occurs through a vector, a sandfly of the genus Lutzomyia. There are three main clinical forms of leishmaniasis: visceral leishmaniasis, cutaneous leishmaniasis, and mucocutaneous leishmaniasis. The wide spectrum of nonvisceral forms includes: localized cutaneous leishmaniasis, a papular lesion that progresses to ulceration with granular base and a large framed board; diffuse cutaneous leishmaniasis; mucocutaneous leishmaniasis, which can cause disfiguring and mutilating injuries of the nasal cavity, pharynx, and larynx. Leishmaniasis/HIV coinfection is considered an emerging problem in several countries, including Brazil, where, despite the growing number of cases, a problem of late diagnosis occurs. Clinically, the cases of leishmaniasis associated with HIV infection may demonstrate unusual aspects, such as extensive and destructive lesions. This study aims to report a case of mucocutaneous leishmaniasis/HIV coinfection with atypical presentation of diffuse desquamative eruption and nasopharyngeal involvement.

  2. Visceral leishmaniasis: experimental models for drug discovery.

    Science.gov (United States)

    Gupta, Suman

    2011-01-01

    Visceral leishmaniasis (VL) or kala-azar is a chronic protozoan infection in humans associated with significant global morbidity and mortality. The causative agent is a haemoflagellate protozoan Leishmania donovani, an obligate intracellular parasite that resides and multiplies within macrophages of the reticulo-endothelial system. Most of the existing anti-leishmanial drugs have serious side effects that limit their clinical application. As an alternate strategy, vaccination is also under experimental and clinical trials. The in vitro evaluation designed to facilitate rapid testing of a large number of drugs has been focussed on the promastigotes milt little attention on the clinically relevant parasite stage, amastigotes. Screening designed to closely reflect the situation in vivo is currently time consuming, laborious, and expensive, since it requires intracellular amastigotes and animal model. The ability to select transgenic Leishmania expressing reporter proteins, such as the green fluorescent proteins (GFP) or the luciferase opened up new possibilities for the development of drug screening models. Many experimental animal models like rodents, dogs and monkeys have been developed, each with specific features, but none accurately reproduces what happens in humans. Available in vitro and in vivo methodologies for antileishmanial drug screening and their respective advantages and disadvantages are reviewed. PMID:21321417

  3. [Visceral leishmaniasis in Central Asia and Kazakhstan].

    Science.gov (United States)

    Dergacheva, T I; Darchenkova, N N

    1990-01-01

    At present sporadic foci of visceral leishmaniasis (VL) are encountered mainly in the natural foci. The natural foci of VL are situated mainly in valleys and foothills. In southern areas of the Turkmen SSR the majority of cases were registered in small settlements situated near wells in interbarkhan lowerings. The reservoir of pathogen here may be Vulpes vulpes and dogs and the most likely vector is Phlebotomus turanicus. In Kazakhstan cases of VL are encountered in the thickets of the Syr-Darya floodlands in Kzyl-Orda Province, where the natural reservoir of the pathogen are Canis aureus L. and Vulpes corsac, and the vector is P. smirnovi. Synanthropic foci in Dzhambul and Chimkent, where dogs were most likely the source of the infection and P. longiductus was the vector, are at present inactive. The maps have been plotted where landscape dissemination of mosquitoes (VL vectors) is compared to places of habitation of Canis aureus L. and VL incidence in humans at peaks of the disease endemia. Medical personnel should be on the look-out for VL on the whole territory with VL natural foci. PMID:2146471

  4. Human visceral leishmaniasis: a picture from Italy.

    Science.gov (United States)

    Abdalmaula, Giuma Harun; Barbadoro, Pamela; Marigliano, Anna; Illuminati, Diego; Di Stanislao, Francesco; D'Errico, Marcello Mario; Prospero, Emilia

    2013-12-01

    The aim of our study was to describe the distribution of Visceral Leishmaniasis (VL) in Italy, focusing on HIV-infected patients, to estimate the burden of the disease and the public health actions that should be undertaken. A review of official notifications and hospitalization data has been performed. From 2006 to 2008, a total of 289 cases of VL were notified; the overall notification rate was 1.63/1,000,000 (95% CI 1.45-1.83). In total, 1192 VL-associated hospitalizations were detected, with a hospitalization rate of 6.71/1,000,000 (95% CI 6.34-7.10). For the age group "≤ 24 years", a statistically significant increase was detected (p<0.05). A total of 68.9% (n = 821) of hospitalizations were detected in HIV-positive patients. The geographic distribution of rates revealed a significant increase in the north-eastern area of the country. Our study confirms that the epidemiological pattern of VL is changing and that, in Italy, control measures and preventive strategies should be based on not only the official notification system but also hospital data. This would lead to the identification of areas of parasite spread and to the creation of awareness campaigns geared toward general practitioners in the affected areas. Easy case detection would allow for timely public health actions and strategies for the implementation of more effective interventions for reservoir control. PMID:23999330

  5. Interest in paromomycin for the treatment of visceral leishmaniasis (kala-azar

    Directory of Open Access Journals (Sweden)

    Wiwanitkit V

    2012-06-01

    Full Text Available Viroj Wiwanitkit1–31Wiwanitkit House, Bang Khae, Bangkok, Thailand; 2Hainan Medical University, Haikou, Hainan, People's Republic of China; 3Joseph Ayo Babalola University, Ikeji-Arakeji, Osun State, NigeriaAbstract: Leishmaniasis is an important vector-borne disease, and it is classified as one of the most important tropical fly-borne infections. This disease can cause two types of clinical manifestations: cutaneous forms and visceral forms. Visceral leishmaniasis, which is also called kala-azar, is a very serious infection that can be fatal. The management of visceral leishmaniasis requires informed diagnostic and therapeutic approaches. Continuous research and development regarding the treatment of visceral leishmaniasis had led to many improvements. Paromomycin is a relatively new antibiotic drug that has been used for the treatment of visceral leishmaniasis for several years. This article reviews and discusses the use of paromomycin for visceral leishmaniasis therapy.Keywords: visceral, leishmaniasis, paromomycin

  6. High levels of plasma IL-10 and expression of IL-10 by keratinocytes during visceral leishmaniasis predict subsequent development of post-kala-azar dermal leishmaniasis

    DEFF Research Database (Denmark)

    Gasim, S; Elhassan, A M; Khalil, E A;

    1998-01-01

    Some patients develop post-kala-azar dermal leishmaniasis (PKDL) after they have been treated for the systemic infection kala-azar (visceral leishmaniasis). It has been an enigma why the parasites cause skin symptoms after the patients have been successfully treated for the systemic disease. We...... report here that PKDL development can be predicted before treatment of visceral leishmaniasis, and that IL-10 is involved in the pathogenesis. Before treatment of visceral leishmaniasis, Leishmania parasites were present in skin which appeared normal on all patients. However, IL-10 was detected...

  7. Trace elements in sera from patients with visceral leishmaniasis

    Energy Technology Data Exchange (ETDEWEB)

    Mukhopadhyay, R.; Bhattacharya, A. [Department of Zoology, Calcutta University, Calcutta (India); Chakraborty, A.; Sudarshan, M.; Jal, P.K.; Chintalapudi, S.N. [Inter University Consortium for DAE Facilities, Calcutta Centre 3/LB-8, Bidhan Nagar, Calcutta (India); Dutta, R.K. [Schonland Research Centre for Nuclear Sciences, University of Witwatersrand, Johannesburg (South Africa)

    2000-07-01

    Trace elements are known to have pivotal role in human health and disease. Present investigation employed PIXE analysis to probe into the elemental profile of patients suffering from visceral Leishmaniasis. Remarkable alternations were observed in concentration of elements like Cl, K, Ca, Mn, Fe, Cu, Zn. The pattern of enhancement of elemental concentration corresponds to the progression of the disease. Additionally, our present data reflect probable correlation between alteration in trace elemental status and other pathological syndromes associated with Leishmaniasis. The possibility of considering trace elements as a diagnostic marker for a better understanding of the disease is discussed. (author)

  8. Health economic evaluations of visceral leishmaniasis treatments: a systematic review.

    OpenAIRE

    Marinho, Daniel S.; Casas, Carmen N. P. R.; Pereira, Claudia C. A.; Iuri C. Leite

    2015-01-01

    Visceral leishmaniasis (VL) is a severe form of the leishmaniasis-disease complex. Its importance to public health relies on its high fatality rate in non-treated cases, the socio-economic impact related to its morbidity, and its endemicity on different continents. The estimated burden of disease of VL varies from 1,969,000 to 2,357,000 Disability Adjusted Life Years (DALYs). VL is classified as a Neglected Tropical Disease (NTD), and is strongly related to poverty and its consequences. Visce...

  9. Aspectos ecológicos da leishmaniose tegumentar americana: 1. estudo experimental da freqüência de flebotomineos a ecótopos artificiais com referência especial a Psychodopygus intermedius Ecological aspects of American cutaneous leishmaniasis: 1. experimental study of the frequency of phlebotomine sandflies in artificial biotope with special reference to Psychodopygus intermedius

    Directory of Open Access Journals (Sweden)

    Almério de Castro Gomes

    1980-12-01

    Full Text Available A utilização de galinheiro como modelo experimental na observação do comportamento de Psychodopygus intermedius, desenvolvida na região do Vale do Ribeira, Estado de São Paulo, Brasil, revelou uma estreita associação entre o flebotomíneo e biótopo artificial estudado. Sua maior densidade à margem da mata sugeriu a hipótese de estar adaptado ao efeito marginal. As investigações em ambiente florestal e extraflorestal demonstraram sua nítida preferência pelo último. Diversos aspectos discutidos explicam parcialmente a ocorrência de leishmaniose tegumentar nesse Estado.The use of chicken roosts as experimental models for observing the behavior of Psychodopygus intermedius in the Ribeira River Valley region of the State of S. Paulo (Brazil, showed that there is a close association between the biotope studied and the phlebotomine sandfly. Its greater frequency along the edge of woods suggested the hypothesis of its adaptation to the edge effect. Investigation of forest and extraforest environments showed the fly's clear preference for the latter. Several of the aspects discussed in the paper partially explain the occurrence of cutaneous leishmaniasis in S. Paulo State.

  10. Leishmaniasis in the middle East: incidence and epidemiology.

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    Nasir Salam

    2014-10-01

    Full Text Available Leishmaniasis is a major health problem worldwide, with several countries reporting cases of leishmaniasis resulting in loss of human life or a lifelong stigma because of bodily scars. The Middle East is endemic for cutaneous leishmaniasis, with countries like Syria reporting very high incidence of the disease. Despite several countries establishing national control programs for containing the sandfly vector and treatment of infection, the disease continues to spread. In addition to the endemicity of the region for leishmaniasis, the Middle East has seen a great deal of human migration either for earning of livelihood or due to political upheaval in the region. These factors contribute to the spread and proliferation of the causative species Leishmania and its sandfly host. This review discusses the current epidemiological scenario in Iraq, Syria, Saudi Arabia, and Jordan, emphasizing the number of cases reported, vector species, Leishmania species, and treatment available. The data is primarily from WHO reports for each country and current and old literature.

  11. Cutaneous leishmaniasis responds to daylight-activated photodynamic therapy

    DEFF Research Database (Denmark)

    Enk, C D; Nasereddin, A; Alper, R;

    2015-01-01

    BACKGROUND: Cutaneous leishmaniasis (CL) is endemic in Israel, with hundreds of new cases reported in recent years. Photodynamic therapy (PDT) is highly effective for treatment of CL, but requires equipment available only at specialized centres. Daylight-activated PDT (DA-PDT) abolishes the need...

  12. Vaccines and vaccination strategies against human cutaneous leishmaniasis.

    Science.gov (United States)

    Okwor, Ifeoma; Uzonna, Jude

    2009-05-01

    One might think that the development of a vaccine against cutaneous leishmaniasis would be relatively straightforward because the type of immune response required for protection is known and natural immunity occurs following recovery from primary infection. However, there is as yet no effective vaccine against the disease in humans. Although vaccination in murine studies has yielded promising results, these vaccines have failed miserably when tested in primates or humans. The reasons behind these failures are unknown and remain a major hurdle for vaccine design and development against cutaneous leishmaniasis. In contrast, recovery from natural, deliberate or experimental infections results in development of long-lasting immunity to re-infection. This so called infection-induced resistance is the strongest anti-Leishmania immunity known. Here, we briefly review the different approaches to vaccination against cutaneous leishmaniasis and argue that vaccines composed of genetically modified (attenuated) parasites, which induce immunity akin to infection-induced resistance, may provide best protection against cutaneous leishmaniasis in humans.

  13. Evaluation of treatment with pentamidine for cutaneous leishmaniasis in Suriname

    NARCIS (Netherlands)

    W.F. van der Meide; L.O.A. Sabajo; A.J. Jensema; I. Peekel; W.R. Faber; H.D.F.H. Schallig; R.F.M.L.A. Fat

    2009-01-01

    In Suriname, pentamidine isethionate (PI) is the only drug available for the treatment of cutaneous leishmaniasis (CL). Recently, local dermatologists have observed an increase in CL patients not responding adequately to the standard doses. In this study, patient compliance to PI treatment was asses

  14. Antimony to Cure Visceral Leishmaniasis Unresponsive to Liposomal Amphotericin B.

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    Gloria Morizot

    2016-01-01

    Full Text Available We report on 4 patients (1 immunocompetent, 3 immunosuppressed in whom visceral leishmaniasis had become unresponsive to (or had relapsed after treatment with appropriate doses of liposomal amphotericin B. Under close follow-up, full courses of pentavalent antimony were administered without life-threatening adverse events and resulted in rapid and sustained clinical and parasitological cure.

  15. Antimony to Cure Visceral Leishmaniasis Unresponsive to Liposomal Amphotericin B.

    Science.gov (United States)

    Morizot, Gloria; Jouffroy, Romain; Faye, Albert; Chabert, Paul; Belhouari, Katia; Calin, Ruxandra; Charlier, Caroline; Miailhes, Patrick; Siriez, Jean-Yves; Mouri, Oussama; Yera, Hélène; Gilquin, Jacques; Tubiana, Roland; Lanternier, Fanny; Mamzer, Marie-France; Legendre, Christophe; Peyramond, Dominique; Caumes, Eric; Lortholary, Olivier; Buffet, Pierre

    2016-01-01

    We report on 4 patients (1 immunocompetent, 3 immunosuppressed) in whom visceral leishmaniasis had become unresponsive to (or had relapsed after) treatment with appropriate doses of liposomal amphotericin B. Under close follow-up, full courses of pentavalent antimony were administered without life-threatening adverse events and resulted in rapid and sustained clinical and parasitological cure.

  16. Deteccion de amastigotas en Leishmaniasis cutanea y mucocutanea por el metodo de inmunoperoxidasa, usando anticuerpo policlonal: sensibilidad y especificidad comparadas con metodos convencionales de diagnostico Detection of amastigotes in cuteneous and mucocutaneous leishmaniasis by the immunoperoxidase method, using polyclonal antibody sensibility and specifity compared with conventional diagnosis methods

    Directory of Open Access Journals (Sweden)

    Graciela Salinas

    1989-03-01

    was evaluated in 265 biopsies with the purpose of increasing the sensitivity of the diagnostic histopathology of tegumentary lesions caused by subspecies of the Leishmania braziliensis complex. A diagnosis of leishmaniasis was established by parasitological methods (181 or clinical criteria (12 in 193 patients (72.8%. In the latter group of confirmed cases standard histochemstry and immunoperoxidase were compared with direct examination of tissue scraping and culture of lesion aspirates. The detection and localization of amastigotes was more efficient using the immunoperoxidase method (61.3% than conventional histopathology with hematoxilin and eosin (34.6% or direct examination of tissue scraping (43.9%. Howerver, culture of lesion aspirates was the most sensitive procedure (89.8%. The efficiency of the immunoperoxidase method was greater in recent lesions, being positive in 75% of cases with less than 3 months evolution, while 55.6%, 37.5% and 21.1% of cases with lesion evolution of 3-5.9, 6-11, and 12 months or greater, respectively, were positive. The combined use of the direct examination of lesion scraping and immunoperoxidase applied to histological sections of the biopsy from the lesion border allowed an etiologic diagnosis of 72% of confirmed cases. Cross-reactivity was observed with Paracoccidioides braziliensis but not with Mycobacterium leprae, Sporothrix schenckii, or Histoplasma capsulatum.

  17. Aspectos ecológicos da leishmaniose tegumentar americana: 3. Observações naturais sobre o ritmo diário de Psychodopygus intermedius em ambiente florestal e extraflorestal Ecological aspects of American cutaneous leishmaniasis: 3. Natural observations on the daily rhythm of the activity of Psychodopygus intermedius in forested and neighbouring environments

    Directory of Open Access Journals (Sweden)

    Almério de Castro Gomes

    1983-02-01

    Full Text Available Pela primeira vez se determina a atividade diária de Psychodopygus intermedius em ambiente florestal residual e extraflorestal, em Pariquera-Açú, Região do Vale do Ribeira, Estado de São Paulo, Brasil. A análise final revelou ter esse flebotomíneo atividade noturna nos dois ambientes. Contudo, houve divergência quanto ao pico de atividade máxima que oscilou entre 20 e 02 horas. Persistiu também a sua predominância no ambiente extraflorestal. Por outro lado, uma acentuada preferência pelo homem parece ter influenciado sua dispersão, pois demonstrou ser ubiquitária. A importância do evento reside na possibilidade de haver uma estreita associação alimentar Ps. intermedius-Homem. Subsequente, a infecção leishmaniótica poderá ocorrer ao nível do domicílio.The daily activity of Psychodopygus intermedius was measured for the first time, within and outside of a residual forest in the Ribeira Valley, S. Paulo State, Brazil. The results showed nocturnal activity in both environments, with different times of maximum activity occuring between 8 p.m. and 2 a.m. However, the most intense activity continued to take place outside the forest. A strong preference for humans seems to have contributed to Ps. intermedius' ubiquitous distribution. The importance of this fact lies in the possibility of there existing a close feeding association Ps. intermedius - Man. Hence cutaneous leishmaniasis infection may take place in the household environment.

  18. Anticorpos antipromastigotas vivas de Leishmania (Viannia braziliensis, detectados pela citometria de fluxo, para identificação da infecção ativa na leishmaniose tegumentar americana Anti-live Leishmania (Viannia braziliensis promastigote antibodies, detected by flow cytometry, to identify active infection in american cutaneous leishmaniasis

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    Roberta Dias Rodrigues Rocha

    2002-12-01

    Full Text Available Neste estudo, descrevemos etapas iniciais de padronização de uma nova metodologia para detecção de anticorpos antipromastigotas vivas de Leishmania (Viannia braziliensis, pela citometria de fluxo e a análise de sua aplicabilidade para estudos clínicos. Foram avaliados 39 indivíduos com sorologia convencional (RIFI positiva para leishmaniose, classificados quanto à ausência/presença de lesão (L- e L+. Os resultados foram expressos sob a forma de percentual de parasitas fluorescentes positivos (PPFP. A análise dos dados, na diluição 1:1.024, permitiu distinguir 95% dos pacientes L+ como um grupo de alta reatividade (PPFP>50% e 72% dos indivíduos L- como um grupo de baixa reatividade (PPFPIn the current study we described initial standardization steps of a new methodology to detect anti-live Leishmania (Viannia braziliensis promastigote antibodies by flow cytometry, followed by analysis of its applicability to clinical studies. We have studied 39 individuals with positive conventional serology to leishmaniasis, classified according to the absence/presence of cutaneous lesions (L- and L+. The results were expressed as percentage of positive fluorescent parasites (PPFP. Data analysis at dilution of 1:1,024, allowed the distinction of 95% of L+ patients as a group of high reactivity (PPFP>50% and 72% of L- individuals as a group of low reactivity (PPFP<50%. The analysis of immunofluorescence assay titers did not show any relationship with the absence/presence of lesion. Together, our data support the applicability of flow cytometry to identify cases of active infection, which has not been possible through conventional serological reactions.

  19. Current treatment of visceral leishmaniasis (Kala-azar: an overview

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    Premshanker S. Singh

    2014-06-01

    Full Text Available Visceral Leishmaniasis (VL is also popularly known as kala-azar which was first reported in early forties and since then it continues to affect millions of people. The ranges of common drugs available for the treatment of visceral leishmaniasis are limited. It mainly includes pentavalent antimonials e.g. stibogluconate (SbV, amphotericin B deoxycholate (AB, lipid formulations of amphotericin B (L-AB, miltefosine (MF and paromomycin (PM - all of which have limitations in terms of toxicity, variable efficacy, price and inconvenient treatment schedules. Most are parenteral except MF which is administered orally. Due to the parasite and #8217;s drug resistance, the most widely used (SbV of these drugs is now of little use in northern Bihar, India, which alone accounts for 50% of the worlds burden of visceral leishmaniasis. In areas of resistance to SbV, AB is highly effective. The formulation of AB in liposomes (L-AB has been a major advancement in the treatment of visceral leishmaniasis. However, despite a significant reduction in price, this treatment remains very expensive for endemic countries like India. Combination short course therapy has been reported by many researchers who found that it is equally effective as conventional monotherapy with added benefits of less side effects, better compliance and less resistance. The aim of this article is to review the current aspects of the treatment for leishmaniasis, giving an overview of current agents clinically used to new agents and modalities of treatment under development. [Int J Res Med Sci 2014; 2(3.000: 810-817

  20. Systemic hypertension in dogs with leishmaniasis: prevalence and clinical consequences.

    Science.gov (United States)

    Cortadellas, Oscar; del Palacio, María Josefa Fernández; Bayón, Alejandro; Albert, Angel; Talavera, Jesús

    2006-01-01

    A prospective study was performed (November 1998 to December 2003) to determine the prevalence of systemic hypertension (SH) in dogs with glomerular disease secondary to leishmaniasis. One hundred and five dogs with leishmaniasis were screened and staged for the presence of renal disease (RD) and SH. For the purpose of the study, RD was defined as serum creatinine concentration > or = 1.4 mg/dL, a urine protein/creatinine ratio > or = 0.5, or both. SH was defined as a systolic blood pressure (SBP) > or =180 mm Hg or an SBP between 150 and 179 mm Hg in the presence of clinical manifestations of SH. Fifty-two (49.5%) of the dogs had some degree of RD, and 32 (61.5%) of these dogs were diagnosed with SH. Moreover, SH also was diagnosed in 3 dogs without RD. Left ventricular hypertrophy (LVH), estimated by echocardiography, was the most frequently observed systemic consequence of hypertension, being present in 32 (91.4%) of the hypertensive dogs. Echocardiographic abnormalities were not detected in any of the 33 dogs with leishmaniasis without RD, which were used as controls. Ocular consequences of SH were observed in only 2 (5.7%) of the dogs with hypertension. We conclude that SH is prevalent in dogs with RD secondary to leishmaniasis, not only in the more severe stages but also in the early course of the illness before azotemia becomes apparent. Canine leishmaniasis may be a useful natural model to study SH secondary to glomerular disease.

  1. Evaluation of the in vivo leishmanicidal activity of amphotericin B emulgel: An alternative for the treatment of skin leishmaniasis.

    Science.gov (United States)

    Pinheiro, Iluska Martins; Carvalho, Ivana Pereira; de Carvalho, Camila Ernanda Sousa; Brito, Lucas Moreira; da Silva, Andrezza Braga Soares; Conde Júnior, Airton Mendes; de Carvalho, Fernando Aécio Amorim; Carvalho, André Luis Menezes

    2016-05-01

    The American Cutaneous Leishmaniasis (ACL) is an infectious disease that can be fatal. The first line of treatment is pentavalent antimonies. However, due to its potential to develop resistance, Amphotericin B (AmB) started to be used as an alternative medicine. Current treatments are limited, a fact that has led to a growing interesting in developing new therapies. This study aims to evaluate the therapeutic potential in vivo of an amphotericin B + oleic acid (OA) emulgel in the treatment of cutaneous leishmaniasis in an experimental model. Strains of Leishmania major MHOM/IL/80/Friendlin of Leishmania major were used. The animals were inoculated subcutaneously. After the development of leishmanial, nodular or ulcerative lesions, the animals were divided into three groups (control, Group A and Group B) and treated twice a day for twelve days. The weight of the animals was measured and the size of the lesions was observed. A histopathological analysis was performed with skin fragments of lesions and with the spleen of animals treated with different treatments (emulgel, AmB 3% emulgel and AmB 3% plus OA 5% emulgel). It was observed that when subjected to treatment with AmB 3% emulgel during the study period using both formulations, with enhancer and without enhancer, ulcerative lesions regress gradually or even complete cure. The quantification of the average number of parasites recovered from the inoculation site was made after the treatment in each group and the differences were considered significant. The treatment with AmB 3% and OA 5% emulgel had the best in vivo therapeutic response, showing good prospects for cutaneous leishmaniasis therapy as an alternative therapy. PMID:26902606

  2. Characterization and speculations on the urbanization of visceral leishmaniasis in Brazil Caracterização e especulações acerca da urbanização da leishmaniose visceral no Brasil

    OpenAIRE

    Carlos Henrique Nery Costa

    2008-01-01

    The available hypotheses or explanations for the urbanization of American visceral leishmaniasis are insufficient. An alternative hypothesis is that changes in the ecology and biology of the vector, Lutzomyia longipalpis, might explain all the new urban epidemiological features of the disease. To tackle the knowledge gaps in this process, certain key research areas need to be prioritized: the role of dogs in expanding transmission in cities, community trials to evaluate new insecticides, and ...

  3. Molecular epidemiology of imported cases of leishmaniasis in Australia from 2008 to 2014.

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    Tamalee Roberts

    Full Text Available Leishmaniasis is a vector borne disease caused by protozoa of the genus Leishmania. Human leishmaniasis is not endemic in Australia though imported cases are regularly encountered. This study aimed to provide an update on the molecular epidemiology of imported leishmaniasis in Australia. Of a total of 206 biopsies and bone marrow specimens submitted to St Vincent's Hospital Sydney for leishmaniasis diagnosis by PCR, 55 were found to be positive for Leishmania DNA. All PCR products were subjected to restriction fragment length polymorphism analysis for identification of the causative species. Five Leishmania species/species complexes were identified with Leishmania tropica being the most common (30/55. Travel or prior residence in a Leishmania endemic region was the most common route of acquisition with ~47% of patients having lived in or travelled to Afghanistan. Cutaneous leishmaniasis was the most common manifestation (94% with only 3 cases of visceral leishmaniasis and no cases of mucocutaneous leishmaniasis encountered. This report indicates that imported leishmaniasis is becoming increasingly common in Australia due to an increase in global travel and immigration. As such, Australian clinicians must be made aware of this trend and consider leishmaniasis in patients with suspicious symptoms and a history of travel in endemic areas. This study also discusses the recent identification of a unique Leishmania species found in native kangaroos and a potential vector host which could create the opportunity for the establishment of a local transmission cycle within humans.

  4. Anthropogenic influence on the distribution, abundance and diversity of sandfly species (Diptera: Phlebotominae: Psychodidae, vectors of cutaneous leishmaniasis in Panama

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    Anayansi Valderrama

    2011-12-01

    Full Text Available In Panama, species of the genus Lutzomyia are vectors of American cutaneous leishmaniasis (ACL. There is no recent ecological information that may be used to develop tools for the control of this disease. Thus, the goal of this study was to determine the composition, distribution and diversity of Lutzomyia species that serve as vectors of ACL. Sandfly sampling was conducted in forests, fragmented forests and rural environments, in locations with records of ACL. Lutzomyia gomezi, Lutzomyia panamensis and Lutzomyia trapidoi were the most widely distributed and prevalent species. Analysis of each sampling point showed that the species abundance and diversity were greatest at points located in the fragmented forest landscape. However, when the samples were grouped according to the landscape characteristics of the locations, there was a greater diversity of species in the rural environment locations. The Kruskal Wallis analysis of species abundance found that Lu. gomezi and Lu. trapidoi were associated with fragmented environments, while Lu. panamensis, Lutzomyia olmeca bicolor and Lutzomyia ylephiletor were associated with forested environments. Therefore, we suggest that human activity influences the distribution, composition and diversity of the vector species responsible for leishmaniasis in Panama.

  5. Dispersal pattern of the sand fly Lutzomyia neivai (Diptera: Psychodidae in a cutaneous leishmaniasis endemic rural area in Southeastern Brazil

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    Cláudio Casanova

    2005-11-01

    Full Text Available The dispersal pattern of the sand fly Lutzomyia neivai was studied through mark-release-recapture experiments in an American cutaneous leishmaniasis endemic rural area in Southeastern Brazil. Over 6500 specimens were marked with fluorescent powder and released in forest edge and peridomicile habitats from August to November 1999, February and April 2000. Recapture attempts were made using Shannon and CDC traps up to eight successive nights after releases. A total of 493 (7.58% specimens were recaptured. The number of recaptured males and females of L. neivai in CDC traps was not affected by the distance between the trap and the release points. Approximately 90% of males and females recaptured in CDC traps were caught up to 70 m from the release points. The maximum female flight range recorded was 128 m. The average flight range per day was less than 60 m for males and females. Of the flies released in forest edge, approximately 16% of the recaptured females were caught in Shannon traps in the peridomicile habitat. The results indicate that the movements of L. neivai are spatially focal and the possibility of dispersion from forest to peridomicile habitat may be an important way of contracting leishmaniasis in dwellings.

  6. Leishmania infantum AS A CAUSATIVE AGENT OF CUTANEOUS LEISHMANIASIS IN THE STATE OF MATO GROSSO DO SUL, BRAZIL

    Science.gov (United States)

    CASTRO, Ludiele Souza; FRANÇA, Adriana de Oliveira; FERREIRA, Eduardo de Castro; HANS, Günther; HIGA, Minoru German; GONTIJO, Célia Maria Ferreira; PEREIRA, Agnes Antônia Sampaio; DORVAL, Maria Elizabeth Moraes C.

    2016-01-01

    Cutaneous leishmaniasis is caused by different species of theLeishmania genus. Leishmania(Leishmania) infantum, causing cutaneous leishmaniasis, has been described in patients living in areas where visceral leishmaniasis is endemic. In this study, it was possible to characterize this species in seven slides from cutaneous tissue imprints from patients with cutaneous leishmaniasis in the State of Mato Grosso do Sul, Brazil. PMID:27007566

  7. Leishmaniasis worldwide and global estimates of its incidence.

    Science.gov (United States)

    Alvar, Jorge; Vélez, Iván D; Bern, Caryn; Herrero, Mercé; Desjeux, Philippe; Cano, Jorge; Jannin, Jean; den Boer, Margriet

    2012-01-01

    As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 countries and three territories (see 'Leishmaniasis Country Profiles Text S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11, S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S25, S26, S27, S28, S29, S30, S31, S32, S33, S34, S35, S36, S37, S38, S39, S40, S41, S42, S43, S44, S45, S46, S47, S48, S49, S50, S51, S52, S53, S54, S55, S56, S57, S58, S59, S60, S61, S62, S63, S64, S65, S66, S67, S68, S69, S70, S71, S72, S73, S74, S75, S76, S77, S78, S79, S80, S81, S82, S83, S84, S85, S86, S87, S88, S89, S90, S91, S92, S93, S94, S95, S96, S97, S98, S99, S100, S101'). Additional information was collated during meetings conducted at WHO regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica

  8. Leishmaniasis worldwide and global estimates of its incidence.

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    Jorge Alvar

    Full Text Available As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 countries and three territories (see 'Leishmaniasis Country Profiles Text S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11, S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S25, S26, S27, S28, S29, S30, S31, S32, S33, S34, S35, S36, S37, S38, S39, S40, S41, S42, S43, S44, S45, S46, S47, S48, S49, S50, S51, S52, S53, S54, S55, S56, S57, S58, S59, S60, S61, S62, S63, S64, S65, S66, S67, S68, S69, S70, S71, S72, S73, S74, S75, S76, S77, S78, S79, S80, S81, S82, S83, S84, S85, S86, S87, S88, S89, S90, S91, S92, S93, S94, S95, S96, S97, S98, S99, S100, S101'. Additional information was collated during meetings conducted at WHO regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North

  9. Reactive Oxygen Species and Nitric Oxide in Cutaneous Leishmaniasis

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    Maria Fátima Horta

    2012-01-01

    Full Text Available Cutaneous leishmaniasis affects millions of people around the world. Several species of Leishmania infect mouse strains, and murine models closely reproduce the cutaneous lesions caused by the parasite in humans. Mouse models have enabled studies on the pathogenesis and effector mechanisms of host resistance to infection. Here, we review the role of nitric oxide (NO, reactive oxygen species (ROS, and peroxynitrite (ONOO− in the control of parasites by macrophages, which are both the host cells and the effector cells. We also discuss the role of neutrophil-derived oxygen and nitrogen reactive species during infection with Leishmania. We emphasize the role of these cells in the outcome of leishmaniasis early after infection, before the adaptive Th-cell immune response.

  10. Visceral leishmaniasis with endobronchial involvement in an immunocompetent adult.

    Science.gov (United States)

    Kotsifas, Konstantinos; Metaxas, Eugenios; Koutsouvelis, Ioannis; Skoutelis, Athanassios; Kara, Panayiota; Tatsis, George

    2011-01-01

    Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement. PMID:21577261

  11. Visceral Leishmaniasis with Endobronchial Involvement in an Immunocompetent Adult

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    Konstantinos Kotsifas

    2011-01-01

    Full Text Available Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.

  12. One Health: The global challenge of epidemic and endemic leishmaniasis

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    Day Michael J

    2011-10-01

    Full Text Available Abstract 'One Health' proposes the unification of medical and veterinary sciences with the establishment of collaborative ventures in clinical care, surveillance and control of cross-species disease, education, and research into disease pathogenesis, diagnosis, therapy and vaccination. The concept encompasses the human population, domestic animals and wildlife, and the impact that environmental changes ('environmental health' such as global warming will have on these populations. Visceral leishmaniasis is a perfect example of a small companion animal disease for which prevention and control might abolish or decrease the suffering of canine and human patients, and which aligns well with the One Health approach. In this review we discuss how surveillance for leishmaniases is undertaken globally through the control of anthroponootic visceral leishmaniasis (AVL and zoonotic visceral leishmaniasis (ZVL. The ZVL epidemic has been managed to date by the culling of infected dogs, treatment of human cases and control of the sandfly vector by insecticidal treatment of human homes and the canine reservoir. Recently, preventive vaccination of dogs in Brazil has led to reduction in the incidence of the canine and human disease. Vaccination permits greater dog owner compliance with control measures than a culling programme. Another advance in disease control in Africa is provided by a surveillance programme that combines remote satellite sensing, ecological modelling, vector surveillance and geo-spatial mapping of the distribution of vectors and of the animal-to-animal or animal-to-human pathogen transmission. This coordinated programme generates advisory notices and alerts on emerging infectious disease outbreaks that may impede or avoid the spreading of visceral leishmaniasis to new areas of the planet as a consequence of global warming.

  13. ANIMAL MODELS FOR THE STUDY OF LEISHMANIASIS IMMUNOLOGY

    OpenAIRE

    Elsy Nalleli Loria-Cervera; Fernando Jose Andrade-Narvaez

    2014-01-01

    Leishmaniasis remains a major public health problem worldwide and is classified as Category I by the TDR/WHO, mainly due to the absence of control. Many experimental models like rodents, dogs and monkeys have been developed, each with specific features, in order to characterize the immune response to Leishmania species, but none reproduces the pathology observed in human disease. Conflicting data may arise in part because different parasite strains or species are being examined, different tis...

  14. Spitz Nevus on the Earlobe Mimicking Cutaneous Leishmaniasis

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    İbrahim Özmen

    2010-06-01

    Full Text Available Spitz nevus is a benign, usually acquired melanocytic tumor which is seen especially in children and adolescents. It usually appears as a pink or light-brown, smooth-surfaced, well-circumscribed and asymptomatic papulonodular lesion. A large group of dermatologic disorders should be considered in the differential diagnosis. Herein we present a case of Spitz nevus with a two month history of a nodular lesion on the earlobe which mimicks cutaneous leishmaniasis clinically.

  15. VISCERAL LEISHMANIASIS IN PETROLINA, STATE OFPERNAMBUCO, BRAZIL, 2007-2013

    OpenAIRE

    Andreina de Carvalho ARAUJO; GONÇALVES, Nara Nagle Vieira Matos; Dantas-Torres, Filipe; Ferreira, Fernando; HORTA, Mauricio Claudio

    2016-01-01

    Visceral leishmaniasis is a life-threatening disease of great public health relevance in Brazil. The municipality of Petrolina is an endemic area in the State of Pernambuco, Brazil. This study was designed to assess the recent expansion of VL in the municipality of Petrolina, Pernambuco. Patients data were obtained from the Brazilian National Information System for Notifiable Diseases (SINAN). A total of 111 records from 2007 to 2013 were investigated, of which 69 were residents in Petrolina....

  16. Epidemiological study on acute cutaneous leishmaniasis in Morocco

    Institute of Scientific and Technical Information of China (English)

    Kholoud Kahime; Samia Boussaa; Haddou Nhammi; Ali Boumezzough

    2016-01-01

    Objective: To describe and compare the epidemiological features of anthroponotic cutaneous leishmaniasis (ACL) caused by Leishmania tropica, and zoonotic cutaneous leishmaniasis (ZCL) due to Leishmania major in Morocco. Methods: We performed a retrospective study of ZCL and ACL cases reported during the last ten years in Morocco (2004–2013). Epidemiological data were analyzed by using Pearson's correlation method as well as Tukey test and digital maps were produced for incidence repartition calculated by using ArcMap GIS version 10. Results: A total of 41 656 cases of cutaneous leishmaniasis were notified between 2004 and 2013 in Morocco. The mean incidence was 139 cases/100 000 population/10 years and it was significantly higher in 2010. In the spatial context, ACL form was the most common in Morocco, while ZCL was the most important in terms of the number of reported cases. For both forms, the highest incidence occurred in females and children (0–14 years). When analyzed according to the number of cases in each province, Errachidia (8 728 cases) and Azilal (3 523 cases) were the most affected by ZCL and ACL, respectively, while the highest incidence was noted in Zagora (231 cases/100 000 pop-ulation/10 years) and in Chichaoua (97 cases/100 000 population/10 years), for ZCL and ACL, respectively. Maps of incidence repartition were performed to identify the risk area of ZCL and ACL. Conclusions: ZCL and ACL are still major health problems in Morocco. We highlight the spatiotemporal change of cutaneous leishmaniasis incidence through the country during the last ten years and we underline the correlation between ZCL incidence and the percentage of rural population in Morocco.

  17. Visceral leishmaniasis: immunology and prospects for a vaccine.

    Science.gov (United States)

    Kaye, P M; Aebischer, T

    2011-10-01

    Human visceral leishmaniasis (HVL) is the most severe clinical form of a spectrum of neglected tropical diseases caused by protozoan parasites of the genus Leishmania. Caused mainly by L. donovani and L. infantum/chagasi, HVL accounts for more than 50 000 deaths every year. Drug therapy is available but costly, and resistance against several drug classes has evolved. Here, we review our current understanding of the immunology of HVL and approaches to and the status of vaccine development against this disease.

  18. Recent understanding in the treatment of visceral leishmaniasis.

    OpenAIRE

    Rosenthal E; Marty P.

    2003-01-01

    Visceral leishmaniasis (VL) is a severe disease associated with infection of the reticuloendothelial system by Leishmania species. The infection is acquired through sandfly bites. Recent large scale epidemics of VL in east Africa and India and the emergence of a HIV epidemic make VL a priority for the World Health Organization. Pentavalent antimonials have been cornerstone of treatment for the last six decades. The appearance of antimonial-resistance and the development of lipid formulations ...

  19. Visceral leishmaniasis in eastern Africa – current status

    OpenAIRE

    Reithinger, Richard; Brooker, Simon; Jan H Kolaczinski

    2007-01-01

    Summary Visceral leishmaniasis (VL) is among the most neglected of the tropical diseases, afflicting the poorest of the poor. In eastern Africa, VL causes at least 4000 deaths annually, a loss of approximately 385 000 disability-adjusted life years. Due to the chronicity of underlying causes, it is likely that the caseload will increase in the foreseeable future. While efforts should be pursued to develop novel case management and prevention tools, several effective interventions already exis...

  20. Obtaining membranes for alternative treatment hydrogels of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Polymeric Hydrogels formed by crosslinked polymeric chains were obtained by ionizing radiation process according to Rosiak technique. In the last 40 years the use of hydrogels has been investigated for various applications as curatives. In this work hydrogel membranes were synthesized with poly (N-2-pyrrolidone) (PVP), poly (vinyl alcohol) (PVA), chitosan and laponita clay for use as a vehicle for controlled glucantime release on the surface of skin tissues injured by leishmaniasis. Leishmaniasis is a disease caused by a protozoan parasite of the genus Leishmania transmitted by the bite of phlebotomies sandfly. The traditional treatment of patients infected by these parasites is done with pentavalent antimony in injectable form. However, these antimonates are highly toxic and cause side effects in these patients. In addition, patients with heart and kidney disease can not use this treatment. In treatment with drug delivery hydrogel membrane applied on the surface of leishmaniasis injured tissues the drug is released directly to the wound in a controlled manner, reducing the side effects. Membranes prepared in this study were characterized by X-ray diffraction (XRD), thermogravimetric analysis (TG), swelling, gel fraction, infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and atomic force microscopy (AFM). The characterizations of cytotoxicity and drug release were made 'in vitro' and 'in vivo' with functional test according to ethical protocol of the Division of Infectious and Parasitic Diseases at the Hospital of Clinics, Sao Paulo University-School of Medicine, University. The 'in vivo' test of these membranes proved to be effective in controlled release of drugs directly into leishmaniasis damaged tissues. Results of 'in vivo' tests using PVP/PVAl / clay 1,5% and glucantime membrane showed remarkable contribution to wound reduction and cure in clinical therapy. (author)

  1. [The Elba triad: harara, light dermatoses, leishmaniasis. The ecological background].

    Science.gov (United States)

    Krampitz, H E

    1981-05-01

    A report is given on a travel to Elba, the largest island of the Tuscany archepelago (Italy) and a holiday place preferred by German speaking tourists. In the last years some cases of visceral leishmaniasis and oriental sores, respectively, were introduced to Germany from this island. The geoecological background of this development was investigated. Reproduction and spread of the most abundant sandfly species Phlebotomus (Laroussius) perniciosus favour ruinous buildings, actually used as animal shelters sometimes in the immediate vicinity of new tourist bungalows. A typical allergic response upon sandfly bites occurs in almost all of the newcomers. This skin irritation is wellknown as urticaria multiformis endemica of Harara. Local people and tourists connect this itching disorder with certain types of sun trauma and do not take notice of their real etiology. Cortisone treatment in severe cases may facilitate the start of simultaneously transmitted leishmaniasis. The possible epidemiological role, which the dog travelling to southern countries in connection with leishmaniasis plays, is considered. PMID:7016813

  2. Therapeutic enhancement of protective immunity during experimental leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Senad Divanovic

    2011-09-01

    Full Text Available BACKGROUND: Leishmaniasis remains a significant cause of morbidity and mortality in the tropics. Available therapies are problematic due to toxicity, treatment duration and emerging drug resistance. Mouse models of leishmaniasis have demonstrated that disease outcome depends critically on the balance between effector and regulatory CD4(+ T cell responses, something mirrored in descriptive studies of human disease. Recombinant IL-2/diphtheria toxin fusion protein (rIL-2/DTx, a drug that is FDA-approved for the treatment of cutaneous T cell lymphoma, has been reported to deplete regulatory CD4(+ T cells. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the potential efficacy of rIL-2/DTx as adjunctive therapy for experimental infection with Leishmania major. Treatment with rIL-2/DTx suppressed lesional regulatory T cell numbers and was associated with significantly increased antigen-specific IFN-γ production, enhanced lesion resolution and decreased parasite burden. Combined administration of rIL-2/DTx and sodium stibogluconate had additive biological and therapeutic effects, allowing for reduced duration or dose of sodium stibogluconate therapy. CONCLUSIONS/SIGNIFICANCE: These data suggest that pharmacological suppression of immune counterregulation using a commercially available drug originally developed for cancer therapy may have practical therapeutic utility in leishmaniasis. Rational reinvestigation of the efficacy of drugs approved for other indications in experimental models of neglected tropical diseases has promise in providing new candidates to the drug discovery pipeline.

  3. High levels of C-reactive protein in the peripheral blood during visceral leishmaniasis predict subsequent development of post kala-azar dermal leishmaniasis

    DEFF Research Database (Denmark)

    Gasim, S; Theander, T G; ElHassan, A M

    2000-01-01

    Post kala-azar dermal leishmaniasis (PKDL) is a known sequel to visceral leishmaniasis in India and East Africa, and in Sudan about 50% of the kala-azar patients develop PKDL. In this study we followed kala-azar patients from diagnosis and up to 2 years after initiation of treatment. During...... and in keratinocytes during visceral leishmaniasis predict subsequent development of PKDL. The method however requires expensive equipment and reagents. The results of the present study indicate that kala-azar patients, who have a high risk of developing PKDL after treatment can be identified by measuring plasma CRP....

  4. Searching for cutaneous leishmaniasis in tribals from Kerala, India

    Directory of Open Access Journals (Sweden)

    S M Simi

    2010-01-01

    Full Text Available Background : In India, indigenous cases of cutaneous leishmaniasis (CL are mainly confined to the northwestern region. But now, more and more case reports are coming in from other parts of India. In January 2009, a 26-year-old lady residing in a forest area in Thiruvananthapuram district of Kerala State presented with bluish red nodules on her upper extremities, of six months duration, which was clinically more in favor of cutaneous leishmaniasis. She had never gone out of the district of Thiruvananthapuram in her life. Aim : To investigate whether the patient hails from a new endemic focus of cutaneous leishmaniasis. Setting and Design : An epidemiological investigation in the form of a survey was carried out in March 2009 by a multidisciplinary team among 63 persons residing in the Mele Aamala and Aayiramkala forest tribal settlements in Kuttichal Panchayat of Thiruvananthapuram district. Material and Methods : History taking and clinical examination of 38 persons in the area with special consideration to skin lesions was undertaken. Microbiological and histopathological examination of the skin lesions was done. Breeding places of sand fly and possible reservoirs of Leishmania were also simultaneously investigated. Statistical analysis used : The data obtained was tabulated as frequency and percentage. Chi-square test was done to find out the statistical significance of differences in distributions. Results : Out of the 38 persons examined, active lesions were found in 12 persons and six had healed lesions. Tissue samples were obtained from seven out of the 12 suspected cases. Four of them showed Leishman Donovan (LD bodies in tissue smears. Out of the cultures taken from three patients, one showed promastigote forms in Novy McNeal Nicolle (NNN medium. Histopathological study was done in five patients and two patients had LD bodies, one had epithelioid cell granuloma and the other two had mixed infiltrate with predominantly macrophages. All

  5. Anti-leishmania igA immunoenzymatic assay in mucocutaneous leishmaniasis (Preliminary report

    Directory of Open Access Journals (Sweden)

    M. Carolina S. Guimarães

    1984-12-01

    Full Text Available The Authors describe an anti-Leishmania IgA-ELISA assay in mucocutaneous leishmaniasis. Increased titers were found in leishmaniasis patients, mainly in the first and second year of infection and in deep mycoses patients showing either mucosal involvement or widespread disease.

  6. Anti-leishmania igA immunoenzymatic assay in mucocutaneous leishmaniasis (Preliminary report)

    OpenAIRE

    M. Carolina S. Guimarães; Antonio Walter Ferreira; Márcia B. de Carvalho; Beatriz J. Celeste; Luiz Carlos Cucé; Walter Belda Jr.

    1984-01-01

    The Authors describe an anti-Leishmania IgA-ELISA assay in mucocutaneous leishmaniasis. Increased titers were found in leishmaniasis patients, mainly in the first and second year of infection and in deep mycoses patients showing either mucosal involvement or widespread disease.

  7. Leishmaniasis isoleret til larynx som årsag til kronisk laryngitis

    DEFF Research Database (Denmark)

    Kaltoft, Mikkel; Munch-Petersen, Helga Richert; Møller, Henrik

    2010-01-01

    Mucosal leishmaniasis is uncommon outside Central and South America, where it is commonly caused by Leishmania (L.) braziliensis. We present a case of isolated laryngeal leishmaniasis detected in a 78-year-old male, who presented with chronic hoarseness. Histologic examination of biopsies taken...

  8. Oronasal leishmaniasis caused by a parasite with an unusual isoenzyme profile

    DEFF Research Database (Denmark)

    Ibrahim, M.; Suliman, A.; Hashim, F.A.;

    1997-01-01

    A 45-year-old Sudanese man from western Sudan presented with oronasal leishmaniasis of three years duration. He had no history of previous kala-azar or cutaneous leishmaniasis. The parasite isolated from the oral mucosa was characterized by isoenzymes using 12 enzymes and by polymerase chain...

  9. Intralesional autotherapy of cutaneous leishmaniasis with buffy coat cells: cytological findings

    DEFF Research Database (Denmark)

    Dabiri, S; Meymandi, S S; Hayes, M M;

    2000-01-01

    The skin lesions of five patient volunteers with dry-type cutaneous leishmaniasis were treated by intralesional injection of auto-leukocytes prepared from buffy coat of the patient's own blood. Giemsa stained, air-dried cytological smear preparations were prepared from scrapings taken from...... the potential for intralesional autotherapy with buffy coat in dry-type cutaneous leishmaniasis....

  10. Immunopathology of post kala-azar dermal leishmaniasis (PKDL): T-cell phenotypes and cytokine profile

    DEFF Research Database (Denmark)

    Ismail, A; El Hassan, A M; Kemp, K;

    1999-01-01

    In Sudan, post kala-azar dermal leishmaniasis (PKDL) caused by Leishmania donovani develops in half of the patients treated for visceral leishmaniasis (kala-azar). In most patients lesions heal spontaneously, but in others symptoms are severe and persist for years. This study examined...

  11. Cutaneous Leishmaniasis: The Truth about the 'Flesh-Eating Disease' in Syria.

    Science.gov (United States)

    Mondragon-Shem, Karina; Acosta-Serrano, Alvaro

    2016-06-01

    Recent news headlines claimed that corpses thrown into Syrian streets are causing cutaneous leishmaniasis (CL) outbreaks. However, leishmaniasis is only transmitted by blood-feeding sandflies, not through human remains. High CL prevalence in Syria may instead be attributed to the absence of disease control programs due to the disruption of health services.

  12. Can Saffron (Crocus sativus) be effective in the treatment of leishmaniasis?

    Science.gov (United States)

    Bagherani, Nooshin

    2013-10-01

    Leishmaniasis is a parasitic disease caused by Leishmania, transmitted by the bite of some sandfly species. It is endemic in 88 countries throughout the world. Pentavalent antimonials are the standard therapy for leismaniasis. Saffron (crocus sativus) belongs to the iridaceae family. This paper will outline the benefits and challenges of repurposing saffron for treating leishmaniasis.

  13. Cutaneous Leishmaniasis: The Truth about the 'Flesh-Eating Disease' in Syria.

    Science.gov (United States)

    Mondragon-Shem, Karina; Acosta-Serrano, Alvaro

    2016-06-01

    Recent news headlines claimed that corpses thrown into Syrian streets are causing cutaneous leishmaniasis (CL) outbreaks. However, leishmaniasis is only transmitted by blood-feeding sandflies, not through human remains. High CL prevalence in Syria may instead be attributed to the absence of disease control programs due to the disruption of health services. PMID:27105932

  14. [Feline leishmaniasis: what's the epidemiological role of the cat?].

    Science.gov (United States)

    Mancianti, F

    2004-06-01

    Feline leishmaniasis (FL) is a quite uncommon feature. Clinical disease has been described in cats since nineties begin. More than 40 reports in world literature have been referred, but the clinical cases have been only recently well defined. Most of the reports focus on infected cats living in endemic areas, even if, more recently FL due to Leishmania infantum was found in Sao Paulo State, in Brazil where autochthonous human or canine leishmaniasis cases have never reported. In Europe clinical cases of FL have been described from Portugal, France, Spain and Italy from 1996 to 2002. When a typing of the etiological agent was performed L. infantum was identified in all reported cases. In some endemic areas serological surveys have also been carried out in cats, using IHAT in Egypt, Western blot in France or IFAT in Italy. Sixty Egyptian cats had low serological antibody titers, from 1/32 to 1/128, in the endemic focus of canine leishmaniasis of Alpes Maritimes 12 out of 97 (12.5%) cats showed antibodies versus antigens 14 and/or 18 kDa of L. infantum. A previous survey by means of IFAT in Liguria and Toscana on 110 and 158 feline sera respectively reports a seroprevalence of 0.9% with low titer, while sera from Sicily seem to be positive at higher dilutions. Animals living in an endemic area can develop specific antibodies against leishmania and, in our experience, they can be evidentiated by means of IFAT. The antibody titers appear to be lower in affected cats than in dogs, even if the number of clinical cases is very scanty. PCR tests on feline blood samples are in progress, but preliminary results confirm the presence of leishmania DNA in such specimens. Cutaneous leishmaniasis is the more frequent form in cats and it was reported from several countries. Typical signs include nodular to ulcer or crusty lesions on the nose, lips, ears, eyelids, alopecia: clinical signs of cutaneous FL are unspecific and in endemic area this infection must be taken into account

  15. Systemic Therapy of New World Cutaneous Leishmaniasis: A Case Report and Review Article

    Directory of Open Access Journals (Sweden)

    Amir Abadir

    2010-01-01

    Full Text Available Cutaneous leishmaniasis is a disease endemic to Central and South America, Mexico and the Caribbean, and affects millions of people. As travel to these regions becomes more common, cutaneous leishmaniasis is becoming a disease of increasing importance in the developed world. However, disease recognition and access to appropriate therapy for cutaneous leishmaniasis remains a challenge in North America. The present article reports a case of cutaneous leishmaniasis in a Canadian man following a trip to Costa Rica. Species-specific diagnosis was confirmed by polymerase chain reaction analysis of a skin biopsy, which was positive for Leishmania panamensis. After failing a course of itraconazole, the patient was successfully treated with sodium stibogluconate, despite significant barriers to administering this therapy, and the paucity of data regarding its efficacy and tolerability. The pathophysiology, diagnosis and systemic treatment of cutaneous leishmaniasis, as well as its emerging presence in the developed world, are reviewed.

  16. Leishmaniasis–HIV coinfection: current challenges

    Directory of Open Access Journals (Sweden)

    Lindoso JAL

    2016-10-01

    Full Text Available José Angelo Lauletta Lindoso,1,2 Mirella Alves Cunha,3 Igor Thiago Queiroz,4 Carlos Henrique Valente Moreira2 1Laboratory of Soroepidemiology (LIM HC-FMUSP, São Paulo University, São Paulo, 2Instituto de Infectologia Emilio Ribas-SES, São Paulo, 3Department of Infectious Disease, Faculty of Medicine, São Paulo University, São Paulo, 4Hospital Giselda Trigueiro - SESAP, Natal, Brazil Abstract: Leishmaniasis – human immunodeficiency virus (HIV coinfection can manifest itself as tegumentary or visceral leishmaniasis. Almost 35 countries have reported autochthonous coinfections. Visceral leishmaniasis is more frequently described. However, usual and unusual manifestations of tegumentary leishmaniasis have been reported mainly in the Americas, but the real prevalence of Leishmania infection in HIV-infected patients is not clear. Regarding the clinical manifestations, there are some reports showing unusual manifestations in visceral leishmaniasis and tegumentary leishmaniasis in HIV-infected patients; yet, the usual manifestations are more frequent. Leishmaniasis diagnosis relies on clinical methods, but serological tests are used to diagnose visceral leishmaniasis despite them having a low sensitivity to tegumentary leishmaniasis. The search for the parasite is used to diagnose both visceral leishmaniasis and tegumentary leishmaniasis. Nevertheless, in HIV-infected patients, the sensitivity of serology is very low. Drugs available to treat leishmaniasis are more restricted and cause severe side effects. Furthermore, in HIV-infected patients, these side effects are more prominent and relapses and lethality are more recurrent. In this article, we discuss the current challenges of tegumentary leishmaniasis and visceral leishmaniasis–HIV infection, focusing mainly on the clinical manifestations, diagnosis, and treatment of leishmaniasis. Keywords: leishmaniasis, HIV infection, coinfection, epidemiology, clinical manifestations, diagnosis

  17. Larval microhabitats of Lutzomyia longipalpis (Diptera: Psychodidae) in an endemic focus of visceral leishmaniasis in Colombia.

    Science.gov (United States)

    Ferro, C; Pardo, R; Torres, M; Morrison, A C

    1997-11-01

    An intensive search for the larval habitats of Lutzomyia longipalpis (Lutz & Neiva) was conducted from November 1992 to October 1993 at a small rural community in Colombia where American visceral leishmaniasis is endemic. Emergence traps constructed from polyvinyl chloride pipes were used to sample a variety of soil microhabitats that included edge areas of covered pigpens, cattle corrals, the base of trees, and leaf litter at sites within 40 m of a house, rocks in fields located between 50 and 500 m from houses, and sites within a patch of secondary forest (rocks, base of palm trees, and leaf litter). The teneral status of the sand flies captured in the emergence traps was confirmed by laboratory studies that determined the rate of terminalia rotation in male L. longipalpis and the rate of cuticular growth layer formation of the thoracic phragma in both sexes of this species. A total of 58 teneral sand flies was captured during the study period (49 wk). Fifteen specimens were L. longipalpis; of these 11 (5 sand flies per square meter) were captured near pigpens, 3 (1.4 sand flies per square meter) were captured near rock resting sites, and 1 (1.6 sand flies per square meter) was collected at the base of a tree. The remainder of the sand flies were either L. trinidadensis (Newstead) or L. cayennensis (Flock & Abonnenc). Our results indicate that L. longipalpis larvae were dispersed widely in sites near houses, rather than concentrated in a few optimal microhabitats.

  18. Canine visceral leishmaniasis in Barra de Guaratiba, Rio de Janeiro, Brazil: assessment of risk factors

    Directory of Open Access Journals (Sweden)

    Cabrera Maria Alice A.

    2003-01-01

    Full Text Available Barra de Guaratiba is a coastal area of the city of Rio de Janeiro where American visceral leishmaniasis (AVL is endemic. Although control measures including killing of dogs and use of insecticides have been applied at this locality, the canine seroprevalence remains at 25% and during 1995 and 1997 eight autochthonous human cases were notified. In order to evaluate factors related to the increase of the risk for Leishmania (Leishmania chagasi infection in dogs we have screened 365 dogs by anti-Leishmania immunofluorescent antibody test (IFAT and captured sandflies in the domestic and peridomestic environment. Some variables related to the infection were assessed by uni- and multivariate analysis. The distance of the residence from the forest border, its altitude and the presence of the opossum Didelphis marsupialis in the backyard, were found predictor factors for L. (L. chagasi infection in dogs in Barra de Guaratiba. The presence of Lutzomyia longipalpis in the peridomestic environment indicates the possibility of appearence of new human cases. Our data also suggest the presence of a sylvatic enzootic cycle at this locality.

  19. Canine visceral leishmaniasis in Barra de Guaratiba, Rio de Janeiro, Brazil: assessment of risk factors.

    Science.gov (United States)

    Cabrera, Maria Alice A; Paula, Adelzon A; Camacho, Luis Antonio B; Marzochi, Mauro Célio A; Xavier, Samanta C; da Silva, Alba Valéria M; Jansen, Ana Maria

    2003-01-01

    Barra de Guaratiba is a coastal area of the city of Rio de Janeiro where American visceral leishmaniasis (AVL) is endemic. Although control measures including killing of dogs and use of insecticides have been applied at this locality, the canine seroprevalence remains at 25% and during 1995 and 1997 eight autochthonous human cases were notified. In order to evaluate factors related to the increase of the risk for Leishmania (Leishmania) chagasi infection in dogs we have screened 365 dogs by anti-Leishmania immunofluorescent antibody test (IFAT) and captured sandflies in the domestic and peridomestic environment. Some variables related to the infection were assessed by uni- and multivariate analysis. The distance of the residence from the forest border, its altitude and the presence of the opossum Didelphis marsupialis in the backyard, were found predictor factors for L. (L.) chagasi infection in dogs in Barra de Guaratiba. The presence of Lutzomyia longipalpis in the peridomestic environment indicates the possibility of appearence of new human cases. Our data also suggest the presence of a sylvatic enzootic cycle at this locality. PMID:12754572

  20. Synthetic sex pheromone attracts the leishmaniasis vector Lutzomyia longipalpis (Diptera: Psychodidae) to traps in the field.

    Science.gov (United States)

    Bray, D P; Bandi, K K; Brazil, R P; Oliveira, A G; Hamilton, J G C

    2009-05-01

    Improving vector control remains a key goal in reducing the world's burden of infectious diseases. More cost-effective approaches to vector control are urgently needed, particularly because vaccines are unavailable and treatment is prohibitively expensive. The causative agent of American visceral leishmaniasis (AVL), Leishmania chagasi, Cunha and Chagas (Kinetoplastida: Trypanosomatidae), is transmitted between animal and human hosts by blood-feeding female sand flies attracted to mating aggregations formed on or above host animals by male-produced sex pheromones. Our results show the potential of using synthetic pheromones to control populations of Lutzomyia longipalpis Lutz and Neiva (Diptera: Psychodidae), the sand fly vector of one of the world's most important neglected diseases, AVL. We showed that a synthetic pheromone, (+/-)-9-methylgermacrene-B, produced from a low-cost plant intermediate, attracted females in the laboratory. By formulating dispensers that released this pheromone at a rate similar to that released by aggregating males, we were able to attract flies of both sexes to traps in the field. These dispensers worked equally well when deployed with mechanical light traps and inexpensive sticky traps. If deployed effectively, pheromone-based traps could be used to decrease AVL transmission rates through specific targeting and reduction of L. longipalpis populations. This is the first study to show attraction of a human disease-transmitting insect to a synthetic pheromone in the field, showing the general applicability of this novel approach for developing new tools for use in vector control. PMID:19496409

  1. Larval microhabitats of Lutzomyia longipalpis (Diptera: Psychodidae) in an endemic focus of visceral leishmaniasis in Colombia.

    Science.gov (United States)

    Ferro, C; Pardo, R; Torres, M; Morrison, A C

    1997-11-01

    An intensive search for the larval habitats of Lutzomyia longipalpis (Lutz & Neiva) was conducted from November 1992 to October 1993 at a small rural community in Colombia where American visceral leishmaniasis is endemic. Emergence traps constructed from polyvinyl chloride pipes were used to sample a variety of soil microhabitats that included edge areas of covered pigpens, cattle corrals, the base of trees, and leaf litter at sites within 40 m of a house, rocks in fields located between 50 and 500 m from houses, and sites within a patch of secondary forest (rocks, base of palm trees, and leaf litter). The teneral status of the sand flies captured in the emergence traps was confirmed by laboratory studies that determined the rate of terminalia rotation in male L. longipalpis and the rate of cuticular growth layer formation of the thoracic phragma in both sexes of this species. A total of 58 teneral sand flies was captured during the study period (49 wk). Fifteen specimens were L. longipalpis; of these 11 (5 sand flies per square meter) were captured near pigpens, 3 (1.4 sand flies per square meter) were captured near rock resting sites, and 1 (1.6 sand flies per square meter) was collected at the base of a tree. The remainder of the sand flies were either L. trinidadensis (Newstead) or L. cayennensis (Flock & Abonnenc). Our results indicate that L. longipalpis larvae were dispersed widely in sites near houses, rather than concentrated in a few optimal microhabitats. PMID:9439128

  2. Accounting for False Positive HIV Tests: Is Visceral Leishmaniasis Responsible?

    Directory of Open Access Journals (Sweden)

    Leslie Shanks

    Full Text Available Co-infection with HIV and visceral leishmaniasis is an important consideration in treatment of either disease in endemic areas. Diagnosis of HIV in resource-limited settings relies on rapid diagnostic tests used together in an algorithm. A limitation of the HIV diagnostic algorithm is that it is vulnerable to falsely positive reactions due to cross reactivity. It has been postulated that visceral leishmaniasis (VL infection can increase this risk of false positive HIV results. This cross sectional study compared the risk of false positive HIV results in VL patients with non-VL individuals.Participants were recruited from 2 sites in Ethiopia. The Ethiopian algorithm of a tiebreaker using 3 rapid diagnostic tests (RDTs was used to test for HIV. The gold standard test was the Western Blot, with indeterminate results resolved by PCR testing. Every RDT screen positive individual was included for testing with the gold standard along with 10% of all negatives. The final analysis included 89 VL and 405 non-VL patients. HIV prevalence was found to be 12.8% (47/ 367 in the VL group compared to 7.9% (200/2526 in the non-VL group. The RDT algorithm in the VL group yielded 47 positives, 4 false positives, and 38 negatives. The same algorithm for those without VL had 200 positives, 14 false positives, and 191 negatives. Specificity and positive predictive value for the group with VL was less than the non-VL group; however, the difference was not found to be significant (p = 0.52 and p = 0.76, respectively.The test algorithm yielded a high number of HIV false positive results. However, we were unable to demonstrate a significant difference between groups with and without VL disease. This suggests that the presence of endemic visceral leishmaniasis alone cannot account for the high number of false positive HIV results in our study.

  3. Study of an outbreak of cutaneous leishmaniasis in Venezuela: the role of domestic animals

    Directory of Open Access Journals (Sweden)

    Cruz Manuel Aguilar

    1984-06-01

    Full Text Available During an outbreak of cutaneous leishmaniasis in a locality (Las Rosas, Cojedes State, venezuela previously non-endemic, 12.9% of humans, 7% of dogs and 21.4% of donkeys (Equus asinus had lesions with paraites. The agent in the three hosts was identified as Leishmania braziliensis, subspecies braziliensis at least in man and donkey. The probable vector was Lutzomyia panamensis. No infection was found in a small sample of wild mammals examined. The outbreak was apparently linked with the importation of donkeys with ulcers, from endemic areas. The Authors call attention to the fact that not only in the foci of "uta", but also in areas of the other forms of American cutaneous leishmaniasis, dogs are frequently found infected. They emphasize the necessity of searching for the infection in donkeys and of performing hemocultures and xenodiagnosis with sandflies in human, canine and equine cases, to verify their possible role as sources of infection, and not merely as dead ends in the epidemiological chain of the disease.Durante um surto de leishmaniose tegumentar em Las Rosas, localidade previamente não endêmica do Estado Cojedes, Venezuela, 12,9% dos habitantes, 7% dos cães e 21,4% dos asnos (Equus asinus apresentavam lesões com parasitos. O agente etiológico nos tres hospedeiros foi identificado como Leishmania braziliensis, sendo da subespécie braziliensis pelo menos em pessoas e asnos. O transmissor provável foi Lutzomyia panamensis. Não comprovamos a infecção numa pequena amostra de mamíferos silvestres examinados. O surto esteve aparentemente relacionado com a importação de asnos com úlceras de áreas endêmicas. Chamamos a atenção para o fato de que não é apenas nos fócos de "uta", mas também nos de outras formas de leishmaniose tegumentar americana que os cães estão freqüentemente parasitados. Enfatizamos a necessidade de se procurar a infecção em asnos e de se proceder a hemoculturas e a xenodiagnósticos com

  4. A Cluster of Cutaneous Leishmaniasis Associated with Human Smuggling

    OpenAIRE

    Anthony P Cannella; Nguyen, Bichchau M.; Piggott, Caroline D.; Lee, Robert A.; Vinetz, Joseph M.; Mehta, Sanjay R.

    2011-01-01

    Cutaneous leishmaniasis (CL) is rarely seen in the United States, and the social and geographic context of the infection can be a key to its diagnosis and management. Four Somali and one Ethiopian, in U.S. Border Patrol custody, came to the United States by the same human trafficking route: Djibouti to Dubai to Moscow to Havana to Quito; and then by ground by Columbia/Panama to the United States - Mexico border where they were detained. Although traveling at different times, all five patients...

  5. Antissaliva Antibodies of Lutzomyia Longipalpis in area of Visceral Leishmaniasis.

    Science.gov (United States)

    Fraga, Thiago Leite; Fernandes, Magda Freitas; Pontes, Elenir Rose Jardim Cury; Levay, Ana Paula Silva; Almeida da Cunha, Elenice Brandão; França, Adriana de Oliveira; Dorval, Maria Elizabeth Cavalheiros

    2016-07-01

    The aim of the present study was to assess the presence of antissaliva antibodies of Lutzomyia longipalpis in human hosts living in area of visceral leishmaniasis, located in the Center-West region of Brazil. The presence of antissaliva antibodies of L. longipalpis exhibited a strong correlation with the protection and development of antibodies against Leishmania sp. Of the 492 children studied, elevated antissaliva antibodies of L. longipalpis were detected in 38.4% of the participants. There was a higher percentage of positivity (64.7%) among children who exhibited anti-Leishmania sp. antibodies and among those who were positive in the delayed hypersensitivity test (34.8%). PMID:27093167

  6. Pharmacokinetic of antimony in mice with cutaneous Leishmaniasis

    Energy Technology Data Exchange (ETDEWEB)

    Borborema, Samanta E.T.; Nascimento, Nanci do [Instituto de Pesquisas Energeticas e Nucleares IPEN/CNEN-SP, Sao Paulo, SP (Brazil). Lab. de Biologia Molecular]. E-mails: samanta@usp.br; nnascime@ipen.br; Andrade Junior, Heitor F. de [Instituto de Pesquisas Energeticas e Nucleares IPEN/CNEN-SP, Sao Paulo, SP (Brazil). Lab. de Biologia Molecular; Instituto de Medicina Tropical de Sao Paulo, Sao Paulo, SP (Brazil); E-mail: hfandrad@usp.br; Osso Junior, Joao A. [Instituto de Pesquisas Energeticas e Nucleares IPEN/CNEN-SP, Sao Paulo, SP (Brazil). Centro de Radiofarmacia]. E-mail: jaosso@ipen.br

    2007-07-01

    Cutaneous Leishmaniasis (CL) remains a major world health problem, with about 1.5 million new cases each year. Caused by protozoa Leishmania, in South America, this infection can vary from a chronic skin ulcer, to an erosive mucosal disease and severe facial disfigurement. Pentavalent antimony (Sb{sup +5}) as sodium stibogluconate (Pentostam) or meglumine antimoniate (Glucantime) are main drugs for treating most forms of human leishmaniasis. For six decades, despite the recent developments, the effective therapy to cutaneous leishmaniasis has been based on long parenteral courses of such drugs, even though these are fairly costly, toxic and inconvenient to use, without adequate knowledge on their pharmacokinetics or mechanism of action. Pharmacokinetics studies could be based on bioactive traceable drugs, usually with radioactive isotopes, but antimony radioisotopes are unavailable commercially. Neutron irradiation is a powerful tool in the analysis of mineral content of samples, for antimony, there are at least two main isotopes that could be formed after neutron irradiation in nuclear reactor. The aim of the present study was to construct antimony salts with those radioisotopes to obtain tracers to compare the pharmacokinetic and the tissue distribution of neutron irradiated meglumine antimoniate in healthy and cutaneous leishmaniasis experimentally infected mice. Meglumine antimoniate, (Glucantime, Aventis, S.P, Brazil), was neutron irradiated inside the IEA-R1 nuclear reactor (IPEN/CNEN-SP), producing two radioisotopes {sup 122}Sb and {sup 124}Sb. Its biodistribution was verified in BALB/c mice experimentally infected with Leishmania (Leishmania) Amazonensis, which received a single intraperitoneal dose of the drug. At different times after injection, the tissues and blood were excised and activity measured in a NaI (Tl) scintillation counter. Compared with the healthy mice, experimentally infected mice had significantly lower maximum concentration of antimony

  7. Antissaliva Antibodies of Lutzomyia Longipalpis in area of Visceral Leishmaniasis.

    Science.gov (United States)

    Fraga, Thiago Leite; Fernandes, Magda Freitas; Pontes, Elenir Rose Jardim Cury; Levay, Ana Paula Silva; Almeida da Cunha, Elenice Brandão; França, Adriana de Oliveira; Dorval, Maria Elizabeth Cavalheiros

    2016-07-01

    The aim of the present study was to assess the presence of antissaliva antibodies of Lutzomyia longipalpis in human hosts living in area of visceral leishmaniasis, located in the Center-West region of Brazil. The presence of antissaliva antibodies of L. longipalpis exhibited a strong correlation with the protection and development of antibodies against Leishmania sp. Of the 492 children studied, elevated antissaliva antibodies of L. longipalpis were detected in 38.4% of the participants. There was a higher percentage of positivity (64.7%) among children who exhibited anti-Leishmania sp. antibodies and among those who were positive in the delayed hypersensitivity test (34.8%).

  8. Visceral leishmaniasis in eastern Africa--current status.

    Science.gov (United States)

    Reithinger, Richard; Brooker, Simon; Kolaczinski, Jan H

    2007-12-01

    Visceral leishmaniasis (VL) is among the most neglected of the tropical diseases, afflicting the poorest of the poor. In eastern Africa, VL causes at least 4000 deaths annually, a loss of approximately 385,000 disability-adjusted life years. Due to the chronicity of underlying causes, it is likely that the caseload will increase in the foreseeable future. While efforts should be pursued to develop novel case management and prevention tools, several effective interventions already exist but are rarely deployed. Funds are needed now to procure commodities and strengthen health systems, so that effective VL control can be delivered to populations at risk. PMID:17632193

  9. Nano-Synthetic Devices in Leishmaniasis: A Bioinformatics Approach

    Science.gov (United States)

    Mol, Milsee; Kosey, Dipali; Singh, Shailza

    2015-01-01

    Synthetic biology is an investigative and constructive means of understanding the complexities of biology. Substantial progress in the fields has resulted in the creation of synthetic gene circuits, which when uploaded into the appropriate nanoliposomal vehicle, can be used for a tunable response in a cell. These tunable elements can be applied to treat diseased condition for a transition to a healthy state. Though in its nascent stage of development synthetic biology is beginning to use its constructs to bring engineering approaches into biomedicine for treatment of infectious disease leishmaniasis. PMID:26150819

  10. American Religion

    Institute of Scientific and Technical Information of China (English)

    田甜

    2008-01-01

    It is said that American religion,as a great part of American culture,plays an important role in American culture. It is hoped that some ideas can be obtained from this research paper,which focuses on analyzing the great impact is produced to American culture by American religion. Finally, this essay gives two useful standpoints to English learners:Understunding American religion will help understand the American history, culture and American people,and help you to communic.ate with them better. Understanding American religion will help you understand English better.

  11. Sun, sangria and sandflies: Leishmaniasis in an immunosuppressed patient returning from Spain.

    Science.gov (United States)

    Moore, James; Brown, Kevin

    2013-01-01

    Despite the global financial downturn, millions of people continue to travel abroad each year. Many travel with co-morbidities such as immunosuppression, placing them at greater risk of bacterial, viral and parasitic infections.(1) Leishmaniasis is one of the principal neglected tropical diseases.(2) Although it threatens 350 million people each year(3) it is not an infection that most General Physicians would associate with travel to Southern Europe. A case of visceral leishmaniasis is described in a lady with mild immunosuppression caused by systemic lupus erythematosus, following a holiday in Southern Spain, a destination not normally associated with this leishmaniasis. PMID:23369438

  12. Lutzomyia longipalpis in Clorinda, Formosa province, an area of potential visceral leishmaniasis transmission in Argentina

    Directory of Open Access Journals (Sweden)

    Oscar D Salomón

    2005-08-01

    Full Text Available Phlebotomine captures were performed during 2004 in Clorinda, Argentina. Clorinda is located across the branches of the Paraguay river in front of Asunción city, Paraguay. Reports of canine and human visceral leishmaniasis in Asunción have been increasing since 1997, however neither leishmaniasis cases nor sand flies were ever recorded from Clorinda. Light traps were located in migration paths (bridges, port, and peridomestic environments of Clorinda and surrounding localities. Lutzomyia longipalpis was found in Clorinda and Puerto Pilcomayo, first report in a potential visceral leishmaniasis transmission area for Argentina. Active surveillance is required immediately in the localities involved and the surrounding area.

  13. Imported cutaneous leishmaniasis caused by Leishmania major in a Chinese laborer who worked in Saudi Arabia*

    Science.gov (United States)

    Zhang, Min; Liu, Fang; Liu, Haibo; Hu, Wenxing; Sang, Hong

    2016-01-01

    We report an imported case of cutaneous leishmaniasis in a 37-year-old man from Saudi Arabia caused by Leishmania major. He presented with non-healing nodulo-ulcerative lesions with a "volcanic crater" on the lower limbs. It was clearly cutaneous leishmaniasis - a rare disease in China - as reflected by the patient's clinical history, the lesions' morphology, histopathological examination, culture and PCR analysis of the lesions. The patient was completely cured after two cycles of sodium stibogluconate treatment. This case report demonstrates that dermatologists should be aware of sporadic cutaneous leishmaniasis cases in non-endemic areas. PMID:27438208

  14. VISCERAL LEISHMANIASIS IN PETROLINA, STATE OFPERNAMBUCO, BRAZIL, 2007-2013

    Directory of Open Access Journals (Sweden)

    Andreina de Carvalho ARAUJO

    2016-01-01

    Full Text Available Visceral leishmaniasis is a life-threatening disease of great public health relevance in Brazil. The municipality of Petrolina is an endemic area in the State of Pernambuco, Brazil. This study was designed to assess the recent expansion of VL in the municipality ofPetrolina, Pernambuco. Patients data were obtained from the Brazilian National Information System for Notifiable Diseases (SINAN. A total of 111 records from 2007 to 2013 were investigated, of which 69 were residents in Petrolina. The disease has predominantly affected 1-4 year old children (34.8%. Most of the patients were males (59.4%. Co-infection with human immunodeficiency virus occurred in 14.5% of the cases. The criterion most frequently used was the clinical and epidemiological confirmation (59.4%, with clinical cure in 78.3% of cases and one fatal outcome. Visceral leishmaniasis is endemic in Petrolina with transmission levels varying from moderate to high. The present study has shown the precariousness of the use of diagnostic tests in primary healthcare units, and this misuse has interfered with the diagnosis and treatment of cases.

  15. VISCERAL LEISHMANIASIS IN PETROLINA, STATE OFPERNAMBUCO, BRAZIL, 2007-2013.

    Science.gov (United States)

    Araujo, Andreina de Carvalho; Gonçalves, Nara Nagle Vieira Matos; Dantas-Torres, Filipe; Ferreira, Fernando; Horta, Mauricio Claudio

    2016-01-01

    Visceral leishmaniasis is a life-threatening disease of great public health relevance in Brazil. The municipality of Petrolina is an endemic area in the State of Pernambuco, Brazil. This study was designed to assess the recent expansion of VL in the municipality of Petrolina, Pernambuco. Patients data were obtained from the Brazilian National Information System for Notifiable Diseases (SINAN). A total of 111 records from 2007 to 2013 were investigated, of which 69 were residents in Petrolina. The disease has predominantly affected 1-4 year old children (34.8%). Most of the patients were males (59.4%). Co-infection with human immunodeficiency virus occurred in 14.5% of the cases. The criterion most frequently used was the clinical and epidemiological confirmation (59.4%), with clinical cure in 78.3% of cases and one fatal outcome. Visceral leishmaniasis is endemic in Petrolina with transmission levels varying from moderate to high. The present study has shown the precariousness of the use of diagnostic tests in primary healthcare units, and this misuse has interfered with the diagnosis and treatment of cases. PMID:27074323

  16. Jaundice in pediatric visceral leishmaniasis (kala-azar)pa-tients

    Institute of Scientific and Technical Information of China (English)

    AKMMamunur Rashid; MdAsrafuzzaman; Abdullah Al Mamun; Abdullah Al Mahboob

    2009-01-01

    Objective:Visceral leishmaniasis (Kala-azar)is endemic in many countries including Bangladesh.Clinical presentation of visceral leishmaniasis in children and adult may vary and at time may simulate many tropical and hepatobiliary diseases.Jaundice and ascites are not common in kala-azar patients.Methods:During the period of January 2005 to December 2006,all the records of the confirmed kala-azar patients presented with jaundice were included in this study.Kala-azar was confirmed by serology test ICT (Immuno Chromatography) and Bone Marrow study.Results:Total 12 kala-azar patients were encountered during this period.Among these twelve cases,presenting features were jaundice (7),splenomegaly (12),hepatomegaly (11)and asci-tes (4).Initial clinical diagnosis of chronic liver disease (CLD)was made in (5),Congenital hemolytic a-naemia in (1)and kala-azar in rest of the patients (6).Common leucopenia and relative lymphocytosis was not observed in any patients.Conclusion:Kala-azar may present with various clinical manifestation in chil-dren and adult.Jaundice can be considered to be a common manifestation particularly in pediatric kala-azar patients.Otherwise,it may mislead to another diagnosis if it is taken as a rare feature in kala-azar.

  17. Recurrent cutaneous leishmaniasis Leishmaniose recidiva cútis

    Directory of Open Access Journals (Sweden)

    Ciro Martins Gomes

    2013-06-01

    Full Text Available We present a case of an 18-year-old male patient who, after two years of inappropriate treatment for cutaneous leishmaniasis, began to show nodules arising at the edges of the former healing scar. He was immune competent and denied any trauma. The diagnosis of recurrent cutaneous leishmaniasis was made following positive culture of aspirate samples. The patient was treated with N-methylglucamine associated with pentoxifylline for 30 days. Similar cases require special attention mainly because of the challenges imposed by treatment.Paciente do sexo masculino, 18 anos. Dois anos após tratamento insuficiente para leishmaniose tegumentar americana, apresentou, na mesma localização, lesão formada por cicatriz atrófica central e nódulos verrucosos na periferia. Era imunocompetente, hígido e negava qualquer trauma local. O diagnóstico de leishmaniose recidiva cutis foi feito através de cultura do aspirado da lesão. Realizou tratamento com N-metilglucamina (20mgSbV/kg/dia associado à pentoxifilina (1200mg/dia durante 30 dias alcançando cura clínica. Os casos semelhantes requerem atenção diferenciada pela dificuldade ao tratamento.

  18. Comparison of Three Methods for Diagnosis of Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    P Habibi

    2010-12-01

    Full Text Available Background: Leishmaniasis is one of the infectious parasitic diseases of highest incidence in the world. Cutaneous Leishmaniasis (CL has long been reported in Shiraz, Southern Iran. There is a need to find a sensitive and specific method for treatment and control of the disease.Methods: We have compared the sensitivity of the conventional methods microscopy and cultiva­tion of lesion scrapes against PCR amplification of parasite kinetoplast DNA from these sam­ples. The samples (n=219 were obtained from the patients clinically suspected of CL. The smears were stained with Giemsa for microscopy and cultured in Novy-Nicolle-McNeal (NNN blood agar for promastigote growth. For PCR, the dry smears were scraped off the slides and DNA was extracted.Results: The positive rates from 219 specimens were 76.71%, 50.68%, and 93.61% for micros­copy, cultivation, and PCR, respectively. The highest correlation was found between PCR and micros­copy method (P= 0.014. In PCR assay, 95.61%, 3.9%, and 0.49% of the samples were identi­fied as Leishmania major, L. tropica, and dermatropic L. infantum, respectively.Conclusion: The PCR method appears to be the most sensitive for the diagnosis of CL and is valu­able for identifying the other species of Leishmania with confusing dermatropic signs.

  19. Shigella Bacteremia in a Patient with Visceral Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Mengistu Endris

    2013-01-01

    Full Text Available Bacteremia due to Shigella is rare. A 26-year-old HIV-negative male presented with a persistent high-grade fever of two months duration to the Leishmaniasis Research and Treatment Center of University of Gondar Hospital. He was anorexic and had lost significant weight (from 76 to 57 kg in 4 months, BMI = 17.2 kg/m2. He also complained of headache, chills, and rigor. In the last one year, he was experiencing a few episodes of acute bloody diarrhea, the last episode being two months ago. Microscopy from splenic aspiration showed Leishman-Donovan bodies with parasite load of +3. The blood culture showed Shigella species, but the stool was culture negative. The isolate was sensitive to most tested antibiotic discs, sulfamethoxazole, ceftriaxone, gentamicin, tetracycline, and norfloxacilin, except ampicillin. Therefore, requesting blood culture for identifying unexpected type of organisms causing infections in patients with underlying diseases like visceral leishmaniasis should be encouraged.

  20. Validity and reliability of enzyme immunoassays using Leishmania major or L. infantum antigens for the diagnosis of canine visceral leishmaniasis in Brazil.

    Directory of Open Access Journals (Sweden)

    Mauro Maciel de Arruda

    Full Text Available BACKGROUND: American visceral leishmaniasis is caused by the protozoan Leishmania infantum. Dogs are the main reservoirs in the domestic transmission cycle. The limited accuracy of diagnostic tests for canine leishmaniasis may contribute to the lack of impact of control measures recommended by the Brazilian Ministry of Health. The objective of this study was to estimate the accuracy of two enzyme-linked immunosorbent assays employing L. major or L. infantum antigens and their reliability between three laboratories of different levels of complexity. METHODS: A validation study of ELISA techniques using L. major or L. infantum antigens was conducted. Direct visualization of the parasite in hematoxylin/eosin-stained histopathological sections, immunohistochemistry, and isolation of the parasite in culture.were used as gold standard. An animal that was positive in at least one of the tests was defined as infected with L. infantum. Serum samples collected from 1,425 dogs were analyzed. Samples were separated in three aliquots and tested in three different laboratories. Sensitivity, specificity and the area under de ROC curve were calculated and the reliability was evaluated between the participant laboratories. RESULTS: The sensitivity was 91.8% and 89.8% for the L. major and L. infantum assays, respectively. The specificity was 83.75% and 82.7% for the L. major and L. infantum assays, respectively. The area under de ROC curve was 0.920 and 0.898 for L. major and L. infantum, respectively. The mean intraclass correlation coefficients between laboratories ranged from 0.890 to 0.948 when L. major was used as antigen, and from 0.818 to 0.879 when L. infantum was used. INTERPRETATION: ELISA tests using L. major or L. infantum antigens have similar accuracy and reliability. Our results do not support the substitution of the L. major antigen of the ELISA test currently used for the diagnosis of canine visceral leishmaniasis in Brazil.

  1. Noninferiority of Miltefosine Versus Meglumine Antimoniate for Cutaneous Leishmaniasis in Children

    OpenAIRE

    Rubiano, Luisa Consuelo; Miranda, María Consuelo; Muvdi Arenas, Sandra; Montero, Luz Mery; Rodríguez-Barraquer, Isabel; Garcerant, Daniel; Prager, Martín; Osorio, Lyda; Rojas, Maria Ximena; Pérez, Mauricio; Nicholls, Ruben Santiago; Gore Saravia, Nancy

    2012-01-01

    Background. Children have a lower response rate to antimonial drugs and higher elimination rate of antimony (Sb) than adults. Oral miltefosine has not been evaluated for pediatric cutaneous leishmaniasis.

  2. First Cases of Cutaneous Leishmaniasis Caused by Leishmania (Viannia) naiffi Infection in Surinam

    NARCIS (Netherlands)

    P.P.A.M. van Thiel; T. van Gool; P.A. Kager; A. Bart

    2010-01-01

    Cutaneous leishmaniasis in Surinam is generally caused by infection by Leishmania guyanensis. We report three cases of infection with Leishmania (Viannia) naiffi, a Leishmania species not described from Surinam before. Treatment with pentamidine proved to be effective

  3. Disseminated Cutaneous Leishmaniasis with Ocular Involvement in An Immunocompromised Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Bita Kiafar

    2013-12-01

    Full Text Available Purpose: To introduce a case of cutaneous and lid leishmaniasis in an immune suppressed woman Case report: We report an unusual clinical course of old world cutaneous leishmaniasis (OWCL in an immune suppressed 51 years old women recipient of kidney transplant. She developed disseminated cutaneous leishmaniasis (DCL with bilateral upper and lower eye lids lesions. Antimoniate compounds were not available and she did not tolerate amphotricin B. After replacing mycophenolate mofetil and cyclosporine by sirolimus, her Lesions though partially improved, were still persistent in the last visit after six months. Conclusion: Ocular leishmaniasis should be considered in the differential diagnosis of modula or ulcerative of the eyelids specially in the endormic cases.

  4. The rK39 immunochromatic dipstick testing: A study for K39 seroprevalence in dogs and human leishmaniasis patients for possible animal reservoir of cutaneous and visceral leishmaniasis in endemic focus of Satluj river valley of Himachal Pradesh (India)

    OpenAIRE

    Sharma Nand; Mahajan Vikram; Negi Ajit; Verma Ghanshyam

    2009-01-01

    Background: The newly recognized endemic focus of leishmaniasis in Satluj river valley of Himachal Pradesh (India) has both localized cutaneous leishmaniasis (LCL) and visceral leishmaniasis (VL) predominantly caused by Leishmania donovani. Rapid rK39 immunochromatographic dipstick test detects circulating antibodies to recombinant K39 antigen of L. donovani-infantum complex and is highly specific/sensitive in diagnosing symptomatic or asymptomatic infection in humans and dogs. Methods: Th...

  5. Genetic Control of Canine Leishmaniasis: Genome-Wide Association Study and Genomic Selection Analysis

    OpenAIRE

    Quilez, Javier; Martínez, Verónica; Woolliams, John A.; Sanchez, Armand; Pong-Wong, Ricardo; Kennedy, Lorna J.; Quinnell, Rupert J.; William E. R. Ollier; Roura, Xavier; Ferrer, Lluís; Altet, Laura; Francino, Olga

    2012-01-01

    Background: the current disease model for leishmaniasis suggests that only a proportion of infected individuals develop clinical disease, while others are asymptomatically infected due to immune control of infection. The factors that determine whether individuals progress to clinical disease following Leishmania infection are unclear, although previous studies suggest a role for host genetics. Our hypothesis was that canine leishmaniasis is a complex disease with multiple loci responsible for...

  6. Arginase activity in the blood of patients with visceral leishmaniasis and HIV infection.

    Directory of Open Access Journals (Sweden)

    Yegnasew Takele

    Full Text Available BACKGROUND: Visceral leishmaniasis is a parasitic disease associated with high mortality. The most important foci of visceral leishmaniasis in Ethiopia are in the Northwest and are predominantly associated with high rates of HIV co-infection. Co-infection of visceral leishmaniasis patients with HIV results in higher mortality, treatment failure and relapse. We have previously shown that arginase, an enzyme associated with immunosuppression, was increased in patients with visceral leishmaniasis and in HIV seropositive patients; further our results showed that high arginase activity is a marker of disease severity. Here, we tested the hypothesis that increased arginase activities associated with visceral leishmaniasis and HIV infections synergize in patients co-infected with both pathogens. METHODOLOGY/PRINCIPAL FINDINGS: We recruited a cohort of patients with visceral leishmaniasis and a cohort of patients with visceral leishmaniasis and HIV infection from Gondar, Northwest Ethiopia, and recorded and compared their clinical data. Further, we measured the levels of arginase activity in the blood of these patients and identified the phenotype of arginase-expressing cells. Our results show that CD4(+ T cell counts were significantly lower and the parasite load in the spleen was significantly higher in co-infected patients. Moreover, our results demonstrate that arginase activity was significantly higher in peripheral blood mononuclear cells and plasma of co-infected patients. Finally, we identified the cells-expressing arginase in the PBMCs as low-density granulocytes. CONCLUSION: Our results suggest that increased arginase might contribute to the poor disease outcome characteristic of patients with visceral leishmaniasis and HIV co-infection.

  7. Seroepidemiological Studies of Cutaneous Leishmaniasis in the Campeche State of México

    OpenAIRE

    Amalia Monroy-Ostria; Tayde Sosa-Cabrera; Beatriz Rivas -Sanchez; Rosaura Ruiz-Tuyu; Ana R Mendoza-Gonzalez; Luis Favila-Castillo

    1997-01-01

    Seroepidemiological studies of cutaneous leishmaniasis were carried out on 169 individuals in a rural area of the Campeche state of México. Fifty showed cutaneous lesions suggestive of leishmaniasis, 70% were parasite positive and 96% skin test positive. An overall 40% positivity to skin test with Montenegro's antigen was found. Most of the affected individuals were males from 11 to 30 years-old. Antibodies were determined by immunofluorescent antibody test (IFA) and by Western blot. Two anti...

  8. The Potential Economic Value of a Cutaneous Leishmaniasis Vaccine in Seven Endemic Countries in the Americas

    OpenAIRE

    Bacon, Kristina M.; Hotez, Peter J.; Kruchten, Stephanie D.; Kamhawi, Shaden; Bottazzi, Maria Elena; Valenzuela, Jesus G.; Bruce Y Lee

    2012-01-01

    Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Mar...

  9. Pink plaque on the arm of a man after a trip to Mexico: cutaneous leishmaniasis

    OpenAIRE

    Cohen, Jeffrey M.; Saavedra, Arturo P; Sax, Paul E.; Lipworth, Adam D

    2015-01-01

    Cutaneous leishmaniasis is a parasitic infection caused by protozoa of the Leishmania genus that presents as asymptomatic pink papules that may ulcerate. There are several species of Leishmania found in 98 endemic countries and whereas all are associated with cutaneous disease, only specific species can cause mucocutaneous or visceral disease. Although the diagnosis of cutaneous leishmaniasis can be confirmed with Giemsa staining of a biopsy or “touch prep” specimen, only speciation at specia...

  10. Consultation meeting on the development of therapeutic vaccines for post kala azar dermal leishmaniasis

    OpenAIRE

    Ghalib, Hashim; Modabber, Farrokh

    2007-01-01

    Background Post kala azar dermal leishmaniasis (PKDL) is a disease that appears after treatment of visceral leishmaniasis (VL). The highest incidence of PKDL in the world is in Sudan. Many patients heal spontaneously within 6 months but those who don't are difficult to treat, often requiring months of daily injections. These patients harbour parasite in their skin and are believed to be a source of infection and possibly epidemics. Present treatment modalities of PKDL are inadequate and impra...

  11. Successful Miltefosine Treatment of Post-Kala-Azar Dermal Leishmaniasis Occurring During Antiretroviral Therapy.

    OpenAIRE

    Belay, A Dejenie; Asafa, Y; Mesure, J; Davidson, R. N.

    2006-01-01

    The first two patients to be treated with miltefosine for post-kala-azar dermal leishmaniasis (PKDL) are reported. One was a 26-year-old Ethiopian man who had been treated with sodium stibogluconate, for relapsing visceral leishmaniasis (VL), four times between August 2002 and March 2004. In January 2004 this patient was found to be seropositive for HIV and began antiretroviral treatment with stavudine, lamivudine and nevirapine. Five months later he developed clinical PKDL, with extensive cu...

  12. Epidemiological Status of Cutaneous Leishmaniasis in Bafgh City,Yazd Province 2005.

    OpenAIRE

    A Dehghan-Shadkam; Hajjaran, H; AA Akhavan; Soleimani, H.; AR Dehghan-Dehnoee; Mohebali, M; Jafari, R; J Fatahi

    2007-01-01

    Interoduction: Cutaneous leishmaniasis is a major health problem in some parts of Iran,which exists as zoonotic and anthroponotic forms in different foci of the country.Following an epidemic of cutaneous leishmaniasis in Bafgh city,(Yazd province, centeral Iran),this study was carried out to determine the ecology of sandflies,reservoir hosts and human infection in 2005. Methods: This descriptive-crosss section study was done in the year 2005. Sandflies were collected biweekly from fixed sites...

  13. Genetic control of canine leishmaniasis: genome-wide association study and genomic selection analysis

    OpenAIRE

    Javier Quilez; Verónica Martínez; Woolliams, John A.; Armand Sanchez; Ricardo Pong-Wong; Kennedy, Lorna J; Rupert J Quinnell; William E. R. Ollier; Xavier Roura; Lluís Ferrer; Laura Altet; Olga Francino

    2012-01-01

    BACKGROUND: The current disease model for leishmaniasis suggests that only a proportion of infected individuals develop clinical disease, while others are asymptomatically infected due to immune control of infection. The factors that determine whether individuals progress to clinical disease following Leishmania infection are unclear, although previous studies suggest a role for host genetics. Our hypothesis was that canine leishmaniasis is a complex disease with multiple loci responsible for...

  14. Serotonin transporter protein overexpression and association to Th17 and T regulatory cells in lupoid leishmaniasis.

    Science.gov (United States)

    Mashayekhi Goyonlo, Vahid; Elnour, Husameldin; Nordlind, Klas

    2014-03-01

    The immunopathogenesis of chronic non-healing Old World cutaneous leishmaniasis is challenging. There is a bidirectional communication between the nervous and immune systems, serotonin being an important mediator in this respect. Our aim was to study the role of the serotonin transporter protein (SERT) and its relation to T cell-related immune responses in lupoid leishmaniasis. Paraffin-embedded skin biopsies of 12 cases of lupoid and 12 cases of usual types of cutaneous leishmaniasis were investigated using immunohistochemistry regarding expression of SERT, Th1, Th2, Th17 and T regulatory cell (Treg) markers. SERT as well as Tregs and interleukin (IL)-17 positive cells were more prevalent while IL-5 (Th2) and interferon (IFN)-γ (Th1) expressing cells were less numerous in the lupoid tissue compared to those from the usual type of leishmaniasis. The majority of the SERT(+) cells were also tryptase(+) (mast cells). There was a positive correlation between a higher number of SERT(+) and IL-17(+) cells in the lupoid type, while lower numbers of SERT(+) cells were significantly related to lower percentages of CD25(+) cells in the usual type of leishmaniasis. These results might indicate a role for SERT, Th17 and Tregs in the pathogenesis of lupoid leishmaniasis. PMID:23989888

  15. Preclinical Studies Evaluating Subacute Toxicity and Therapeutic Efficacy of LQB-118 in Experimental Visceral Leishmaniasis.

    Science.gov (United States)

    Cunha-Júnior, Edézio Ferreira; Martins, Thiago Martino; Canto-Cavalheiro, Marilene Marcuzzo; Marques, Paulo Roberto; Portari, Elyzabeth Avvad; Coelho, Marsen Garcia Pinto; Netto, Chaquip Daher; Costa, Paulo Roberto Ribeiro; Sabino, Katia Costa de Carvalho; Torres-Santos, Eduardo Caio

    2016-06-01

    Visceral leishmaniasis (VL) is the most severe form of leishmaniasis and is the second major cause of death by parasites, after malaria. The arsenal of drugs against leishmaniasis is small, and each has a disadvantage in terms of toxicity, efficacy, price, or treatment regimen. Our group has focused on studying new drug candidates as alternatives to current treatments. The pterocarpanquinone LQB-118 was designed and synthesized based on molecular hybridization, and it exhibited antiprotozoal and anti-leukemic cell line activities. Our previous work demonstrated that LQB-118 was an effective treatment for experimental cutaneous leishmaniasis. In this study, we observed that treatment with 10 mg/kg of body weight/day LQB-118 orally inhibited the development of hepatosplenomegaly with a 99% reduction in parasite load. An in vivo toxicological analysis showed no change in the clinical, biochemical, or hematological parameters. Histologically, all of the analyzed organs were normal, with the exception of the liver, where focal points of necrosis with leukocytic infiltration were observed at treatment doses 5 times higher than the therapeutic dose; however, these changes were not accompanied by an increase in transaminases. Our findings indicate that LQB-118 is effective at treating different clinical forms of leishmaniasis and presents no relevant signs of toxicity at therapeutic doses; thus, this framework is demonstrated suitable for developing promising drug candidates for the oral treatment of leishmaniasis. PMID:27067332

  16. Leishmania spp. Epidemiology of Canine Leishmaniasis in the Yucatan Peninsula

    Directory of Open Access Journals (Sweden)

    A. López-Céspedes

    2012-01-01

    Full Text Available Canine Leishmaniasis is widespread in various Mexican states, where different species of Leishmania have been isolated from dogs. In the present study, we describe the detection of L. braziliensis, L. infantum, and L. mexicana in serum of dogs from the states of Yucatan and Quintana Roo in the Yucatan Peninsula (Mexico. A total of 412 sera were analyzed by ELISA using the total extract of the parasite and the iron superoxide dismutase excreted by different trypanosomatids as antigens. We found the prevalence of L. braziliensis to be 7.52%, L. infantum to be 6.07%, and L. mexicana to be 20.63%, in the dog population studied. The results obtained with ELISA using iron superoxide dismutase as the antigen were confirmed by western blot analysis with its greater sensitivity, and the agreement between the two techniques was very high.

  17. Laryngeal leishmaniasis in a patient taking inhaled corticosteroids.

    Science.gov (United States)

    Roberts, Rachel Margaret; Mukherjee, Jayanta; Phillips, David

    2016-01-01

    We present a case of a man in his late 60s, who had spent 3-4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection. PMID:27329097

  18. Hemophagocytic Lymphohistiocytosis Associated with Visceral Leishmaniasis: Varied Presentation.

    Science.gov (United States)

    Ranjan, Piyush; Kumar, Vivek; Ganguly, Shuvadeep; Sukumar, M; Sharma, Sanchit; Singh, Neha; Vikram, Naval K; Pati, Hara Prasad; Sood, Rita

    2016-06-01

    Visceral leishmaniasis (VL) is endemic in many parts of India. Rarely, it may be complicated by hemophagocytic lymphohistiocytosis (HLH) that has varied presentation and course. We describe two cases of VL complicated by HLH that were markedly different in clinical presentation, course and management. First case presented with Fever of unknown origin whereas second case had fever with severe bleeding manifestations. VL was diagnosed by bone marrow aspiration and serum rk39 immunodiagnostic test respectively in these cases. HLH was diagnosed by HLH 2004 diagnostic criteria. VL was treated by intravenous amphotericin B in both cases. HLH was managed by treating primary disease in the first case whereas steroid was given for management in the second case. High index of suspicion is crucial for early diagnosis of HLH to reduce morbidity and mortality. PMID:27408434

  19. Incidence of localized cutaneous leishmaniasis (chiclero's ulcer) in Mexico.

    Science.gov (United States)

    Andrade-Narváez, F J; Simmonds-Díaz, E; Rico-Aguilar, S; Andrade-Narvéez, M; Palomo-Cetina, A; Canto-Lara, S B; García-Miss, M R; Madera-Sevilla, M; Albertos-Alpuche, N

    1990-01-01

    Cutaneous leishmaniasis in Mexico was first described in 1912. Since then, its existence has been repeatedly confirmed in the forest regions of the peninsula of Yucatan. In order to obtain reliable knowledge about the magnitude of this problem, we questioned and skin-tested a sample of 449 persons randomly selected from men aged 15-45 years. We found a positivity rate of 24 to 90% (mean 43%) in the seven rural health posts studied. Furthermore, 72 patients were examined between January and December 1987 by parasitological investigation (smear, isolation, culture and/or biopsy) and the Montenegro skin test; 56 had acquired the disease in 1987. Based on these data, we found an annual incidence rate of 508 per 100,000 inhabitants. Further long-term studies are indicated to determine the incidence and prevalence rates for this disease in other parts of the country. PMID:2389310

  20. [Leishmaniasis in Ecuador. 3. Lutzomyia trapidoi, vector of Leishmania panamensis].

    Science.gov (United States)

    Le Ponti, F; Leon, R; Guerrini, F; Gantier, J C; Mouchet, J; Echeverria, R; Guderian, R H

    1994-03-01

    Lutzomyia trapidoi, the more abundant anthropophilic species, is a presumed leishmaniasis vector in the Pacific foothills of Ecuador. Three biotopes have been sampled (dwelling, and nearby coffee crop and primary forest) in the focus of Paraiso Escondido, by human bait catches, from August 1991 to October 1992. A large number of sandflies, 6,965 specimens, have been dissected to estimate peri and hypopyloric infections. All the peripyloric infections, characterized by isoenzyme electrophoresis, were Leishmania panamensis. The percentage of these infections was low, around 3%, but they were massive. They occurred only in dry season. Hypopyloric infections were observed in Lu. trapidoi all the year round in the three biotopes. Their percentage was high, reaching 40%. Despite of many trials to cultivate the parasite on NNN medium, no stain could be isolated. It is suggested that the parasite could be L. equatorensis. PMID:8024346

  1. Vaccines for leishmaniasis: from proteome to vaccine candidates.

    Science.gov (United States)

    Schroeder, Juliane; Aebischer, Toni

    2011-01-01

    Leishmania spp. cause a wide spectrum of tropical diseases which are threatening an estimated 350 million people around the globe. While in most cases non-fatal, the disease is associated with high morbidity, social stigmata and poverty. However, the most severe form visceral leishmaniasis can be fatal if left untreated. Chemotherapeutics are available but show high toxicity, costs and are prone to resistance development due to prolonged treatment periods. Healing is associated with a life-long resistance to re-infection and this argues for the feasibility of vaccination. However, despite much effort, no such vaccine has become available yet. Here, the status of vaccine development in this field is briefly summarized before the focus is set on the promise of reverse vaccinology for anti-Leishmania vaccine development in the post-genomic era. We report on our own experience with this approach using an instructive example of successful candidate vaccine antigen identification.

  2. Experimental models in vaccine research: malaria and leishmaniasis.

    Science.gov (United States)

    Teixeira, C; Gomes, R

    2013-02-01

    Animal models have a long history of being useful tools, not only to test and select vaccines, but also to help understand the elaborate details of the immune response that follows infection. Different models have been extensively used to investigate putative immunological correlates of protection against parasitic diseases that are important to reach a successful vaccine. The greatest challenge has been the improvement and adaptation of these models to reflect the reality of human disease and the screening of vaccine candidates capable of overcoming the challenge of natural transmission. This review will discuss the advantages and challenges of using experimental animal models for vaccine development and how the knowledge achieved can be extrapolated to human disease by looking into two important parasitic diseases: malaria and leishmaniasis.

  3. Agrochemicals against malaria, sleeping sickness, leishmaniasis and Chagas disease.

    Directory of Open Access Journals (Sweden)

    Matthias Witschel

    Full Text Available In tropical regions, protozoan parasites can cause severe diseases with malaria, leishmaniasis, sleeping sickness, and Chagas disease standing in the forefront. Many of the drugs currently being used to treat these diseases have been developed more than 50 years ago and can cause severe adverse effects. Above all, resistance to existing drugs is widespread and has become a serious problem threatening the success of control measures. In order to identify new antiprotozoal agents, more than 600 commercial agrochemicals have been tested on the pathogens causing the above mentioned diseases. For all of the pathogens, compounds were identified with similar or even higher activities than the currently used drugs in applied in vitro assays. Furthermore, in vivo activity was observed for the fungicide/oomyceticide azoxystrobin, and the insecticide hydramethylnon in the Plasmodium berghei mouse model, and for the oomyceticide zoxamide in the Trypanosoma brucei rhodesiense STIB900 mouse model, respectively.

  4. Uniting mathematics and biology for control of visceral leishmaniasis.

    Science.gov (United States)

    Rock, Kat S; le Rutte, Epke A; de Vlas, Sake J; Adams, Emily R; Medley, Graham F; Hollingsworth, T Deirdre

    2015-06-01

    The neglected tropical disease (NTD) visceral leishmaniasis (VL) has been targeted by the WHO for elimination as a public health problem on the Indian subcontinent by 2017 or earlier. To date there is a surprising scarcity of mathematical models capable of capturing VL disease dynamics, which are widely considered central to planning and assessing the efficacy of interventions. The few models that have been developed are examined, highlighting the necessity for better data to parameterise and fit these and future models. In particular, the characterisation and infectiousness of the different disease stages will be crucial to elimination. Modelling can then assist in establishing whether, when, and how the WHO VL elimination targets can be met. PMID:25913079

  5. Visceral leishmaniasis: new foci of infection in Libya.

    Science.gov (United States)

    Mehabresh, M I

    1994-10-01

    Although cases of visceral leishmaniasis in Libya have been reported for over 80 years, all these reports were from the northern coastal areas near Tripoli and the Green Mountain area. Since 1985, there have been new cases of the disease from the southern part of Libya in the Saharan and sub-Saharan areas, an area 250 km to the south-west of Sabha. This southern area has recently undergone much agricultural organization with increasing water supply and other environmental changes, which may be partially responsible for the establishment of these new foci. Twenty patients with hepatosplenomegaly and fever were referred from that area to the El-Fateh Children's Hospital in Benghazi for investigation. All had the clinical features and laboratory data indicative of the Mediterranean type of the disease. All were treated with sodium stibogluconate (10 mg kg-1 day-1), and responded well to this regime.

  6. Crosstalk between purinergic receptors and lipid mediators in leishmaniasis.

    Science.gov (United States)

    Chaves, Mariana M; Canetti, Cláudio; Coutinho-Silva, Robson

    2016-01-01

    Leishmaniasis is a neglected tropical disease affecting millions of people around the world caused by organisms of the genus Leishmania. Parasite escape mechanisms of the immune system confer the possibility of resistance and dissemination of the disease. A group of molecules that has become a target for Leishmania survival strategies are lipid mediators. Among them, leukotriene B4 (LTB4) has been described as a pro-inflammatory molecule capable of activating cells of the immune system to combat Leishmania. In an opposite way, prostaglandin E2 (PGE2) is a lipid mediator described as a deactivator of macrophages and neutrophils. The balance of these two molecules can be generated by extracellular nucleotides, such as adenosine 5'-triphosphate (ATP) and adenosine (Ado), which activate the purinergic receptors system. Herein, we discuss the role of extracellular nucleotides and the resulting balance of LTB4 and PGE2 in Leishmania fate, survival or death. PMID:27595742

  7. Ecological aspects of phlebotomines (Diptera: Psychodidae) in endemic area of visceral leishmaniasis, Campo Grande, State of Mato Grosso do Sul, Brazil.

    Science.gov (United States)

    Oliveira, Alessandra Gutierrez; Galati, Eunice Aparecida Bianchi; Fernandes, Carlos Eurico; Dorval, Maria Elizabeth Cavalheiros; Brazil, Reginaldo Peçanha

    2012-01-01

    Aspects of phlebotomine behavior were investigated in the city of Campo Grande, Mato Grosso do Sul state. The insects were captured weekly during December 2003 to November 2005, with Centers for Disease Control light traps at seven different sites including forests and residential areas. In total, 11,024 specimens (7,805 males and 3,219 females) were collected, from which 9,963 (90.38%) were identified as Lutzomyia longipalpis, the proven vector of American visceral leishmaniasis agent. The remaining 9.62% comprised 21 species. L. longipalpis was the most frequent species in all sampled sites, and the first in the ranking of standardized species abundance index. In residential areas this species clearly predominated in the peridomicile (90.96%), in contrast to the intradomicile (9.04%); in animal shelters, it was more numerous in hen houses and prevailed at ground level, inside, and at forest edge around the residences; this aspect is worrying because this insect may remain sheltered in forested environments during the use of insecticides in homes. In the forest environment, other probable or proven vector of cutaneous leishmaniasis agents were also captured such as Lutzomyia whitmani (=Nyssomyia whitmani, sensu Galati), Lutzomyia antunesi (=Nyssomyia antunesi, sensu Galati), and Lutzomyia flaviscutellata (=Bichromomyia flaviscutellata, sensu Galati).

  8. An iron-superoxide dismutase antigen-based serological screening of dogs indicates their potential role in the transmission of cutaneous leishmaniasis and trypanosomiasis in Yucatan, Mexico.

    Science.gov (United States)

    Longoni, Silvia S; Marín, Clotilde; Sauri-Arceo, Carlos H; López-Cespedes, Angeles; Rodríguez-Vivas, Roger I; Villegas, Noelia; Escobedo-Ortegón, Javier; Barrera-Pérez, Mario A; Bolio-Gonzalez, Manuel E; Sánchez-Moreno, Manuel

    2011-07-01

    An increasing number of studies have reported high infection rates for American cutaneous leishmaniasis in dogs, which have thus been proposed as the reservoir host. Canine leishmaniasis is widespread in different states in Mexico, where a number of Leishmania species have been isolated from dogs. In the present study, the detection of different Leishmania species is described in stray dogs from two localities, namely Tulum and Celestún on the Yucatan Peninsula (Mexico). The use of iron-superoxide dismutase excreted by the parasites as the antigen fraction and enzyme-linked immunosorbent assay and western blot tests allowed us to confirm the presence of at least three species of Leishmania (Le. mexicana, Le. braziliensis, and Le. panamensis), some of which are reported for the first time in this species. In addition to a high prevalence of Le. mexicana and Le. braziliensis, and to a lesser degree, Le. panamensis, there is a significant prevalence of Trypanosoma cruzi, suggesting that the dog may be a source of transmission of trypanosomiasis. However, a more thorough epidemiological study on the dog population, both wild as well as urban, of the Yucatan Peninsula will be required to design a control strategy for these diseases, paying particular attention to the population affected and even broadening the study to other Mexican states as well as neighboring countries. These results again confirm that iron-superoxide dismutase excreted by the different trypanosomatid species constitutes a good source of antigen for serodiagnosis in epidemiological studies. PMID:21323424

  9. ITS1 PCR-RFLP Diagnosis and Characterization of Leishmania in Clinical Samples and Strains from Cases of Human Cutaneous Leishmaniasis in States of the Mexican Southeast

    Directory of Open Access Journals (Sweden)

    Amalia Monroy-Ostria

    2014-01-01

    Full Text Available American cutaneous leishmaniasis includes a spectrum of clinical forms localized cutaneous, diffuse cutaneous, and mucocutaneous leishmaniasis which can be caused by different strains of Leishmania belonging to the L. mexicana or L. braziliensis complexes which may coexist in the same endemic area. We evaluated the PCR-RFLP assay of the ITS1 genes for direct identification of Leishmania species in 163 clinical samples and 21 Mexican isolates of Leishmania. In relation to the Mexican isolates of Leishmania 52% displayed a pattern similar to the L. (L. mexicana, 5% showed a mixed pattern compatible with L. (L. mexicana and L. (V. braziliensis, eight with L. (L. amazonensis and L. (L. mexicana, and one to L. (V. braziliensis. Most of the clinical samples, 109/116 (94%, gave a pattern similar to that of the L. mexicana, two clinical samples gave similar patterns to that of Leishmania braziliensis, and 5 samples gave patterns that suggest a coinfection of L. (L. mexicana and L. (V. braziliensis or L. (L. mexicana and L. (L. amazonensis. The ITS1 PCR-RFLP assay is a multipurpose tool for diagnosis of Leishmania from clinical samples and enables determination of the infecting species of New World Leishmania in the field in relatively short time and low cost.

  10. The Leishmaniasis East Africa Platform (LEAP): strengthening clinical trial capacity in resource-limited countries to deliver new treatments for visceral leishmaniasis.

    Science.gov (United States)

    Wasunna, Monique; Musa, Ahmed; Hailu, Asrat; Khalil, Eltahir A G; Olobo, Joseph; Juma, Rashid; Wells, Susan; Alvar, Jorge; Balasegaram, Manica

    2016-06-01

    Visceral leishmaniasis is a neglected tropical disease endemic in East Africa where improved patient-adapted treatments are needed. The Leishmaniasis East Africa Platform (LEAP) was created in 2003 to strengthen clinical research capacity, serve as a base for training, and evaluate and facilitate implementation of new treatments. Major infrastructure upgrades and personnel training have been carried out. A short course of Sodium Stibogluconate and Paramomycin (SSG&PM) was evaluated and is now first-line treatment in the region; alternative treatments have also been assessed. LEAP can serve as a successful model of collaboration between different partners and countries when conducting clinical research in endemic countries to international standards. PMID:27268714

  11. Vaccines for leishmaniasis in the fore coming 25 years.

    Science.gov (United States)

    Palatnik-de-Sousa, Clarisa B

    2008-03-25

    Human vaccination against leishmaniasis using live Leishmania was used in Middle East and Russia (1941-1980). First-generation vaccines, composed by killed parasites induce low efficacies (54%) and were tested in humans and dogs Phase III trials in Asia and South America since 1940. Second-generation vaccines using live genetically modified parasites, or bacteria or viruses containing Leishmania genes, recombinant or native fractions are known since the 1990s. Due to the loss of PAMPs, the use of adjuvants increased vaccine efficacies of the purified antigens to 82%, in Phase III dog trials. Recombinant second-generation vaccines and third-generation DNA vaccines showed average values of parasite load reduction of 68% and 59% in laboratory animal models, respectively, but their success in field trials had not yet been reported. This review is focused on vaccine candidates that show any efficacy against leishmaniasis and that are already in different phase trials. A lot of interest though was generated in recent years, by the studies going on in experimental models. The promising candidates may find a place in the forth coming years. Among them most probably are the multiple-gene DNA vaccines that are stable and do not require cold-chain transportation. In the mean time, second-generation vaccines with native antigens and effective adjuvants are likely to be licensed and used in Public Health control programs in the fore coming 25 years. To date, only three vaccines have been licensed for use: one live vaccine for humans in Uzbekistan, one killed vaccine for human immunotherapy in Brazil and a second-generation vaccine for dog prophylaxis in Brazil.

  12. Histological grading patterns in patients of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    To determine the histological grading patterns in a cohort of hospitalized patients of cutaneous leishmaniasis. One hundred patients of Cutaneous Leishmaniasis (CL), admitted in dermatology wards at PNS Shifa Hospital, Karachi, were examined. Only admitted patients of all ages and both sexes were included in the study. Patients of CL, who had received or were receiving systemic treatment were excluded. The lesions having marked secondary bacterial infection were also excluded. Initial diagnosis was clinical. History of being to an endemic area supported the diagnosis. The lesions were divided in two groups. Early, with duration less than 03 months and late, with duration between 3 and 12 months. The clinical lesions were noted as nodules, plaques, ulcers, crusted ulcers, lupoid lesions and plaques with scarring. Three types of skin smears (slit skin smear, saline aspirate smear and dab smear) were taken and examined with Giemsa stain. Cultures were performed on Nicolle-Novy-MacNeal (NNN) culture medium from Defense Scientific and Technology Organization (DESTO) Lab., Pakistan. Incisional skin biopsies were done. The biopsy specimens were examined by hemotoxylin and eosin stain (H and E stain). The number of Leishmania Tropica (LT) bodies was graded according to modified Ridley's parasitic index 1983. Clinical features were correlated with the histological patterns. Five histological patterns were identified in current study: 1) diffuse dermal infiltration without necrosis, 2) patchy dermal infiltration, 3) diffuse dermal infiltration with necrosis, 4) early reactive granuloma formation and 5) established epithelioid granuloma formation. LT bodies were identified in 75% of cases. Epidermal features were non-specific. The early lesions presented with diffuse infiltrate and late lesions showed granuloma formation. Five distinct types of histological patterns of CL have been recognized in this study. The early lesions presented with diffuse infiltrate and late lesions

  13. Fatores relacionados à ocorrência de leishmaniose tegumentar no Vale do Ribeira Factors relating to occurrences of cutaneous leishmaniasis in the Ribeira Valley

    Directory of Open Access Journals (Sweden)

    Alessandra Ferreira da Silva

    2010-02-01

    Full Text Available INTRODUÇÃO: este estudo teve como objetivo identificar fatores ambientais e sociais determinantes na incidência da leishmaniose tegumentar americana no Vale do Ribeira no período de 1998 a 2006. MÉTODOS: foram utilizados dados secundários de domínio público dos 23 municípios que integram a região. O intervalo de tempo foi dividido em três períodos, pelas características gráficas dos coeficientes de incidência, os quais foram submetidos à análise por regressão linear múltipla. RESULTADOS: para o período de 1998 a 2000, as variáveis correlacionadas com a LTA foram índice de desenvolvimento humano médio (p = 0,007, renda per capita (p =0,390 e grau de urbanização (p = 0,079. No período de 2001 a 2003 e 2004 a 2006 as variáveis correlacionadas com LTA foram: a existência de flebotomíneos (p = 0,000 e p = 0,001 e a população urbana média (p = 0,007 e p = 0,001. CONCLUSÕES: esses dados demonstram a tendência de pauperização e urbanização da doença.INTRODUCTION: This study aimed to identify the environmental and social factors that determined occurrences of American cutaneous leishmaniasis in the Ribeira valley region of the State of São Paulo between 1998 and 2006. METHODS: Secondary public-domain data from the 23 municipalities forming this region were used. The study period was divided into three ranges based on the graphical characteristics of the incidence coefficients. These data were subjected to analysis using multiple linear regression. RESULTS: Over the period 1998 to 2000, the variables correlated with American cutaneous leishmaniasis were mean human development index (p = 0.007, per capita income (p = 0.390 and degree of urbanization (p = 0.079. Over the periods 2001 to 2003 and 2004 to 2006, the variables correlated with American cutaneous leishmaniasis were the presence of sandflies (p = 0.000; p = 0.001 and mean urban population (p = 0.007; p = 0.001. CONCLUSIONS: These data show the trend towards

  14. Attraction of the cutaneous leishmaniasis vector Nyssomyia neivai (Diptera: Psychodidae to host odour components in a wind tunnel

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    Pinto Mara C

    2012-09-01

    Full Text Available Abstract Background Laboratory studies of host-seeking olfactory behaviour in sandflies have largely been restricted to the American visceral leishmaniasis vector Lutzomyia longipalpis. In comparison, almost nothing is known about the chemical ecology of related species, which transmit American cutaneous leishmaniasis (ACL, due in part to difficulties in raising these insects in the laboratory. Understanding how ACL vectors locate their hosts will be essential to developing new vector control strategies to combat this debilitating disease. Methods This study examined host-odour seeking behaviour of the ACL vector Nyssomyia neivai (Pinto (=Lutzomyia neivai using a wind tunnel olfactometer. The primary aim was to determine whether field-collected female N. neivai would respond to host odours in the laboratory, thereby eliminating the need to maintain colonies of these insects for behavioural experiments. Responses to two key host odour components, 1-octen-3-ol and lactic acid, and a commercially-available mosquito lure (BG-Lure™ were assessed and compared relative to an air control. We also tested whether trials could be conducted outside of the normal evening activity period of N. neivai without impacting on fly behaviour, and whether the same flies could be used to assess baseline responses to air without affecting responses to octenol, thereby reducing the number of flies required for experiments. Results Octenol was found to both activate host-seeking behaviour and attract female N. neivai in the wind tunnel, while lactic acid elicited weaker responses of activation and attractiveness under identical conditions. The BG-Lure did not activate or attract N. neivai under test conditions. Further experiments showed that sandfly behaviour in the wind tunnel was not affected by time of day, such that experiments need not be restricted to nocturnal hours. Moreover, using the same flies to measure both baseline responses to air and attraction to test

  15. Lutzomyia longipalpis naturally infected by Leishmania (L.) chagasi in Várzea Grande, Mato Grosso State, Brazil, an area of intense transmission of visceral leishmaniasis.

    Science.gov (United States)

    Missawa, Nanci A; Michalsky, Erika Monteiro; Fortes-Dias, Consuelo Latorre; Santos Dias, Edelberto

    2010-12-01

    The American visceral leishmaniasis (AVL) is caused by parasites belonging to the genus Leishmania (Trypanosomatidae) and is transmitted to humans through the bite of certain species of infected phlebotomine sand flies. In this study, we investigated the natural infection ratio of Lutzomyia longipalpis, the main vector species of AVL in Brazil, in Várzea Grande, Mato Grosso State. Between July 2004 and June 2006, phlebotomine sand flies were captured in peridomestic areas using CDC light-traps. Four hundred and twenty (420) specimens of Lu. longipalpis were captured. 42 pools, containing 10 specimens of Lu. longipalpis each, were used for genomic DNA extraction and PCR (polymerase chain reaction) amplification. Leishmania spp. DNA was detected in three out of the 42 pools tested, resulting in a minimal infection ratio of 0.71%. Restriction fragment length polymorphism (RFLP) analysis indicated that Leishmania (L.) chagasi was the infective agent in the positive pools.

  16. Species composition and relative abundance of sand flies of the genus Lutzomyia (Diptera: Psychodidae) at an endemic focus of visceral leishmaniasis in Colombia.

    Science.gov (United States)

    Ferro, C; Morrison, A C; Torres, M; Pardo, R; Wilson, M L; Tesh, R B

    1995-07-01

    Ecological studies on the sand fly Lutzomyia longipalpis (Lutz & Neiva) were conducted during 1990-1993 at a small rural community in Colombia where American visceral leishmaniasis is endemic. Weekly sand fly collections were made from pigpens, houses, and natural resting sites, using hand-held aspirators, sticky (oiled) paper traps, and opossum-baited Disney traps. In total, 263,094 sand flies were collected; L. longipalpis predominated (86.1%), followed by L. trinidadensis (11.0%), L. cayennensis (2.7%), and 8 other Lutzomyia species. The species composition and sex ratio of these sand flies varied among sites and by collection method. L. longipalpis were captured most efficiently by direct aspiration from animal bait. Conversely, sticky paper traps, especially inside houses and at rock resting sites, collected a greater diversity of species, but a lower relative abundance of L. longipalpis.

  17. SAND FLY SPECIES COMPOSITION (DIPTERA: PSYCHODIDAE: PHLEBOTOMINAE) IN THE MUNICIPALITY OF CANTAGALO , AN AREA WITH SPORADIC CASES OF HUMAN CUTANEOUS LEISHMANIASIS IN RIO DE JANEIRO STATE, BRAZIL.

    Science.gov (United States)

    Peres-Dias, Quezia Nunes; Oliveira, Claudete Diniz; Souza, Marcos Barbosa de; Meira, Antônio de Medeiros; Villanova, Ciro Benigno

    2016-07-11

    The municipality of Cantagalo is an area with sustained transmission of American Cutaneous Leishmaniasis (ACL). Monthly sand fly collections were performed for three years (June 2012 - May 2015) using a CDC light trap. A total of 3,310 specimens belonging to 12 species were trapped: Nyssomyia intermedia, Nyssomyia whitmani, Migonemyia migonei, Evandromyia lenti, Evandromyia cortelezzii, Micropygomyia quinquefer, Brumptomyia brumpti, Psathyromyia aragaoi, Micropygomyia schreiberi, Pintomyia fischeri, Sciopemyia sordellii, and Evandromyia edwardsi. The last seven species have not been previously recorded in this area. The highest abundance of species occurred between October and March. October was the month with the highest number of captured sand flies, one month before the peak in the summer rainfall. In October the highest number of Ny. intermedia, Ny. whitmani and Mg. migonei, were also collected, the three epidemiologically most important species. The high abundance of species with epidemiological importance for ACL transmission might explain the sporadic occurrence of the disease in the area. PMID:27410910

  18. SAND FLY SPECIES COMPOSITION (DIPTERA: PSYCHODIDAE: PHLEBOTOMINAE IN THE MUNICIPALITY OF CANTAGALO , AN AREA WITH SPORADIC CASES OF HUMAN CUTANEOUS LEISHMANIASIS IN RIO DE JANEIRO STATE, BRAZIL

    Directory of Open Access Journals (Sweden)

    Quezia Nunes PERES-DIAS

    2016-01-01

    Full Text Available SUMMARY The municipality of Cantagalo is an area with sustained transmission of American Cutaneous Leishmaniasis (ACL. Monthly sand fly collections were performed for three years (June 2012 - May 2015 using a CDC light trap. A total of 3,310 specimens belonging to 12 species were trapped: Nyssomyia intermedia, Nyssomyia whitmani, Migonemyia migonei, Evandromyia lenti, Evandromyia cortelezzii, Micropygomyia quinquefer, Brumptomyia brumpti, Psathyromyia aragaoi, Micropygomyia schreiberi, Pintomyia fischeri, Sciopemyia sordellii, and Evandromyia edwardsi. The last seven species have not been previously recorded in this area. The highest abundance of species occurred between October and March. October was the month with the highest number of captured sand flies, one month before the peak in the summer rainfall. In October the highest number of Ny. intermedia, Ny. whitmani and Mg. migonei, were also collected, the three epidemiologically most important species. The high abundance of species with epidemiological importance for ACL transmission might explain the sporadic occurrence of the disease in the area.

  19. A two years study on vectors of cutaneous leishmaniasis: Evidence for sylvatic transmission cycle in the State of Campeche, Mexico

    OpenAIRE

    Rebollar-Téllez, Eduardo A.; Alejandro Ramírez-Fraire; Fernando J. Andrade-Narvaez

    1996-01-01

    Vectors of cutaneous leishmaniasis in the State of Campeche were studied in relation to the transmission cycle of Leishmania (Le.) mexicana. To determine how transmission of leishmaniasis occurs, we collected phlebotomine sand flies for two years. In the first year (October 1990 to November 1991) the collections were made with CDC light traps, Shannon traps and direct captures at natural shelters around the village (

  20. Successful Treatment of Cutaneous Leishmaniasis Caused by Leishmania aethiopica with Liposomal Amphothericin B in an Immunocompromised Traveler Returning from Eritrea

    OpenAIRE

    Zanger, Philipp; Kötter, Ina; Raible, Armin; Gelanew, Tesfaye; Schönian, Gabriele; Peter G Kremsner

    2011-01-01

    Cutaneous leishmaniasis caused by Leishmania aethiopica is rarely encountered outside disease-endemic areas and there have been no clinical trials evaluating its pharmacotherapy. We describe the treatment of cutaneous leishmaniasis caused by L. aethiopica using liposomal amphothericin B in an immunocompromised traveler returning from Eritrea.

  1. Leishmaniasis transmission: distribution and coarse-resolution ecology of two vectors and two parasites in Egypt

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    Abdallah M. Samy

    2014-01-01

    Full Text Available Introduction: In past decades, leishmaniasis burden has been low across Egypt; however, changing environment and land use has placed several parts of the country at risk. As a consequence, leishmaniasis has become a particularly difficult health problem, both for local inhabitants and for multinational military personnel. Methods: To evaluate coarse-resolution aspects of the ecology of leishmaniasis transmission, collection records for sandflies and Leishmania species were obtained from diverse sources. To characterize environmental variation across the country, we used multitemporal Land Surface Temperature (LST and Normalized Difference Vegetation Index (NDVI data from the Moderate Resolution Imaging Spectroradiometer (MODIS for 2005-2011. Ecological niche models were generated using MaxEnt, and results were analyzed using background similarity tests to assess whether associations among vectors and parasites (i.e., niche similarity can be detected across broad geographic regions. Results: We found niche similarity only between one vector species and its corresponding parasite species (i.e., Phlebotomus papatasi with Leishmania major, suggesting that geographic ranges of zoonotic cutaneous leishmaniasis and its potential vector may overlap, but under distinct environmental associations. Other associations (e.g., P. sergenti with L. major were not supported. Mapping suitable areas for each species suggested that northeastern Egypt is particularly at risk because both parasites have potential to circulate. Conclusions: Ecological niche modeling approaches can be used as a first-pass assessment of vector-parasite interactions, offering useful insights into constraints on the geography of transmission patterns of leishmaniasis.

  2. Canine Visceral Leishmaniasis in Boyer Ahmad District, Kohgiluyeh & Boyer Ahmad Province, Southwest of Iran

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    V Barati

    2012-12-01

    Full Text Available Background: Mediterranean type of visceral leishmaniasis (VL is present in different parts of Iran. Several studies have identified dogs as the main reservoirs of the VL caused by Leishmania infantum in Iran and other Mediterranean regions. This study aimed to determine the seroprevalence of canine visceral leishmaniasis as animal reservoir host for human visceral leishmaniasis in Boyer Ahmad dis­trict in southwest of Iran.Methods: A seroepidemiological study was carried out to determine the seroprevalence of canine visceral leishmaniasis (CVL among ownership dogs by using direct agglutination test (DAT in 23 of 182 villages of Boyer Ahmad district, during August 2009 to August 2010. One hundred and seventy serum samples from ownership dogs were selected by multi-stage cluster sampling in villages of Boyer Ahmad district. All samples were tested by DAT and anti-Leishmania antibodies titers at ≥ 1:320 was considered as positive.Results: Of the 170 serum samples, 10% were positive by DAT at titers of 1:320 and higher. No statistical significant difference was found between male (10.7% and female (8.3% seroprevalence. The highest seroprevalence rate (15.1% was observed among the ownership dogs of four to seven years age. Altogether, seventeen (25.4% of the seropositive dogs had clinical signs and symptoms.Conclusion: It seems that Boyer Ahmad district is an endemic area for canine visceral leishmaniasis in Iran.

  3. Epidemiological aspects of vector, parasite, and domestic reservoir in areas of recent transmission and no reported human cases of visceral leishmaniasis in Brazil.

    Science.gov (United States)

    Lara-Silva, Fabiana de Oliveira; Michalsky, Érika Monteiro; Fortes-Dias, Consuelo Latorre; Fiuza, Vanessa de Oliveira Pires; Pessanha, José Eduardo Marques; Regina-Silva, Shara; de Avelar, Daniel Moreira; Silva, Maiara Alves; Lima, Ana Cristina Vianna Mariano da Rocha; da Costa, Ailton Junior Antunes; Machado-Coelho, George Luiz Lins; Dias, Edelberto Santos

    2015-08-01

    About 97% of the human cases of the American visceral leishmaniasis (VL) occur in Brazil. In the last few years, the disease expanded to medium- and large-sized cities, in which surveillance and control actions have been intensified, in an effort to control VL spreading. Our two-year study was conducted in Belo Horizonte, the sixth most populous city in Brazil, which is endemic for VL. We focused in two particular districts of recent transmission of the disease, with no reported human cases and submitted to minor surveillance and control actions. Our aim was to draw an epidemiological profile of the local situation concerning Lutzomyia vector, Leishmania parasites, and the main domestic reservoirs (dogs). Lutzomyia longipalpis comprised 96.5% of the total phlebotomine sand flies captured and displayed an expressive minimal infection rate by Leishmania infantum (16.7%). Positive correlations were found between the population densities of L. longipalpis, rainfall and temperature. L. infantum was also detected in the cortelezzii complex and, for the first time, in Lutzomyia lloydi. Leishmania braziliensis, an etiological agent of the American cutaneous leishmaniasis, was also identified in L. longipalpis. Among the 1408 dogs serologically tested by standard enzyme-linked and fluorescence immune assays (ELISA/IFA) 3.6% were positive for VL. L. infantum DNA and Leishmania parasites were identified in 100% and 72.5% of the seropositive dogs, respectively. The co-positivity of other diagnostic tests for VL-Leishmania-nested PCR, imprint and myeloculture-was compared to the standard serology. Both symptomatic or asymptomatic dogs displayed an equal average number of positive diagnostic tests for VL. The districts studied display favorable conditions for the rapid spreading of human infection, in terms of L. longipalpis population density, and presence of L. infantum in both vector and main reservoir.

  4. Interferon-¿- and tumour necrosis factor-a-producing cells in humans who are immune to cutaneous leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, K; Theander, T G; Hviid, L;

    1999-01-01

    Individuals infected with Leishmania major usually acquire immunity to cutaneous leishmaniasis. In this study we have investigated peripheral blood mononuclear cells (PBMC) stimulated by Leishmania antigens in two groups of Sudanese individuals, one with a history of cutaneous leishmaniasis and one...... leishmaniasis produced significantly higher levels of IFN-gamma and TNF-alpha than cells from individuals without a history of the disease. Similar levels of IL-10 were found in the two groups. Flow cytometric analysis revealed high numbers of CD3+ cells producing IFN-gamma and TNF-alpha, and only a few CD3......+ cells containing IL-10, in the PBMC cultures from the individuals with a history of cutaneous leishmaniasis. Interferon-gamma and TNF-alpha were predominantly produced by CD4+ T cells rather than CD8+ T cells. The results suggest that cellular immunity against cutaneous leishmaniasis is mediated...

  5. Oral ulcer as an unusual feature of visceral leishmaniasis in an AIDS patient

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    Kumar Pramod

    2007-02-01

    Full Text Available Leishmaniasis, a globally prevalent parasitic disease, occurs in three forms, viz., visceral, cutaneous and mucocutaneous. It is transmitted by female Phlebotomus sandflies. Human immunodeficiency virus (HIV infection is increasing worldwide, and several reports indicate a rising trend of VL / HIV co-infection, modifying the traditional anthroponotic pattern of VL transmission. India is one of the countries having the largest burden of leishmaniasis; nevertheless, there are very few HIV / leishmania co-infection cases reported so far. We report a 35-year-old homemaker infected with the human immunodeficiency virus; she presented with an oral ulcer. The investigations carried out on her revealed that she was afflicted by visceral leishmaniasis, and the oral ulceration was a part of the same. This is only the second such case from the Indian subcontinent, and more significantly from a non-endemic area.

  6. Molecular diagnosis of Leishmania mexicana in a cutaneous leishmaniasis case in Sinaloa, Mexico.

    Science.gov (United States)

    Ochoa-Diaz, Yssete O; Lopez-Moreno, Carmina Y; Rendon-Maldonado, Jose G; Lopez-Moreno, Hector S

    2012-01-01

    Leishmaniasis has been considered endemic in Sinaloa, Mexico, since 1994. Despite that Leishmania mexicana is the main etiological agent of cutaneous leishmaniasis (CL) in other regions of Mexico, the species causing CL in patients from Sinaloa state has not been previously established, although Leishmania braziliensis has been found in the neighboring southern state, Nayarit. L. braziliensis is also associated with mucocutaneous leishmaniasis, which is a more complicated clinical variant. Due to the implications on individual and public health, the objective of this report was to identify the Leishmania species present in Sinaloa, Mexico. Using the first internal transcribed spacer (ITS-1) polymerase chain reaction-restriction fragment length polymorphism, we identified L. mexicana in a CL patient from Sinaloa and confirmed the extended distribution of this parasite in Mexico. PMID:21923263

  7. Concurrent cutaneous, visceral and ocular leishmaniasis caused by Leishmania (Viannia braziliensis in a kidney transplant patient

    Directory of Open Access Journals (Sweden)

    Gontijo Célia MF

    2002-01-01

    Full Text Available Although cases of leishmaniasis co-infection have been described in acquired immunodeficiency syndrome patients as well as those who have undergone organ transplants, to our knowledge, the present report is the first documented case of simultaneous cutaneous, visceral and ocular leishmaniasis due to Leishmania (Viannia braziliensis in a transplant patient. The patient had been using immunosuppressive drugs since receiving a transplanted kidney. The first clinical signs of leishmaniasis included fever, thoracic pain, hepatosplenomegaly, leucopenia and anemia. The cutaneous disease was revealed by the presence of amastigotes in the skin biopsy. After three months, the patient presented fever with conjunctive hyperemia, intense ocular pain and low visual acuity. Parasites isolated from iliac crest, aqueous humor and vitreous body were examined using a range of molecular techniques. The same strain of L. (V. braziliensis was responsible for the different clinical manifestations. The immunosuppressive drugs probably contributed to the dissemination of Leishmania.

  8. The development and clinical evaluation of second-generation leishmaniasis vaccines.

    Science.gov (United States)

    Duthie, Malcolm S; Raman, Vanitha S; Piazza, Franco M; Reed, Steven G

    2012-01-01

    Infection with Leishmania parasites results in a range of clinical manifestations and outcomes. Control of Leishmania parasite transmission is extremely difficult due to the large number of vectors and potential reservoirs, and none of the current treatments are ideal. Vaccination could be an effective strategy to provide sustained control. In this review, the current global situation with regard to leishmaniasis, the immunology of Leishmania infection and various efforts to identify second generation vaccine candidates are briefly discussed. The variety of clinical trials conducted using the only current second generation vaccine approved for clinical use, LEISH-F1+MPL-SE, are described. Given that epidemiological evidence suggests that reducing the canine reservoir also positively impacts human incidence, efforts at providing a vaccine for leishmaniasis in dogs are highlighted. Finally, potential refinements and surrogate markers that could expedite the introduction of a vaccine that can limit the severity and incidence of leishmaniasis are discussed.

  9. Molecular diagnosis of Leishmania mexicana in a cutaneous leishmaniasis case in Sinaloa, Mexico.

    Science.gov (United States)

    Ochoa-Diaz, Yssete O; Lopez-Moreno, Carmina Y; Rendon-Maldonado, Jose G; Lopez-Moreno, Hector S

    2012-01-01

    Leishmaniasis has been considered endemic in Sinaloa, Mexico, since 1994. Despite that Leishmania mexicana is the main etiological agent of cutaneous leishmaniasis (CL) in other regions of Mexico, the species causing CL in patients from Sinaloa state has not been previously established, although Leishmania braziliensis has been found in the neighboring southern state, Nayarit. L. braziliensis is also associated with mucocutaneous leishmaniasis, which is a more complicated clinical variant. Due to the implications on individual and public health, the objective of this report was to identify the Leishmania species present in Sinaloa, Mexico. Using the first internal transcribed spacer (ITS-1) polymerase chain reaction-restriction fragment length polymorphism, we identified L. mexicana in a CL patient from Sinaloa and confirmed the extended distribution of this parasite in Mexico.

  10. Pink plaque on the arm of a man after a trip to Mexico: cutaneous leishmaniasis.

    Science.gov (United States)

    Cohen, Jeffrey M; Saavedra, Arturo P; Sax, Paul E; Lipworth, Adam D

    2015-06-01

    Cutaneous leishmaniasis is a parasitic infection caused by protozoa of the Leishmania genus that presents as asymptomatic pink papules that may ulcerate. There are several species of Leishmania found in 98 endemic countries and whereas all are associated with cutaneous disease, only specific species can cause mucocutaneous or visceral disease. Although the diagnosis of cutaneous leishmaniasis can be confirmed with Giemsa staining of a biopsy or "touch prep" specimen, only speciation at specialized centers such as the Centers for Disease Control (CDC) can determine the risk of mucocutaneous or visceral disease. Treatment of cutaneous leishmaniasis is varied and depends on the extent of cutaneous disease and the risk of mucocutaneous or visceral disease. PMID:26158361

  11. Canine leishmaniasis surveillance program in a San Marino Republic kennel

    Directory of Open Access Journals (Sweden)

    Daniela Salvatore

    2013-12-01

    Full Text Available The Republic of San Marino is an autonomous State that, in view of its geographical and environmental features, can be considered a part of the Northern Italian territory, where the canine leishmaniasis (CanL is endemic. In the past, a CanL focus in the Republic's kennel was described. As a consequence of this epidemiological situation, a surveillance program was carried-out covering a 6-year period (2006-2012. A total of 1,094 sera were collected from 420 kennel dogs and examined for antibodies to Leishmania infantum by the indirect fluorescent antibody test (IFAT. Eighty-eight (21% dogs resulted IFAT positive (antibody titre ≥1/40. The overall seroprevalence increased in the first 4 years (2006-2010, going from 5.5% to 26.8% and then decreased in the 2 following years going to 17.9% (2011 and 3.9% (2012. The cumulative incidence constantly increased from 0.6% to 2.6%. This trend could be attributed to a changed infection pressure due to the dog turnover in the kennels. According to the observed incidence values, the CanL focus seems to be stable, supported by autochthonous transmission, new case introduction and Leishmania spp. circulation in owned dogs in the same area.

  12. A sensitive new microculture method for diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Allahverdiyev, Adil M; Uzun, Soner; Bagirova, Malahat; Durdu, Murat; Memisoglu, Hamdi R

    2004-03-01

    A sensitive microcapillary culture method (MCM) was developed for rapid diagnosis of cutaneous leishmaniasis (CL). The MCM is superior to the traditional culture method (TCM) as determined by the smaller inoculum size, the higher sensitivity for detection of promastigotes, and the more rapid time for emergence of promastigotes. With lesion amastigote loads from grade III to 0, the positive rates and the periods for promastigote emergence were 3-4-fold higher and faster with the MCM than with the TCM, e.g., 83-97% positive in 4-7 days versus 20-40% positive in 15-30 days (P = 0.0001). The higher Pco(2) and lower Po(2) and pH presumably encourage a rapid amastigote-to-promastigote differentiation and/or the survival or growth of the latter. This MCM has the advantage of simplicity, and may be suitable for diagnostic use and for parasite retrieval in many other endemic sites where parasites are known to be difficult to grow. PMID:15031519

  13. Leishmaniasis and Climate Change—Case Study: Argentina

    Directory of Open Access Journals (Sweden)

    Oscar Daniel Salomón

    2012-01-01

    Full Text Available Vector-borne diseases closely associated with the environment, such as leishmaniases, have been a usual argument about the deleterious impact of climate change on public health. From the biological point of view interaction of different variables has different and even conflicting effects on the survival of vectors and the probability transmission of pathogens. The results on ecoepidemiology of leishmaniasis in Argentina related to climate variables at different scales of space and time are presented. These studies showed that the changes in transmission due to change or increase in frequency and intensity of climatic instability were expressed through changes in the probability of vector-human reservoir effective contacts. These changes of contact in turn are modulated by both direct effects on the biology and ecology of the organisms involved, as by perceptions and changes in the behavior of the human communities at risk. Therefore, from the perspective of public health and state policy, and taking into account the current nonlinear increased velocity of climate change, we concluded that discussing the uncertainties of large-scale models will have lower impact than to develop-validate mitigation strategies to be operative at local level, and compatibles with sustainable development, conservation biodiversity, and respect for cultural diversity.

  14. Clinical Manifestations and Distribution of Cutaneous Leishmaniasis in Pakistan

    Directory of Open Access Journals (Sweden)

    Abaseen Khan Afghan

    2011-01-01

    Full Text Available Cutaneous leishmaniasis (CL is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs should be trained in identification of at least the common presentations of CL.

  15. Characteristics of bacterial sepsis among patients with visceral leishmaniasis

    Institute of Scientific and Technical Information of China (English)

    Mengistu Endris; Yegnasew Takele; Desalegn Woldeyohannes; Chandrashekhar Unakal; Feleke Moges; Moges Tiruneh; Ermias Diro

    2014-01-01

    Sepsis is one of the major causes and predictors of death in patients with visceral leishmaniasis (VL). Globally, incidence rate of sepsis ranged from 56-91 cases per 100000 people, with a mortality rate of 30%. Incidence of sepsis has been raised due to aging of the population and the higher incidence of immunosuppressive conditions such as HIV, VL and others. The prevalence of sepsis was reported from 4.2% to 32.3% and 14.1% in VL and VL-HIV coinfected patients, respectively. The mortality rate of VL patients with sepsis is greater than 50%. Factors associated with sepsis in VL patients are immune suppression, pancytopenia, HIV co-infection, age 40 years old, indwelling of central venous lines and hospitalization. Although antimicrobial susceptibility patterns were not well reported, both Gram-positive and Gram-negative bacteria were isolated from patients with VL. So far, limited information is available on sepsis in VL, especially in VL-HIV coinfected patients. Therefore, further studies about sepsis prevalence, causative agents and their antibiotic patterns, and associated factors among VL and VL-HIV coinfected patients are necessary. This review provides information about bacterial sepsis in patients with VL.

  16. Leishmaniasis: focus on the design of nanoparticulate vaccine delivery systems.

    Science.gov (United States)

    Doroud, Delaram; Rafati, Sima

    2012-01-01

    Although mass vaccination of the entire population of an endemic area would be the most cost-effective tool to diminish Leishmania burden, an effective vaccine is not yet commercially available. Practically, vaccines have failed to achieve the required level of protection, possibly owing to the lack of an appropriate adjuvant and/or delivery system. Therefore, there is still an imperative demand for an improved, safe and efficient delivery system to enhance the immunogenicity of available vaccine candidates. Nanoparticles are proficient in boosting the quality and magnitude of immune responses in a predictable fashion. Herein, we discuss how nanoparticulate vaccine delivery systems can be used to induce appropriate immune responses against leishmaniasis by controlling physicochemical properties of the vaccine. Stability, production reproducibility, low cost per dose and low risk-benefit ratios are desirable characteristics of an ideal vaccine formulation and solid lipid nanoparticles may serve as one of the most promising practical strategies to help to achieve such a leishmanial vaccine, at least in canine species in the developing world.

  17. Characteristics of bacterial sepsis among patients with visceral leishmaniasis

    Institute of Scientific and Technical Information of China (English)

    Mengistu; Endris; Yegnasew; Takele; Desalegn; Woldeyohannes; Chandrashekhar; Unakal; Feleke; Moges; Moges; Tiruneh; Ermias; Diro

    2014-01-01

    Sepsis is one of the major causes and predictors of death in patients with visceral leishmaniasis(VL).Globally,incidence rate of sepsis ranged from 56-91 cases per 100000 people,with a mortality rate of 30%.Incidence of sepsis has been raised due to aging of the population and the higher incidence of immunosuppressive conditions such as HIV.VL and others.The prevalence of sepsis was reported from 4.2%to 32.3%and 14.1%in VL and VL-HIV coinfectcd patients,respectively.The mortality rate of VL patients with sepsis is greater than50%.Factors associated with sepsis in VL patients are immune suppression,pancytopenia.HIV co-infection,age 40 years old,indwelling of central venous lines and hospitalization.Although antimicrobial susceptibility patterns were not well reported,both Gram-positive and Gram-negative bacteria were isolated from patients with VL.So far.limited information is available on sepsis in VL.especially in VL-HIV coinfected patients.Therefore,further studies about sepsis prevalence,causative agents and their antibiotic patterns,and associated factors among VL and VL-HIV coinfectcd patients arc necessary.This review provides information about bacterial sepsis in patients with VL.

  18. Evolution of coauthorship networks: worldwide scientific production on leishmaniasis

    Directory of Open Access Journals (Sweden)

    Gregorio Gonzalez-Alcaide

    2013-12-01

    Full Text Available Introduction Collaboration is one of the defining features of contemporary scientific research, and it is particularly important with regard to neglected diseases that primarily affect developing countries. Methods The present study has identified publications on leishmaniasis in the Medline database from 1945 to 2010, analyzing them according to bibliometric indicators and statistics from social network analysis. Examining aspects such as scientific production, diachronic evolution, and collaboration and configuration of the research groups in the field, we have considered the different types of Leishmania studied and the institutional affiliation and nationality of the authors. Results Seven-hundred and thirty-five authors participate in 154 prominent research clusters or groups. Although the most predominant and consolidated collaborations are characterized by members from the same country studying the same type of Leishmania, there are also notable links between authors from different countries or who study different clinical strains of the disease. Brazil took the lead in this research, with numerous Brazilian researchers heading different clusters in the center of the collaboration network. Investigators from the USA, India, and European countries, such as France, Spain, the United Kingdom, and Italy, also stand out within the network. Conclusions Research should be fostered in countries such as Bangladesh, Nepal, Sudan, and Ethiopia, where there is a high prevalence of different forms of the disease but limited research development with reference authors integrated into the collaboration networks.

  19. Forecasting temporal dynamics of cutaneous leishmaniasis in Northeast Brazil.

    Directory of Open Access Journals (Sweden)

    Joseph A Lewnard

    2014-10-01

    Full Text Available INTRODUCTION: Cutaneous leishmaniasis (CL is a vector-borne disease of increasing importance in northeastern Brazil. It is known that sandflies, which spread the causative parasites, have weather-dependent population dynamics. Routinely-gathered weather data may be useful for anticipating disease risk and planning interventions. METHODOLOGY/PRINCIPAL FINDINGS: We fit time series models using meteorological covariates to predict CL cases in a rural region of Bahía, Brazil from 1994 to 2004. We used the models to forecast CL cases for the period 2005 to 2008. Models accounting for meteorological predictors reduced mean squared error in one, two, and three month-ahead forecasts by up to 16% relative to forecasts from a null model accounting only for temporal autocorrelation. SIGNIFICANCE: These outcomes suggest CL risk in northeastern Brazil might be partially dependent on weather. Responses to forecasted CL epidemics may include bolstering clinical capacity and disease surveillance in at-risk areas. Ecological mechanisms by which weather influences CL risk merit future research attention as public health intervention targets.

  20. First molecular epidemiological study of cutaneous leishmaniasis in Libya.

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    Ahmad Amro

    Full Text Available BACKGROUND: Cutaneous leishmaniasis (CL is a major public health problem in Libya. The objective of this study was to investigate, for the first time, epidemiological features of CL outbreaks in Libya including molecular identification of parasites, the geographical distribution of cases and possible scenarios of parasite transmission. METHODOLOGY/PRINCIPAL FINDINGS: We studied 450 patients that came from 49 areas distributed in 12 districts in north-west Libya. The patients' ages ranged from 9 months to 87 years (median age 25 years; 54% of the cases were males. Skin scrapings spotted on glass slides were collected for molecular identification of causative agent. The ribosomal internal transcribed spacer 1 (ITS1 was amplified and subsequently characterized by restriction fragment length polymorphism (RFLP analysis. In total, 195 samples were successfully identified of which 148 (75.9% were Leishmania major, and 47 (24.1% Leishmania tropica. CL cases infected with L. major were found in all CL areas whereas L. tropica cases came mainly from Al Jabal Al Gharbi (46.4%, Misrata (17.8% and Tarhuna districts (10.7%. A trend of seasonality was noticed for the infections with L. major which showed a clear peak between November and January, but was less pronounced for infections by L. tropica. CONCLUSION: The first molecular study on CL in Libya revealed that the disease is caused by L. major and L. tropica and the epidemiological patterns in the different foci were the same as in other Mediterranean foci of CL.

  1. Clinical manifestations and distribution of cutaneous leishmaniasis in pakistan.

    Science.gov (United States)

    Afghan, Abaseen Khan; Kassi, Masoom; Kasi, Pashtoon Murtaza; Ayub, Adil; Kakar, Niamatullah; Marri, Shah Muhammad

    2011-01-01

    Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs) should be trained in identification of at least the common presentations of CL. PMID:22174721

  2. An improved microculture method for diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Pagheh, Abdolsattar; Fakhar, Mahdi; Mesgarian, Fatemeh; Gholami, Shirzad; Ahmadpour, Ehsan

    2014-12-01

    This study evaluated the performance of three diagnostic methods for cutaneous leishmaniasis (CL). Patients who came to the Health Center Laboratory of Gonbad-e-Qabus in Golestan Province, Iran, were enrolled in the study. Skin scraping smear, improved microculture (IMC) and polymerase chain reaction (PCR) were performed. A total of 303 subjects were recruited, among whom 273 subjects fulfilled the criteria for CL. Sensitivity and specificity were 88.8 % (95 % CI = 84.2-92.2 %) and 100.0 % for smears, 98.4 % (95 % CI = 96.1-99.1 %) and 100.0 % for IMC, both of them 100.0 % for PCR. Although, PCR was relatively more sensitive than the IMC, the high correlation (agreement = 96 %, Kappa = 0.82) between IMC and PCR along with the advantages of simplicity, rapidity, adequate sensitivity and as a needle free method, offers the IMC as a valuable alternative diagnostic method for PCR in diagnosis of CL. PMID:25320480

  3. Immunotherapy and immunochemotherapy in visceral leishmaniasis: promising treatments for this neglected disease

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    Bruno Mendes Roatt

    2014-06-01

    Full Text Available Leishmaniasis has several clinical forms: self-healing or chronic cutaneous leishmaniasis or post-kala-azar dermal leishmaniasis; mucosal leishmaniasis; and visceral leishmaniasis, which is fatal if left untreated. The epidemiology and clinical features of VL vary greatly due to the interaction of multiple factors including parasite strains, vectors, host genetics, and the environment. HIV infection, augments the severity of VL increasing the risk of developing active disease by 100 to 2320 times. An effective vaccine for humans is not yet available. Resistance to chemotherapy is a growing problem in many regions, and the costs associated with drug identification and development, make commercial production for leishmaniasis, unattractive. The toxicity of currently drugs, their long treatment course, and limited efficacy are significant concerns. For cutaneous disease, many studies have shown promising results with immunotherapy/immunochemotherapy, aimed to modulate and activate the immune response to obtain a therapeutic cure. Nowadays, the focus of many groups centers on treating canine VL by using vaccines and immunomodulators with or without chemotherapy. In human disease, the use of cytokines like Interferon-γ associated with pentavalent antimonials demonstrated promising results in patients that did not respond to conventional treatment. In mice, immunomodulation based on monoclonal antibodies to remove endogenous immunosuppressive cytokines (interleukin-10 or block their receptors, antigen-pulsed syngeneic dendritic cells, or biological products like Pam3Cys (TLR ligand has already been shown as a prospective treatment of the disease. This review addresses VL treatment, particularly immunotherapy and/or immunochemotherapy as an alternative to conventional drug treatment in experimental models, canine VL, and human disease.

  4. The Contribution of Immune Evasive Mechanisms to Parasite Persistence in Visceral Leishmaniasis

    Science.gov (United States)

    de Freitas, Elisangela Oliveira; Leoratti, Fabiana Maria de Souza; Freire-de-Lima, Célio Geraldo; Morrot, Alexandre; Feijó, Daniel Ferreira

    2016-01-01

    Leishmania is a genus of protozoan parasites that give rise to a range of diseases called Leishmaniasis that affects annually an estimated 1.3 million people from 88 countries. Leishmania donovani and Leishmania (L.) infantum chagasi are responsible to cause the visceral leishmaniasis. The parasite can use assorted strategies to interfere with the host homeostasis to establish persistent infections that without treatment can be lethal. In this review, we highlight the mechanisms involved in the parasite subversion of the host protective immune response and how alterations of host tissue physiology and vascular remodeling during VL could affect the organ-specific immunity against Leishmania parasites. PMID:27148272

  5. Leishmaniasis isoleret til larynx som årsag til kronisk laryngitis

    DEFF Research Database (Denmark)

    Kaltoft, Mikkel; Munch-Petersen, Helga Richert; Møller, Henrik

    2010-01-01

    Mucosal leishmaniasis is uncommon outside Central and South America, where it is commonly caused by Leishmania (L.) braziliensis. We present a case of isolated laryngeal leishmaniasis detected in a 78-year-old male, who presented with chronic hoarseness. Histologic examination of biopsies taken...... from the larynx showed L. amastigotes. An L.-specific indirect fluorescent antibody test was positive. Polymerase chain reaction showed infection with L. donovani, L. infantum or L. tropica, species which do not normally cause isolated mucosal infection. This is the first reported case from Scandinavia....

  6. Linfocitos T citotóxicos CD8+ en la leishmaniasis cutánea CD8+ cytotoxic lymphocytes in cutaneous leishmaniasis

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    Joselín Hernández-Ruiz

    2006-10-01

    Full Text Available OBJETIVO: Examinar la bibliografía relacionada con la participación de los linfocitos T CD8+ en la reacción inmunitaria a especies de Leishmania causantes de leishmaniasis cutánea. En esta enfermedad se ha resaltado la intervención de macrófagos, células dendríticas, NK y células T CD4+; sin embargo, es poco lo que se conoce de las células T CD8+. Los trabajos en modelos murinos señalan que la participación de las células CD8+ sucede a través de la producción de IFN-gamma, aunque su capacidad citotóxica puede desempeñar una función importante, como lo demuestran los hallazgos en seres humanos. La forma como se activan las células citotóxicas CD8+ es un enigma. Es posible que las células dendríticas realicen esa labor a través de mecanismos que incluyen transpresentación de antígenos. Comprender la contribución de este subtipo celular en la respuesta inmunitaria a Leishmania aportará novedosos conocimientos sobre la fisiopatogenia de la leishmaniasis, lo cual hará posible desarrollar nuevos enfoques terapéuticos para esta parasitosis.OBJECTIVE: Review of the literature on the role of CD8+ T cell in the immune response against Leishmania species that cause cutaneous leishmaniasis. The role of macrophages, dendritic cells, CD4 T cells and NK cells has been extensively analyzed in leishmaniasis, yet very little knowledge has been gained on CD8+ T cells in this disease. Murine models of leishmaniasis suggest that CD8+ T cells participate through IFNg production, yet their cytotoxic capacity may also play a crucial role, as has been found in human disease. It is an enigma what mechanisms underlie the CD8+ T cell activation. It is possible that dendritic cells activate CD8+ T cells through mechanisms that include antigen traspresentation. A better understanding of CD8+ T cells in the immune response against Leishmania will undoubtedly provide new insights into the physiopathogenesis of the disease that could lead to new

  7. Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia Termoterapia efectiva y más segura que la miltefosina en el tratamiento de la leishmaniasis cutánea en Colombia

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    Liliana López

    2013-06-01

    Full Text Available In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems, cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145 or a thermotherapy (Thermomed® application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149. Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients and 69% (85/145 patients, respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol between the two treatments. ClinicalTrials.gov: NCT00471705.En Colombia antimoniales pentavalentes y miltefosina son los medicamentos de primera elección para el tratamiento de la leishmaniosis cutánea; sin embargo, su toxicidad, duración (que lleva a problemas de adherencia, costo y la disminución de la sensibilidad de los parásitos a los mismos, hacen necesaria la búsqueda de nuevas alternativas de tratamiento para la leishmaniosis cutánea americana. A partir de resultados derivados de un ensayo clínico controlado abierto, aleatorizado, fase III, se comparó la eficacia y seguridad de la miltefosina con la de la termoterapia, para el

  8. Synthetic sex pheromone attracts the leishmaniasis vector Lutzomyia longipalpis to experimental chicken sheds treated with insecticide

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    Brazil Reginaldo P

    2010-03-01

    Full Text Available Abstract Background Current strategies for controlling American visceral leishmaniasis (AVL have been unable to prevent the spread of the disease across Brazil. With no effective vaccine and culling of infected dogs an unpopular and unsuccessful alternative, new tools are urgently needed to manage populations of the sand fly vector, Lutzomyia longipalpis Lutz and Neiva (Diptera: Psychodidae. Here, we test two potential strategies for improving L. longipalpis control using the synthetic sand fly pheromone (±-9-methylgermacrene-B: the first in conjunction with spraying of animal houses with insecticide, the second using coloured sticky traps. Results Addition of synthetic pheromone resulted in greater numbers of male and female sand flies being caught and killed at experimental chicken sheds sprayed with insecticide, compared to pheromone-less controls. Furthermore, a ten-fold increase in the amount of sex pheromone released from test sheds increased the number of females attracted and subsequently killed. Treating sheds with insecticide alone resulted in a significant decrease in numbers of males attracted to sheds (compared to pre-spraying levels, and a near significant decrease in numbers of females. However, this effect was reversed through addition of synthetic pheromone at the time of insecticide spraying, leading to an increase in number of flies attracted post-treatment. In field trials of commercially available different coloured sticky traps, yellow traps caught more males than blue traps when placed in chicken sheds. In addition, yellow traps fitted with 10 pheromone lures caught significantly more males than pheromone-less controls. However, while female sand flies showed a preference for both blue and yellow pheromone traps sticky traps over white traps in the laboratory, neither colour caught significant numbers of females in chicken sheds, either with or without pheromone. Conclusions We conclude that synthetic pheromone could

  9. Combined Immune Therapy for the Treatment of Visceral Leishmaniasis

    Science.gov (United States)

    Bunn, Patrick T.; Singh, Neetu; Chauhan, Shashi Bhushan; Sheel, Meru; Amante, Fiona H.; Montes de Oca, Marcela; Edwards, Chelsea L.; Ng, Susanna S.; Best, Shannon E.; Haque, Ashraful; Beattie, Lynette; Hafner, Louise M.; Sacks, David; Nylen, Susanne; Sundar, Shyam; Engwerda, Christian R.

    2016-01-01

    Chronic disease caused by infections, cancer or autoimmunity can result in profound immune suppression. Immunoregulatory networks are established to prevent tissue damage caused by inflammation. Although these immune checkpoints preserve tissue function, they allow pathogens and tumors to persist, and even expand. Immune checkpoint blockade has recently been successfully employed to treat cancer. This strategy modulates immunoregulatory mechanisms to allow host immune cells to kill or control tumors. However, the utility of this approach for controlling established infections has not been extensively investigated. Here, we examined the potential of modulating glucocorticoid-induced TNF receptor-related protein (GITR) on T cells to improve anti-parasitic immunity in blood and spleen tissue from visceral leishmaniasis (VL) patients infected with Leishmania donovani. We found little effect on parasite growth or parasite-specific IFNγ production. However, this treatment reversed the improved anti-parasitic immunity achieved by IL-10 signaling blockade. Further investigations using an experimental VL model caused by infection of C57BL/6 mice with L. donovani revealed that this negative effect was prominent in the liver, dependent on parasite burden and associated with an accumulation of Th1 cells expressing high levels of KLRG-1. Nevertheless, combined anti-IL-10 and anti-GITR mAb treatment could improve anti-parasitic immunity when used with sub-optimal doses of anti-parasitic drug. However, additional studies with VL patient samples indicated that targeting GITR had no overall benefit over IL-10 signaling blockade alone at improving anti-parasitic immune responses, even with drug treatment cover. These findings identify several important factors that influence the effectiveness of immune modulation, including parasite burden, target tissue and the use of anti-parasitic drug. Critically, these results also highlight potential negative effects of combining different

  10. Cutaneous leishmaniasis: recent developments in diagnosis and management.

    Science.gov (United States)

    de Vries, Henry J C; Reedijk, Sophia H; Schallig, Henk D F H

    2015-04-01

    This review focuses on recent developments in the diagnosis, treatment, management, and strategies for the prevention and control of cutaneous leishmaniasis (CL) caused by both Old and New World Leishmania species. CL is caused by the vector-borne protozoan parasite Leishmania and is transmitted via infected female sandflies. The disease is endemic in more than 98 countries and an estimated 350 million people are at risk. The overall prevalence is 12 million cases and the annual incidence is 2-2.5 million. The World Health Organization considers CL a severely neglected disease and a category 1 emerging and uncontrolled disease. The management of CL differs from region to region and is primarily based on local experience-based evidence. Most CL patients can be treated with topical treatments, but some Leishmania species can cause mucocutaneous involvement requiring a systemic therapeutic approach. Moreover, Leishmania species can vary in their sensitivity to available therapeutic options. This makes species determination critical for the choice of treatment and the clinical outcome of CL. Identification of the infecting parasite used to be laborious, but now the Leishmania species can be identified relatively easy with new DNA techniques that enable a more rational therapy choice. Current treatment guidelines for CL are based on poorly designed and reported trials. There is a lack of evidence for potentially beneficial treatments, a desperate need for large well-conducted studies, and standardization of future trials. Moreover, intensified research programs to improve vector control, diagnostics, and the therapeutic arsenal to contain further incidence and morbidity are needed. PMID:25687688

  11. ANIMAL MODELS FOR THE STUDY OF LEISHMANIASIS IMMUNOLOGY

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    Elsy Nalleli Loria-Cervera

    2014-01-01

    Full Text Available Leishmaniasis remains a major public health problem worldwide and is classified as Category I by the TDR/WHO, mainly due to the absence of control. Many experimental models like rodents, dogs and monkeys have been developed, each with specific features, in order to characterize the immune response to Leishmania species, but none reproduces the pathology observed in human disease. Conflicting data may arise in part because different parasite strains or species are being examined, different tissue targets (mice footpad, ear, or base of tail are being infected, and different numbers (“low” 1×102 and “high” 1×106 of metacyclic promastigotes have been inoculated. Recently, new approaches have been proposed to provide more meaningful data regarding the host response and pathogenesis that parallels human disease. The use of sand fly saliva and low numbers of parasites in experimental infections has led to mimic natural transmission and find new molecules and immune mechanisms which should be considered when designing vaccines and control strategies. Moreover, the use of wild rodents as experimental models has been proposed as a good alternative for studying the host-pathogen relationships and for testing candidate vaccines. To date, using natural reservoirs to study Leishmania infection has been challenging because immunologic reagents for use in wild rodents are lacking. This review discusses the principal immunological findings against Leishmania infection in different animal models highlighting the importance of using experimental conditions similar to natural transmission and reservoir species as experimental models to study the immunopathology of the disease.

  12. Animal models for the study of leishmaniasis immunology.

    Science.gov (United States)

    Loría-Cervera, Elsy Nalleli; Andrade-Narváez, Fernando José

    2014-01-01

    Leishmaniasis remains a major public health problem worldwide and is classified as Category I by the TDR/WHO, mainly due to the absence of control. Many experimental models like rodents, dogs and monkeys have been developed, each with specific features, in order to characterize the immune response to Leishmania species, but none reproduces the pathology observed in human disease. Conflicting data may arise in part because different parasite strains or species are being examined, different tissue targets (mice footpad, ear, or base of tail) are being infected, and different numbers ("low" 1 × 10(2) and "high" 1 × 10(6)) of metacyclic promastigotes have been inoculated. Recently, new approaches have been proposed to provide more meaningful data regarding the host response and pathogenesis that parallels human disease. The use of sand fly saliva and low numbers of parasites in experimental infections has led to mimic natural transmission and find new molecules and immune mechanisms which should be considered when designing vaccines and control strategies. Moreover, the use of wild rodents as experimental models has been proposed as a good alternative for studying the host-pathogen relationships and for testing candidate vaccines. To date, using natural reservoirs to study Leishmania infection has been challenging because immunologic reagents for use in wild rodents are lacking. This review discusses the principal immunological findings against Leishmania infection in different animal models highlighting the importance of using experimental conditions similar to natural transmission and reservoir species as experimental models to study the immunopathology of the disease. PMID:24553602

  13. Visceral leishmaniasis in the Indian subcontinent: modelling epidemiology and control.

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    Anette Stauch

    2011-11-01

    Full Text Available BACKGROUND: In the Indian subcontinent, about 200 million people are at risk of developing visceral leishmaniasis (VL. In 2005, the governments of India, Nepal and Bangladesh started the first regional VL elimination program with the aim to reduce the annual incidence to less than 1 per 10,000 by 2015. A mathematical model was developed to support this elimination program with basic quantifications of transmission, disease and intervention parameters. This model was used to predict the effects of different intervention strategies. METHODS AND FINDINGS: Parameters on the natural history of Leishmania infection were estimated based on a literature review and expert opinion or drawn from a community intervention trial (the KALANET project. The transmission dynamic of Leishmania donovani is rather slow, mainly due to its long incubation period and the potentially long persistence of parasites in infected humans. Cellular immunity as measured by the Leishmanin skin test (LST lasts on average for roughly one year, and re-infection occurs in intervals of about two years, with variation not specified. The model suggests that transmission of L. donovani is predominantly maintained by asymptomatically infected hosts. Only patients with symptomatic disease were eligible for treatment; thus, in contrast to vector control, the treatment of cases had almost no effect on the overall intensity of transmission. CONCLUSIONS: Treatment of Kala-azar is necessary on the level of the individual patient but may have little effect on transmission of parasites. In contrast, vector control or exposure prophylaxis has the potential to efficiently reduce transmission of parasites. Based on these findings, control of VL should pay more attention to vector-related interventions. Cases of PKDL may appear after years and may initiate a new outbreak of disease; interventions should therefore be long enough, combined with an active case detection and include effective treatment.

  14. Combined Immune Therapy for the Treatment of Visceral Leishmaniasis.

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    Rebecca J Faleiro

    2016-02-01

    Full Text Available Chronic disease caused by infections, cancer or autoimmunity can result in profound immune suppression. Immunoregulatory networks are established to prevent tissue damage caused by inflammation. Although these immune checkpoints preserve tissue function, they allow pathogens and tumors to persist, and even expand. Immune checkpoint blockade has recently been successfully employed to treat cancer. This strategy modulates immunoregulatory mechanisms to allow host immune cells to kill or control tumors. However, the utility of this approach for controlling established infections has not been extensively investigated. Here, we examined the potential of modulating glucocorticoid-induced TNF receptor-related protein (GITR on T cells to improve anti-parasitic immunity in blood and spleen tissue from visceral leishmaniasis (VL patients infected with Leishmania donovani. We found little effect on parasite growth or parasite-specific IFNγ production. However, this treatment reversed the improved anti-parasitic immunity achieved by IL-10 signaling blockade. Further investigations using an experimental VL model caused by infection of C57BL/6 mice with L. donovani revealed that this negative effect was prominent in the liver, dependent on parasite burden and associated with an accumulation of Th1 cells expressing high levels of KLRG-1. Nevertheless, combined anti-IL-10 and anti-GITR mAb treatment could improve anti-parasitic immunity when used with sub-optimal doses of anti-parasitic drug. However, additional studies with VL patient samples indicated that targeting GITR had no overall benefit over IL-10 signaling blockade alone at improving anti-parasitic immune responses, even with drug treatment cover. These findings identify several important factors that influence the effectiveness of immune modulation, including parasite burden, target tissue and the use of anti-parasitic drug. Critically, these results also highlight potential negative effects of

  15. Cost of Pediatric Visceral Leishmaniasis Care in Morocco.

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    Nabil Tachfouti

    Full Text Available Visceral leishmaniasis (VL is a neglected parasitic disease that is fatal if left untreated. VL is endemic in Morocco and other countries in North Africa were it mainly affects children from rural areas. In Morocco, the direct observation of Leishmania parasites in bone marrow aspirates and serological tests are used to diagnose VL. Glucantime is the first line of treatment. The objective of this study was to report the costs associated to standard clinical management of pediatric VL from the provider perspective in Morocco. As a secondary objective we described the current clinical practices and the epidemiological characteristics of pediatric VL patients.From March to June 2014 we conducted a survey in eight hospitals treating pediatric VL patients in Morocco. A pro-forma was used to collect demographic, clinical and management data from medical records. We specifically collected data on VL diagnosis and treatment. We also estimated the days of hospitalization and the time to start VL treatment. Costs were estimated by multiplying the use of resources in terms of number of days in hospital, tests performed and drugs provided by the official prices. For patients receiving part of their treatment at Primary Health Centers (PHC we estimated the cost of administering the Glucantime as outpatient. We calculated the median cost per VL patient. We also estimated the cost of managing a VL case when different treatment strategies were applied: inpatient and outpatient.We obtained data from 127 VL patients. The median total cost per pediatric VL case in Morocco is 520 US$. The cost in hospitals applying an outpatient strategy is significantly lower (307 US$ than hospitals keeping the patients for the whole treatment (636 US$. However the outpatient strategy is not yet recommended as VL treatment for children in the Moroccan guidelines. VL diagnosis and treatment regimens should be standardized following the current guidelines in Morocco.

  16. [Visceral leishmaniasis as a threat for non-endemic countries].

    Science.gov (United States)

    Górski, Stanisław; Wiercińska-Drapało, Alicja

    2009-01-01

    Global warming, globalisation, and constantly increasing number of people involved in long-distance tourism and travel to exotic destinations are likely to increase the number of cases of exotic diseases "imported" to nonendemic countries. One of the often forgotten and neglected diseases has been visceral leishmaniasis (VL or kala-azar). The disease is endemic to 62 countries, with India and Sudan accounting for the majority of the cases. It is typically fatal if left untreated. Each year about 500 000 new cases are reported worldwide, and 50 000 die as a result of the disease. Kala-azar is present in the Mediterranean Europe and 70% of cases are imported to non-endemic countries of European Union from that area. Immunocompromised status of patients, like HIV carriers are the principal prospective target for kala-azar. HIV/VL-coinfected patients have significantly higher relapse rates and decreased life expectancy. There is no formal system of reporting imported cases in Europe, except from Germany. In non-endemic countries, including Poland, there is usually the substantial delay between the onset of symptoms and the final diagnosis, with an average exceeding 3 months. This fact suggests that physicians are not familiar with leishmania infections. Despite progress in vaccine development, the only way to prevent the infection is avoiding sandfly bites. Mosquito nets, wearing appropriate clothes and repellents containing DEET (diethyl toluamide) can reduce number of bites and protect also from the other vector-borne diseases like malaria or dengue. Education concerning kala-azar risk and ways of the disease prevention is a needed for tourists and the other travelers. PMID:19856834

  17. Panniculitis is a common unrecognized histopathological feature of cutaneous leishmaniasis

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    Khalifa E Sharquie

    2016-01-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is a parasitic cutaneous infection caused by Leishmania parasite. The histopathology is usually granulomatous in nature. Aims: The aim of the present study is to elucidate the histology of CL and evaluate the presence and the frequency of panniculitis among the affected patients. Settings and Design: Case series interventional study. Materials and Methods: Thirty-five patients with CL were diagnosed clinically between December-2012 and May-2013. Diagnostic confirmation established by smears, culture, and polymerase chain reaction (PCR. The histopathological assessment was carried out to study the general pathology and to look for the presence of panniculitis. Statistical Analysis Used: Simple statistics utilized via SPSS version 16.0 (SPSS, Inc., Chicago, USA. Results: Eighteen women and 17 men with CL were enrolled in the present work with a mean duration of their disease was 3 months. The results of the diagnostic tests were as follow: The smear was positive in 21 (60% of cases, Leishman-Donovan (LD bodies were seen in 7 (20% patients, culture was positive in 24 (68%, and PCR was positive in 32 (91.4% patients. The epidermal changes included acanthosis, pseudoepitheliomatous hyperplasia, ulceration, focal spongiosis, and interface dermatitis while the dermal changes were dependent on the spectrum of the disease, so in the ulcerative lesions there was lymphohistiocytic infiltration with foci of plasma cells and sometimes aggregate of LD bodies, whereas in the dry lesions the pathology is mainly of epithelioid granuloma. Panniculitis was seen in 16 (46% cases as a diffuse lymphohistiocytic infiltration of both the septum and lobules of the subcutaneous layer of the skin. Conclusion: Panniculitis is an important feature of CL that must be differentiated from other diseases that can simulate CL such as chronic skin infections, Discoid lupus erythematosus, and cutaneous lymphoma.

  18. Epidemiological Feature of Visceral Leishmaniasis in China, 2004-2012.

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    Shuqing Zhao

    2015-01-01

    Full Text Available Visceral leishmaniasis (VL remains an important public health problem in China. It is essential to elucidate the current epidemiological characteristics of VL for designing control policy.The data were obtained from China Disease Prevention and Control Information System from 2004 to 2012. Characteristics by major variables, such as age, gender, season and geography were analyzed using SPSS13.0.The incidence of VL in China remained at a lower level in recent years. The outbreak appeared in xinjiang kashgar region in 2008. A total of 3337 VL cases were reported in China from 2004 to 2012, 97.03% of cases were concentrated in Xinjiang, Gansu and Sichuan provinces. The cases under 5 year-old accounted for 59.21%. concentrated in 3 ~ 5 months each year and annual December to January of next year The ratio of males to females was 1.67:1(2088:1249. The lag time between symptom onset and diagnosis of VL appeared a marked decrease after 2008, and were shorter in endemic provinces of Xinjiang, Gansu and Sichuan than non-endemic provinces. The case fatality rate was 2.99% (10/3337 during the study period.The reported cases of VL were concentrated in Xinjiang, Gansu, Sichuan provinces in China, 2004-2012. The onset was given priority to children. The lag time between symptom onset and diagnosis of VL were difference among years and provinces. Therefore, prevention and control measures should be focused on improving awareness and capacities of diagnosis and treatment, targeting high-risk people in high-risk areas.

  19. Genetic epidemiology of visceral leishmaniasis in northeastern Brazil.

    Science.gov (United States)

    Peacock, C S; Collins, A; Shaw, M A; Silveira, F; Costa, J; Coste, C H; Nascimento, M D; Siddiqui, R; Shaw, J J; Blackwell, J M

    2001-04-01

    Familial clustering of disease, racial differences in asymptomatic:disease ratios, and studies of mice all point to a genetic component for disease susceptibility in visceral leishmaniasis. Analysis of 87 multi-case pedigrees (824 individuals; 138 nuclear families) from a region of northeastern Brazil endemic for Leishmania chagasi demonstrates a high relative risk ratio (lambda(2S) = 34) to further siblings of affected sibling pairs. Complex segregation analysis using POINTER and COMDS show that all single locus models, as well as polygenic and multifactorial models, provide a significantly (P fit to the data than a sporadic model. Of the genetic models, the general single locus model was not significantly different from additive or dominant single locus models, all of which gave a gene frequency for the putative disease susceptibility allele of approximately 0.002. The general single locus model was strongly favored (P < 0.001) over a recessive single gene model. Using POINTER, polygenic and multifactorial models were clearly rejected (P < 0.001 in all cases) in favor of the general single locus model. Using COMDS, the analysis was extended to consider two locus models. Results under a general two-locus model did not differ significantly from the dominant, additive, or general single locus models. Under this model, one locus was estimated at a gene frequency of 0.0017, i.e., in the same range as the disease susceptibility locus for the most favored single gene models, with the second locus at a much lower frequency of 0.0002. Hence, the data support the hypothesis that a single major gene may be important in determining disease susceptibility in this population. To identify the gene(s) involved, a genome scan with replication using two subsets of these larger pedigrees with power to detect linkage is in progress. PMID:11255246

  20. Application of an Improved Enzyme-Linked Immunosorbent Assay Method for Serological Diagnosis of Canine Leishmaniasis

    NARCIS (Netherlands)

    N. Santarem; R. Silvestre; L. Cardoso; H. Schallig; S.G. Reed; A. Cordeiro-da-Silva

    2010-01-01

    Accurate diagnosis of canine leishmaniasis (CanL) is essential toward a more efficient control of this zoonosis, but it remains problematic due to the high incidence of asymptomatic infections. In this study, we present data on the development of enzyme-linked immunosorbent assay (ELISA)-based techn

  1. Seroepidemiological Studies of Cutaneous Leishmaniasis in the Campeche State of México

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    Monroy-Ostria Amalia

    1997-01-01

    Full Text Available Seroepidemiological studies of cutaneous leishmaniasis were carried out on 169 individuals in a rural area of the Campeche state of México. Fifty showed cutaneous lesions suggestive of leishmaniasis, 70% were parasite positive and 96% skin test positive. An overall 40% positivity to skin test with Montenegro's antigen was found. Most of the affected individuals were males from 11 to 30 years-old. Antibodies were determined by immunofluorescent antibody test (IFA and by Western blot. Two antigen preparations were used, one from a Leishmania mexicana strain which produced localized cutaneous leishmaniasis (LCL and the other from a diffuse cutaneous leishmaniasis (DCL. In the general population from the area of study 19% gave positive IFA tests with DCL antigen and 20% with LCL antigen while for the patients 67% gave positive IFA tests with DCL and 71% with LCL. By Western blot analysis most of the patients recognized more antigens in the DCL than in the LCL strain. In the DCL strain 78% of patients recognized a 105 kDa, 34% a 139 kDa, 28% a 117 kDa and 26% a 205 kDa MW antigen. In the LCL strain 40% of patients recognized a 205 kDa and 22% a 175 kDa antigens

  2. Visceral leishmaniasis in border areas: clustered distribution of phlebotomine sand flies in Clorinda, Argentina

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    Oscar D Salomón

    2009-08-01

    Full Text Available Three years after the first report of Lutzomyia longipalpis in Clorinda, Argentina, a border city near Asunción, Paraguay, the city was surveyed again. Lu. longipalpis was found clustered in the same neighbourhoods in 2007 as in 2004, even though the scattered distribution of canine visceral leishmaniasis was more related to the traffic of dogs through the border.

  3. Visceral leishmaniasis in border areas: clustered distribution of phlebotomine sand flies in Clorinda, Argentina.

    Science.gov (United States)

    Salomón, Oscar D; Quintana, María G; Bruno, Mario R; Quiriconi, Ricardo V; Cabral, Viviana

    2009-08-01

    Three years after the first report of Lutzomyia longipalpis in Clorinda, Argentina, a border city near Asunción, Paraguay, the city was surveyed again. Lu. longipalpis was found clustered in the same neighbourhoods in 2007 as in 2004, even though the scattered distribution of canine visceral leishmaniasis was more related to the traffic of dogs through the border.

  4. Cutaneous leishmaniasis in three Dutch military cohorts following jungle training in Belize

    NARCIS (Netherlands)

    P.P.A.M. van Thiel; J.E. Zeegelaar; T. van Gool; W.R. Faber; P.A. Kager

    2011-01-01

    Skin lesions occur frequently in travelers to tropical countries. Military personnel acquire skin lesions regularly during jungle training as did Dutch troops who trained in the jungle of Belize in 1998, 2004 and 2009, in an area endemic for cutaneous leishmaniasis. Demographic and clinical data wer

  5. Antigen-presenting cells in human cutaneous leishmaniasis due to Leishmania major

    DEFF Research Database (Denmark)

    ElHassan, A M; Gaafar, A; Theander, T G

    1995-01-01

    In this study biopsies from skin lesions and draining lymph nodes of patients suffering from cutaneous leishmaniasis caused by Leishmania major were examined by immunohistochemistry, and by light and electron microscopy to identify the types of antigen-presenting cells (APC) and their location. APC...

  6. Tre tilfaelde af visceral leishmaniasis: det ene hos en HIV-positiv mand

    DEFF Research Database (Denmark)

    Balslev, U; Jonsbo, F; Junge, Jette;

    1991-01-01

    Three cases of visceral leishmaniasis (kala-azar) are presented. One of these was in a 43-year-old patient with AIDS who was infected in Southern Spain. Another was in a man aged 25 years infected in West Africa. These cases are the first two adults to be reported in Denmark. The third case...

  7. CAPA-gene products in the haematophagous sandfly Phlebotomus papatasi (Scopoli) - vector for leishmaniasis disease

    DEFF Research Database (Denmark)

    Predel, Reinhard; Neupert, Susanne; Russell, William K.;

    2013-01-01

    Sandflies (Phlebotominae, Nematocera, Diptera) are responsible for transmission of leishmaniasis and other protozoan-borne diseases in humans, and these insects depend on the regulation of water balance to cope with the sudden and enormous intake of blood over a very short time period. The sandfly...

  8. CAPA-gene products in the haematophagous sandfly Phlebotomus papatasi (Scopoli) - Vector for leishmaniasis disease

    Science.gov (United States)

    Sandflies (Phlebotominae, Nematocera, Diptera) are responsible for transmission of leishmaniasis and other protozoan-borne diseases in humans, and these insects depend on the regulation of water balance to cope with the sudden and enormous intake of blood over a very short time period. The sandfly ...

  9. Visceral leishmaniasis hos to børn efter ferie i Sydeuropa

    DEFF Research Database (Denmark)

    Castberg, Filip Christian; Poulsen, Anja; Petersen, Bodil Laub;

    2013-01-01

    Pancytopenia, fever and splenomegaly are frequent causes for referrals to paediatric haematology departments, on the suspicion of acute leukaemia. We report two cases of Danish children with the tropical disease visceral leishmaniasis (VL) contracted on short vacations in Southern Europe. One...

  10. The pathology of cutaneous leishmaniasis due to Leishmania major in Sudan

    DEFF Research Database (Denmark)

    Gaafar, A; el Kadaro, A Y; Theander, T G;

    1995-01-01

    The pathology of cutaneous leishmaniasis in Sudan, where the disease is caused by Leishmania major, was studied by light and electron microscopy. Lesions were classified into four distinct groups based on the ratio of different cell types, especially lymphocytes, macrophages, and plasma cells...

  11. Survey of feline visceral leishmaniasis in Azarshahr area, north west of Iran, 2013.

    Science.gov (United States)

    Fatollahzadeh, Mohammad; Khanmohammadi, Majid; Bazmani, Ahad; Mirsamadi, Nasrin; Jafari, Rasool; Mohebali, Mehdi; Nemati, Taher; Fallah, Esmail

    2016-09-01

    Leishmania infantum is a causative agent of visceral leishmaniasis or kala-azar, which is endemic in some part of Iran. Azarshahr city located in East Azerbaijan province, North West of Iran, which is endemic for visceral leishmaniasis. This study aimed to investigate the possible reservoir role of cats for visceral leishmaniasis in the Azarshahr area. Totally 65 cats have been trapped alive from villages of Azarshahr county and their serum samples subjected to direct agglutination test (DAT) for L. infantum antibodies. Giemsa stained impression smears have been prepared for parasitological examination of spleen and liver tissue. Also liver and spleen samples of the cats have been cultured in Novy-MacNeal-Nicolle (NNN) medium and also used for PCR. None from 65 samples was positive in NNN culture, PCR and microscopic examination. Fifteen (23.07 %) out of 65 serum samples showed Leishmania specific antibody agglutination at 1:320 dilution or above, but all considered as negative because none of them confirmed by Giemsa stained smears, PCR and NNN culture. According to the findings of the present study, cats are not a reservoir for visceral leishmaniasis in the Azarshahr area. PMID:27605767

  12. Risk assessment for canine leishmaniasis spreading in the north of Italy

    Directory of Open Access Journals (Sweden)

    Giulia Morosetti

    2009-11-01

    Full Text Available The incidence of zoonotic visceral leishmaniasis has not only been recognized but is, in fact, increasing in territories of northern continental Italy previously regarded as non-endemic. Recent findings of sporadic autochthonous canine infections and the presence of phlebotomine vectors in some provinces of north-eastern Italy have stimulated risk assessment for the spreading of leishmaniasis in the autonomous province of Bolzano-South Tyrol, the northernmost territory of the Italian eastern Alps. In July 2008, 61 phlebotomine sand flies (Diptera, Psychodidae were caught and identified as Phlebotomus perniciosus and Sergentomyia minuta. This is the first record in South Tyrol of P. perniciosus, the most competent vector of Leishmania infantum in Mediterranean countries. Leishmania serology on local dogs kept in kennels gave negative results, while only imported canine leishmaniasis cases were reported by local veterinarians through a questionnaire survey. Bio-geographic aspects and epidemiological consequences are analyzed in relation with the risk of leishmaniasis introduction into the area.

  13. Leishmania (Viannia braziliensis em cães naturalmente infectados Leishmania (Viannia braziliensis in naturally infected dogs

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Madeira

    2003-10-01

    Full Text Available Foram estudados oito cães provenientes do Município de Maricá (RJ, com lesões sugestivas de leishmaniose tegumentar americana por métodos parasitológicos e sorológicos. Leishmania spp foi encontrada em seis cães através do cultivo in vitro. Anticorpos específicos foram detectados em seis animais pelo ELISA e em dois pela imunofluorescência indireta. Cinco isolados caninos analisados apresentaram zimodema similar a Leishmania (Viannia braziliensis. Sugere-se que cães clinicamente suspeitos sejam acompanhados periodicamente, na tentativa de confirmar o diagnóstico da leishmaniose tegumentar canina.Eight dogs from Maricá Municipality (RJ, with suggestive lesion of american tegumentary leishmaniasis were studied by parasitological and serological methods. Leishmania spp was found in six dogs by in vitro cultivation. Specific antibodies were detected in six dogs by ELISA and in two by indirect immunofluorescence. Five canine isolates were found to belong to the same zymodeme as Leishmania (Viannia braziliensis. The authors suggest that clinically suspect dogs should be followed-up in an attempt to confirm the diagnostic of canine tegumentary leishmaniasis.

  14. Knowledge, attitude, and practices related to cutaneous leishmaniasis in an endemic focus of cutaneous leishmaniasis, Southern Iran

    Institute of Scientific and Technical Information of China (English)

    Bahador Sarkari; Asgari Qasem; Mohammad Reza Shafaf

    2014-01-01

    Objective: To assess knowledge, attitudes, and practices (KAP) of inhabitants of an endemic area in Fars province toward cutaneous leishmaniasis (CL). Methods: The study was carried out in Lapui district in Fars province, south of Iran, one of the most important foci of CL in this province. Sample size (237 residents) was calculated based on population. House-to-house survey was done to collect the data regarding knowledge, attitudes, and practices of the inhabitants. The head of each household was interviewed by a trained staff to assess his/her KAP related to CL. A semi-structured KAP questionnaire was used for data collection.Results:Mean age of participants was 39 and more than half of the respondents were in the age group of 31-40. Males constituted 172 (72.5%) of subjects. Most of the respondents (84.3%) were literate. The majority of the study population (83%) had heard about Salak (local name for CL) and most of these respondents (91%) were aware that CL is presented with a cutaneous lesion. Nearly two-third of the participants (63.5%) stated the bite of mosquito (not specifically sandflies) for CL transmission. The respondents’ attitude regarding the treatment of CL was not satisfactory since only 48% believed that CL can be treated by medicine. A noticeable proportion of respondents (21%) believed in indigenous medicine for the treatment of CL. A small proportion of respondents (14%) stated that traditional healers are good at treating this disease. More than two-third (69%) of respondents believed that the disease is preventable although most of interviewees did not know about preventive measures. Conclusions: In this study, insufficient knowledge of community about infection nature, vector, transmission mode and preventive measures of CL, highlights the needs for a health education initiative to enhance the awareness of people about CL. This would improve inhabitants’ contribution in control program of CL in this area.

  15. Molecular detection of Leishmania in phlebotomine sand flies (Diptera: Psychodidae) from a cutaneous leishmaniasis focus atXakriabá Indigenous Reserve, Brazil.

    Science.gov (United States)

    Rêgo, Felipe Dutra; Rugani, Jeronimo Marteleto Nunes; Shimabukuro, Paloma Helena Fernandes; Tonelli, Gabriel Barbosa; Quaresma, Patrícia Flávia; Gontijo, Célia Maria Ferreira

    2015-01-01

    Autochthonous cases of American cutaneous leishmaniasis (ACL) have been reported since 2001 in the Xakriabá Indigenous Reserve located in the municipality of São João das Missões in northern Minas Gerais state, Brazil. In order to study the presence of Leishmania DNA in phlebotomine sand flies, six entomological collections were carried out from July 2008 through July 2009, using 40 light traps placed in peridomicile areas of 20 randomly selected houses. From October 2011 through August 2012, another six collections were carried out with 20 light traps distributed among four trails (five traps per trail) selected for a previous study of wild and synanthropic hosts of Leishmania. A total of 4,760 phlebotomine specimens were collected belonging to ten genera and twenty-three species. Single female specimens or pools with up to ten specimens of the same locality, species and date, for Leishmania detection by molecular methods. Species identification of parasites was performed with ITS1 PCR-RFLP using HaeIII enzyme and genetic sequencing for SSU rRNA target. The presence of Leishmania DNA was detected in eleven samples from peridomicile areas: Lu. longipalpis (two), Nyssomyia intermedia (four), Lu. renei (two), Lu. ischnacantha, Micropygomyia goiana and Evandromyia lenti (one pool of each specie). The presence of Leishmania DNA was detected in twelve samples from among the trails: Martinsmyia minasensis (six), Ny. intermedia (three), Mi. peresi (two) and Ev. lenti (one). The presence of Leishmania infantum DNA in Lu. longipalpis and Leishmania braziliensis DNA in Ny. intermediasupport the epidemiological importance of these species of sand flies in the cycle of visceral and cutaneous leishmaniasis, respectively. The results also found other species associated with Leishmania DNA, such as Mt. minasensis and Ev. lenti, which may participate in a wild and/or synanthropic cycle of Leishmania transmission in the studied area.

  16. A new focus of cutaneous leishmaniasis in Jammu division of Jammu and Kashmir State, India

    Directory of Open Access Journals (Sweden)

    Neenu Kaul

    2016-01-01

    Full Text Available Background: Cutaneous leishmaniasis in India is mainly confined to the deserts of Rajasthan; some cases have been reported from the dry north-western half of the Indo-Gangetic plain, including Punjab, Himachal Pradesh, Delhi and Varanasi. Aims: To highlight a new focus of cutaneous leishmaniasis in the Jammu division of Jammu and Kashmir State, previously a non-endemic area. This report presents the clinico-epidemiological and investigative results of 120 new cases of cutaneous leishmaniasis detected between November 2012 and October 2013. Methods: The clinical diagnosis of cutaneous leishmaniasis was made using criteria proposed by Bari and Rahman. It was further confirmed by the demonstration of Leishman-Donovan bodies in Leishman stained slit skin smears and skin biopsy specimens, and/or by a satisfactory response to intra-lesional sodium stibogluconate given weekly for 4 weeks. Serial clinical photographs were taken before giving injections and at the end of the 6 th week. Results: There were 67 females and 53 males with an age range of 8 months to 80 years. The most frequently affected site was the face. Lesions were most commonly of the nodulo-ulcerative type. The number of lesions ranged from 1 to 4. Farmers (28.1%, homemakers (27.2% and students (27.2% were significantly over-represented among the occupations (P < 0.001. Skin smears and biopsies were positive for Leishman-Donovan bodies in 50.8% and 44.2% cases, respectively. Conclusions: There is a new focus of cutaneous leishmaniasis in Jammu division which deserves urgent attention from the public health angle. Further epidemiological studies are warranted to establish the identity of the vector and the strain of Leishmania involved.

  17. Ecological Niche Modeling for the Prediction of the Geographic Distribution of Cutaneous Leishmaniasis in Tunisia.

    Science.gov (United States)

    Chalghaf, Bilel; Chlif, Sadok; Mayala, Benjamin; Ghawar, Wissem; Bettaieb, Jihène; Harrabi, Myriam; Benie, Goze Bertin; Michael, Edwin; Salah, Afif Ben

    2016-04-01

    Cutaneous leishmaniasis is a very complex disease involving multiple factors that limit its emergence and spatial distribution. Prediction of cutaneous leishmaniasis epidemics in Tunisia remains difficult because most of the epidemiological tools used so far are descriptive in nature and mainly focus on a time dimension. The purpose of this work is to predict the potential geographic distribution of Phlebotomus papatasi and zoonotic cutaneous leishmaniasis caused by Leishmania major in Tunisia using Grinnellian ecological niche modeling. We attempted to assess the importance of environmental factors influencing the potential distribution of P. papatasi and cutaneous leishmaniasis caused by L. major. Vectors were trapped in central Tunisia during the transmission season using CDC light traps (John W. Hock Co., Gainesville, FL). A global positioning system was used to record the geographical coordinates of vector occurrence points and households tested positive for cutaneous leishmaniasis caused by L. major. Nine environmental layers were used as predictor variables to model the P. papatasi geographical distribution and five variables were used to model the L. major potential distribution. Ecological niche modeling was used to relate known species' occurrence points to values of environmental factors for these same points to predict the presence of the species in unsampled regions based on the value of the predictor variables. Rainfall and temperature contributed the most as predictors for sand flies and human case distributions. Ecological niche modeling anticipated the current distribution of P. papatasi with the highest suitability for species occurrence in the central and southeastern part of Tunisian. Furthermore, our study demonstrated that governorates of Gafsa, Sidi Bouzid, and Kairouan are at highest epidemic risk. PMID:26856914

  18. Sporotrichoid cutaneous leishmaniasis due to Leishmania major of different zymodemes in the Sudan and Saudi Arabia: a comparative study

    DEFF Research Database (Denmark)

    Gaafar, A; Fadl, A; el Kadaro, A Y;

    1994-01-01

    Sporotrichoid cutaneous leishmaniasis is due to dissemination of amastigotes via the lymphatics to the subcutaneous tissues. A comparison was made between the potential to disseminate by this route of 2 parasites of different zymodemes in Sudan and Saudi Arabia. In Sudan cutaneous leishmaniasis...... is caused by Leishmania major zymodeme LON-1, and in Saudi Arabia by L. major LON-4. Sporotrichoid leishmaniasis was significantly more common in Sudan, occurring in 23% of patients compared with 10% in Saudi Arabia. Lymph node involvement was slightly more prevalent in the Sudan. Clinical and pathological...... differences between subcutaneous nodules, particularly when they ulcerate, and multiple primary cutaneous lesions are described and treatment of localized and sporotrichoid leishmaniasis is discussed. The pathological features of the primary lesions in the Sudan and Saudi Arabia were similar....

  19. American palm ethnomedicine: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Balslev Henrik

    2009-12-01

    Full Text Available Abstract Background Many recent papers have documented the phytochemical and pharmacological bases for the use of palms (Arecaceae in ethnomedicine. Early publications were based almost entirely on interviews that solicited local knowledge. More recently, ethnobotanically guided searches for new medicinal plants have proven more successful than random sampling for identifying plants that contain biodynamic ingredients. However, limited laboratory time and the high cost of clinical trials make it difficult to test all potential medicinal plants in the search for new drug candidates. The purpose of this study was to summarize and analyze previous studies on the medicinal uses of American palms in order to narrow down the search for new palm-derived medicines. Methods Relevant literature was surveyed and data was extracted and organized into medicinal use categories. We focused on more recent literature than that considered in a review published 25 years ago. We included phytochemical and pharmacological research that explored the importance of American palms in ethnomedicine. Results Of 730 species of American palms, we found evidence that 106 species had known medicinal uses, ranging from treatments for diabetes and leishmaniasis to prostatic hyperplasia. Thus, the number of American palm species with known uses had increased from 48 to 106 over the last quarter of a century. Furthermore, the pharmacological bases for many of the effects are now understood. Conclusions Palms are important in American ethnomedicine. Some, like Serenoa repens and Roystonea regia, are the sources of drugs that have been approved for medicinal uses. In contrast, recent ethnopharmacological studies suggested that many of the reported uses of several other palms do not appear to have a strong physiological basis. This study has provided a useful assessment of the ethnobotanical and pharmacological data available on palms.

  20. Early clinical manifestations associated with death from visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Valdelaine Etelvina Miranda de Araújo

    Full Text Available BACKGROUND: In Brazil, lethality from visceral leishmaniasis (VL is high and few studies have addressed prognostic factors. This historical cohort study was designed to investigate the prognostic factors for death from VL in Belo Horizonte (Brazil. METHODOLOGY: The analysis was based on data of the Reportable Disease Information System-SINAN (Brazilian Ministry of Health relating to the clinical manifestations of the disease. During the study period (2002-2009, the SINAN changed platform from a Windows to a Net-version that differed with respect to some of the parameters collected. Multivariate logistic regression models were performed to identify variables associated with death from VL, and these were included in prognostic score. PRINCIPAL FINDINGS: Model 1 (period 2002-2009; 111 deaths from VL and 777 cured patients included the variables present in both SINAN versions, whereas Model 2 (period 2007-2009; 49 deaths from VL and 327 cured patients included variables common to both SINAN versions plus the additional variables included in the Net version. In Model 1, the variables significantly associated with a greater risk of death from VL were weakness (OR 2.9; 95%CI 1.3-6.4, Leishmania-HIV co-infection (OR 2.4; 95%CI 1.2-4.8 and age ≥60 years (OR 2.5; 95%CI 1.5-4.3. In Model 2, the variables were bleeding (OR 3.5; 95%CI 1.2-10.3, other associated infections (OR 3.2; 95%CI 1.3-7.8, jaundice (OR 10.1; 95%CI 3.7-27.2 and age ≥60 years (OR 3.1; 95%CI 1.4-7.1. The prognosis score was developed using the variables associated with death from VL of the latest version of the SINAN (Model 2. The predictive performance of which was evaluated by sensitivity (71.4%, specificity (73.7%, positive and negative predictive values (28.9% and 94.5% and area under the receiver operating characteristic curve (75.6%. CONCLUSIONS: Knowledge regarding the factors associated with death from VL may improve clinical management of patients and contribute to lower

  1. Therapeutic Effect of Hedera helix Alcoholic Extract Against Cutaneous Leishmaniasis Caused by Leishmania major in Balb/c Mice

    OpenAIRE

    Hooshyar, Hossein; Talari, Safarali; Feyzi, Fatemeh

    2014-01-01

    Background: Cutaneous leishmaniasis (CL) is common and endemic in many areas of Iran, caused by species of a protozoan parasite belonging to the genus Leishmania. There is not any effective vaccine against leishmaniasis; so, therapy is important for prevention and separation of disease. Herbal extract for treatment of CL is cost-effective, applicable topically to lesions, and can avoid the development of drug resistance. Objectives: The aim of this study was to evaluate the in vivo activity o...

  2. Mucocutaneous Leishmaniasis: clinical markers in presumptive diagnosis Leishmaniose mucosa: marcadores clínicos no diagnóstico presuntivo

    OpenAIRE

    João Luiz Cioglia Pereira Diniz; Manoel Otávio da Rocha Costa; Denise Utsch Gonçalves

    2011-01-01

    Mucocutaneous Leishmaniasis (ML) can lead to serious sequela; however, early diagnosis can prevent complications. AIM: To evaluate clinical markers for the early diagnosis of ML. MATERIALS AND METHODS: A series study of 21 cases of ML, which were evaluated through clinical interview, nasal endoscopy, biopsy and the Montenegro test. RESULTS: A skin scar and previous diagnosis of cutaneous leishmaniasis (CL) were reported in 8(38%) patients, and 13(62%) of them denied having had previous CL and...

  3. Concomitant Infection with Leishmania donovani and L. major in Single Ulcers of Cutaneous Leishmaniasis Patients from Sudan

    OpenAIRE

    Babiker, A. M.; S. Ravagnan; Fusaro, A.; M.M. Hassan; Bakheit, S. M.; Mukhtar, M.M.; Cattoli, G.; G. Capelli

    2014-01-01

    In Sudan human leishmaniasis occurs in different clinical forms, that is, visceral (VL), cutaneous (CL), mucocutaneous (ML), and post-kala-azar dermal leishmaniasis (PKDL). Clinical samples from 69 Sudanese patients with different clinical manifestations were subjected to a PCR targeting the cytochrome oxidase II (COII) gene for Leishmania species identification. Mixed infections were suspected due to multiple overlapping peaks presented in some sequences of the COII amplicons. Cloning thes...

  4. Treatment of leishmaniasis in the Oyapock basin (French Guiana) : a KAP survey and analysis of the evolution of phytotherapy knowledge amongst Wayapi Indians

    OpenAIRE

    Odonne, G.; Berger, F; Stien, D.; Grenand, Pierre; Bourdy, Geneviève

    2011-01-01

    Ethnopharmacological relevance: Cutaneous leishmaniasis is a neglected disease with a high incidence in French Guiana, mainly in the middle and upper Oyapock basin, where Amerindian and some Brazilian people live. The main goals of this work were (i) to assess the knowledge about leishmaniasis in the different populations of the middle and upper Oyapock basin, (ii) to study the therapeutic strategies adopted by people affected by leishmaniasis and (iii) to document the use of phytotherapeutic...

  5. Knowledge,attitude,and practices related to cutaneous leishmaniasis in an endemic focus of cutaneous leishmaniasis,Southern Iran

    Institute of Scientific and Technical Information of China (English)

    Bahador; Sarkari; Asgari; Qasem; Mohammad; Reza; Shafaf

    2014-01-01

    Objective:To assess knowledge,attitudes,and practices(KAP)of inhabitants of an endemic area it)Fars province toward cutaneous leishmaniasis(CI).Methods:the study was carried out in Lapui district in Fars province,south of Iran,one of the most important foci of CL in this province.Sample size(237 residents)was calculated based on population.House-to-house survey was done to collect the data regarding knowledge,attitudes,and practices of the inhabitants.The head of each household was interviewed by a trained staff to assess his/her KAP related to CL.A semi-structured KAP questionnaire was used for data collection.Results:Mean age of participants was 39 and more titan half of the respondents were in the age group of 31-40.Males constituted 172(72.5%)of subjects.Most of the respondents(84.3%)were literate.The majority of the study poulation(83%)had heard about SalaJc(local name for CL)and most of these respondents(91%)were aware that CL is presented with a cutaneous lesion.Nearly two-third of the participants(63.5%)stated the bite of mosquito(not specifically sandflies)for CL transmission.The respondents’attitude regarding the treatment of CL was not satisfactory since Only 48%believed that CL can be treated by medicine.A noticeable proportion of respondents(21%)believed in indigenous medicine for the treatment of CL.A small proportion of respondents(14%)stated that traditional healers are good at treating this disease.More than two-third(69%)of respondents believed that the disease is preventable although most of interviewees did not know about preventive measures.Conclusions:In this study,insufficient knowledge of community about infection nature,vector,transmission mode and preventive measures of CL,highlights the needs for a health education initiative to enhance the awareness of people about CL.This would improve inhabitants’contribution in control program of CL in this area.

  6. Comparison of oral itraconazole and intramuscular meglumine antimoniate in the treatment of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    To compare the efficacy and tolerability of oral itraconazole against intramuscular meglumine antimoniate in the treatment of Cutaneous Leishmaniasis (CL). Two hundred eligible and consenting patients of Cutaneous Leishmaniasis (CL) were divided in two groups with 100 patients in each. The number and location of the lesions were documented and clinical types of cutaneous leishmaniasis were noted. The diagnosis was confirmed by skin slit smear and histopathology of the lesional skin. Culture on Nicolle Novy MacNeal (NNN) medium and Leishmanin test was done in all patients. All the patients in both groups were subjected to complete blood picture, urine examination, serum urea and creatinine levels and ECG examination. One group was given itraconazole 100 mg twice daily orally for a duration of 6-8 weeks. The other group was given meglumine antimoniate 10 cc in the form of deep intramuscular injections for 15-30 days. The efficacy of the treatment was judged by clinical and parasitological response. Side effects of the agents were also noted during treatment. Out of 200 patients studied, 185 were males and 15 were females. The mean age of presentation was 30 + 6.6 years. Single lesion was seen in 132 (66%) subjects whereas 68 (34%) subjects had multiple lesions. Slit skin smears were positive in 50 (25%) of the patients. Skin biopsy yielded the presence of LT bodies in 150 (75%) subjects. The culture was positive in 102 (51%) cases. Leishmanin test was positive in 94% subjects. Seventy-five (75%) patients on itraconazole therapy showed complete clinical and parasitological cure in 4-8 weeks duration. A rise in ALT was seen in 12% subjects. Five (5%) subjects did not show any improvement till the end of therapy. Sixty-five (65%) subjects on meglumine antimoniate showed complete healing in 15-30 days. In 35 (35%) of the patients, the treatment had to be stopped due to intolerable side-effects. Four cases of lupoid leishmaniasis and 4 cases of sporotrichoid leishmaniasis

  7. American Dream in Early American Literatuer

    Institute of Scientific and Technical Information of China (English)

    屈彩娥; 李小玺

    2008-01-01

    American dream has often been closely rehted to American literature.Many say that the American literary history can be seen as the history of American dreams.In most periods in history,writers,whose dreams have been infused in a variety of characters create the American literature.While in Early American literature,American dream had been presented in a dif-ferent way.

  8. Eco-epidemiology of visceral leishmaniasis in the urban area of Paracatu, state of Minas Gerais, Brazil.

    Science.gov (United States)

    Dias, Edelberto Santos; Regina-Silva, Shara; França-Silva, João Carlos; Paz, Gustavo Fontes; Michalsky, Erika Monteiro; Araújo, Simone Costa; Valadão, Josiane Lopes; de Oliveira Lara-Silva, Fabiana; de Oliveira, Fernanda Santos; Pacheco, Raquel Silva; Fortes-Dias, Consuelo Latorre

    2011-03-10

    The present study was developed in the urban area of Paracatu, an endemic city for the American visceral leishmaniasis in Brazil. A six-month canine survey was performed with 6295 domiciled dogs in 28 districts in that area and showed that 4.2% of those (267 dogs) were positive for VL by ELISA and IFAT serum assays. Prevalence ratios for canine VL varied between 1.2% and 16.1%, depending on the district under investigation. Fifteen dogs - 80% of which were clinically asymptomatic for VL - were submitted to a more detailed study that comprised direct parasitological examination and Leishmania kDNA amplification of tissue samples as well as two PCR-RFLP methods using myelocultures. Leishmania amastigotes or Leishmania DNA were detected in all dogs but one. The infecting species of Leishmania was identified in about 50% (7/15) of the sample dogs: Leishmania (Leishmania) chagasi in two of them and, unexpectedly, Leishmania (Leishmania) amazonensis in the remaining five. Three months after the end of confiscation and elimination of the VL-seropositive dogs in the 28 districts of Paracatu, a systematic entomological survey was performed in five of them. Six hundred and sixty five (665) phlebotomine sand flies were captured in total, from which 89.5% were identified as Lutzomyia longipalpis. The population density of that species increased during the rainy season. Other thirteen (13) species of phlebotomine sand flies were captured at varying percentages from 0.2 to 5.0%. It is worth noting that L. longipalpis females were predominantely intradomicile when compared to males, suggesting that the VL transmission cycle in Paracatu may be occurring inside home.

  9. Visceral leishmaniasis with cardiac involvement in a dog: a case report

    Directory of Open Access Journals (Sweden)

    Goicoa Ana

    2009-04-01

    Full Text Available Abstract A dog presented with cutaneous nodules, enlarged lymph nodes and oedema in limbs, face and abdomen. The diagnosis of visceral leishmaniasis was established by identification of Leishmania amastigotes within macrophages from skin and popliteal lymph node biopsies. At necropsy, lesions were found in different organs, but it was particularly striking to observe large areas of pallor in the myocardium. Histological examination revealed an intense chronic inflammatory reaction in many organs, and numerous macrophages were found to contain amastigote forms of Leishmania. The inflammatory reaction was especially severe in the heart, where large areas of the myocardium appeared infiltrated with huge numbers of mononuclear immune cells, causing cardiac muscle atrophy and degeneration. Despite the severe inflammation, the number of parasitized macrophages was low in the myocardium, as revealed by immunohistochemical staining of Leishmania amastigotes. Because cardiac involvement is not usually described in this condition, this dog represents a very rare case of canine visceral leishmaniasis with affection of the myocardium.

  10. Seroepidemiological and leishmanin skin test surveys of visceral leishmaniasis in south and southwest Ethiopia.

    Science.gov (United States)

    Hailu, A; Berhe, N; Sisay, Z; Abraham, I; Medhin, G

    1996-01-01

    Sero-epidemiological and leishmanin skin test surveys of visceral leishmaniasis were carried out in eight localities of South and Southwest Ethiopia between the July 1989 and June 1992. A total number of 4870 subjects comprising semi-pastoral nomads, peasants and farm labourers were included in the study. Areas of high and low leishmanin skin test positivity were identified, with rates varying from 1.0-80.5%. An enzyme-linked immunosorbent assay was used to determine prevalence of antileishmanial antibodies. The rates varied from 1.8% to 27.8%. Age and sex related serological and leishmanin skin test profiles are described. Correlation analysis of serological and leishmanin skin test was made for data in each locality. The relationships between seroprevalence, leishmanin skin test rates and prevalence of active visceral leishmaniasis and the implications on degrees of endemicity and patterns of transmission are discussed. PMID:8674496

  11. IDENTIFICATION OF SANDFLIES (Diptera: Psychodidae: Phlebotominae) BLOOD MEALS IN AN ENDEMIC LEISHMANIASIS AREA IN BRAZIL

    Science.gov (United States)

    TANURE, Aline; PEIXOTO, Jennifer Cunha; AFONSO, Margarete Martins dos Santos; DUARTE, Rosemere; PINHEIRO, Aimara da Costa; COELHO, Suedali Villas Bôas; BARATA, Ricardo Andrade

    2015-01-01

    SUMMARY The aim of this study was to identify blood meals of female sandflies captured in the municipality of Governador Valadares, an endemic area of visceral and cutaneous leishmaniasis, in the State of Minas Gerais, Brazil. From May 2011 to January 2012, captures were performed using HP light traps in four districts. There were 2,614 specimens (2,090 males and 524 females) captured; 97 engorged females were identified belonging to the species Lutzomyia longipalpis (82.1%) and Lutzomyia cortelezzii (17.9%). Considering simple and mixed feeding, the enzyme-linked immunosorbent assay revealed a predominance of chicken blood (43.6%) in Lutzomyia longipalpis, showing the important role that chickens exert around the residential areas of Governador Valadares. This finding increases the chances of sandflies contact with other vertebrates and consequently the risk of leishmaniasis transmission. PMID:26422156

  12. Leishmaniosis phytotherapy:Review of plants used in Iranian traditional medicine on leishmaniasis

    Institute of Scientific and Technical Information of China (English)

    Mahmoud Bahmani; Kourosh Saki; Behrouz Ezatpour; Somayeh Shahsavari; Zohreh Eftekhari; Mahyar Jelodari; Mahmoud Rafieian-Kopaei; Reza Sepahvand

    2015-01-01

    Many native plants in traditional medicine have been used for the treatment of cutaneous leishmaniasis and the recent clinical trials have proven the efficacy of some of them. Researches conducted on these plants have shown that garlic, shallots, wormwood, yarrow, walnuts, thyme, henna plant, mimosa, aloe, wood betony, medlar, periwinkle, yeah, savory, black beans, etc. are effective on cutaneous leishmania. Synthetic agents in Iranian market have some disadvantages such as high cost and side effects and are painful in injections. Given the effectiveness of these plants, they can be a source of natural and safe compounds for the treatment of Leishmania. Therefore, more clinical researches should be done to determine the effectiveness and safety of these medicinal plants, their active ingredients and their possible toxic substances which can lead to the production of effective and safe drugs for leishmaniasis. It also might be an effective way to prepare herbal ointment on wound healing.

  13. Leishmaniosis phytotherapy: Review of plants used in Iranian traditional medicine on leishmaniasis

    Institute of Scientific and Technical Information of China (English)

    Mahmoud; Bahmani; Kourosh; Saki; Behrouz; Ezatpour; Somayeh; Shahsavari; Zohreh; Eftekhari; Mahyar; Jelodari; Mahmoud; Rafieian; Kopaei; Reza; Sepahvand

    2015-01-01

    Many native plants in traditional medicine have been used for the treatment of cutaneous leishmaniasis and the recent clinical trials have proven the efficacy of some of them. Researches conducted on these plants have shown that garlic, shallots, wormwood, yarrow, walnuts, thyme, henna plant, mimosa, aloe, wood betony, medlar, periwinkle, yeah, savory, black beans, etc. are ef ective on cutaneous leishmania. Synthetic agents in Iranian market have some disadvantages such as high cost and side ef ects and are painful in injections. Given the ef ectiveness of these plants, they can be a source of natural and safe compounds for the treatment of Leishmania. Therefore, more clinical researches should be done to determine the ef ectiveness and safety of these medicinal plants, their active ingredients and their possible toxic substances which can lead to the production of ef ective and safe drugs for leishmaniasis. It also might be an ef ective way to prepare herbal ointment on wound healing.

  14. IDENTIFICATION OF SANDFLIES (Diptera: Psychodidae: Phlebotominae BLOOD MEALS IN AN ENDEMIC LEISHMANIASIS AREA IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Aline TANURE

    2015-08-01

    Full Text Available SUMMARY The aim of this study was to identify blood meals of female sandflies captured in the municipality of Governador Valadares, an endemic area of visceral and cutaneous leishmaniasis, in the State of Minas Gerais, Brazil. From May 2011 to January 2012, captures were performed using HP light traps in four districts. There were 2,614 specimens (2,090 males and 524 females captured; 97 engorged females were identified belonging to the species Lutzomyia longipalpis (82.1% and Lutzomyia cortelezzii (17.9%. Considering simple and mixed feeding, the enzyme-linked immunosorbent assay revealed a predominance of chicken blood (43.6% in Lutzomyia longipalpis, showing the important role that chickens exert around the residential areas of Governador Valadares. This finding increases the chances of sandflies contact with other vertebrates and consequently the risk of leishmaniasis transmission.

  15. Leishmaniosis phytotherapy: Review of plants used in Iranian traditional medicine on leishmaniasis

    Directory of Open Access Journals (Sweden)

    Mahmoud Bahmani

    2015-09-01

    Full Text Available Many native plants in traditional medicine have been used for the treatment of cutaneous leishmaniasis and the recent clinical trials have proven the efficacy of some of them. Researches conducted on these plants have shown that garlic, shallots, wormwood, yarrow, walnuts, thyme, henna plant, mimosa, aloe, wood betony, medlar, periwinkle, yeah, savory, black beans, etc. are effective on cutaneous leishmania. Synthetic agents in Iranian market have some disadvantages such as high cost and side effects and are painful in injections. Given the effectiveness of these plants, they can be a source of natural and safe compounds for the treatment of Leishmania. Therefore, more clinical researches should be done to determine the effectiveness and safety of these medicinal plants, their active ingredients and their possible toxic substances which can lead to the production of effective and safe drugs for leishmaniasis. It also might be an effective way to prepare herbal ointment on wound healing.

  16. Lutzomyia longipalpis in Uruguay: the first report and the potential of visceral leishmaniasis transmission.

    Science.gov (United States)

    Salomón, Oscar Daniel; Basmajdian, Yester; Fernández, María Soledad; Santini, María Soledad

    2011-05-01

    Phlebotomine captures were performed in February 2010 in Salto (Salto department) and Bella Unión-Cuarein (Artigas department), Uruguay. Bella Unión is located across the Paraná River from Monte Caseros, Argentina, where a focus of canine visceral leishmaniasis (VL) was reported in 2009. No VL cases have ever been recorded in Uruguay and the last reported capture of Phlebotominae was in 1932 (Lutzomyia cortelezzii and Lutzomyia gaminarai). Light traps were placed in peridomestic environments, and Lutzomyia longipalpis, the main vector of visceral leishmaniasis, was found in Salto and Bella Unión. This is a first report of an area of potential VL transmission in Uruguay. Active and coordinated surveillance is required immediately the Uruguay-Argentina-Brazil border area.

  17. Variations in seroprevalences of canine leishmaniasis: Could it be a consequence of the population structure?

    Science.gov (United States)

    Muniesa, Ana; Peris, Ana; Castillo, Juan Antonio; de Blas, Ignacio

    2016-08-15

    Canine leishmaniasis is a parasitic disease caused by Leishmania infantum and is transmitted by Phlebotominae vectors. Despite numerous publications on the subject, some essential aspects of the epidemiology are not yet sufficiently clear. We proposed a stochastic model with the aim of identifying some important gaps in the current knowledge of leishmaniasis, such as the frequency of vector infection or a dog's life expectancy depending on their purpose and their health status. We only found that the purpose was a significant factor. Furthermore, we detected relationships among age, gender and habitat with the dogs' purposes that can affect the calculation of the overall seroprevalence of the analysed sample. The development of this model will allow us to discard potential confounding factors as gender, age, purpose or habitat. PMID:27514874

  18. American Culture Reflected in American English

    Institute of Scientific and Technical Information of China (English)

    李华芳

    2013-01-01

    Language is a vehicle for culture. It is also a key component of culture. It not only reflects culture but also influences culture. As a variety of British English, American English, especially American words and expressions can reflect American culture from many aspects. This paper studies some typical traits of American culture reflected in words and expressions of American Eng-lish.

  19. Visceral Leishmaniasis: A Differential Diagnosis to Remember after Bone Marrow Transplantation

    OpenAIRE

    2014-01-01

    Leishmania infection in immunocompromised hosts is reported in the literature, mostly concerning human immunodeficiency virus infected patients. It is not well characterized in the context of stem cell transplantation. We report a rare case clinical case of visceral leishmaniasis after allogeneic bone marrow transplantation. A 50-year-old Caucasian male was referred to allogeneic bone marrow transplantation with a high-risk acute lymphoblastic B leukemia in first complete remission. Allogenei...

  20. Temperature-derived potential for the establishment of phlebotomine sandflies and visceral leishmaniasis in Germany

    Directory of Open Access Journals (Sweden)

    Dominik Fischer

    2010-11-01

    Full Text Available Climate change is expected to manifest in the shift of organisms to regions where they were not present in the past, potentially entailing previously unseen biological risks. However, studies evaluating these future trends are scarce. Here, an important group of vectors (sandflies and the pathogen transmitted (Leishmania infantum complex causing the infectious disease visceral leishmaniasis is investigated, focussing on potential establishment in Germany during the 21st century. As the most important habitat factor, temperature requirements of pathogen and vector were derived from the literature and compared with recent climate records - provided by worldclim - and climate change scenarios. Climate data from the Regional Climate Model REMO were obtained and averaged over the time periods 2011- 2040, 2041-2070 and 2071-2100. Projected temperature changes (based on the A1B and A2 scenarios were correlated with the constraints of vector and pathogen. Simulated potentially suitable habitat areas for vector and pathogen were merged to generate a temperature-derived risk map of visceral leishmaniasis. Temperature conditions seem to become suitable for the vector across large swaths of Germany. Nevertheless, temperature constraints for the pathogen may defer the establishment of the parasitic disease, particularly during the first half of the 21st century. Long-lasting epidemics of visceral leishmaniasis are therefore not expected in Germany during the next few decades, although during extremely warm years an increase in autochthonous cases of leishmaniasis may occur. The southwest (Upper Rhine Valley and west (Cologne Bight of Germany are identified as risk areas. The time of potential establishment and corresponding rise in biological risk varies between scenarios, due to differences in the predicted rate of temperature increase.

  1. Canine antibody response to Lutzomyia longipalpis saliva in endemic area of visceral leishmaniasis.

    OpenAIRE

    Luís Fábio da Silva Batista; Vânia Lúcia Ribeiro da Matta; Thaise Yumie Tomokane; Acácio Duarte Pacheco; Fernando Tobias Silveira; Claudio Nazaretian Rossi; Mary Marcondes; Márcia Dalastra Laurenti

    2016-01-01

    Abstract: INTRODUCTION: Canine exposure to Lutzomyia longipalpis bites and the potential of Leishmania infantum transmissibility for the vector were evaluated. METHODS Immunoglobulin G (IgG) anti-Lu longipalpis saliva and -L. infantum, and blood parasite load were determined in dogs from endemic areas of visceral leishmaniasis. RESULTS Blood parasitism was similar between symptomatic and asymptomatic dogs. IgG anti-L. infantum was higher in symptomatic dogs, but IgG anti-Lu. longipalpis ...

  2. Multi-modal analysis of courtship behaviour in the old world leishmaniasis vector Phlebotomus argentipes.

    Directory of Open Access Journals (Sweden)

    Daniel P Bray

    2014-12-01

    Full Text Available The sand fly Phlebotomus argentipes is arguably the most important vector of leishmaniasis worldwide. As there is no vaccine against the parasites that cause leishmaniasis, disease prevention focuses on control of the insect vector. Understanding reproductive behaviour will be essential to controlling populations of P. argentipes, and developing new strategies for reducing leishmaniasis transmission. Through statistical analysis of male-female interactions, this study provides a detailed description of P. argentipes courtship, and behaviours critical to mating success are highlighted. The potential for a role of cuticular hydrocarbons in P. argentipes courtship is also investigated, by comparing chemicals extracted from the surface of male and female flies.P. argentipes courtship shared many similarities with that of both Phlebotomus papatasi and the New World leishmaniasis vector Lutzomyia longipalpis. Male wing-flapping while approaching the female during courtship predicted mating success, and touching between males and females was a common and frequent occurrence. Both sexes were able to reject a potential partner. Significant differences were found in the profile of chemicals extracted from the surface of males and females. Results of GC analysis indicate that female extracts contained a number of peaks with relatively short retention times not present in males. Extracts from males had higher peaks for chemicals with relatively long retention times.The importance of male approach flapping suggests that production of audio signals through wing beating, or dispersal of sex pheromones, are important to mating in this species. Frequent touching as a means of communication, and the differences in the chemical profiles extracted from males and females, may also indicate a role for cuticular hydrocarbons in P. argentipes courtship. Comparing characteristics of successful and unsuccessful mates could aid in identifying the modality of signals

  3. Cutaneous leishmaniasis caused by members of Leishmania braziliensis complex in Nayarit, State of Mexico

    OpenAIRE

    Gustavo Sanchez-Tejeda; Noris Rodríguez; Carlos I Parra; Omar Hernandez-Montes; Barker, Douglas C.; Amalia Monroy-Ostria

    2001-01-01

    An epidemiological study was carried out in the northern Mexican state, Nayarit. Fourteen patients with possible cutaneous leishmaniasis skin lesions gave positive Montenegro skin tests. Biopsies were taken from the skin ulcer and analyzed by polymerase chain reaction (PCR) with specific primers for the Leishmania mexicana complex; however all biopsies were not amplified. PCR carried out with specific primers for the L. braziliensis complex resulted in the amplification of all patient DNA. DN...

  4. Control of mucocutaneous leishmaniasis, a neglected disease: results of a control programme in Satipo Province, Peru.

    OpenAIRE

    Guthmann, Jean-Paul; Arlt, Doris; Garcia, Luis Miguel Leon; Rosales, Milena; de Jesus Sanchez, Juan; Alvarez, Eugenia; Lonlas, Sylvaine; Conte, Mado; Bertoletti, Guillermo; Fournier, Christophe; Huari, Roberto; Torreele, Els; A. Llanos-Cuentas

    2005-01-01

    Mucocutaneous leishmaniasis (MCL) is an important health problem in many rural areas of Latin America, but there are few data on the results of programmatic approaches to control the disease. We report the results of a control programme in San Martin de Pangoa District, which reports one of the highest prevalences of MCL in Peru. For 2 years (2001--2002), the technicians at the health post were trained in patient case management, received medical support and were supplied with antimonials. An...

  5. IL-10 Neutralization Promotes Parasite Clearance in Splenic Aspirate Cells From Patients With Visceral Leishmaniasis

    OpenAIRE

    Gautam, Shalini; Kumar, Rajiv; Maurya, Radheshyam; Nylén, Susanne; Ansari, Nasim; Rai, Madhukar; Sundar, Shyam; Sacks, David

    2011-01-01

    The mechanisms underlying the failure to contain the growth of Leishmania parasites in human visceral leishmaniasis (VL) are not understood. L donovani amastigotes were quantified in cultured splenic aspirate cells to assess the function of IL-10 in lesional tissue ex vivo. In 67 patients with active VL, IL-10 neutralization promoted parasite killing in 73% and complete clearance in 30%, while 18% had more parasites and 9% did not change. The splenic cells secreted increased levels of both tu...

  6. Safety and Effectiveness of Amphotericin B Deoxycholate for the Treatment of Visceral Leishmaniasis in Uganda.

    OpenAIRE

    Mueller, Y; Nguimfack, A; Cavailler, Philippe; Couffignal, Sophie; Rwakimari, J B; Loutan, Louis; Chappuis, Francois

    2008-01-01

    Between September 2003 and April 2004, the supply of antimonial drugs to Amudat Hospital, in north-eastern Uganda, was interrupted and all cases of visceral leishmaniasis presenting at the hospital could only be treated with amphotericin B deoxycholate (AmB). This allowed the safety and effectiveness of the AmB to be evaluated, in comparison with an historical cohort of patients treated, at the same hospital, with meglumine antimoniate (Sb(V)). Demographic and clinical data were collected bef...

  7. Leishmaniasis tegumentaria americana: encuesta epidemiológica en una comunidad indígena

    Directory of Open Access Journals (Sweden)

    Martha Wolff

    1988-01-01

    Full Text Available Se realizó un estudio epidemiológico sobre Leishmaniasis tegumentarla americana (LTA en 809 personas del Resguardo Indígena de San Andrés de Sotavento, Departamento de Córdoba, foco endémico tanto de Leishmaniasis cutánea como de Leishmaniasis visceral. La distribución por sexo de la población encuestada fue de 355 (43,9% hombres y 454 (56, 1% mujeres; sus índices alérgicos fueron de 36,9% y 40,5% respectivamente. La positividad de la Intradermorreacción de Montenegro ascendió en personas de ambos sexos, a medida que aumentó la edad. El índice parasitario fue de 0.37%. La especie de Lutzomyia más frecuente en el intra y peridomicilio fue la Lu. evansi que mostró comportamiento antropofílico. Se encontró una alta exposición de la población general al vector dada la facilidad de penetración de los flebotomineos alintradomicilio, por el tipo de construcción de las viviendas; además, al no existir servicios sanitarios, acueductos ni alcantarillados Intradomiciliarios, todo el núcleo familiar debe desplazarse al peridomicilio para la disposición de excretas y en busca del agua. Otros hallazgos fueron el gran desconocimiento sobre la etiología y tratamiento de la Leishmaniasis y las pésimas condiciones sociales y económicas de la región.

  8. Peripheral Blood Buffy Coat Smear: a Promising Tool for Diagnosis of Visceral Leishmaniasis

    OpenAIRE

    Salam, M. Abdus; Khan, M. Gulam Musawwir; Bhaskar, Khondaker Rifat Hasan; Afrad, Mokibul Hassan; Huda, M Mamun; Mondal, Dinesh

    2012-01-01

    Confirmative diagnosis of visceral leishmaniasis (VL) is still a challenge at the primary health care facilities in most of the rural areas of endemicity in the Indian subcontinent. Conventional methods for parasitological confirmation are risky and require skilled personnel, and hence they are unavailable to the poor people in the regions of endemicity. Buffy coat smear microscopy, as a minimally invasive, simple alternative for the parasitological diagnosis of VL, was evaluated in this pros...

  9. Human Skin Permeation of a Chloroaluminum Phthalocyanine Nanoemulsion for Optimization of Topical Cutaneous Leishmaniasis Formulations

    OpenAIRE

    Victoria Eugenia Ospina; Julio Cesar Mantilla; Carlos Arturo Conde; Patricia Escobar

    2014-01-01

    Introduction: The nanoemulsions constitute excellent drug delivery systems for carrying and delivering active drugs. Chloroaluminum phthalocyanine (ClAlPc) in photodynamic therapy constitutes an interesting alternative in cutaneous leishmaniasis treatment. Objective: To de-termine the diffusion and retention of ClAlPc contained in a nanoemulsion (nano-ClAlPc) in human skin membranes for optimization of topical formulations. Materials and methods: Two formulations (ClAlPc-nano- and ClAlPc-solu...

  10. An Epidemiological Study of Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya

    OpenAIRE

    Abdellatif, Manal Z. M.; El-Mabrouk, Khamis; Ewis, Ashraf A.

    2013-01-01

    Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that ma...

  11. Combination Therapy with Tamoxifen and Amphotericin B in Experimental Cutaneous Leishmaniasis

    OpenAIRE

    Trinconi, Cristiana T.; Reimão, Juliana Q.; Yokoyama-Yasunaka, Jenicer K. U.; Miguel, Danilo C.; Uliana, Silvia R. B.

    2014-01-01

    Leishmaniasis chemotherapy remains very challenging. The high cost of active drugs, along with the severity of their side effects and the increasing failure rate of the current therapeutic schemes, calls for the discovery of new active drugs and schemes of treatment. The use of combination therapy has gained much attention in recent years as a possible strategy for overcoming the various shortcomings in the present arsenal. We recently described the effectiveness of tamoxifen in murine models...

  12. Comparison between Conventional and Real-Time PCR Assays for Diagnosis of Visceral Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Mariana R. Pereira

    2014-01-01

    Full Text Available The diagnosis of visceral leishmaniasis (VL is a challenging issue and several studies worldwide have evaluated the different tools to reach a diagnostic solution. The polymerase chain reaction (PCR has proven to be effective in detecting the genome of Leishmania species in different biological samples. In this study, we compared the conventional PCR and real-time PCR using the Sybr Green system and their application in molecular diagnosis of visceral leishmaniasis in peripheral blood as a biological sample. The genus-specific conserved region of kinetoplast DNA (kDNA was the target of amplification. We studied 30 samples from patients with suspect of visceral leishmaniasis who were treated by the Medical Clinic of Santa Casa de Belo Horizonte Hospital, Brazil. Among the samples studied, 19 had a confirmed diagnosis for VL by serology and/or by clinical findings. Among these 19 samples, 63% (n=12 presented positive results for serology and 79% (n=15 positive results in both PCR methodologies. This fact suggests that the PCR technique can assist in the diagnosis of visceral leishmaniasis in patients who do not have detectable antibodies by serology but can present the genome of the parasite circulating in whole blood. Also, it was possible to observe that there was conformity between the results of the techniques of cPCR and qPCR using the Sybr Green system in 100% of samples analyzed. These data suggest that both PCR techniques were equally effective for detection of the genome of the parasite in the patient’s blood.

  13. Pediatric visceral leishmaniasis diagnosis in Tunisia: comparative study between optimised PCR assays and parasitological methods

    Directory of Open Access Journals (Sweden)

    Kaouech E.

    2008-06-01

    Full Text Available There has been a steady increase of visceral leishmaniasis during the past 20 years in Tunisia. In this study, we assess the value of two optimised PCR versus those of classical methods for the diagnosis of human visceral leishmaniasis. 106 samples were collected from 53 cases of pediatric visceral leishmaniasis. Peripheral blood and bone marrow samples were analysed both by parasitological methods (direct examination, leukocytoconcentration (LCC and culture and by PCR methods with two primer pair (R221/R332 and Lei 70L/Lei 70R. We diagnosed visceral leishmaniasis in all patients: 44 cases were diagnosed by culture (83%, 42 by direct examination of bone marrow (79%, 17 by LCC (32%, and 53 positive cases with both PCR assays (R221/R332 and/or Lei 70L/Lei 70R (100%. Regarding each PCR assay, for blood samples, the difference between the sensitivities of PCR Lei 70L/Lei 70R (86,8% and PCR R221/R332 (17% is statistically significant with p-value 0.025. For bone marrow, the sensitivities of the two PCR methods were respectively 96,2% (Lei 70L/Lei 70R and 75,5% (R221/R332. On the whole, PCR Lei 70L/Lei 70R was more effective than PCR R221/R332 and conventional methods for the two biological samples. Moreover, the requirement of less invasive sample using blood has the advantage of being repeatable for screening and for post therapeutic monitoring.

  14. Isolation of bacteria causing secondary bacterial infection in the lesions of cutaneous leishmaniasis

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    Ziaie Hengameh

    2008-01-01

    Full Text Available Background: Cutaneous Leishmaniasis (CL is a parasitic disease characterized by single or multiple ulcerations. Secondary bacterial infection is one of the complications of the disease that can increase the tissue destruction and the resulting scar. Objective: To effectively determine the incidence of real secondary bacteria infection in cutaneous leishmaniasis, we designed the current study. Methods and Materials: This was a cross-sectional study performed in Skin Diseases and Leishmaniasis Research Centre, Isfahan, Iran. In this study, 854 patients with confirmed CL were enrolled. Samples were taken from all the patients. Sterile swaps were achieved for the ulcer exudates and scraping was used for nonulcerated lesions. All the samples were transferred to tryptic soy broth medium. After 24 h of incubation in 37°C, they were transferred to eosin methylene blue agar (EBM and blood agar. Laboratory tests were used to determine the species of bacteria. All of the collected data were analyzed by SPSS software and chi-square. Results: Among 854 patients with confirmed cutaneous leishmaniasis, 177 patients (20.7% had positive cultures for secondary bacterial infection. Bacteria isolated from the lesions were as follows: Staphylococcus aureus - 123 cases (69.4%, coagulase negative Staphylococcus - 41 cases (23.1%, E. coil - 7 cases (3.9%, Proteus - 3 cases (1.7% and Klebsiella - 3 cases (1.7%. Conclusions: The incidence of secondary bacterial infection in lesions of CL was 20.7%. The most common isolated pathogen was Staphylococcus aureus . The incidence of secondary bacterial infection was significantly more in the ulcerated lesions as compared with nonulcerated lesions ( P = 0.00001.

  15. Heterogeneity of environments associated with transmission of visceral leishmaniasis in South-Eastern France and implication for control strategies.

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    Benoit Faucher

    Full Text Available BACKGROUND: Visceral leishmaniasis due to Leishmania infantum is currently spreading into new foci across Europe. Leishmania infantum transmission in the Old World was reported to be strongly associated with a few specific environments. Environmental changes due to global warming or human activity were therefore incriminated in the spread of the disease. However, comprehensive studies were lacking to reliably identify all the environments at risk and thereby optimize monitoring and control strategy. METHODOLOGY/FINDINGS: We exhaustively collected 328 cases of autochthonous visceral leishmaniasis from 1993 to 2009 in South-Eastern France. Leishmaniasis incidence decreased from 31 yearly cases between 1993 and 1997 to 12 yearly cases between 2005 and 2009 mostly because Leishmania/HIV coinfection were less frequent. No spread of human visceral leishmaniasis was observed in the studied region. Two major foci were identified, associated with opposite environments: whereas one involved semi-rural hillside environments partly made of mixed forests, the other involved urban and peri-urban areas in and around the region main town, Marseille. The two neighboring foci were related to differing environments despite similar vectors (P. perniciosus, canine reservoir, parasite (L. infantum zymodeme MON-1, and human host. CONCLUSIONS/SIGNIFICANCE: This unprecedented collection of cases highlighted the occurrence of protracted urban transmission of L. infantum in France, a worrisome finding as the disease is currently spreading in other areas around the Mediterranean. These results complete previous studies about more widespread canine leishmaniasis or human asymptomatic carriage. This first application of systematic geostatistical methods to European human visceral leishmaniasis demonstrated an unsuspected heterogeneity of environments associated with the transmission of the disease. These findings modify the current view of leishmaniasis epidemiology. They

  16. Ecological interactions of visceral leishmaniasis in the state of Bahia, Brazil

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    Italo A Sherlock

    1996-12-01

    Full Text Available The laboratory and field observations summarized in this paper on visceral leishmaniasis ecology in the State of Bahia, Brazil are based on the author's observations over the past 35 years in a number of state's foci, public health records and literature citations. The disease is endemic with epidemic outbreaks occurring every ten years and its geographical distribution is expanding rapidly in the last years. Leishmania chagasi is the main ethiologic agent of the visceral leishmaniasis but Le. amazonensis s. lato was the only leishmania isolated by other authors from some visceral leishmaniasis human cases in the state. Lutzomyia longipalpis (with one or two spots on tergites III and IV and two sized different populations was epidemiologically incriminated as the main vector. It was found naturally infected with promastigotes, and it was infected with four species of leishmanias in the laboratory. Although the experimental transmission of Le. amazonensis by the bite of Lu. longipalpis to hamsters was performed, the author was not successful in transmitting Le. chagasi in the same way. The dog is the most important domestic source for infection of the vector, however it is not a primary reservoir. The opossum Didelphis albiventris was found naturally infected with Le. chagasi but its role as reservoir is unknown. Foxes and rodents were not found infected with leishmanias in Bahia.

  17. Use of hematological parameters in evaluation of treatment efficacy in cutaneous leishmaniasis

    Directory of Open Access Journals (Sweden)

    Bilal Sula

    2015-12-01

    Full Text Available Objective: In the present study we investigated the role of hematological parameters, including neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, mean platelet volume and platelet distribution width in the evaluation of treatment efficacy in adult patients diagnosed with cutaneous leishmaniasis. Methods: The study group included 45 adult patients diagnosed with cutaneous leishmaniasis and treated as inpatients in the dermatology clinic between 2011 and 2014. A group of 45 healthy adults served as a control group. Results: Pre- and post-treatment white blood cell count, neutrophils, and lymphocytes were significantly reduced among the patient group relative to the control group. Platelet distribution width, red cell distribution width, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were significantly elevated among the patients compared to the healthy subjects. Pre-treatment white blood cell, lymphocyte and platelet counts were significantly elevated compared to post-treatment counts among the patient cohort. Treatment was associated with reduced eosinophil count, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio relative to pre-treatment status. Conclusion: Routine hematological testing results such as platelet/lymphocyte ratio, white blood cell count, neutrophil count, red cell distribution width, platelet distribution width, and mean platelet volume may be clinically significant markers of the inflammatory state useful in the evaluation of early treatment efficacy among patients with cutaneous leishmaniasis. J Microbiol Infect Dis 2015;5(4: 167-172

  18. Performance of Alere™ immunochromathographic test for the diagnosis of canine visceral leishmaniasis.

    Science.gov (United States)

    Souza Filho, Job Alves de; Barbosa, José Ronaldo; Figueiredo, Fabiano Borges; Mendes, Artur Augusto Velho; Silva, Shara Regina da; Coelho, George Luiz Lins Machado; Marcelino, Andreza Pain

    2016-07-30

    The diagnosis and control of canine visceral leishmaniasis (CVL) has fundamental importance in the control of human visceral leishmaniasis. In this context, the immunochromathographic test (ICT) has emerged as a valuable diagnostic tool. Currently, in Brazil, the algorithm for the diagnosis of CVL uses Dual Path Platform (DPP) ICT as a screening test and ELISA as a confirmatory test. However, the DPP(®) ICT has been facing a problem of insufficient production to meet the national demand. Here, the Alere™ canine visceral leishmaniasis ICT was tested with serum samples from 159 dogs, including symptomatic, asymptomatic and healthy dogs, characterized by DPP(®) ICT and ELISA (panel A), or ELISA and Indirect Immunofluorescence Assay (IFA) (panel B), and parasitological examination as gold standard. In this study, the Alere™ ICT obtained 0.974 sensitivity for panel A and 0.854 sensitivity for panel B. The specificity was 1.0 for both panels. Thus, the Alere™ ICT has potential to be used for the serological diagnosis of CVL. PMID:27369585

  19. Spatial analysis of eco-environmental risk factors of cutaneous leishmaniasis in Southern Iran

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    Mohsen Ali-Akbarpour

    2012-01-01

    Full Text Available Background: Despite the advances in the diagnosis and treatment of leishmaniasis, it is still considered as a severe public health problem particularly in developing countries and a great economic burden on the health resources. The present study was designed and conducted to determine the eco-environmental characteristics of the leishmaniasis disease by spatial analysis. Materials and Methods: In an ecological study, data were collected on eco-environmental factors of Fars province in Iran and on cutaneous leishmaniasis (CL cases from 2002 to 2009. geographic weighted regression (GWR was used to analyse the data and compare them with ordinary least square (OLS regression model results. Moran′s Index was applied for analysis of spatial autocorrelation in residual of OLS. P value less than 0.05 was considered as significant and adjusted R2 was used for model preferences. Results: There was a significant spatial autocorrelation in the residuals of OLS model (Z=2.45, P=0.014. GWR showed that rainy days, minimum temperature, wind velocity, maximum relative humidity and population density were the most important eco-environmental risk factors and explained 0.388 of the associated factors of CL. Conclusion: Spatial analysis can be a good tool for detection and prediction of CL disease. In autocorrelated and non-stationary data, GWR model yields a better fitness than OLS regression model. Also, population density can be used as a surrogate variable of acquired immunity and increase the adjusted R2.

  20. Some Ecological Characteristics of Phlebotomine sandflies in a Focus of Cutaneous Leishmaniasis, Chabahar, Iran

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    Hamid Kassiri

    2012-08-01

    Full Text Available Background: Leishmaniasis is one of the main health problems in Iran. The purpose of this study was to determine species composition, sex ratio and relative abundance of sandfliesas vectors of cutaneous leishmaniasis.Materials and Methods: This cross-sectional study was conducted in Chabahar, Iran. Sandflies were caught using sticky traps. Traps were installed in 21 rural and urban areas.Results: A total of 17859 sandflieswere caught. Species caught including Phlebotomus papatasi Scopoli, P. salehi Mesghali, P. sergenti Parrot, P. alexandri Sinton, P. kazeruni Theodor and Mesghali, P. bergeroti Parrot, P. mesghali Seyedi-Rashti and Nadim, P. elaenorae Sinton, Sergentomyia clydei Sinton, S. sintoni Pringle, S. tiberiadis Adler, Theodor and Lourie, S. baghdadis Adler and Theodor , S. hodgsoni Sinton, S. dentate Sinton, S. africana Newstead, S. dreyfussi Theodor and Mesghali, S. mervynae Pringle, S. iranica Lewis and Mesghali and S. christophersi Sinton. Seven species, including P. elaenorae, P. kazeruni, S. hodgsoni, S. dreyfussi, S. mervynae, S. iranica and S. christophersi are reported for the first time in Chabahar.Conclusion: P. papatasi and P. salehi respectively play the role of primary and secondary vectors of cutaneous leishmaniasis in Chabahar city, due to their high abundance, presence in all the monthly activities, presence in all areas affected with oriental sore and finding leptomonad infection in them.

  1. Seroepidemiological Study of Visceral Leishmaniasis (Kala-azar in Ardabil Province, Iran, 1986 – 2009

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    S Molaie

    2010-10-01

    Full Text Available Introduction & Objective: Visceral Leishmaniasis (kala-azar is the most important endemic disease in Northwestern Iran, particularly in Ardabil province. This study aimed to review the seroepidemiological studies which have been performed in Ardabil province during 1986-2009. Materials & Methods: In this descriptive analytical study, studies which have been carried out from 1986 through 2009 in Northwestern Iran about clinical, diagnostic and epidemiological features of Kala azar, using DAT, were reviewed. Collected data were analyzed using the SPSS software. Results: in total, 2703 of human visceral leishmaniasis were detected by direct agglutination test (DAT in Ardabil province, 1787 (66.1% of them were from Meshkin-shahr district, 837 (31% cases were from Moghan district, and 79 (2.9% cases were from Ardabil district. Ninety eight percent of the cases were under 10 years old while only 0.5% of the VL cases were ≥20 years old and 17% of them were under 1 year of age. Conclusion: Currently Kala-Azar is the most important endemic disease in Northwestern Iran, particularly in Ardabil province. Anti-Leishmania antibodies at the titers of ≥1:3200 using DAT along with clinical signs including fever, anemia and hepatosplenomegaly are considered as active visceral leishmaniasis. DAT antibody titer of 1/800 and lower and absent of clinical signs is considered as negative VL.

  2. The use of radionuclide DNA probe technology in epidemiological studies of leishmaniasis

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Antero Silva Ribeiro de [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil); Fernandes, Octavio [Fundacao Inst. Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ (Brazil). Dept. de Medicina Tropical; Gomes, Rosangela Fatima; Melo, Maria Norma de [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Dept. de Parasitologia]|[Cor Jesus Fontes Mato Grosso Univ., Cuiaba, MT (Brazil). Hospital Universitario Julio Muller

    2000-07-01

    Cutaneous and mucosal leishmaniasis are due to different species that belongs to Leishmania (Leishmania) mexicana complex and Leishmania (Viannia) braziliensis complex, respectively. Cutaneous leishmaniasis ulcers may persist for months to years but eventually they heal, while mucocutaneous leishmaniasis can result in destructive lesions on the nose, oral pharynx, lips or face. The specific diagnosis of the disease is important because of the high cost and toxicity of the treatment and the subsequent medical follow-up depends on the precise identification of the complex that causes the infection. The epidemiological information furnished by the identification of parasites of a given endemic region is also essential for the design of appropriate control measures. In this work we typed, using specific DNA probes labelled with {sup 32}P radionuclide, samples collected from patients living in endemic areas of Mato Grosso state. The results showed that L. braziliensis is the predominant group infecting human patients in the state. We have typed, up to the moment 68 samples. 64 samples (94.1%) belonged to the L. braziliensis complex and only 4 (5.9%) belonged to the L. mexicana complex. (author)

  3. Sandfly Surveillance within an Emerging Epidemic Focus ofCutaneous Leishmaniasis in Southeastern Iran

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    MR Yaghoobi-Ershadi

    2010-06-01

    Full Text Available "n "nBackground: Cutaneous leishmaniasis due to Leishmania major has become a hot topic in Iran. The objective of this study was to determine some ecological aspects of sand flies in the study area. "n "nMethods: Sand flies were collected biweekly from indoors and outdoors fixed places in the selected villages, using 30 sticky paper traps from the beginning to the end of the active season of 2006 in Kerman Province, south of Iran. The flies were mounted and identified. Some blood fed and gravid female sand flies of rodent burrows and indoors were dissected and examined microscopically for natural promastigote infection of Leishmania parasite during August to September. "n "nResults: In total, 2439 specimens comprising 8 species (3 Phlebotomus and 5 Sergentomyia were identified. The most common sand fly was P. papatasi and represented 87.1% of sand flies from indoors and 57.2% from outdoors. The activity of the species extended from April to end October. There are two peaks in the density curve of this species, one in June and the second in August. Natural promastigote infection was found in P. papatasi (12.7%. "n "nConclusion: Phlebotomus papatasi is considered as a probable vector among gerbils and to humans with a high percentage of promastigote infection in this new focus of cutaneous leishmaniasis. The Bahraman area which until recently was unknown as an endemic area seems now to represent a focus of zoonotic cutaneous leishmaniasis transmission in Iran.

  4. Leishmania infantum HSP70-II null mutant as candidate vaccine against leishmaniasis: a preliminary evaluation

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    Fresno Manuel

    2011-07-01

    Full Text Available Abstract Background Visceral leishmaniasis is the most severe form of leishmaniasis and no effective vaccine exists. The use of live attenuated vaccines is emerging as a promising vaccination strategy. Results In this study, we tested the ability of a Leishmania infantum deletion mutant, lacking both HSP70-II alleles (ΔHSP70-II, to provide protection against Leishmania infection in the L. major-BALB/c infection model. Administration of the mutant line by either intraperitoneal, intravenous or subcutaneous route invariably leads to the production of high levels of NO and the development in mice of type 1 immune responses, as determined by analysis of anti-Leishmania IgG subclasses. In addition, we have shown that ΔHSP70-II would be a safe live vaccine as immunodeficient SCID mice, and hamsters (Mesocricetus auratus, infected with mutant parasites did not develop any sign of pathology. Conclusions The results suggest that the ΔHSP70-II mutant is a promising and safe vaccine, but further studies in more appropriate animal models (hamsters and dogs are needed to appraise whether this attenuate mutant would be useful as vaccine against visceral leishmaniasis.

  5. Interstitial pulmonary alterations in visceral leishmaniasis: evaluation with high-resolution computed tomography

    International Nuclear Information System (INIS)

    Visceral leishmaniasis, also called kala-azar, is a disease caused by a protozoan, the Leishmania donovani chagasi, that comprises reticuloendothelial system with involvement of the liver, spleen and bone marrow. It is endemic in some areas of northeastern Brazil and other countries of Latin America and Africa. The pathogenesis is related to the immunologic system of patients that present with the inability to activate the phagocytosis of the macrophages. As occurs in the liver and kidneys, the lungs are also involved with interstitial abnormalities caused by Leishmania that are not dependent upon the presence of the parasite.The histopathologic changes described are the involvement of inter alveolar septal in three different phases, irregularly and diffusely throughout the whole pulmonary parenchyma. This work analyzed high-resolution computed tomography (HRCT) of the thorax in 17 patients with visceral leishmaniasis in order to detect and characterize the abnormalities described in the anatomo pathologic findings reported in the literature. The HRCT is being used to evaluate chronic interstitial lung disease in a good correlation with histologic findings. THe mos common findings detected by HRCT were the reticular opacities that include peribronchovascular interstitial thickening and interlobular septal thickening an ground-glass opacity. The HRCT suggests that similar changes to that found in alveolar structures may occur int he secondary pulmonary lobule and that the involvement in the parenchymal interstitium represents the findings reported by pathological studies in visceral leishmaniasis. (author)

  6. American Houses

    Institute of Scientific and Technical Information of China (English)

    张梦华

    2004-01-01

    American houses usually have private kitchens,a living room and sometimes separate areas for eating and watching television,A house usually has its own mailbox,a yard with plants or perhaps a lawn,and a place to store garbage out of sight.

  7. American Occupation

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Angry Americans across the country are protesting against inequality, greed and corruption The "Occupy Wall Street" protests have grown from an insignificant lower Manhattan gathering of around 1,500 people to tens of thousands of people across the United States, from Anchorage,

  8. Radioisotope Study of Tegumentary Pigmentation in Insects

    International Nuclear Information System (INIS)

    The nature of insect cuticle, which is made up in large part of scleroproteins, calls for the use of labelled isotopes to obtain answers to certain questions regarding pigmentation. The following method, which has the advantage of being quick and easy to apply, has been developed. The labelled substance chosen is injected into the animal at various phases of its skin-shedding cycle: before secretion of the cuticular proteins, i. e. when the cuticle is at rest; at the time these proteins are deposited; and, lastly, at the time their sclerification begins. After a suitable interval the cuticle is removed, suitably treated, and subjected to full autoradiography. Photographic comparison of the results then indicates whether or not the substance chosen has been used for any formation of pigment, due account being taken of prior chemical processes involving the substance. The findings presented in the paper relate to three labelled substances: two carbon-14 amino-acids - tyrosine and tryptophane - and inorganic sulphur-35 in the form of sodium sulphate. It has thus been possible to give direct proof of the origin of variously-coloured cuticular pigments and to discuss the role of tryptophane and sulphur in forming pigments in insect integument. All cuticular pigments spring from the metabolism of tyrosine, thus confirming the term ''melanic'' hitherto applied to them without direct proof. Tryptophane, exceptionally integrated in the cuticle, is the substratum of the ommochromic red and black pigments in the hypodermis. Inorganic sulphur plays no regular specific role in the formation of cuticular pigments, contrary to what has been suggested by various hypotheses on the role of the sulpbydryl group. From the standpoint of comparative biochemistry, the melanins appear to be purely cuticular among insects, granular melanins being confined to the vertebrates. Dark hypodermic granules in insects are ommochromic, derived from tryptophane, and not melanic. (author)

  9. Cancer and African Americans

    Science.gov (United States)

    ... Population Profiles > Black/African American > Cancer Cancer and African Americans African Americans have the highest mortality rate ... 65MB] At a glance – Top Cancer Sites for African Americans (2008-2012) Cancer Incidence Rates per 100, ...

  10. American Sign Language

    Science.gov (United States)

    ... Health Info » Voice, Speech, and Language American Sign Language On this page: What is American Sign Language? ... signs "I love you." What is American Sign Language? American Sign Language (ASL) is a complete, complex ...

  11. Non invasive diagnostic tools for visceral leishmaniasis: a comparison of the immunoserological tests DAT, rK26 and rK39

    NARCIS (Netherlands)

    G. Teran-Angel; V. Rodriguez; R. de Silva; O. Zerpa; H. Schallig; M. Ulrich; M. Cabrera

    2010-01-01

    Introduction. Human visceral leishmaniasis is a serious public health problem in endemic countries because of its high potential lethality, particularly in children. Rapid diagnosis is essential to early treatment and control of visceral leishmaniasis. Objective. The aim was to compare three serodia

  12. Pathology of post-kala-azar dermal leishmaniasis: a light microscopical, immunohistochemical, and ultrastructural study of skin lesions and draining lymph nodes

    DEFF Research Database (Denmark)

    Ismail, Ahmed; Gadir, A Fattah A; Theander, Thor G;

    2006-01-01

    BACKGROUND: Whereas the clinical manifestations and treatment of post-kala-azar dermal leishmaniasis (PKDL) have been adequately described before, the pathology received little attention, particularly the African form of PKDL which shows some clinical differences from the disease in India...... leishmaniasis: a light microscopical, immunohistochemical, and ultrastructural study of skin lesions and draining lymph nodes....

  13. The pathogenesis of post kala-azar dermal leishmaniasis from the field to the molecule: does ultraviolet light (UVB) radiation play a role?

    DEFF Research Database (Denmark)

    Ismail, A; Khalil, E A G; Musa, A M;

    2006-01-01

    Post kala-azar dermal leishmaniasis (PKDL) is a dermatosis caused by persistence of Leishmania donovani parasites in the skin following apparently successful treatment of visceral leishmaniasis. The distribution of PKDL lesions in Sudanese patients often mirrors the clothing habits of those...

  14. Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc supplementation together with antimony treatment

    Directory of Open Access Journals (Sweden)

    Miguel Guzman-Rivero

    2014-11-01

    Full Text Available Background: The role of micronutrient status for the incidence and clinical course of cutaneous leishmaniasis is not much studied. Still zinc supplementation in leishmaniasis has shown some effect on the clinical recovery, but the evidence in humans is limited. Objective: To compare biochemical nutritional status in cutaneous leishmaniasis patients with that in controls and to study the effects of zinc supplementation for 60 days. Design: Twenty-nine patients with cutaneous leishmaniasis were treated with antimony for 20 days. Fourteen of them got 45 mg zinc daily and 15 of them got placebo. Biomarkers of nutritional and inflammatory status and changes in size and characteristics of skin lesions were measured. Results: The level of transferrin receptor was higher in patients than in controls but otherwise no differences in nutritional status were found between patients and controls. No significant effects of zinc supplementation on the clinical recovery were observed as assessed by lesion area reduction and characteristics or on biochemical parameters. Conclusions: It is concluded that nutritional status was essentially unaffected in cutaneous leishmaniasis and that oral zinc supplementation administered together with intramuscular injection of antimony had no additional clinical benefit.

  15. Epidemiological features, clinical manifestation and laboratory findings of patients with cutaneous leishmaniasis in Genaveh County, Bushehr Province, Southern Iran

    Institute of Scientific and Technical Information of China (English)

    Hamid Kassiri; Ali Kasiri; Hossein Najafi; Masoud Lotfi; Elnaz Kasiri

    2014-01-01

    Objective: To examine the epidemiological features of cutaneous leishmaniasis in Genaveh County, Southern Iran.Methods:This descriptive study was conducted during 2004-2008. A questionnaire was completed for each case regarding age, gender, place of residence, the number and location of cutaneous leishmaniasis lesions etc. Suspected active lesions were scraped with a sterile blade and the samples smeared onto glass slides, fixed with methanol, stained with Giemsa and examined under a light microscope for the presence of amastigotes.Results:Totally, 135 cases of cutaneous leishmaniasis came to the health centers. The highest number of patients catching cutaneous leishmaniasis was found in 2006 (n=54). Most cases (56.3%) occurred during winter. The most highly infected age group was 1 to 10 years .The hands were the most affected parts of the body. About 54% of the patients had one lesion. The most cases (53.3%) occurred in rural areas.Concluions:It is important for the health authorities to take powerful actions to control cutaneous leishmaniasis. Meanwhile, It is significant to prepare quick treatment of cases.

  16. Indirect immunofluorescence test in new world Leishmaniasis: serological and clinical relation-ship

    Directory of Open Access Journals (Sweden)

    Sergio C. F. Mendonça

    1988-09-01

    Full Text Available The indirect immunofluorescence test (IF for anti-Leishmania antibodies (IgC and IgM was performed with sera form the following groups of individuals: 214 cutaneous leishmaniasis patients, 28 healthy subjects with positive Montenegro's skin test (MST, 29 healthy subjects with negativeMST and 16 visceral leishmaniasis patients. The first four groups came from a suburban area of Rio de Janeiro (Jacarepaguá where cutaneous leishmaniasis caused by Leishmania braziliensis braziliensis is endemic. It was observed that IF-IgM titers were significantly higher amongst the cutaneous leishmaniasis patients with less than four months of disease as compared to those with longer periods and that IF-IgG titers were significantly higher in patients with multiple lesions as compared to those with single lesions. The visceral leishmaniasis patients had IF-IgG titers significantly higher than those from cutaneous leishmaniasis patients. A group of 28 individuals selected amongst the 214 cutaneous leishmaniasis patients had their IF-titers (IgG and IgM compared to those of the two control groups of healthy subjects from the endemic area, respectively with positive and negative MST. Significantly higher titers of IF-IgG and IF-IgM were found in the group with active disease. The same group of patients showed IF-IgG titers significantly lower at the end of the antimonial therapy than those observed during this tratment.O teste de imunofluorescência indireta (IF para a detecção de anticorpos anti-Leismania nas classes IgG e IgM foi realizado em soros de indivíduos dos seguintes grupos: 214 pacientes com leismaniose cutânea, quatro pacientes com leismaniose mucocutânea, 28 indivíduos sadios com intradermorreação de Montenegro (IDRM positiva, 29 indivíduos sadios com IDRM negativa e 16 pacientes com leishmaniose visceral. Os indivíduos dos quatro primeiros grupos eram provenientes de uma área da periferia da cidade do Rio de Janeiro (Jacarepaguá onde a

  17. FIRST CASE OF AUTOCHTHONOUS HUMAN VISCERAL LEISHMANIASIS IN THE URBAN CENTER OF RIO DE JANEIRO: CASE REPORT

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    Guilherme Almeida Rosa da Silva

    2014-01-01

    Full Text Available Visceral leishmaniasis is an anthropozoonosis that is caused by protozoa of the genus Leishmania, especially Leishmania (Leishmania infantum, and is transmitted to humans by the bite of sandflies of the genus Lutzomyia, such as Lutzomyia longipalpis. There are many reservoirs, including Canis familiaris. It is a chronic infectious disease with systemic involvement that is characterized by three phases: the initial period, the state period and the final period. The main symptoms are fever, malnutrition, hepatosplenomegaly, and pancytopenia. This article reports a case of a patient diagnosed with visceral leishmaniasis in the final period following autochthonous transmission in the urban area of Rio de Janeiro. The case reported here is considered by the Municipal Civil Defense and Health Surveillance of Rio de Janeiro to be the first instance of autochthonous visceral leishmaniasis in humans in the urban area of this city. The patient was discharged and is undergoing a follow-up at the outpatient clinic, demonstrating clinical improvement.

  18. Inorganic particles in the skin of inhabitants of volcanic areas of Central America: their possible immunomodulatory influence in leishmaniasis and leprosy.

    Science.gov (United States)

    Convit, J; Ulrich, M; Castillo, J; De Lima, H; Pérez, M; Caballero, N; Hung, J; Arana, B; Pérez, P

    2006-08-01

    We have evaluated biopsies from patients with atypical nodular and typical ulcerated lesions of cutaneous leishmaniasis, from leishmanin reactions and skin from normal individuals from Nicaragua, Honduras and Guatemala for the presence of inorganic particles using confocal microscopy with a polarised light source and conventional histopathological techniques. Analysis by semiquantitative confocal microscopy permitted the demonstration of significantly larger numbers of particles in atypical lesions. Silica and aluminium, important components of these particles, were less abundant in particles from normal skin. The histology of these atypical lesions, characterised by 'naked' sarcoidal granulomas with epithelioid differentiation but very few lymphocytes, was very similar to the histological reaction observed after 14 days in persisting inflammation at leishmanin skin test sites. The presence of these unusual lesions in areas of Central American countries characterised by the presence of large amounts of volcanic ash, as well the unexpectedly low prevalence of leprosy in Central America, suggest that environmental factors may contribute significantly to the frequency and clinical manifestations of these infections. Among possible environmental features, the presence of inorganic particles with immunomodulatory properties in the skin may be a significant factor.

  19. The sandfly fauna, anthropophily and the seasonal activities of Pintomyia spinicrassa (Diptera: Psychodidae: Phlebotominae) in a focus of cutaneous leishmaniasis in northeastern Colombia.

    Science.gov (United States)

    Ovallos, Fredy Galvis; Silva, Yanis Ricardo Espinosa; Fernandez, Nelson; Gutierrez, Reynaldo; Galati, Eunice Aparecida Bianchi; Sandoval, Claudia Magaly

    2013-05-01

    This study was conducted to identify the sandfly fauna and the anthropophilic species in a coffee-growing area of Villanueva, Norte de Santander, Colombia, a focus of American cutaneous leishmaniasis, and to analyse the relationship between the most frequent species and rainfall, relative humidity and temperature, with the aim of contributing to epidemiological surveillance in the area. Sandfly collections were performed fortnightly between February 2006-September 2007 using automatic light traps, Shannon traps, protected human bait and aspiration in resting places. A total of 7,051 sandflies belonging to 12 species were captured. Pintomyia spinicrassa (95.7%) predominated. Pintomyia oresbia and Lutzomyia sp. of Pichinde were found in the state of Norte de Santander for the first time. Pi. spinicrassa, Pintomyia nuneztovari, Micropygomyia venezuelensis, Lutzomyia (Helcocyrtomyia) scorzai and Lu. (Helcocyrtomyia) sp. were captured on the protected human bait. A significant association between Pi. spinicrassa abundance and the total rainfall and the average temperature and humidity 10 days before the collection was observed. The dominance of Pi. spinicrassa, a recognised vector of Leishmania braziliensis, especially during the dry periods, indicates that the risk of parasite transmission may increase. PMID:23778653

  20. The sandfly fauna, anthropophily and the seasonal activities of Pintomyia spinicrassa (Diptera: Psychodidae: Phlebotominae in a focus of cutaneous leishmaniasis in northeastern Colombia

    Directory of Open Access Journals (Sweden)

    Fredy Galvis Ovallos

    2013-05-01

    Full Text Available This study was conducted to identify the sandfly fauna and the anthropophilic species in a coffee-growing area of Villanueva, Norte de Santander, Colombia, a focus of American cutaneous leishmaniasis, and to analyse the relationship between the most frequent species and rainfall, relative humidity and temperature, with the aim of contributing to epidemiological surveillance in the area. Sandfly collections were performed fortnightly between February 2006-September 2007 using automatic light traps, Shannon traps, protected human bait and aspiration in resting places. A total of 7,051 sandflies belonging to 12 species were captured. Pintomyia spinicrassa (95.7% predominated. Pintomyia oresbia and Lutzomyia sp. of Pichinde were found in the state of Norte de Santander for the first time. Pi. spinicrassa, Pintomyia nuneztovari, Micropygomyia venezuelensis, Lutzomyia (Helcocyrtomyia scorzai and Lu. (Helcocyrtomyia sp. were captured on the protected human bait. A significant association between Pi. spinicrassa abundance and the total rainfall and the average temperature and humidity 10 days before the collection was observed. The dominance of Pi. spinicrassa, a recognised vector of Leishmania braziliensis, especially during the dry periods, indicates that the risk of parasite transmission may increase.