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Sample records for american visceral leishmaniasis

  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. Active surveillance of canine visceral leishmaniasis and american trypanossomiasis in rural dogs from non endemic area.

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    Tome, Rozeani Olimpio; Gaio, Fernanda Conceição; Generoso, Diego; Menozzi, Benedito Donizete; Langoni, Helio

    2011-01-01

    The canine visceral leishmaniasis (CVL) and american trypanosomiasis are important zoonoses in public health and dogs are the main domestic reservoir of the parasite for humans. The goal of this study was to estimate the prevalence of circulating antibodies anti-Trypanosoma cruzi and anti-Leishmania sp. in sera of dogs from the rural area of Botucatu, SP, Brazil. During the annual vaccination campaign against canine rabies in rural area, 689 blood samples were taken and processed by indirect immunofluorescent antibody test. The serological tests revealed the absence of antibodies anti-Leishmania spp., but anti-T. cruzi antibodies were detected in 3 (0.4%) dogs.

  3. American visceral leishmaniasis dissociated from Lutzomyia longipalpis (Diptera, Psychodidae) in the State of Espírito Santo, Brazil.

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    Pinto, Israel de Souza; Santos, Claudiney Biral dos; Grimaldi, Gabriel; Ferreira, Adelson Luiz; Falqueto, Aloísio

    2010-02-01

    The occurrence of American visceral leishmaniasis in the State of Espírito Santo, Brazil has always been associated with the presence of the Lutzomyia longipalpis vector. The geographic distribution of this vector in this state is related to the presence of specific geoclimatic characteristics, such as a dry climate, low elevations (longipalpis. Sand flies were captured monthly from July 2006 to August 2007 using Shannon and CDC traps in two municipalities with records of autochthonous American visceral leishmaniasis and one with no record. We captured 13,112 sand flies, but no Lu. longipalpis was found. The absence of Lu. longipalpis and the possible role of another American visceral leishmaniasis vector in these localities were discussed.

  4. Introduction and expansion of human American visceral leishmaniasis in the state of Sao Paulo, Brazil, 1999-2011.

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    Cardim, Marisa Furtado Mozini; Rodas, Lilian A Colebrusco; Dibo, Margareth Regina; Guirado, Marluci Monteiro; Oliveira, Agda Maria; Chiaravalloti-Neto, Francisco

    2013-08-01

    To analyze the spread of human American visceral leishmaniasis and identify the key municipalities for developing surveillance and control activities. The area of the study was composed of the 316 municipalities in the state of Sao Paulo belonging to the five health districts in which human American visceral leishmaniasis occurs, using data on autochthonous cases and deaths according to the reporting year and municipality in which the death occurred. The incidence, mortality and case fatality rates for each municipality and for the entire area were calculated. An empirical Bayes estimator was used to calculate the local Bayesian incidence and rates of mortality per municipality, and Kriging was used to visualize the spatial distribution of temperature and rainfall. A total of 73 municipalities with transmission of the disease were identified. Human American visceral leishmaniasis was first detected in areas with higher temperatures and lower rainfall, but it also spread in cooler and wetter areas. The expansion of human American visceral leishmaniasis occurred along a main axis of dissemination, from Northwest to Southeast, following the Marechal Rondon highway and the Bolivia-Brazil gas pipeline, and along a secondary axis that was derived from the main axis, which runs both North and South, following the highway network. Rates of incidence according to health district exhibit a peak, followed by a fall, except the Sao Jose do Rio Preto region. Higher concentrations of municipalities with high incidence and mortality rates were observed in the Araçatuba, Presidente Prudente and Marília health districts. This study indicates possible determinants of the spread of disease, including the Marechal Rondon highway and the construction of the Bolivia-Brazil gas pipeline. Climatic factors seemed to play no role in the spread. The use of spatial analysis techniques allowed the municipalities where cases and deaths are possibly underreported to be identified, which

  5. American visceral leishmaniasis: disease control strategies in dracen microregion in alta paulista, SP, Brazil

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    LAZ D'Andrea

    2009-01-01

    Full Text Available Despite measures adopted to control American visceral leishmaniasis (AVL, the disease is spreading in a fast and worrying way throughout western São Paulo state. The aim of this work was to study the variables involved in the disease cycle as well as the effectiveness of controlling measures. The study was carried out in the microregion of Dracena, which is composed of twelve cities and belongs to Alta Paulista, a region of western São Paulo. The necessary data were provided by the Superintendence for Endemic Disease Control and Adolfo Lutz Institute, Regional Laboratory of Presidente Prudente. From August 2005 to January 2008, the following factors were observed: detection of phlebotomine sandflies in the cities and periods in which dogs or humans were diagnosed; number of human deaths; prevalence of suspected dogs tested by serology; percentage of euthanasia in suspected dogs; a possible correlation between positive dogs and cases of the disease in humans; and the disease prevalence among municipalities from the studied region. It was verified that, despite the strategies adopted in Dracena microregion to control AVL, the disease continues to rise. Thus, some procedures of the AVL Monitoring and Control Program should be reviewed, to grant the initiative more credibility and effectiveness.

  6. 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

  7. Visceral leishmaniasis: an update of laboratory diagnosis

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    Zineb Tlamcani

    2016-07-01

    Full Text Available Visceral leishmaniasis, is an infection due to obligate intracellular protozoa of the genus Leishmania. There exist two varieties of visceral leishmaniasis, that vary in their transmission aspects: zoonotic visceral leishmaniasis and anthroponotic visceral leishmaniasis. Their clinical features are comparable with sevral differences. Laboratory diagnosis of visceral leishmaniasis consists of microscopic observation of parasite, culture from appropriate samples, detection of antigen, serological tests, and identification of parasite DNA. In this review, we will discuss the different techniques of diagnosis and the interet of the recent methods such as rapid diagnostic test and direct agglutination test.

  8. 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

  9. [Visceral leishmaniasis. Pediatric case report].

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    Gomila H, Andrés; Vanzo, Carolina; Garnero, Analía; Peruzzo, Luisina; Badalotti, Mónica

    2017-08-01

    La leishmaniasis es una enfermedad causada por parásitos obligados intracelulares pertenecientes al género Leishmania y que reconoce tres formas clínicas principales: cutánea, visceral y mucocutánea. Es una patología del grupo de las "enfermedades desatendidas". Es la única enfermedad tropical transmitida a través de vectores que se ha mantenido endémica por décadas en el sur de Europa. La leishmaniasis visceral representa la forma más grave. Se caracteriza por fiebre, pérdida de peso, anemia y hepatoesplenomegalia. Su período de incubación oscila entre 2 semanas y 18 meses. La leishmaniasis se considera una enfermedad reemergente a nivel mundial. Algunos de los factores que favorecen esta situación son los cambios en las condiciones climáticas, migraciones y urbanizaciones deficitarias en saneamiento ambiental. Se presenta el caso de un niño europeo que estaba vacacionando en Córdoba y fue derivado a nuestro Hospital por fiebre y pancitopenia, lo que generó un abordaje multidisciplinario con resolución clínica favorable. Sociedad Argentina de Pediatría.

  10. 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.

  11. Drug Resistance in Visceral Leishmaniasis

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    Helena C. Maltezou

    2010-01-01

    Full Text Available Visceral leishmaniasis remains a public health problem worldwide. This illness was included by the World Health Organization in the list of neglected tropical diseases targeted for elimination by 2015. The widespread emergence of resistance to pentavalent antimonials in India where half cases occur globally and the unavailability of a vaccine in clinical use constitute major obstacles in achieving this goal. The last decade new antileishmanials became available, including the oral agent miltefosine. However, in poor endemic countries their wide use was curtailed because of the high costs, and also due to concerns of toxicity and emergence of resistance. Various mechanisms of antileishmanial resistance were identified recently in field isolates. Their elucidation will boost the design of new drugs and the molecular surveillance of resistance. Combination regimens should be evaluated in large trials. Overall, the development of antileishmanials has been generally slow; new drugs are needed. In order to control visceral leishmaniasis worldwide, treatment advances should become affordable in the poorest countries, where they are needed most.

  12. Interstitial pneumonitis in canine visceral leishmaniasis

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    M. I. S. Duarte

    1986-12-01

    Full Text Available Forty-one naturally infected dogs with visceral leishmaniasis from an urban area of Corumbá (Mato Grosso do Sul-BRAZIL were studied and three types of lung involvement due to visceral leishmaniasis were characterized; a cellular, a cellular-fibrotic and a fibrotic type. These types seem to represent a sequential evolutive proce'as. Visceral leishmaniasis frequently causes an interstitial pneu monitis in naturally infected dogs (80.5% as well as in man and experimentally infected hamsters.

  13. 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.

  14. [Visceral leishmaniasis in immunocompromised patients].

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    Ramos, A; Portero, J L; Gazapo, T; Yebra, M; Portero, F; Martín, T

    1998-06-01

    Most patients who developed visceral leishmaniasis (VL) in our country are ímmunocompromised (IC) host, frequently HIV-infected patients. One objective was to know if there were differences about the clinical manifestations, diagnostic tests or prognosis in IC patients who were infected or not with HIV (HIV+ and HIV-, respectively). Also we wonder if some features were associated with death during the initial episodes of VL. We studied 16 IC patients with VL, 9 were VIH+ and 7 were VIH-. Most frequently observed findings were fever (94%), splenomegaly (81%), hepatomegaly (69%), and constitutional syndrome (50%). HIV+ patients had symptoms during a lapse of time (70 +/- 78 days) larger than the VIH- cases had (17 +/- 12 days, p VIH patients). Seven patients (44%, 4 VIH- and 3 VIH+) died during the initial episode of VL. Nine patients (66%) who survived to it were followed-up during 68 +/- 49 months. Seven patients (4 VIH+ and 3 VIH-) showed several relapses (2.5 +/- 1.6 relapses/patient) through the follow-up. The patients who died during the initial episode had more frequently (p CD4+ lymphocyte counts in HIV+ patients were lower in patients who died during the initial episode of VL (19 +/- 15/mm) than in survivors (108 +/- 67/mm3, p = 0.07).

  15. Vaccines for visceral leishmaniasis: A review.

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    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. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Urbanization of human visceral leishmaniasis in Morocco

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    Kholoud Kahime; Samia Boussaa; Haddou Nhammi; Ali Boumezzough

    2017-01-01

    Human visceral leishmaniasis one of the seven most neglected tropical diseases in the world. In Morocco, HVL is widespread in all regions; but it is more common in the northern part with sporadic cases observed in the South. During the period between 2004 and 2013, the most affected Moroccan provinces were Taounate province, with 220 cases (16.09% of all cases), followed by Chefchaouen with 13.17% and Taza with 10.46% of the total cases. Children

  17. 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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    Afonso, Margarete Martins dos Santos; Duarte, Rosemere; Miranda, José Carlos; Caranha, Lindenbergh; Rangel, Elizabeth Ferreira

    2012-01-01

    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. PMID:22315621

  18. 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.

  19. 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.

  20. 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.

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

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    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.

  2. Genetically modified organisms and visceral leishmaniasis.

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    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.

  3. Expansão espacial da leishmaniose visceral americana em São Luis, Maranhão, Brasil Space expansion of the American visceral leishmaniasis in São Luis, Maranhão, Brazil

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    Wellington da Silva Mendes

    2002-06-01

    Full Text Available Descreve-se a ocupação espacial no município de São Luis e a expansão da leishmaniose visceral americana(LVA na mesma. Foram analisadas as fichas de registro de atendimento de casos de leishmaniose visceral da Diretoria Regional da Fundação Nacional de Saúde do Maranhão no período de setembro de 1982 a dezembro de 1996, assim como documentos oficiais sobre a ocupação espacial do município. Foi observado que os casos de LVA ao longo da evolução da epidemia em São Luis apresentaram distribuição espacial e concentração semelhantes a apresentada pelo fluxo migratório na cidade no mesmo período.The space occupation and the expansion of American visceral leishmaniasis (AVL were described in the municipality of São Luis, Maranhão, Northeast Brazil. AVL medical notes from the Fundação Nacional de Saúde as well as official documents about the space occupation were analyzed from September 1982 to December 1996. AVL cases were more likely to occur in recently settled suburbs and tended to follow the same spatial pattern observed for land occupations secondary to migratory fluxes.

  4. Immune Regulation during Chronic Visceral Leishmaniasis

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

    2014-01-01

    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. PMID:25010815

  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.

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    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. Determinants for the development of visceral leishmaniasis disease.

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    Laura-Isobel McCall

    2013-01-01

    Full Text Available Leishmaniasis is a vector-borne neglected tropical disease associated with a spectrum of clinical manifestations, ranging from self-healing cutaneous lesions to fatal visceral infections. Among the most important questions in Leishmania research is why some species like L. donovani infect visceral organs, whereas other species like L. major remain in the skin. The determinants of visceral leishmaniasis are still poorly understood, although genomic, immunologic, and animal models are beginning to provide important insight into this disease. In this review, we discuss the vector, host, and pathogen factors that mediate the development of visceral leishmaniasis. We examine the progression of the parasite from the initial site of sand fly bite to the visceral organs and its ability to survive there. The identification of visceral disease determinants is required to understand disease evolution, to understand visceral organ survival mechanisms, and potentially to develop better interventions for this largely neglected disease.

  7. Genetically Modified Organisms and Visceral Leishmaniasis

    Directory of Open Access Journals (Sweden)

    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.

  8. Visceral Leishmaniasis in Ethiopia: An Evolving Disease

    Science.gov (United States)

    Leta, Samson; Dao, Thi Ha Thanh; Mesele, Frehiwot; Alemayehu, Gezahegn

    2014-01-01

    Visceral leishmaniasis (also known as kala-azar) is classified as one of the most neglected tropical diseases. It is becoming a growing health problem in Ethiopia, with endemic areas that are continually spreading. The annual burden of visceral leishmaniasis (VL) in Ethiopia is estimated to be between 4,500 and 5,000 cases, and the population at risk is more than 3.2 million. There has been a change in the epidemiology of VL in Ethiopia. Over the last decades, almost all cases and outbreaks of VL were reported from arid and semi-arid parts of the country; however, recent reports indicated the introduction of this disease into the highlands. Migration of labourers to and from endemic areas, climatic and environmental changes, and impaired immunity due to HIV/AIDS and malnutrition resulted in the change of VL epidemiology. HIV spurs the spread of VL by increasing the risk of progression from asymptomatic infection towards full VL. Conversely, VL accelerates the onset of AIDS. In Ethiopia, VL epidemiology remains complex because of the diversity of risk factors involved, and its control is becoming an increasing challenge. This paper reviews the changes in epidemiology of VL in Ethiopia and discusses some of the possible explanations for these changes. The prospects for novel approaches to VL control are discussed, as are the current and future challenges facing Ethiopia's public health development program. PMID:25188253

  9. 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....

  10. Leishmaniasis in Turkey: Visceral and cutaneous leishmaniasis caused by Leishmania donovani in Turkey

    NARCIS (Netherlands)

    Özbilgin, Ahmet; Harman, Mehmet; Karakuş, Mehmet; Bart, Aldert; Töz, Seray; Kurt, Özgür; Çavuş, İbrahim; Polat, Erdal; Gündüz, Cumhur; van Gool, Tom; Özbel, Yusuf

    2017-01-01

    In Turkey, the main causative agents are Leishmania tropica (L. tropica) and Leishmania infantum (L. infantum) for cutaneous leishmaniasis (CL) and L. infantum for visceral leishmaniasis (VL). In this study, we investigated leishmaniasis cases caused by L. donovani and established animal models for

  11. Evaluation of antibody responses in american visceral leishmaniasis by ELISA and immunoblot Avaliação da resposta imune humoral na leishmaniose visceral americana pelos métodos ELISA e "immunoblot"

    Directory of Open Access Journals (Sweden)

    Thomas G. Evans

    1989-06-01

    Full Text Available American visceral leishmaniasis (AVL is an important disease among children of northeast Brazil. In order to characterize antibody responses during AVL, sera of hospitalized patients were analyzed by ELISA and Western blot using a Leishmania chagasi antigen preparation. The ELISA was positive (asorbance [greater than or equals to] 0.196 at a serum dilution of 1:1024 in all patients at presentation, and fell to ward control levels over the following year. Only one of 72 control subjects tested positive, and that donor had a sibling with AVL. Immunoblots of the patients' sera recognized multiple bands, the most frequent of which were at approximately 116 kDa, 70 kDa, and 26 kDa. Less frenquently observed were bands at approximately 93 kDa, 74 kDa, 62 kDa, 46 kDa and 32 kDa. The ELISA responses and patterns of banding were distinctive for AVL, and could be used to differentiate patients with AVL from those with Chagas' disease of cutaneous leishmaniasis. Sera from six AVL patients followed for up to six weeks after treatment identified no new bands. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE of surface iodinated parasite proteins showed one major band and four minor bands, whereas SDS-PAGE of biotinylated prarasite proteins revealed a banding pattern similar to those of patient sera. AVL appears to produce characteristic immunoblot patterns which can be used along with a sensitive screening ELISA to diagnose AVL.A leishmaniose visceral americana é uma doença importante entre crianças do nordeste do Brasil. Com o objetivo de caracterizar a resposta imune humoral durante o curso da doença, foram analisados soros de pacientes hospitalizados, pelos métodos ELISA e Western blot, usando-se preparaçöes de antígenos de Leishmania donovani chagasi. O teste de ELISA foi positivo (absorbância > 0,196, numa diluiçäo de 1: 1024, em todos os pacientes no início da doença, diminuindo no decorrer do ano, para os níveis dos

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

    Science.gov (United States)

    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. © 2012 The Society for Vector Ecology.

  13. Experimental visceral leishmaniasis in the opossum.

    Science.gov (United States)

    White, M R; Chapman, W L; Hanson, W L; Latimer, K S; Greene, C E

    1989-07-01

    Adult wild-trapped opossums were infected with Leishmania donovani (Khartoum strain, WR 378) and evaluated as an animal model of visceral leishmaniasis. All infected opossums died within 32 days. Loss of body fat, hepatomegaly, and petechiae of skin and abdominal musculature were seen at necropsy. Microscopically, numerous amastigote-laden macrophages were seen in histologic sections of liver, spleen, and lymph nodes; fewer parasite-laden macrophages were in the bronchial-associated lymphoid tissues and renal glomeruli. Hematological findings included thrombocytopenia (terminal), neutropenia, and lymphopenia. Blood lymphocyte blastogenesis in response to concanavalin A and phytohemagglutinin was decreased markedly at day 24 post-infection (PI). Serum antibodies (1:40 dilution) to promastigotes of L. donovani were detected in five of eight infected opossums tested on days 10 and 24 PI. Total bilirubin concentrations and alanine aminotransferase and aspartate aminotransferase activities were increased after day 25 PI. Activated partial thromboplastin times and one-stage prothrombin times were prolonged before death. Concurrently, factors V, VIII, and XII activities were decreased.

  14. Post-kala-azar dermal leishmaniasis in visceral leishmaniasis-endemic communities in Bihar, India.

    Science.gov (United States)

    Singh, Rudra Pratap; Picado, Albert; Alam, Shahnawaz; Hasker, Epco; Singh, Shri Prakash; Ostyn, Bart; Chappuis, François; Sundar, Shyam; Boelaert, Marleen

    2012-11-01

    We assessed the prevalence of post-kala-azar dermal leishmaniasis (PKDL), a late cutaneous manifestation of visceral leishmaniasis (VL), in 16 VL-endemic communities in Bihar, India. The prevalence of confirmed PKDL cases was 4.4 per 10 000 individuals and 7.8 if probable cases were also considered. The clinical history and treatment of the post-kala-azar dermal leishmaniasis cases are discussed. © 2012 Blackwell Publishing Ltd.

  15. Cost of visceral leishmaniasis care in Brazil.

    Science.gov (United States)

    de Carvalho, Isis Polianna Silva Ferreira; Peixoto, Henry Maia; Romero, Gustavo Adolfo Sierra; de Oliveira, Maria Regina Fernandes

    2017-12-01

    To estimate the Brazilian direct and indirect costs of human visceral leishmaniasis (VL) in 2014. Cost-of-illness study on the Brazilian public health system and societal perspective. VL cases registered in the Notifiable Diseases Information System in the year of 2014 were considered. Direct medical costs regarding diagnostic, treatment and care provided to patients with VL were estimated through the top-down approach. The indirect costs related to productivity loss due to premature mortality and morbidity were estimated by means of the human-capital method. In 2014, 9895 suspected cases of VL were reported in the Notifiable Diseases Information System, and 3453 were later confirmed. There were 234 patients with Leishmania-HIV coinfection underwent a secondary prophylaxis. The total cost of VL in Brazil was US$ 14 190 701.50 (US$ 14 189 150.10 to 14 199 940.53) that varied according to the sensitivity analysis. The total of direct medical costs corresponded to US$ 1 873 681.96 (US$1 872 130.55 to 1 882 920.99), and the majority of costs was associated with hospitalisation (40%), followed by treatment (22%), and secondary prophylaxis (18%). Productivity loss corresponded to US$ 11 421 683.37 for premature mortality and US$ 895 336.18 for work absence due to hospitalisation by the illness. VL represents an expensive health problem for the Brazilian public health system and society, mainly because of its productivity loss due to premature mortality. Interventions to reduce VL lethality could have a great impact on decreasing the cost of illness. © 2017 John Wiley & Sons Ltd.

  16. [Uncommon cutaneous presentation of visceral Leishmaniasis associated with HIV].

    Science.gov (United States)

    Cossart, C; Le Moal, G; Garcia, M; Frouin, E; Hainaut-Wierzbicka, E; Roblot, F

    2016-12-01

    Visceral leishmaniasis is not normally expressed in skin. Herein, we describe the case of an HIV-positive patient who developed two unusual skin manifestations during an episode of visceral leishmaniasis. A 48-year-old female patient consulted initially for infiltrated purpura of all four limbs. Skin biopsy revealed leukocytoclastic vasculitis with Leishman-Donovan bodies. Laboratory tests showed medullary, splenic, gastric and colic involvement, suggesting systemic disease, and enabling visceral leishmaniasis to be diagnosed. Two years later, despite prolonged treatment, the patient presented maculopapular exanthema, and histology revealed persistent Leishman-Donovan bodies. We report herein an association of two rare skin manifestations in an HIV-positive patient with visceral leishmaniasis: infiltrated purpura and maculopapular exanthema. However, the underlying mechanisms remain hypothetical. The initial leukocytoclastic exanthema could be secondary to either polyclonal hypergammaglobulinaemia or to IgA deposits, or possibly to mechanical impairment of blood vessels by the actual parasite. The maculopapular exanthema occurring later raised the possibility of post-Kala-Azar leishmaniasis due to blood-borne dissemination in an anergic subject or perhaps even immune reconstitution inflammatory syndrome. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Cutaneous and visceral leishmaniasis during anti-TNFα therapy.

    Science.gov (United States)

    Guarneri, Claudio; Bevelacqua, Valentina; Patterson, James W; Tchernev, Georgi

    2017-03-01

    The long-term use of novel antipsoriatic systemic biotechnological drugs may increase susceptibility to opportunistic infections. Several cases of visceral leishmaniasis have been reported in immunosuppressed individuals, including those who have been treated with tumour necrosis factor alpha (TNFα) blocking agents. Simultaneous occurrence of cutaneous and visceral involvement has been more rarely recorded in the medical literature. Herein, we describe a case of mucosal leishmaniasis occurring in a farmer living in an endemic region, who was treated with golimumab because of psoriatic arthritis. This highlights the importance of recognizing cutaneous lesions as a first indicator of possible underlying kala-azar disease.

  18. 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

  19. Possible implication of the genetic composition of the Lutzomyia longipalpis (Diptera: Psychodidae) populations in the epidemiology of the visceral leishmaniasis.

    Science.gov (United States)

    Rocha, Leonardo de Souza; Falqueto, Aloisio; Dos Santos, Claudiney Biral; Grimaldi, Gabriel Júnior; Cupolillo, Elisa

    2011-09-01

    Lutzomyia longipalpis (Diptera: Psychodidae) is the principal vector of American visceral leishmaniasis. Several studies have indicated that the Lu. longipalpis population structure is complex. It has been suggested that genetic divergence caused by genetic drift, selection, or both may affect the vectorial capacity of Lu. longipalpis. However, it remains unclear whether genetic differences among Lu. longipalpis populations are directly implicated in the transmission features of visceral leishmaniasis. We evaluated the genetic composition and the patterns of genetic differentiation among Lu. longipalpis populations collected from regions with different patterns of transmission of visceral leishmaniasis by analyzing the sequence variation in the mitochondrial cytochrome b gene. Furthermore, we investigated the temporal distribution of haplotypes and compared our results with those obtained in a previous study. Our data indicate that there are differences in the haplotype composition and that there has been significant differentiation between the analyzed populations. Our results reveal that measures used to control visceral leishmaniasis might have influenced the genetic composition of the vector population. This finding raises important questions concerning the epidemiology of visceral leishmaniasis, because these differences in the genetic structures among populations of Lu. longipalpis may have implications with respect to their efficiency as vectors for visceral leishmaniasis.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Visceral leishmaniasis in Northern Ethiopia | Haile | East African ...

    African Journals Online (AJOL)

    Background: Visceral leishmaniasis (VL) has been well documented by the Medecins sans Frontieres (MSF) VL treatment programmeme in the Tigray region of Ethiopia, but reports are limited from other facilities in this region where this disease continues to cause substantial morbidity and mortality. Objective: To describe ...

  2. Development and application of 'simple' diagnostic tools for visceral leishmaniasis

    NARCIS (Netherlands)

    Schallig, H. D.; Schoone, G. J.; Kroon, C. C.; Hailu, A.; Chappuis, F.; Veeken, H.

    2001-01-01

    The diagnosis of visceral leishmaniasis is difficult. Due to the limitations of direct methods to detect parasites, indirect immunological methods are widely employed. The simple affordable and sensitive/specific direct agglutination test (DAT) is perhaps the most important diagnostic tool under

  3. Importation of visceral leishmaniasis in returning Romanian workers from Spain.

    Science.gov (United States)

    Neghina, Raul; Neghina, Adriana-Maria; Merkler, Carmen; Marincu, Iosif; Moldovan, Roxana; Iacobiciu, Ioan

    2009-01-01

    Over the past two decades visceral leishmaniasis cases and foci have increased in Romania, where the disease has also become a medical concern. The following study aimed to provide essential knowledge on early diagnosis and management of visceral leishmaniasis cases in Romania acquired especially by traveling and working in the Mediterranean countries. Retrospective analysis of the medical records of the patients diagnosed with imported visceral leishmaniasis in a western Romanian county. Three patients with visceral leishmaniasis imported from Spain were admitted to hospital in Timisoara in 2005. Detailed case histories along with clinical and laboratory features are presented. In all the patients the final laboratory confirmation of the disease was by Giemsa-stained blood smears obtained by bone marrow biopsy. Since 2004, many Romanian citizens left their homeland looking for a better job in the Mediterranean region. Unaware of the risks of outdoor labor in warm climatic conditions, they accepted to live and work in improper sanitary conditions. Late identification of the disease resulted mainly from failure of the physicians to diagnose and associate the syndrome with travel.

  4. Foveal hemorrhage in an immunocompetent patient with visceral leishmaniasis.

    Science.gov (United States)

    Cibils Farrés, P; Bedoya Ayala, P; Burga Kuroda, G H; Zegarra Domínguez, M; Luna, J D; Velazco Casapía, J

    2015-12-01

    To report a case of foveal and macular intraretinal hemorrhages in an immunocompetent male patient with visceral leishmaniasis. An immunocompetent, 42 year-old male, presented with progressive visual loss and metamorphopsia in his right eye. The fundus examination showed a foveal round yellow lesion and intraretinal hemorrhages in the macula. The patient was hospitalized with fever, anorexia, weight loss, hepatosplenomegaly, and progressive anemia. Laboratory studies were conducted and a positive test for leishmaniasis and hepatitis A was reported. Treatment was begun with amphotericin B 50mg/day up to a total dose of 1400mg. Bilateral retinal hemorrhages in an endemic country could suggest the diagnosis of visceral leishmaniasis. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Trace elements in sera from patients with visceral leishmaniasis

    International Nuclear Information System (INIS)

    Mukhopadhyay, R.; Bhattacharya, A.; Chakraborty, A.; Sudarshan, M.; Jal, P.K.; Chintalapudi, S.N.; Dutta, R.K.

    2000-01-01

    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)

  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. Characterization and speculations on the urbanization of visceral leishmaniasis in Brazil

    OpenAIRE

    Costa,Carlos Henrique Nery

    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 ...

  9. Visceral Leishmaniasis in Latin America and therapy perspectives

    Directory of Open Access Journals (Sweden)

    Catalina Tovar A

    2017-05-01

    Full Text Available In Latin America, visceral leishmaniasis is caused by Leishmania infantum. In this geographical area, main vectors associated with transmission are Lutzomyia longipalpis and Lutzomyia evansi, with dogs being incriminated as the main reservoir involved in transmission of the disease. This pathology primarily affects children between 0 - 5 years, a highly susceptible population where socio-economic, environmental and nutritional factors affects the pathological outcome and increase the likelihood of vector-human contact. According to the World Health Organization (WHO recommended treatment for Visceral Leishmaniasis is liposomal amphotericin B, a drug with a limited and variable availability between countries depending on market prices, which leaves pentavalent antimonial as the most widely used treatment despite the associated toxic effects. In the Americas, evidence on the efficacy of single-dose (monotherapy and combination therapies as options for treating these parasites is required.

  10. Budgetary impact of diagnostic tests for visceral leishmaniasis in Brazil

    OpenAIRE

    Assis, Tália Santana Machado de; Azeredo-da-Silva, André Luís Ferreira de; Oliveira, Diana; Cota, Gláucia; Werneck, Guilherme Loureiro; Rabello, Ana

    2017-01-01

    Abstract: The aim of the present study was to estimate the financial costs of the incorporation and/or replacement of diagnostic tests for human visceral leishmaniasis (VL) in Brazil. The analysis was conducted from the perspective of the Brazilian Unified National Health System (SUS) over a period of three years. Six diagnostic tests were evaluated: the indirect immunofluorescence antibody test (IFAT), the IT LEISH rapid test, the parasitological examination of bone marrow aspirate, the dire...

  11. 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. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  12. Gene flow between natural and domestic populations of Lutzomyia longipalpis (Diptera: Psychodidae) in a restricted focus of American visceral leishmaniasis in Venezuela.

    Science.gov (United States)

    Márquez, L M; Lampo, M; Rinaldi, M; Lau, P

    2001-01-01

    The epidemiology of the visceral leishmaniasis in the Americas is associated with both a natural and a domestic cycle. The existence of reproductively isolated populations of Lutzomyia longipalpis (Lutz & Neiva), and the scarcity of records of this species from natural habitats in areas where it has been associated with domestic habitats indicated that natural populations could be genetically distinct from domestic ones. Therefore, we compared the genetic structure and estimated the gene flow between L. longipalpis from domestic and peridomestic habitat and from an adjacent undisturbed natural environment along a 1.2-km transect. The analyses were performed on electrophoretic data from eight isozyme loci. The absence of fixed differences in the diagnostic loci Ak and Hk indicated that all specimens belonged to one of the two cryptic species identified in Venezuela. The average number of alleles per locus ranged from 2.0 to 2.9 and the average heterozygosity ranged from 7.8 to 13.4%. No differences were detected in the genetic structure of this species from domestic or peridomestic habitats and those trapped as far as 1.2 km from human dwellings. Nm, estimated from Wright's Fst, indicated that at least 208 individuals per generation migrated between the peridomestic habitat and a 1.2-km distant point to maintain the observed similarities in allelic frequencies. This high rate of gene flow indicated that this species has high migration rates between domestic and natural environments, and has the potential to transport for Leishmania from natural to domestic environments.

  13. Blood pressure and renal injury in dogs with visceral leishmaniasis

    Directory of Open Access Journals (Sweden)

    Marlos G. Sousa

    Full Text Available Abstract: Systemic hypertension is known to be a common consequence of chronic renal disease, which is frequently diagnosed in dogs with visceral leishmaniasis. Although many veterinary investigations have looked at the renal injury caused by Leishmania spp., the role played by this complication in the development of arterial hypertension documented in some animals with visceral leishmaniasis is not completely understood. In this study, 18 adult dogs with naturally-occurring visceral leishmaniasis and varying clinical signs underwent an indirect blood pressure measurement. Also, sera and spot urine were used for laboratory tests. The median systolic blood pressure was 135.2mmHg (95% confidence interval: 128.5-147.7, median mean arterial pressure was 105.8mmHg (98.3-110.4, and median diastolic arterial pressure was 88.5mmHg (77.8-92.5. No differences existed between asymptomatic and symptomatic animals regarding arterial pressure, and no correlations were documented between blood pressure and serum creatinine, blood urea, urine protein-to-creatinine ratio, urine specific gravity, and the fractional excretion of sodium and potassium. Although an association between hypertension and the identification of inflammation on histopathology could not be demonstrated in hypertensive animals, the assessment of kidney samples from 12 dogs indicated mild inflammation with a lymphoplasmacytic infiltrate (6/12, moderate inflammation with multifocal lymphoplasmacytic and histiocytic infiltrates (3/12, and multifocal degeneration and protein casts (2/12. Anti-Leishmania spp. immunohistochemistry assays stained the renal epithelium in 2/12 of the animals. Even though mild systemic hypertension was documented in a small subset of animals, no relationship between the severity of clinical signs and hypertension could be anticipated.

  14. 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%).

  15. 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. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

  16. Association of environmental and climatic factors in the epidemiology of American visceral leishmaniasis in northeast Brazil using remote sensing and geographical information system methods

    Science.gov (United States)

    Thompson, Roland Alexander

    This study associated climatic and environmental factors with the incidence of visceral leishmaniasis (calazar) in Northeast Brazil. Remote sensing (RS) techniques permitted evaluation of spatial and temporal landscape features to stratify the region and define the target population for this vector-borne disease. The Municipality of Caninde, Ceara, Brazil was divided into 873-- 2 x 2 km2 squares centered on coordinates from a Universal Transverse Mercator projection (scale 1:100,000, 1994) and geo-referenced with 2 Landsat T.M. (TM) scenes (September 26, 1976 and July 2, 1996). The assignment of squares into foothills, plains or city strata was based on vegetative categories determined from TM scenes (Bands: 4,5,3) with ERDAS Imagine ISODATA classification procedures. Odds Ratios (OR) with 95% Confidence Intervals (CI) were determined for the juveniles less than age 10 based on 17 years of demographic, calazar incidence and rainfall information supplied by: Fundacao Nacional de Saude, Fundacao Cearense do Metorologia e Recurso Hidricos, and Fundacao Instituto de Planejamento do Ceara. The population and number of calazar cases were determined for each 2 x 2 km 2 square. The odds ratio of calazar for a Caninde juvenile in the foothills relative to the city was OR = 4.11 CI (3.2, 5.3). The calazar odds ratio for juveniles living in years with 3-year rainfall average between 60--90 cm was OR = 3.07 CI (1.3, 7.2), the rainfall average between 40--60 cm had OR = 9.12 CI (4.4, 23.3), and with less than 40 cm OR = 9.23 CI (3.9, 25.2) relative to years with an average greater than 90 cm. The logistic regression model for Ceara comprised an ordinal-incidence-density-response variable, a 5-level region explanatory variable, and a 3-level juvenile proportion variable. The odds ratios for calazar in municipalities located in the interior high plains was OR = 1.94 CI (1.6, 2.4) relative to location in the littoral and for a municipality with less than 26% juvenile population

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

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    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.

  18. Therapeutic effect of ursolic acid in experimental visceral leishmaniasis

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    Jéssica A. Jesus

    2017-04-01

    Full Text Available Leishmaniasis is an important neglected tropical disease, affecting more than 12 million people worldwide. The available treatments are not well tolerated and present diverse side effects in patients, justifying the search for new therapeutic compounds. In the present study, the therapeutic potential and toxicity of ursolic acid (UA, isolated from the leaves of Baccharis uncinella C. DC. (Asteraceae, were evaluated in experimental visceral leishmaniasis. To evaluate the therapeutic potential of UA, hamsters infected with L. (L. infantum were treated daily during 15 days with 1.0 or 2.0 mg UA/kg body weight, or with 5.0 mg amphotericin B/kg body weight by intraperitoneal route. Fifteen days after the last dose, the parasitism of the spleen and liver was stimated and the main histopathological alterations were recorded. The proliferation of splenic mononuclear cells was evaluated and IFN-γ, IL-4, and IL-10 gene expressions were analyzed in spleen fragments. The toxicity of UA and amphotericin B were evaluated in healthy golden hamsters by histological analysis and biochemical parameters. Animals treated with UA had less parasites in the spleen and liver when compared with the infected control group, and they also showed preservation of white and red pulps, which correlate with a high rate of proliferation of splenic mononuclear cells, IFN-γ mRNA and iNOS production. Moreover, animals treated with UA did not present alterations in the levels of AST, ALT, creatinine and urea. Taken together, these findings indicate that UA is an interesting natural compound that should be considered for the development of prototype drugs against visceral leishmaniasis.

  19. The direct agglutination test as an alternative method for the diagnosis of canine and human visceral leishmaniasis

    NARCIS (Netherlands)

    Terán-Angel, Guillermo; Schallig, Henk; Zerpa, Olga; Rodríguez, Vestalia; Ulrich, Marian; Cabrera, Maira

    2007-01-01

    Visceral leishmaniasis is the most severe clinical form of leishmaniasis and is often fatal without proper treatment. Therefore, early and accurate diagnosis is important, but often difficult in endemic areas. The aim was to evaluate a direct agglutination test as a potential visceral leishmaniasis

  20. Patologias genitais associadas à leishmaniose visceral canina Genital pathologies associated with canine visceral leishmaniasis

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    Vinícius Vasconcelos Gomes de Oliveira

    2012-09-01

    Full Text Available A leishmaniose visceral canina (LVC é uma doença parasitária crônica causada por protozoários pertencentes ao gênero Leishmania. No Brasil, a transmissão se dá, principalmente, pela ação hematófaga de insetos vetores pertencentes à subfamília Phlebotominae, particularmente, a espécie Lutzomyia longipalpis. Todavia, a trasmissão vertical e venérea da LVC está presente. Os principais sinais clínicos observados nos animais acometidos pela LVC são linfoadenomegalia, dermatopatias, hepatoesplenomegalia, onicogrifose e oftalmopatias, contudo quadros atípicos podem ser observados, inclusive com o envolvimento do sistema genital. Dessa forma, o objetivo deste artigo é realizar revisão sobre as principais patologias genitais em cães machos e fêmeas com leishmaniose visceral (LV.The canine visceral leishmaniasis (CanL is a chronic parasitic disease caused by protozoa belonging to the genus Leishmania. In Brazil, the transmission occurs mainly by the action of blood-sucking insects belonging to the subfamily Phlebotominae, particularly the Lutzomyia longipalpis species. However, the venereal and vertical transmission of the CanL is present. The main clinical signs observed in animals affected by the CanL are lymphadenopathy, skin diseases, hepatosplenomegaly, onychogryphosis and ophthalmopathy, however atypical manifestations can be observed, including the involvement of the genital system. Thus, the aim of this paper is to review on the major pathologies in genital male and female dogs with visceral leishmaniasis (VL.

  1. The unwelcome trio: HIV plus cutaneous and visceral leishmaniasis.

    Science.gov (United States)

    Guarneri, C; Tchernev, G; Bevelacqua, V; Lotti, T; Nunnari, G

    2016-01-01

    Leishmania/Human Immunodeficiency Virus (HIV) coinfection has emerged as an extremely serious and increasingly frequent health problem in the last decades. Considering the insidious and not typical clinical picture in presence of immunosuppressive conditions, the increasing number of people travelling in endemic zones, the ability to survive, within both human and vector bodies, of the parasite, clinicians and dermatologists as the first line should be aware of these kind of "pathologic alliances," to avoid delayed diagnosis and treatment. In this setting, the occurrence of cutaneous lesions can, paradoxically, aid the physician in recognition and approaching the correct staging and management of the two (or three) diseases. Treatment of these unwelcome synergies is a challenge: apart from the recommended anti-retroviral protocols, different anti-leishmanial drugs have been widely used, according with the standard guidelines for visceral leishmaniasis (VL), with no successful treatment regimen still been established. © 2015 Wiley Periodicals, Inc.

  2. Visceral leishmaniasis with cutaneous symptoms in a patient treated with infliximab followed by fatal consequences.

    Science.gov (United States)

    Juzlova, Katerina; Votrubova, Jana; Kacerovska, Denisa; Lukas, Milan; Bortlik, Martin; Rohacova, Hana; Nohynkova, Eva; Vojackova, Nadezda; Fialova, Jorga; Hercogova, Jana

    2014-01-01

    Leishmaniasis is an infectious disease caused by parasitic flagellates of the genus Leishmania. The authors present a case of 44-year-old man with Crohn's disease treated successfully with infliximab. This case report shows rare visceral leishmaniasis with cutaneous symptoms in an immunocompromised patient. Skin manifestations may occur before or after the visceral infection and they are often diverse. © 2013 Wiley Periodicals, Inc.

  3. Antibodies against sand flies saliva in domestic animals from endemic areas of visceral leishmaniasis

    OpenAIRE

    Košťálová, Tatiana

    2012-01-01

    The main aim of this thesis was to test sera of domestic animals from endemic areas of visceral leishmaniasis in north and northwest Ethiopia for antibodies against presumed vector P. orientalis salivary glands and to clarify behavior of the sand fly and the role of domestic animals in transmission of visceral leishmaniasis. Specific IgG antibodies against P. orientalis saliva were tested in dogs, cattle, goats, sheep and donkeys. Above the cut-off value there was 76 % analyzed dogs, 15 % cat...

  4. Vulnerability to the transmission of human visceral leishmaniasis in a Brazilian urban area

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    Celina Roma Sánchez de Toledo

    Full Text Available ABSTRACT OBJECTIVE To analyze the determinants for the occurrence of human visceral leishmaniasis linked to the conditions of vulnerability. METHODS This is an ecological study, whose spatial analysis unit was the Territorial Analysis Unit in Araguaína, State of Tocantins, Brazil, from 2007 to 2012. We have carried out an analysis of the sociodemographic and urban infrastructure situation of the municipality. Normalized primary indicators were calculated and used to construct the indicators of vulnerability of the social structure, household structure, and urban infrastructure. From them, we have composed a vulnerability index. Kernel density estimation was used to evaluate the density of cases of human visceral leishmaniasis, based on the coordinates of the cases. Bivariate global Moran’s I was used to verify the existence of spatial autocorrelation between the incidence of human visceral leishmaniasis and the indicators and index of vulnerability. Bivariate local Moran’s I was used to identify spatial clusters. RESULTS We have observed a pattern of centrifugal spread of human visceral leishmaniasis in the municipality, where outbreaks of the disease have progressively reached central and peri-urban areas. There has been no correlation between higher incidences of human visceral leishmaniasis and worse living conditions. Statistically significant clusters have been observed between the incidences of human visceral leishmaniasis in both periods analyzed (2007 to 2009 and 2010 to 2012 and the indicators and index of vulnerability. CONCLUSIONS The environment in circumscribed areas helps as protection factor or increases the local vulnerability to the occurrence of human visceral leishmaniasis. The use of methodology that analyzes the conditions of life of the population and the spatial distribution of human visceral leishmaniasis is essential to identify the most vulnerable areas to the spread/maintenance of the disease.

  5. Adenosine and Immune Imbalance in Visceral Leishmaniasis: The Possible Role of Ectonucleotidases

    Science.gov (United States)

    Paletta-Silva, Rafael; Meyer-Fernandes, José Roberto

    2012-01-01

    Visceral leishmaniasis (VL) is the most severe form of leishmaniasis and is responsible for most Leishmania-associated deaths. VL represents a serious public health problem that affects many countries. The immune response in leishmaniasis is very complex and is poorly understood. The Th1 versus Th2 paradigm does not appear to be so clear in visceral leishmaniasis, suggesting that other immunosuppressive or immune-evasion mechanisms contribute to the pathogenesis of VL. It has been demonstrated that generation of adenosine, a potent endogenous immunosuppressant, by extracellular enzymes capable to hydrolyze adenosine tri-nucleotide (ATP) at the site of infection, can lead to immune impairment and contribute to leishmaniasis progression. In this regard, this paper discusses the unique features in VL immunopathogenesis, including a possible role for ectonucleotidases in leishmaniasis. PMID:22007242

  6. High visceral leishmaniasis mortality rate in Barra Mansa, a new area of visceral leishmaniasis transmission in the State of Rio de Janeiro, Brazil

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    Maria Inês Fernandes Pimentel

    2014-07-01

    Full Text Available Introduction Nine cases of visceral leishmaniasis occurred recently in Barra Mansa, State of Rio de Janeiro, with a high mortality rate. Methods We reviewed the medical records of the patients. Results Eight were male; 7 were adults. Patients who died progressed to death quickly and presented with aggravating factors: systemic steroid therapy before diagnosis, bleeding, severe liver involvement, infection, and/or refusal to receive transfusion. Conclusions We warn clinicians to be aware of the emergence of visceral leishmaniasis in new areas and to keep in mind the possibility of atypical clinical pictures and aggravating factors, so timely diagnosis can be made and prompt and adequate treatment can be initiated.

  7. 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. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

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    Amanda Codeço de OLIVEIRA

    2015-08-01

    Full Text Available SUMMARY 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 longipalpiswas not detected. Our results are indicative of an ongoing transmission in the area.

  9. Feeding behavior of Lutzomyia pseudolongipalpis (Diptera: Psychodidae), a putative vector of visceral leishmaniasis in Venezuela.

    Science.gov (United States)

    Agrela, Irma; Sanchez, Erlinda; Gomez, Beverly; Feliciangeli, M Dora

    2002-05-01

    Lutzomyia pseudolongipalpis Arrivillaga & Feliciangeli is the first new sand fly species in the L. longipalpis species complex that has been formally described since it was separated by genetic as well as by morphological characters. It is the putative vector of the American visceral leishmaniasis in La Rinconada, Curarigua, a restricted focus in central western Venezuela. We investigated the feeding behavior of this species. The blood meals from 210 of 429 (48.9%) engorged females caught by CDC light traps were identified by a dot enzyme-linked immuno-absorbent assay using antisera against humans and common domestic animals. We propose a new index, the host selectivity index, which is the number of sand flies fed on a given host relative to the available biomass of that host, as an indicator of the feeding behavior of this phlebotomine sand fly. The host selectivity index is compared with the forage ratio, which is the percentage of sand flies fed on a given host by the percentage which that host represented in the total census of available animals and humans. The most attractive animal for L. pseudolongipalpis in Curarigua was the dog, whereas humans were shown to be relatively unattractive. However, not only selectivity or biomass, but also the accessibility to this host may have influenced these results. The low population density of dogs and the low accessibility of L. pseudolongipalpis to humans in relation to domestic animals might help to explain the sporadic transmission of visceral leishmaniasis in this focus.

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

    Science.gov (United States)

    de OLIVEIRA, Amanda Codeço; FIGUEIREDO, Fabiano Borges; SILVA, Valmir Laurentino; SANTOS, Fernanda Nunes; de SOUZA, Marcos Barbosa; MADEIRA, Maria de Fátima; ABRANTES, Tuanne Rotti; PÉRISSÉ, André Reynaldo Santos

    2015-01-01

    SUMMARY 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 longipalpiswas not detected. Our results are indicative of an ongoing transmission in the area. PMID:26422157

  11. 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.

  12. 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...

  13. Nanoliposomal artemisinin for the treatment of murine visceral leishmaniasis

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    Want MY

    2017-03-01

    Full Text Available Muzamil Y Want,1 Mohammad Islammudin,1 Garima Chouhan,1 Hani A Ozbak,2 Hassan A Hemeg,2 Asoke P Chattopadhyay,3 Farhat Afrin2 1Parasite Immunology Laboratory, Department of Biotechnology, Jamia Hamdard, Hamdard University, New Delhi, India; 2Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia; 3Department of Chemistry, University of Kalyani, Kalyani, India Abstract: Visceral leishmaniasis (VL is a fatal, vector-borne disease caused by the intracellular protozoa of the genus Leishmania. Most of the therapeutics for VL are toxic, expensive, or ineffective. Sesquiterpenes are a new class of drugs with proven antimicrobial and antiviral activities. Artemisinin is a sesquiterpene lactone with potent antileishmanial activity, but with limited access to infected cells, being a highly lipophilic molecule. Association of artemisinin with liposome is a desirable strategy to circumvent the problem of poor accessibility, thereby improving its efficacy, as demonstrated in a murine model of experimental VL. Nanoliposomal artemisinin (NLA was prepared by thin-film hydration method and optimized using Box–Behnken design with a mean particle diameter of 83±16 nm, polydispersity index of 0.2±0.03, zeta potential of -27.4±5.7 mV, and drug loading of 33.2%±2.1%. Morphological study of these nanoliposomes by microscopy showed a smooth and spherical surface. The mechanism of release of artemisinin from the liposomes followed the Higuchi model in vitro. NLA was free from concomitant signs of toxicity, both ex vivo in murine macrophages and in vivo in healthy BALB/c mice. NLA significantly denigrated the intracellular infection of Leishmania donovani amastigotes and the number of infected macrophages ex vivo with an IC50 of 6.0±1.4 µg/mL and 5.1±0.9 µg/mL, respectively. Following treatment in a murine model of VL, NLA demonstrated superior efficacy compared to artemisinin with a

  14. Control strategies and sensitivity analysis of anthroponotic visceral leishmaniasis model.

    Science.gov (United States)

    Zamir, Muhammad; Zaman, Gul; Alshomrani, Ali Saleh

    2017-12-01

    This study proposes a mathematical model of Anthroponotic visceral leishmaniasis epidemic with saturated infection rate and recommends different control strategies to manage the spread of this disease in the community. To do this, first, a model formulation is presented to support these strategies, with quantifications of transmission and intervention parameters. To understand the nature of the initial transmission of the disease, the reproduction number [Formula: see text] is obtained by using the next-generation method. On the basis of sensitivity analysis of the reproduction number [Formula: see text], four different control strategies are proposed for managing disease transmission. For quantification of the prevalence period of the disease, a numerical simulation for each strategy is performed and a detailed summary is presented. Disease-free state is obtained with the help of control strategies. The threshold condition for globally asymptotic stability of the disease-free state is found, and it is ascertained that the state is globally stable. On the basis of sensitivity analysis of the reproduction number, it is shown that the disease can be eradicated by using the proposed strategies.

  15. Recent understanding in the treatment of visceral leishmaniasis.

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    Rosenthal E

    2003-01-01

    Full Text Available 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 of amphotericin B have changed the pattern of VL treatment. Within the past five years, miltefosine has been demonstrated as the first effective and safe oral treatment against VL. The price of miltefosine is yet to be determined. However, miltefosine will certainly be cheaper than lipid formulations of amphotericin B, which are beyond the financial capacity of the poor countries. Because it can be administered orally, miltefosine is suited for the treatment of large number of patients who get affected during epidemics, particularly in regions where the parasites are resistant to the currently used agents. Here, we recommend different treatment schedules according to the resistance pattern and the region-specific socio-economical and cultural factors.

  16. 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.

  17. Characterization and speculations on the urbanization of visceral leishmaniasis in Brazil.

    Science.gov (United States)

    Costa, Carlos Henrique Nery

    2008-12-01

    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 research on the ecological and molecular determinants of Leishmania chagasi transmission. Investment of public funds should focus on the development of a human vaccine, since such a vaccine now appears to be within reach. Even small effects from a vaccine could substantially reduce the impact of the disease, which in the last quarter century has challenged and defeated both the scientific community and the public health field around the world.

  18. 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.

  19. Electrospray Encapsulation of Toll-Like Receptor Agonist Resiquimod in Polymer Microparticles for the Treatment of Visceral Leishmaniasis

    Science.gov (United States)

    2013-01-15

    SECURITY CLASSIFICATION OF: Leishmaniasis is a disease caused by the intracellular protozoan, Leishmania. A current treatment for cutaneous... leishmaniasis involves the delivery of imidazoquinolines via a topical cream. However, there are no parenteral formulations of imidazoquinolines for the most...deadly version of the disease, visceral leishmaniasis . This work investigates the use of electrospray to encapsulate the imidazoquinoline adjuvant

  20. 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...

  1. Risk factors, representations and practices associated with emerging urban human visceral leishmaniasis in Posadas, Argentina.

    Science.gov (United States)

    López, Karen; Tartaglino, Lilian Catalina; Steinhorst, Ingrid Iris; Santini, María Soledad; Salomon, Oscar Daniel

    2016-02-23

    Visceral leishmaniasis is an often overlooked disease with high lethality rates about which there is need of additional local studies to inform the design of effective control strategies. The urbanization of its transmission has already been verified in America, with domestic dogs being the primary reservoirs and vectors of the disease. Socio-economic conditions, demographics and practices of domestic groups typically present in urban settings may play a specific role in the transmission of the infection, which is still poorly understood.  To analyze the sociodemographic characteristics, risk factors and overall practices concerning prevention and coping strategies of visceral leishmaniasis, in both human beings and canines.  This study utilized a cross-sectional case-control design. Cases were defined as a domestic group where the Public Health Ministry had at least one record of a member with human visceral leishmaniasis. Control cases were defined as a domestic group without a clinical record of the disease. The populations were characterized demographically and socially using primary information sources. Measures of household quality and a ranking of knowledge and attitudes towards visceral leishmaniasis were constructed, and practices associated with the presence, and the risk for canine visceral leishmaniasis were described.  Low household quality (p≤0.001), a member of the domestic group out of the household after 6:00 pm (OR=4.4; 95% CI: 1.69-12.18), the uncontrolled racial breeding of dogs (OR=15.7; 95% CI: 3.91-63.2), and the presence of infected dogs infected in the household (OR=120.3; 95% CI: 18.51-728.3) were variables positively associated with the risk of infection.  We observed certain social risk factors, primarily low household quality and overcrowding, associated with structural poverty that could increase human-vector contact probability. The most important risk factor for human visceral leishmaniasis was the possession of infected dogs

  2. Visceral leishmaniasis treatment outcome and its determinants in northwest Ethiopia.

    Science.gov (United States)

    Welay, Getachew Mebrahtu; Alene, Kefyalew Addis; Dachew, Berihun Assefa

    2016-01-01

    Poor treatment outcomes of visceral leishmaniasis (VL) are responsible for the high mortality rate of this condition in resource-limited settings such as Ethiopia. This study aimed to identify the proportion of poor VL treatment outcomes in northwest Ethiopia and to evaluate the determinants associated with poor outcomes. A hospital-based retrospective study was conducted among 595 VL patients who were admitted to Kahsay Abera Hospital in northwest Ethiopia from October 2010 to April 2013. Data were entered into Epi Info version 7.0 and exported to SPSS version 20 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of VL treatment outcomes. Adjusted odds ratio (aORs) with 95% confidence intervals (CIs) were used, and p -values <0.05 were considered to indicate statistical significance. The proportion of poor treatment outcomes was 23.7%. Late diagnosis (≥29 days) (aOR, 4.34; 95% CI, 2.22 to 8.46), severe illness at admission (inability to walk) (aOR, 1.63; 95% CI, 1.06 to 2.40) and coinfection with VL and human immunodeficiency virus (HIV) (aOR, 2.72; 95% CI, 1.40 to 5.20) were found to be determinants of poor VL treatment outcomes. Poor treatment outcomes, such as death, treatment failure, and non-adherence, were found to be common. Special attention must be paid to severely ill and VL/HIV-coinfected patients. To improve VL treatment outcomes, the early diagnosis and treatment of VL patients is recommended.

  3. Risk factors for death in children with visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Márcia Jaqueline Alves de Queiroz Sampaio

    Full Text Available BACKGROUND: Despite the major public health importance of visceral leishmaniasis (VL in Latin America, well-designed studies to inform diagnosis, treatment and control interventions are scarce. Few observational studies address prognostic assessment in patients with VL. This study aimed to identify risk factors for death in children aged less than 15 years admitted for VL treatment in a referral center in northeast Brazil. METHODOLOGY/PRINCIPAL FINDINGS: In a retrospective cohort, we reviewed 546 records of patients younger than 15 years admitted with the diagnosis of VL at the Instituto de Medicina Integral Professor Fernando Figueira between May 1996 and June 2006. Age ranged from 4 months to 13.7 years, and 275 (50% were male. There were 57 deaths, with a case-fatality rate of 10%. In multivariate logistic regression, the independent predictors of risk of dying from VL were (adjusted OR, 95% CI: mucosal bleeding (4.1, 1.3-13.4, jaundice (4.4, 1.7-11.2, dyspnea (2.8, 1.2-6.1, suspected or confirmed bacterial infections (2.7, 1.2-6.1, neutrophil count <500/mm³ (3.1, 1.4-6.9 and platelet count <50,000/mm³ (11.7, 5.4-25.1. A prognostic score was proposed and had satisfactory sensitivity (88.7% and specificity (78.5%. CONCLUSIONS/SIGNIFICANCE: Prognostic and severity markers can be useful to inform clinical decisions such as whether a child with VL can be safely treated in the local healthcare facility or would potentially benefit from transfer to referral centers where advanced life support facilities are available. High risk patients may benefit from interventions such as early use of extended-spectrum antibiotics or transfusion of blood products. These baseline risk-based supportive interventions should be assessed in clinical trials.

  4. Cost of Pediatric Visceral Leishmaniasis Care in Morocco.

    Science.gov (United States)

    Tachfouti, Nabil; Najdi, Adil; Alonso, Sergi; Sicuri, Elisa; Laamrani El Idrissi, Abderahmane; Nejjari, Chakib; Picado, Albert

    2016-01-01

    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.

  5. Visceral leishmaniasis in the Indian subcontinent: modelling epidemiology and control.

    Directory of Open Access Journals (Sweden)

    Anette Stauch

    2011-11-01

    Full Text Available 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.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.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.

  6. Leishmaniasis in Turkey: Visceral and cutaneous leishmaniasis caused by Leishmania donovani in Turkey.

    Science.gov (United States)

    Özbilgin, Ahmet; Harman, Mehmet; Karakuş, Mehmet; Bart, Aldert; Töz, Seray; Kurt, Özgür; Çavuş, İbrahim; Polat, Erdal; Gündüz, Cumhur; Van Gool, Tom; Özbel, Yusuf

    2017-09-01

    In Turkey, the main causative agents are Leishmania tropica (L. tropica) and Leishmania infantum (L. infantum) for cutaneous leishmaniasis (CL) and L. infantum for visceral leishmaniasis (VL). In this study, we investigated leishmaniasis cases caused by L. donovani and established animal models for understanding its tropism in in vivo conditions. Clinical samples (lesion aspirations and bone marrow) obtained from CL/VL patients were investigated using parasitological (smear/NNN) and DNA-based techniques. For species identification, a real time ITS1-PCR was performed using isolates and results were confirmed by hsp70 PCR-N/sequencing and cpb gene PCR/sequencing in order to reveal Leishmania donovani and Leishmania infantum discrimination. Clinical materials from CL and VL patients were also inoculated into two experimental groups (Group CL and Group VL) of Balb/C mice intraperitoneally for creating clinical picture of Turkish L. donovani strains. After 45days, the samples from visible sores of the skin were taken, and spleens and livers were removed. Measurements of the internal organs were done and touch preparations were prepared for checking the presence of amastigotes. The strains were isolated from all patients and amastigotes were seen in all smears of the patients, and then isolates were immediately stored in liquid nitrogen. In real time ITS1-PCR, the melting temperatures of all samples were out of range of L. infantum, L. tropica and L. major. Sequencing of hsp70 PCR-N showed that all isolates highly identical to previously submitted L. donovani sequences in GenBank, and cpb gene sequencing showed five isolates had longer cpbF allele, whereas one isolate contained a mixed sequence of both cpbF and cpbE. All mice in both experimental groups became infected. Compared to controls, the length and width of both liver and spleen were significantly elevated (pTurkey. Animal models using clinical samples were successfully established and important clinical

  7. Immunity to Visceral Leishmaniasis Using Genetically Defined Live-Attenuated Parasites

    Directory of Open Access Journals (Sweden)

    Angamuthu Selvapandiyan

    2012-01-01

    Full Text Available Leishmaniasis is a protozoan parasitic disease endemic to the tropical and subtropical regions of the world, with three major clinical forms, self-healing cutaneous leishmaniasis (CL, mucocutaneous leishmaniasis (MCL, and visceral leishmaniasis (VL. Drug treatments are expensive and often result in the development of drug resistance. No vaccine is available against leishmaniasis. Subunit Leishmania vaccine immunization in animal models has shown some efficacy but little or none in humans. However, individuals who recover from natural infection are protected from reinfection and develop life-long protection, suggesting that infection may be a prerequisite for immunological memory. Thus, genetically altered live-attenuated parasites with controlled infectivity could achieve such memory. In this paper, we discuss development and characteristics of genetically altered, live-attenuated Leishmania donovani parasites and their possible use as vaccine candidates against VL. In addition, we discuss the challenges and other considerations in the use of live-attenuated parasites.

  8. 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 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...

  9. 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

  10. Immunotherapeutic Potential of Eugenol Emulsion in Experimental Visceral Leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Mohammad Islamuddin

    2016-10-01

    Full Text Available The therapy of visceral leishmaniasis (VL is limited by resistance, toxicity and decreased bioavailability of the existing drugs coupled with dramatic increase in HIV-co-infection, non-availability of vaccines and down regulation of cell-mediated immunity (CMI. Thus, we envisaged combating the problem with plant-derived antileishmanial drug that could concomitantly mitigate the immune suppression of the infected hosts. Several plant-derived compounds have been found to exert leishmanicidal activity via immunomodulation. In this direction, we investigated the antileishmanial activity of eugenol emulsion (EE, complemented with its immunomodulatory and therapeutic efficacy in murine model of VL.Oil-in-water emulsion of eugenol (EE was prepared and size measured by dynamic light scattering (DLS. EE exhibited significant leishmanicidal activity with 50% inhibitory concentration of 8.43±0.96 μg ml-1 and 5.05±1.72 μg ml─1, respectively against the promastigotes and intracellular amastigotes of Leishmania donovani. For in vivo effectiveness, EE was administered intraperitoneally (25, 50 and 75 mg/kg b.w./day for 10 days to 8 week-infected BALB/c mice. The cytotoxicity of EE was assessed in RAW 264.7 macrophages as well as in naive mice. EE induced a significant drop in hepatic and splenic parasite burdens as well as diminution in spleen and liver weights 10 days post-treatment, with augmentation of 24h-delayed type hypersensitivity (DTH response and high IgG2a:IgG1, mirroring induction of CMI. Enhanced IFN-γ and IL-2 levels, with fall in disease-associated Th2 cytokines (IL-4 and IL-10 detected by flow cytometric bead-based array, substantiated the Th1 immune signature. Lymphoproliferation and nitric oxide release were significantly elevated upon antigen revoke in vitro. The immune-stimulatory activity of EE was further corroborated by expansion of IFN-γ producing CD4+ and CD8+ splenic T lymphocytes and up-regulation of CD80 and CD86 on

  11. Mathematical analysis of a model for zoonotic visceral leishmaniasis

    Directory of Open Access Journals (Sweden)

    Nafiu Hussaini

    2017-11-01

    Full Text Available Zoonotic visceral leishmaniasis (ZVL, caused by the protozoan parasite Leishmania infantum and transmitted to humans and reservoir hosts by female sandflies, is endemic in many parts of the world (notably in Africa, Asia and the Mediterranean. This study presents a new mathematical model for assessing the transmission dynamics of ZVL in human and non-human animal reservoir populations. The model undergoes the usual phenomenon of backward bifurcation exhibited by similar vector-borne disease transmission models. In the absence of such phenomenon (which is shown to arise due to the disease-induced mortality in the host populations, the nontrivial disease-free equilibrium of the model is shown to be globally-asymptotically stable when the associated reproduction number of the model is less than unity. Using case and demographic data relevant to ZVL dynamics in Arac̣atuba municipality of Brazil, it is shown, for the default case when systemic insecticide-based drugs are not used to treat infected reservoir hosts, that the associated reproduction number of the model (ℛ0 ranges from 0.3 to 1.4, with a mean of ℛ0=0.85. Furthermore, when the effect of such drug treatment is explicitly incorporated in the model (i.e., accounting for the additional larval and sandfly mortality, following feeding on the treated reservoirs, the range of ℛ0 decreases to ℛ0∈[0.1,0.6], with a mean of ℛ0=0.35 (this significantly increases the prospect of the effective control or elimination of the disease. Thus, ZVL transmission models (in communities where such treatment strategy is implemented that do not explicitly incorporate the effect of such treatment may be over-estimating the disease burden (as measured in terms of ℛ0 in the community. It is shown that ℛ0 is more sensitive to increases in sandfly lifespan than that of the animal reservoir (so, a strategy that focuses on reducing sandflies, rather than the animal reservoir (e.g., via culling, may be

  12. A Global Comparative Evaluation of Commercial Immunochromatographic Rapid Diagnostic Tests for Visceral Leishmaniasis

    NARCIS (Netherlands)

    Cunningham, Jane; Hasker, Epco; Das, Pradeep; El Safi, Sayda; Goto, Hiro; Mondal, Dinesh; Mbuchi, Margaret; Mukhtar, Maowia; Rabello, Ana; Rijal, Suman; Sundar, Shyam; Wasunna, Monique; Adams, Emily; Menten, Joris; Peeling, Rosanna; Boelaert, Marleen; Khanal, Basudha; Das, Murari; Oliveira, Edward; de Assis, Tália Machado; Costa, Dorcas Lamounier; Bhaskar, Khondaker Rifathassan; Huda, M. Mamun; Hassan, Mukidul; Abdoun, Asim Osman; Awad, Aymen; Osman, Mohamed; Prajapati, Dinesh Kumar; Gidwani, Kamlesh; Tiwary, Puja; Paniago, Anamaria Mello Miranda; Sanchez, Maria Carmen Arroyo; Celeste, Beatriz Julieta; Jacquet, Diane; Magiri, Charles; Muia, A.; Kesusu, J.; Ageed, Al Farazdag; Galal, Nuha; Osman, Osman Salih; Gupta, A. K.; Bimal, Afrad S.; Das, V. N. R.

    2012-01-01

    Background. Poor access to diagnosis stymies control of visceral leishmaniasis (VL). Antibody-detecting rapid diagnostic tests (RDTs) can be performed in peripheral health settings. However, there are many brands available and published reports of variable accuracy. Methods. Commercial VL RDTs

  13. Use of PCR on lymph-node sample as test of cure of visceral leishmaniasis

    NARCIS (Netherlands)

    Osman, O. F.; Kager, P. A.; Zijlstra, E. E.; El-Hassan, A. M.; Oskam, L.

    1997-01-01

    When the polymerase chain reaction (PCR) was used to test lymph-node aspirates from 35 patients from eastern Sudan, who had had visceral leishmaniasis but were believed cured, leishmanial DNA was detected in samples from 14 of the patients. There were no significant differences between the

  14. Soluble receptors for tumor necrosis factor as markers of disease activity in visceral leishmaniasis

    NARCIS (Netherlands)

    Zijlstra, E. E.; van der Poll, T.; Mevissen, M.

    1995-01-01

    Serum concentrations of soluble receptors for tumor necrosis factor (sTNFRs) were measured before and after antimony therapy in 25 Sudanese patients with active visceral leishmaniasis (VL). Both sTNFR types I and II were significantly elevated in patients with VL compared with healthy controls from

  15. Visceral Leishmaniasis and HIV co-infection in patients admitted to ...

    African Journals Online (AJOL)

    Administrator

    Abstract. Background: Worldwide, after malaria and sleeping sickness, leishmaniases are the third most important vector borne diseases. Visceral leishmaniasis (kala- azar) is a disseminated protozoan infection caused by L. donovani, L. infantum, or L. arachibaldi, and transmitted by the female phlebotomine sand fly bite.

  16. 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...

  17. 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...

  18. 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 was a...

  19. A case of visceral leishmaniasis and pulmonary tuberculosis in a post-partum woman

    Directory of Open Access Journals (Sweden)

    Claudia Colomba

    2015-04-01

    Full Text Available Visceral leishmaniasis due to Leishmania infantum is a vector-borne zoonotic disease transmitted by sand fly bites endemic in rural or periurban areas of the Mediterranean basin. Pregnancy is accompanied by changes in immune response, mainly a decrease in cellular immunity and a proportional increase in humoral immunity. These physiological events result in increased risk of infection by pathogens whose immunity is based on a T-helper 1 predominant response. We describe a case of visceral leishmaniasis and pulmonary tuberculosis diagnosed in a post-partum woman four days after delivery. The diagnosis of leishmaniasis should be considered in pregnant women with fever and haematologic abnormalities in endemic regions or if a history of exposure in endemic areas is reported.

  20. Utilização de ferramentas de análise espacial na vigilância epidemiológica de leishmaniose visceral americana - Araçatuba, São Paulo, Brasil, 1998-1999 Use of spatial analysis tools in the epidemiological surveillance of American visceral leishmaniasis, Araçatuba, São Paulo, Brazil, 1998-1999

    Directory of Open Access Journals (Sweden)

    Vera Lucia Fonseca de Camargo-Neves

    2001-10-01

    Full Text Available O controle da Leishmaniose Visceral Americana (LVA está fundamentado no combate ao vetor e na eliminação do reservatório doméstico da área de foco - 200 metros em torno do caso humano ou canino. O presente trabalho tem como objetivo discutir a utilização de técnicas de análise espacial na vigilância epidemiológica da LVA no Município de Araçatuba, São Paulo, buscando estabelecer um modelo de vigilância epidemiológica em base territorial, redirecionando as estratégias de controle atualmente adotadas. Verificou-se que a transmissão da LVA não foi homogênea no município: a transmissão humana ocorreu nas áreas com maiores taxas de prevalência canina. A dispersão do vetor parece restrita a poucos domicílios, embora não tenha sido possível estabelecer um perfil da densidade vetorial. Visando estudar a distribuição do vetor e variáveis correlacionadas está sendo realizado estudo de campo por amostragem de domicílios, que permitirá o desenvolvimento de novas ferramentas de análise espacial e, possivelmente, permitirá redefinir as propostas de controle da endemia em ambiente urbano.The control of American visceral leishmaniasis (AVL is based on combating the vector and eliminating the domestic reservoir of the focus area - defined as 200 meters around human or canine cases. This paper discusses the use of spatial analysis techniques in the epidemiological surveillance of AVL in Araçatuba, São Paulo State, in order to propose a model for territorial epidemiological surveillance, reformulating current control strategies. The results showed that AVL transmission was not homogeneous; human cases were more frequent in areas with higher canine prevalence rates. Vector dispersion appeared to be restricted to a few houses, although it was not possible to model the vector density. In order to study the vector distribution and correlated covariates, a field study based on house sampling is being conducted. The results will

  1. Visceral Leishmaniasis Treated with Antimonials/Paromomycin followed by Itraconazole/Miltefosine after Standard Therapy Failures in a Human Immunodeficiency Virus–Infected Patient

    OpenAIRE

    Barragán, Patricia; López-Velez, Rogelio; Olmo, Montserrat; Podzamczer, Daniel

    2010-01-01

    Visceral leishmaniasis is an opportunistic infection that affects human immunodeficiency virus–infected persons in leishmaniasis-endemic areas. The standard treatment may not be effective and relapses are common. We report the case of a human immunodeficiency virus-1–infected patient who had several relapses of visceral leishmaniasis after treatment with standard therapies and responded to a combined therapy.

  2. 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....

  3. Oral miltefosine treatment in children with visceral leishmaniasis: a brief review

    Directory of Open Access Journals (Sweden)

    Emilio Palumbo

    Full Text Available Visceral leishmaniasis (VL or kala-azar is an infection disease caused by hemiflagellate protozoan parasites (Leishmania donovani and transmitted to humans by the phlebotomine sandfly. Leishmaniasis is distributed worldwide and 13 million people are estimated to be infected, with about 1.8 million new cases each year. All antileishmanial drugs are toxic and most have to be used parenterally for prolonged period. The therapy has been further complicated by large number of infected children and declining effectiveness of pentavalent antimonial compounds. Although the lipid formulations of amphotericin B are an important advance in therapy, their high cost precludes their use. Miltefosine, a phosphocholine analogue originally developed as antimalignant drug, has been found to be highly active against Leishmania in vitro and in animal model. Based on these experiences this drug was tried against human visceral leishmaniasis and found to be highly effective in children. The aim of this review is to evidence the pharmacodymamic and pharmacokinetic characteristics and the safety, tolerance and efficacy of this drug for treatment of visceral leishmaniasis in children.

  4. The contribution of immune evasive mechanisms to parasite persistence in Visceral Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Elisangela Oliveira De Freitas

    2016-04-01

    Full Text Available 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 remodelling during VL could affect the organ-specific immunity against Leishmania parasites.

  5. Epidemiologic, clinical, diagnostic and therapeutic aspects of visceral leishmaniasis in renal transplant recipients: experience from thirty cases.

    Science.gov (United States)

    de Silva, Avelar Alves; Pacheco e Silva Filho, Álvaro; Sesso, Ricardio de Castro Cinta; Esmeraldo, Ronaldo de Matos; de Oliveira, Cláudia Maria Costa; Fernandes, Paula Frassinetti; de Oliveira, Rodrigo Alves; de Silva, Leila Silveira Veira; de Carvalho, Valencio Pereira; Costa, Carlos Henrique Nery; Andrade, Jesusmar Ximenes; da Silva, Diana Marisa Barros; Chaves, Roosevelt Valente

    2015-02-25

    Visceral leishmaniasis is a disease caused by the protozoan Leishmania sp. and is transmitted by Lutzomyia longipalpis (sand fly). In renal transplant recipients, visceral leishmaniasis causes severe damage to the liver, spleen, and hematopoietic system, as well as poor outcomes for patients with transplanted kidneys. This study describes the largest series of cases of visceral leishmaniasis in renal transplant recipients, providing important information about the diagnostic routines and therapeutic strategies in this patient population. A retrospective, descriptive study was performed to analyze the distribution and evaluate the extent of the epidemiologic, clinical, diagnostic and therapeutic aspects of 30 renal transplant recipients from endemic regions who presented with visceral leishmaniasis in the post-transplantation period. In this study, visceral leishmaniasis was more frequent in men (80%). The mean age of presentation was 40 ± 10.5 years. The majority of patients worked in urban areas (66.7%), cohabitated with domestic animals (90%), and were from low-income households. In 73.3% of cases, diagnosis was made by direct isolation of Leishmania forms. Patients were treated with liposomal amphotericin, resulting in a high degree of disease remission (80%). This study describes the largest series of visceral leishmaniasis in renal transplant recipients and expands clinical-epidemiological knowledge for transplantation teams to perform adequate disease management for this specific patient population.

  6. Relationship between dog culling and incidence of human visceral leishmaniasis in an endemic area.

    Science.gov (United States)

    Nunes, Cáris Maroni; Pires, Marina Mota; da Silva, Karinne Marques; Assis, Filipe Daniel; Gonçalves Filho, Jesualdo; Perri, Silvia Helena Venturoli

    2010-05-28

    Domestic dogs are the main reservoirs of visceral leishmaniasis (VL) in urban areas; one of the control measures adopted in Brazil is the elimination of this reservoir. In order to test the relationship between the euthanasia rate of the canine reservoir and the incidence of the disease in humans, data on dog culling from the Centre for Zoonosis Control of Araçatuba, São Paulo, Brazil, during the period from 1999 to 2008 and visceral leishmaniasis human cases registered in the same period were analyzed. Reduction of human VL incidence was statistically correlated to dog euthanasia rate (P=0.0211; r(2)=0.616) when it was analyzed for the period of two years after application of this measure. Other factors that may influence this relationship are considered. (c) 2010 Elsevier B.V. All rights reserved.

  7. Forum: geographic spread and urbanization of visceral leishmaniasis in Brazil. Introduction.

    Science.gov (United States)

    Werneck, Guilherme L

    2008-12-01

    The geographic spread and urbanization of visceral leishmaniasis in Brazil has been described since the early 1980s. However, the putative factors associated with this process, its full characterization, and the implications for disease control still challenge researchers and Public Health professionals. Although the available data show that the disease occurs mainly in urban areas, current knowledge is insufficient to claim specificity in urban transmission as compared to rural niches. Transmission scenarios in urban settings appear to be highly heterogeneous, each showing some degree of similarity to the rural epidemiological pattern. The understanding of a relatively recent and complex problem like the introduction, spread, and maintenance of visceral leishmaniasis in urban areas requires new analytical approaches that consider the network of relevant variables and more elaborate methods capable of capturing the dynamics of the environmental and demographic transformations taking place in transmission areas.

  8. 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.

  9. Leishmania infantum FML pulsed-dendritic cells induce a protective immune response in murine visceral leishmaniasis.

    Science.gov (United States)

    Foroughi-Parvar, Faeze; Hatam, Gholam-Reza; Sarkari, Bahador; Kamali-Sarvestani, Eskandar

    2015-01-01

    To investigate the efficacy of FML loaded dendritic cells (DCs) in protection against visceral leishmaniasis. Mice were immunized with FML- or soluble Leishmania antigen-loaded DCs as well as FML or soluble Leishmania antigen in saponin and challenged with parasite. The levels of cytokines before and after challenge were detected by ELISA. Parasite burden (total Leishman-Donovan unit) was determined after parasite challenge. FML-saponin induced the highest IFN-γ/IL-4 ratio among vaccinated groups, though this ratio was higher in FML-loaded DCs group subsequent to challenge with Leishmania infantum. Moreover, the greatest reduction in parasite number was detected in mice vaccinated with FML-loaded DCs compared with phosphate-buffered saline-treated mice (p = 0.002). FML-loaded DCs are one of the promising tools for protection against murine visceral leishmaniasis.

  10. 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.

  11. Disease Severity Prediction by Spirometry in Adults with Visceral Leishmaniasis from Minas Gerais, Brazil.

    Science.gov (United States)

    Maia, Isabel A; Bezerra, Frank S; Albuquerque, André Luis Pereira de; Andrade, Heitor F; Nicodemo, Antonio C; Amato, Valdir S

    2017-02-08

    Visceral leishmaniasis (VL) is associated with interstitial pneumonitis according to histology and radiology reports. However, studies to address the functional impact on respiratory function in patients are lacking. We assessed pulmonary function using noninvasive spirometry in a cross-sectional study of hospitalized adult VL patients from Minas Gerais, Brazil, without unrelated lung conditions or acute infections. Lung conditions were graded as normal, restrictive, obstructive, or mixed patterns, according to Brazilian consensus standards for spirometry. To control for regional patterns of lung function, we compared spirometry of patients with regional paired controls. Spirometry detected abnormal lung function in most VL patients (70%, 14/20), usually showing a restrictive pattern, in contrast to regional controls and the standards for normal tests. Alterations in spirometry measurements correlated with hypoalbuminemia, the only laboratory value indicative of severity of parasitic disease. Abnormalities did not correlate with unrelated factors such as smoking or occupation. Clinical data including pulmonary symptoms and duration of therapy were also unrelated to abnormal spirometry findings. We conclude that the severity of VL is correlated with a restrictive pattern of lung function according to spirometry, suggesting that there may be interstitial lung involvement in VL. Further studies should address whether spirometry could serve as an index of disease severity in the management of VL. © The American Society of Tropical Medicine and Hygiene.

  12. Lutzomyia longipalpis behavior and control at an urban visceral leishmaniasis focus in Argentina

    OpenAIRE

    Santini,Maria Soledad; Salomón,Oscar Daniel; Acardi,Soraya Alejandra; Sandoval,Enrique Adolfo; Tartaglino,Lilian

    2010-01-01

    During the earlier stages of visceral leishmaniasis transmission in Posadas City, Misiones, both the night activity and attraction to humans of Lutzomyia longipalpis were assessed, in order to provide preliminary recommendations. The impact of peridomestic deltamethrin spraying performed by local officials was also evaluated. Although Lu. longipalpis were found in traps located over a dog the entire night, 90% of the females were captured from 20.30h to 1.30h, and only landed on a human when ...

  13. Comparison between Conventional and Real-Time PCR Assays for Diagnosis of Visceral Leishmaniasis

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    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.

  14. Concurrent cutaneous, visceral and ocular leishmaniasis caused by Leishmania (Viannia braziliensis in a kidney transplant patient

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    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.

  15. Assessment of the electrocardiogram in dogs with visceral leishmaniasis

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    Marlos G. Sousa

    2013-05-01

    Full Text Available As myocarditis and arrhythmias have been shown to occur in both human beings and dogs with leishmaniasis, electrocardiograms of 105 dogs serologically positive for this disease were assessed for rhythm disturbances and changes in ECG waves. A few expressive alterations were seen, including sinus arrest, right bundle branch block, and atrial premature beats in 14.3%, 4.8%, and 4.8% of the studied subjects, respectively. Also, the analysis of ECG waves showed changes suggestive of left atrium and ventricle enlargements, and myocardial hypoxia in some animals. Although cardiac compromise has been previously reported in dogs with leishmaniasis, only a small subset of dogs showed any alteration in the electrocardiogram, which cannot support the occurrence of myocarditis in this investigation.

  16. Assessment of the electrocardiogram in dogs with visceral leishmaniasis

    OpenAIRE

    Sousa, Marlos G.; Carareto, Roberta; Silva, Jeanna G.; Oliveira, Juliana

    2013-01-01

    As myocarditis and arrhythmias have been shown to occur in both human beings and dogs with leishmaniasis, electrocardiograms of 105 dogs serologically positive for this disease were assessed for rhythm disturbances and changes in ECG waves. A few expressive alterations were seen, including sinus arrest, right bundle branch block, and atrial premature beats in 14.3%, 4.8%, and 4.8% of the studied subjects, respectively. Also, the analysis of ECG waves showed changes suggestive of left atrium a...

  17. Pediatric visceral leishmaniasis in Western Sicily, Italy: a retrospective analysis of 111 cases.

    Science.gov (United States)

    Cascio, A; Colomba, C; Antinori, S; Orobello, M; Paterson, D; Titone, L

    2002-04-01

    The clinical and epidemiological characteristics of 111 consecutive cases of visceral leishmaniasis identified from 1980 to 2000 in a Sicilian pediatric hospital were analyzed retrospectively. The mean age of the patients was 1.7 years. All children were HIV negative, but 15% were severely malnourished. Fever and splenomegaly were present in all cases and hepatomegaly in 101 (90.1%) cases. Thrombocytopenia and anemia were both observed in 78 (70.2%) cases and leukopenia in 47 (42.3%) cases. A bone marrow aspirate was obtained in all cases; Leishmania amastigotes were detected in 89 (80.2%) cases. Initial treatment consisted of meglumine antimoniate in 99 (89.2%) patients and amphotericin B in 12 (10.8%) patients. Only two children treated with meglumine antimoniate relapsed. The findings highlight the differences between the cases of visceral leishmaniasis observed in the Mediterranean basin and those observed in other regions. The use of the term "Mediterranean visceral leishmaniasis", rather than the term "kala-azar", is proposed for cases observed in the Mediterranean area.

  18. Autochthonous visceral leishmaniasis in Brasília, Federal District, Brazil.

    Science.gov (United States)

    Carranza-Tamayo, César Omar; Carvalho, Maria do Socorro Laurentino de; Bredt, Angelika; Bofil, Maria Isabel Rao; Rodrigues, Rodrigo Menna Barreto; Silva, Ailton Domício da; Cortez, Sandra Maria Felipe Coelho; Romero, Gustavo Adolfo Sierra

    2010-01-01

    Visceral leishmaniasis is a public health threat in Brazil considering the high lethality rates and increasing geographical dispersion to large urban conglomerates over the past 25 years. This study aimed to confirm suspected autochthonous cases of visceral leishmaniasis reported from 2005 to 2009 among individuals living in Brasilia, Federal District. A retrospective review of the surveillance data obtained on a regular basis and clinical records of the reported cases were performed in 2009. Data from entomological and canine surveys revealed the presence of both Lutzomyia longipalpis and positive serology for Leishmania in dogs within 19 of the 21 neighborhoods where human cases occurred since 2005. The review of surveillance data and medical records, together with the entomological and canine survey data, permitted confirmation of 21 autochthonous human cases in the Federal District. The disease predominantly affected children (12/21) and those from the Sobradinho region (16/21); the typical presentation of fever, hepatosplenomegaly and pancytopenia was observed in 67% of cases. Three deaths occurred during the study period. Leishmania (Leishmania) chagasi was successfully isolated from one human case and twelve canine cases. Visceral leishmaniasis should be considered endemic in Brasilia based on the documented epidemiological behavior herein described and the confirmed autochthony of human cases.

  19. Effectiveness of the immunomodulatory extract of Kalanchoe pinnata against murine visceral leishmaniasis.

    Science.gov (United States)

    Gomes, D C O; Muzitano, M F; Costa, S S; Rossi-Bergmann, B

    2010-04-01

    Previously, we described the protective action of the immunomodulatory extract of Kalanchoe pinnata (Kp) in murine and human cutaneous leishmaniasis. In the present study, we investigated the effectiveness of Kp against visceral leishmaniasis, using the BALB/c mouse model of infection with Leishmania chagasi. Mice receiving oral daily doses of Kp (400 mg/kg) for 30 days displayed significantly reduced hepatic and splenic parasite burden, when compared with untreated animals. Protectiveness was accompanied by a reduction in parasite-specific IgG serum levels, and impaired capacity of spleen cells to produce IL-4, but not IFN-gamma and nitric oxide upon antigen recall in vitro. The reference drug Pentostam (72 mg/kg) given by the intra-peritoneal route on alternate days produced an anti-leishmanial effect similar to oral Kp. Our findings show that the oral efficacy of Kp, seen previously in murine cutaneous leishmaniasis, extends also to visceral leishmaniasis caused by L. chagasi, a difficult to treat and lethal disease of man.

  20. Vulnerability to the transmission of human visceral leishmaniasis in a Brazilian urban area.

    Science.gov (United States)

    Toledo, Celina Roma Sánchez de; Almeida, Andréa Sobral de; Chaves, Sergio Augusto de Miranda; Sabroza, Paulo Chagastelles; Toledo, Luciano Medeiros; Caldas, Jefferson Pereira

    2017-05-15

    To analyze the determinants for the occurrence of human visceral leishmaniasis linked to the conditions of vulnerability. This is an ecological study, whose spatial analysis unit was the Territorial Analysis Unit in Araguaína, State of Tocantins, Brazil, from 2007 to 2012. We have carried out an analysis of the sociodemographic and urban infrastructure situation of the municipality. Normalized primary indicators were calculated and used to construct the indicators of vulnerability of the social structure, household structure, and urban infrastructure. From them, we have composed a vulnerability index. Kernel density estimation was used to evaluate the density of cases of human visceral leishmaniasis, based on the coordinates of the cases. Bivariate global Moran's I was used to verify the existence of spatial autocorrelation between the incidence of human visceral leishmaniasis and the indicators and index of vulnerability. Bivariate local Moran's I was used to identify spatial clusters. We have observed a pattern of centrifugal spread of human visceral leishmaniasis in the municipality, where outbreaks of the disease have progressively reached central and peri-urban areas. There has been no correlation between higher incidences of human visceral leishmaniasis and worse living conditions. Statistically significant clusters have been observed between the incidences of human visceral leishmaniasis in both periods analyzed (2007 to 2009 and 2010 to 2012) and the indicators and index of vulnerability. The environment in circumscribed areas helps as protection factor or increases the local vulnerability to the occurrence of human visceral leishmaniasis. The use of methodology that analyzes the conditions of life of the population and the spatial distribution of human visceral leishmaniasis is essential to identify the most vulnerable areas to the spread/maintenance of the disease. Analisar determinantes para a ocorrência da leishmaniose visceral humana vinculados

  1. Visceral leishmaniasis in a rheumatoid arthritis patient receiving methotrexate.

    Science.gov (United States)

    Reina, Delia; Cerdà, Dacia; Güell, Elena; Martínez Montauti, Joaquín; Pineda, Antonio; Corominas, Hèctor

    Patients with rheumatoid arthritis (RA) treated with disease-modifying antirheumatic drugs are susceptible to severe infections such as leishmaniasis. As L. infantum is endemic in the Mediterranean region, it is necessary to rule this infectious process out in any RA patient presenting with fever and pancytopenia. An early diagnosis based on a high suspicion can prevent a fatal outcome. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  2. 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

    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...... in the keratinocytes and/or sweat glands of all patients who later developed PKDL (group 1) and not in any of the patients who did not develop PKDL (group 2). Furthermore, the levels of IL-10 in plasma as well as in peripheral blood mononuclear cell culture supernatants were higher in group 1 than in group 2....

  3. Understanding Visceral Leishmaniasis Disease Transmission and its Control—A Study Based on Mathematical Modeling

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    Abhishek Subramanian

    2015-09-01

    Full Text Available Understanding the transmission and control of visceral leishmaniasis, a neglected tropical disease that manifests in human and animals, still remains a challenging problem globally. To study the nature of disease spread, we have developed a compartment-based mathematical model of zoonotic visceral leishmaniasis transmission among three different populations—human, animal and sandfly; dividing the human class into asymptomatic, symptomatic, post-kala-azar dermal leishmaniasis and transiently infected. We analyzed this large model for positivity, boundedness and stability around steady states in different diseased and disease-free scenarios and derived the analytical expression for basic reproduction number (R0. Sensitive parameters for each infected population were identified and varied to observe their effects on the steady state. Epidemic threshold R0 was calculated for every parameter variation. Animal population was identified to play a protective role in absorbing infection, thereby controlling the disease spread in human. To test the predictive ability of the model, seasonal fluctuation was incorporated in the birth rate of the sandflies to compare the model predictions with real data. Control scenarios on this real population data were created to predict the degree of control that can be exerted on the sensitive parameters so as to effectively reduce the infected populations.

  4. Preliminary survey of domestic animal visceral leishmaniasis and risk factors in north-west Ethiopia.

    Science.gov (United States)

    Kenubih, Ambaye; Dagnachew, Shimelis; Almaw, Gizat; Abebe, Tamerat; Takele, Yegnasew; Hailu, Asrat; Lemma, Wessensegad

    2015-02-01

    After the epidemics of L. donovani complex in 2004/05 in human patients, to investigate the presence of antibodies against L. donovani in domestic animals in north-west Ethiopia. Two hundred and three domestic animals were screened. Serum and biopsy samples were collected. A modified direct agglutination test (DAT) for canine reservoirs was used to screen serum samples at ≥ 1:320 cut-off titre. Giemsa stain and culture on Novy macNeal Nicolae (NNN) media were used for biopsy samples. Pre-tested questionnaires were used to elicit information on potential risk factors. Antibody against L. donovani in domestic animals was detected in 30.5% of animals. The highest seropositivity rates were 41.9% in cattle, 40% in dogs, 33.3% in donkeys, 10% in goats and 4.8% in sheep. No Leishmania parasite was isolated from spleen, liver, skin snip and exudates, bone marrow or lymph node of dogs. Dogs owned by households with history of kala-azar treatment and humans sharing the house with cattle were more affected by visceral leishmaniasis (P < 0.05). This study showed a high serological prevalence of leishmaniasis in domestic animals. Their role in the epidemiology of visceral leishmaniasis remains unclear. © 2014 John Wiley & Sons Ltd.

  5. Visceral leishmaniasis due to Leishmania infantum with renal involvement in HIV-infected patients.

    Science.gov (United States)

    Vassallo, Matteo; Moranne, Olivier; Ambrosetti, Damien; Jeandel, Pierre-Yves; Pomares, Christelle; Cassuto, Elisabeth; Boscagli, Annick; Giraud, Guillaume; Montagne, Nathalie; Dentone, Chiara; Demacina, Ilaria; Villaggio, Barbara; Secondo, Giovanni; Ferrea, Giuseppe; Passeron, Corinne; Saudes, Laurence; Kaphan, Regis; Marty, Pierre; Rosenthal, Eric

    2014-10-30

    We describe histological, clinical findings and outcomes of renal involvement during Leishmania infantum infection in four HIV-infected patients in South France and North Italy hospital settings. Four HIV-infected Caucasian patients (age 24-49) performed renal biopsy during episodes of visceral leishmaniasis. They presented severe immunosuppression, frequent relapses of visceral leishmaniasis during a follow-up period of several years and partial or complete recovery of renal function after anti-parasitic treatment. Main clinical presentations were nephrotic or nephritic syndrome and/or acute renal failure secondary to membranoproliferative type III glomerulonephritis or acute interstitial nephritis. Clinical outcome was poor, probably as a consequence of insufficient immuno-virological control of the HIV infection. Our findings suggest that the main histological findings in case of renal involvement due to Leishmania infantum infection in HIV-infected patients are type III MPGN and acute interstitial nephritis, with a histological specificity similar to that observed in canine leishmaniasis. Poor immune status in HIV-infected patients, altering the capacity for parasite clearance, and prolonged course of chronic active VL in this population may lead to the development of specific renal lesions.

  6. Immunoactivation and immunopathogeny during active visceral leishmaniasis Imunoativação e imunopatogenia durante leishmaniose visceral ativa

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    Hiro Goto

    2009-10-01

    Full Text Available Visceral leishmaniasis is caused by protozoan parasites of the Leishmania donovani complex. During active disease in humans, high levels of IFN-γ and TNF-α detected in blood serum, and high expression of IFN-γ mRNA in samples of the lymphoid organs suggest that the immune system is highly activated. However, studies using peripheral blood mononuclear cells have found immunosuppression specific to Leishmania antigens; this poor immune response probably results from Leishmania antigen-engaged lymphocytes being trapped in the lymphoid organs. To allow the parasites to multiply, deactivating cytokines IL-10 and TGF-β may be acting on macrophages as well as anti-Leishmania antibodies that opsonize amastigotes and induce IL-10 production in macrophages. These high activation and deactivation processes are likely to occur mainly in the spleen and liver and can be confirmed through the examination of organ samples. However, an analysis of sequential data from studies of visceral leishmaniasis in hamsters suggests that factors outside of the immune system are responsible for the early inactivation of inducible nitric oxide synthase, which occurs before the expression of deactivating cytokines. In active visceral leishmaniasis, the immune system actively participates in non-lymphoid organ lesioning. While current views only consider immunocomplex deposition, macrophages, T cells, cytokines, and immunoglobulins by diverse mechanism also play important roles in the pathogenesis.A leishmaniose visceral é causada por protozoários do gênero do complexo Leishmania donovani. Durante a doença ativa no homem são detectados altos níveis de IFN-γ e de TNF-α no soro, e elevada expressão de mRNA de IFN-γ em amostras de órgãos linfóides sugerindo um estado intensamente ativado do sistema imunológico. A visão atual, no entanto, refere-se à imunossupressão específica aos antígenos de Leishmania com base em estudos utilizando células mononucleares

  7. 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.

  8. Sandfly fauna in an area endemic for visceral leishmaniasis in Aracaju, State of Sergipe, Northeast Brazil

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    Verónica de Lourdes Sierpe Jeraldo

    2012-06-01

    Full Text Available INTRODUCTION: In recent years, visceral leishmaniasis, a major public health problem, has been spreading from the rural to urban areas in many areas of Brazil, including Aracaju, the capital of the State of Sergipe. However, there are no studies of the sandfly fauna in this municipality or its variation over the year. METHODS: Phlebotomine sandflies were collected from a rural area of Aracaju from September 2007 to July 2009. Modified CDC ultra-violet (UV light traps were used to evaluate sandfly monthly distribution and their presence in the domestic and peridomestic environments. RESULTS: The most abundant species was Lutzomyia longipalpis (90.4% followed by Evandromyia lenti (9.6%. A chicken shed trap site had the highest proportion of L. longipalpis (51.1% and large numbers of L. longipalpis were also collected in the houses closest to the chicken shed. There was a positive correlation between monthly rainfall and L. longipalpis abundance. CONCLUSIONS: Lutzomyia longipalpis is the most abundant species and is probably the main vector of the visceral leishmaniasis agent in the rural area of Aracaju. An increase in L. longipalpis frequency was observed during the rainy season. The peridomicile-intradomicile observations corroborate the importance of chicken sheds for the presence of L. longipalpis in the peridomestic environment. The great numbers of L. longipalpis inside the houses confirm the endophilic behaviour of this species and the possibility of visceral transmission in the intradomicile.

  9. Sandfly fauna in an area endemic for visceral leishmaniasis in Aracaju, State of Sergipe, Northeast Brazil.

    Science.gov (United States)

    Jeraldo, Verónica de Lourdes Sierpe; Góes, Marco Aurélio de Oliveira; Casanova, Claudio; Melo, Claudia Moura de; Araújo, Edilson Divino de; Brandão Filho, Sinval Pinto; Cruz, Danilo Esdras Rocha; Pinto, Mara Cristina

    2012-06-01

    In recent years, visceral leishmaniasis, a major public health problem, has been spreading from the rural to urban areas in many areas of Brazil, including Aracaju, the capital of the State of Sergipe. However, there are no studies of the sandfly fauna in this municipality or its variation over the year. Phlebotomine sandflies were collected from a rural area of Aracaju from September 2007 to July 2009. Modified CDC ultra-violet (UV) light traps were used to evaluate sandfly monthly distribution and their presence in the domestic and peridomestic environments. The most abundant species was Lutzomyia longipalpis (90.4%) followed by Evandromyia lenti (9.6%). A chicken shed trap site had the highest proportion of L. longipalpis (51.1%) and large numbers of L. longipalpis were also collected in the houses closest to the chicken shed. There was a positive correlation between monthly rainfall and L. longipalpis abundance. Lutzomyia longipalpis is the most abundant species and is probably the main vector of the visceral leishmaniasis agent in the rural area of Aracaju. An increase in L. longipalpis frequency was observed during the rainy season. The peridomicile-intradomicile observations corroborate the importance of chicken sheds for the presence of L. longipalpis in the peridomestic environment. The great numbers of L. longipalpis inside the houses confirm the endophilic behaviour of this species and the possibility of visceral transmission in the intradomicile.

  10. Epidemiological Aspects of Visceral Leishmaniasis in Baft District, Kerman Province, Southeast of Iran

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    H Mahmoudvand

    2011-03-01

    Full Text Available Background: Visceral leishmaniasis (kala-azar is an endemic disease in some areas of Iran. A cross- sectional study was conducted for sero-epidemiological survey of visceral leishmaniasis (VL in Baft district from Kerman Province, southeast of Iran.Methods: Blood samples were collected from children up to 12 years old and 10% of adult population from Baft villages with a multi-stage randomized cluster sampling. In addition, blood samples were collected from 30 domestic dogs from the same areas. All the collected blood sam­ples were tested by direct agglutination test (DAT for the detection of anti-Leishmania antibod­ies in both human and dog using the cut-off value of ≥1:3200 and ≥ 1:320, respectively. Parasitologi­cal, molecular, and pathological were performed on infected dogs. Chi-square and Fisher exact tests were used to compare sero-prevalence values.Results: From 1476 collected human serum samples, 23 (1.55% showed anti-Leishmania antibod­ies at titers of 1:800 and 1:1600 whereas 14 (0.95% showed anti-Leishmania infantum antibodies at titers of ≤ 1:3200. No statistically significant difference was found between male (1.18 % and female (0.69% sero-prevalence (P=0.330. Children of 5-8 years showed the high­est sero-prevalence rate (3.22%. Seven out of 30 domestic dogs (23% showed anti-Leishmania antibodies at titers ≤1:320. Leishmania infantum was identified in five infected dogs by nested - PCR assay.Conclusion: It seems that visceral leishmaniasis is being endemic in southern villages of Baft district, southeast of Iran.

  11. Sustaining visceral leishmaniasis elimination in Bangladesh - Could a policy brief help?

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    Alyssa Fitzpatrick

    2017-12-01

    Full Text Available Bangladesh has made significant progress towards elimination of visceral leishmaniasis, and is on track to achieve its target of less than one case per 10,000 inhabitants in each subdistrict in 2017. As the incidence of disease falls, it is likely that the political capital and financial resources dedicated towards the elimination of visceral leishmaniasis may decrease, raising the prospect of disease resurgence. Policy memos may play a crucial role during the transition of the elimination plan from the 'attack' to the 'consolidation' and 'maintenance' phases, highlighting key stakeholders and areas where ongoing investment is crucial. An example of a policy brief is outlined in this paper. The background to the current elimination efforts is highlighted, with emphasis on remaining uncertainties including the impact of disease reservoirs and sustainable surveillance strategies. A stakeholder map is provided outlining the current and projected future activities of key bodies. Identification of key stakeholders subsequently frames the discussion of three key policy recommendations in the Bangladeshi context for the transition to the consolidation and maintenance phases of the elimination program. Recommendations include determining optimal vector control and surveillance strategies, shifting the emphasis towards horizontal integration of disease programs, and prioritising remaining research questions with a focus on operational and technical capacity. Achieving elimination is as much a political as a scientific question. Integrating the discussion of key stakeholders with policy priorities and the research agenda provides a novel insight into potential pathways forwards in the elimination of visceral leishmaniasis in Bangladesh and in the rest of the Indian subcontinent.

  12. Leishmaniose visceral no Brasil: quadro atual, desafios e perspectivas Visceral Leishmaniasis in Brazil: current status, challenges and prospects

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    Célia Maria Ferreira Gontijo

    2004-09-01

    Full Text Available No Brasil, a importância da leishmaniose visceral reside não somente na sua alta incidência e ampla distribuição, mas também na possibilidade de assumir formas graves e letais quando associada ao quadro de má nutrição e infecções concomitantes. A crescente urbanização da doença ocorrida nos últimos 20 anos coloca em pauta a discussão das estratégias de controle empregadas. Neste artigo foram analisados os principais aspectos biológicos, ambientais e sociais que influenciaram no processo de expansão e urbanização dos focos da doença. Os métodos disponíveis para o diagnóstico e tratamento não apresentam a eficácia e aplicabilidade desejadas, embora avanços promissores tenham sido alcançados com as pesquisas de novos testes diagnósticos e drogas terapêuticas. As medidas de controle da doença até agora implementadas foram incapazes de eliminar a transmissão e impedir a ocorrência de novas epidemias. É feita uma breve análise destas medidas e dos desafios a serem enfrentados. A prevenção da doença nos cães através da imunoprofilaxia aparece como uma alternativa para o controle. Uma nova vacina para cães, já testada em campo, está sendo industrializada e será comercializada no Brasil a partir de 2004. Apesar da existência de inúmeros estudos sobre a leishmaniose visceral humana e canina, muitas lacunas ainda precisam ser preenchidas.Visceral leishmaniasis has assumed an increasing importance in Brazil due to its high incidence and wide geographical distribution. When associated with malnutrition and co-infections it can prove to be fatal. A notable increase in transmission rates related to urbanization has been observed in the past 20 years. A combination of measures is needed to define new methods for reducing transmission. This paper analyzes the main biological, environmental and social aspects that have influenced the spread and urbanization of the disease. The diagnostic tests and drugs available

  13. Visceral leishmaniasis in Bangladesh: the value of DAT as a diagnostic tool.

    Science.gov (United States)

    el-Masum, M A; Evans, D A; Minter, D M; el Harith, A

    1995-01-01

    The direct agglutination test (DAT) was performed on 480 serum samples from suspected cases of visceral leishmaniasis (VL) in different parts of Bangladesh. Significant titres (> or = 1:3200) were found in 257 sera (53.5%). All patients with positive bone-marrow aspirates also had significant DAT titres. The male:female seroprevalence ratio was 2:1 and the age-group 0-20 years was the most affected. The DAT proved a simple, economical and reliable diagnostic test for VL.

  14. Visceral leishmaniasis with cutaneous lesions in a patient infected with human immunodeficiency virus.

    Science.gov (United States)

    Ara, M; Maillo, C; Peón, G; Clavel, A; Cuesta, J; Grasa, M P; Carapeto, F J

    1998-07-01

    We report a case of visceral leishmaniasis (VL) with cutaneous lesions in a patient infected with human immunodeficiency virus (HIV). The cutaneous lesions consisted of erythematous papules on the legs. Biopsy of one lesion showed abundant Leishmania amastigotes within epithelial cells of an eccrine sweat gland in the dermis. Leishmania organisms were also found in a blood smear. Rapid and complete clearance of the cutaneous lesions was achieved after antimony therapy. Cutaneous lesions in VL are being reported increasingly frequently in patients with HIV infection and their significance remains in discussion.

  15. Age structure of owned dogs under compulsory culling in a visceral leishmaniasis endemic area

    OpenAIRE

    Bortoletto, Danielly Vieira; Utsunomiya, Yuri Tani; Perri, Silvia Helena Venturoli; Ferreira, Fernando; Nunes, Cáris Maroni

    2016-01-01

    Abstract: The age structure of the dog population is essential for planning and evaluating control programs for zoonotic diseases. We analyzed data of an owned-dog census in order to characterize, for the first time, the structure of a dog population under compulsory culling in a visceral leishmaniasis endemic area (Panorama, São Paulo State, Brazil) that recorded a dog-culling rate of 28% in the year of the study. Data on 1,329 households and 1,671 owned dogs revealed an owned dog:human rati...

  16. Prevalence of zoonotic visceral leishmaniasis in dogs in an endemic area of Brazil.

    Science.gov (United States)

    Pimentel, Danillo de Souza; Ramos, Rafael Antonio Nascimento; Santana, Marília de Andrade; Maia, Carina Scanoni; de Carvalho, Gílcia Aparecida; da Silva, Hernande Pereira; Alves, Leucio Câmara

    2015-01-01

    The northeast region of Brazil is endemic for zoonotic visceral leishmaniasis (ZVL). The aim of this study was to determine the prevalence of infection in dogs in Petrolina. Blood samples were collected from dogs (n = 600), and bone-marrow biopsy was performed in animals with positive serological test results that presented clinical signs of ZVL. The serological analyses were performed using an enzyme-linked immunosorbent assay (ELISA) (S7(r)Biogene). Of the 600 dogs tested, 19% (115/600) presented anti-L. infantum chagasi antibodies. Our data are important because canine infection is an important risk factor for the human disease.

  17. Prevalence of zoonotic visceral leishmaniasis in dogs in an endemic area of Brazil

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    Danillo de Souza Pimentel

    2015-01-01

    Full Text Available INTRODUCTION: The northeast region of Brazil is endemic for zoonotic visceral leishmaniasis (ZVL. The aim of this study was to determine the prevalence of infection in dogs in Petrolina. METHODS: Blood samples were collected from dogs (n = 600, and bone-marrow biopsy was performed in animals with positive serological test results that presented clinical signs of ZVL. The serological analyses were performed using an enzyme-linked immunosorbent assay (ELISA (S7(rBiogene. RESULTS: Of the 600 dogs tested, 19% (115/600 presented anti-L. infantum chagasi antibodies. CONCLUSIONS: Our data are important because canine infection is an important risk factor for the human disease.

  18. Canine antibody response to Lutzomyia longipalpis saliva in endemic area of visceral leishmaniasis.

    Science.gov (United States)

    Batista, Luís Fábio da Silva; Matta, Vânia Lúcia Ribeiro da; Tomokane, Thaise Yumie; Pacheco, Acácio Duarte; Silveira, Fernando Tobias; Rossi, Claudio Nazaretian; Marcondes, Mary; Laurenti, Márcia Dalastra

    2016-01-01

    Canine exposure to Lutzomyia longipalpis bites and the potential of Leishmania infantum transmissibility for the vector were evaluated. Immunoglobulin G (IgG) anti-Lu longipalpis saliva and -L. infantum, and blood parasite load were determined in dogs from endemic areas of visceral leishmaniasis. Blood parasitism was similar between symptomatic and asymptomatic dogs. IgG anti-L. infantum was higher in symptomatic dogs, but IgG anti-Lu. longipalpis saliva was mostly observed in higher titers in asymptomatic dogs, indicating vector preference for feeding on asymptomatic dogs. Our data suggest a pivotal role of asymptomatic dogs in L. infantum transmission in endemic areas.

  19. Outbreak of canine visceral leishmaniasis in Barra Mansa, State of Rio de Janeiro

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    Cintia Xavier de Mello

    2014-12-01

    Full Text Available Introduction In Brazil, visceral leishmaniasis (VL has spread to various regions. This study reports canine cases of VL in Barra Mansa, where human VL cases were recently reported. Methods Using the human index case, a canine survey was performed by dual-path platform immunochromatography and enzyme-linked immunosorbent assay. Seropositive animals were euthanized. Cultures were collected to detect Leishmania parasites. Results Serological tests detected 141 canine VL cases, and Leishmania chagasi were isolated from 82.2% animals. Conclusions Leishmania chagasi is in circulation in Barra Mansa. This study broadens information on the parasite's distribution in the State of Rio de Janeiro.

  20. 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...... of the patients developed secondary haemophagocytic lymphohistocytosis (HLH). Both children were successfully treated with liposomal amphotericin B. In Denmark, VL is a rare but important differential diagnosis to acute leukaemia and HLH, and should be ruled out after journeys to endemic areas, including Southern...

  1. Lutzomyia longipalpis (Diptera, Psychodidae, Phlebotominae and urbanization of visceral leishmaniasis in Brazil Lutzomyia longipalpis (Diptera, Psychodidae, Phlebotominae e urbanização da leishmaniose visceral no Brasil

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    Elizabeth F. Rangel

    2008-12-01

    Full Text Available The article discusses habits related to the vectorial competence of Lutzomyia longipalpis, along with evidence confirming the importance of this sand fly species in the epidemiological chain of visceral leishmaniasis in Brazil. A new epidemiological profile for visceral leishmaniasis is also postulated, associated with domestic environments and the role of Lu. longipalpis in this process, its sylvatic origin, and its capacity to adapt to a wide range of habitats. Another sand fly species, Lu. cruzi, is mentioned as a vector of visceral leishmaniasis in some municipalities in Central Brazil, based on studies in endemic areas of the country.São apresentados os hábitos que condicionam a competência vetorial de Lutzomyia longipalpis e discutidas as evidências que confirmam a importância deste flebotomíneo na cadeia de transmissão da leishmaniose visceral no Brasil. Discute-se, também, o novo perfil epidemiológico da leishmaniose visceral, associado à ambientes urbanos, e o papel desempenhado por Lu. longipalpis neste processo, sua origem silvestre e capacidade de adaptação. É citado outro flebotomíneo, Lu. cruzi, como transmissor em alguns municípios da região central do Brasil, com base em estudos realizados em áreas endêmicas.

  2. [Lutzomyia longipalpis (Diptera: Psychodidae) at a suburban focus of visceral leishmaniasis in the Chicamocha Canyon, Santander, Colombia].

    Science.gov (United States)

    Flórez, Mónica; Martínez, Junny Patricia; Gutiérrez, Reinaldo; Luna, Katherine Paola; Serrano, Victor Hugo; Ferro, Cristina; Angulo, Víctor Manuel; Sandoval, Claudia Magaly

    2006-10-01

    Between 1998 and 2000, the occurrence of 8 cases of American visceral leishmaniasis in children from a recently established human settlement in Guatiguará, in the municipality of Piedecuesta (Santander, Colombia) indicated the possible presence of Leishmania transmission in this locality. This observation motivated the current entomological investigation. To determine the relative frequency of Lutzomyia longipalpis inside houses and outdoors, and the natural infection of this vector with Leishmania spp. CDC light traps were used for sampling inside houses and outdoors, and sand flies were collected on human volunteers and domestic animals, and in resting places, during the period from May 1999 through September 2000. Natural infection was determined by PCR, in pools of female Lutzomyia longipalpis. A total of 7,391 phlebotomine sand flies were collected. The predominant species was Lutzomyia longipalpis (Lutz & Neiva), representing 99.5% of captures. In the sand flies collected with CDC light traps, L. longipalpis was more frequently collected indoors than outdoors (p = 0.0001). The total rate of natural infection was 1.93% and a positive correlation was observed between months with higher abundance and the number of infected females entering human dwellings. The results indicate that in Guatiguará Lutzomyia longipalpis, shows marked tendency for the indoors, which has important implications for leishmaniasis transmission. Furthermore, transmission risk is increased during the months of higher abundance due to the entry of a higher number of infected females. From the standpoint of control, this behaviour permits the design of strategies to reduce indoor transmission.

  3. VISCERAL LEISHMANIASIS IN PETROLINA, STATE OF PERNAMBUCO, 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.

  4. GEOGRAPHICAL EXPANSION OF CANINE VISCERAL LEISHMANIASIS IN RIO DE JANEIRO STATE, BRAZIL

    Science.gov (United States)

    da SILVA, Denise Amaro; MADEIRA, Maria de Fátima; FIGUEIREDO, Fabiano Borges

    2015-01-01

    SUMMARY Visceral Leishmaniasis (VL) is a vector-borne disease that affects humans, and domestic and wild animals. It is caused by the protozoan Leishmania (Leishmania) infantum (syn = Leishmania chagasi). The domestic dog (Canis familiaris) is considered the main reservoir of the etiologic agent of VL in domestic and peridomestic environments. In the past three years, although control actions involving domestic dogs are routinely performed in endemic areas of the Rio de Janeiro State, new cases of canine visceral leishmaniasis (CVL) have been reported in several municipalities. The objective of this short communication was to describe the geographical expansion of CVL in the Rio de Janeiro State, Brazil, through its reports in the scientific literature and studies performed by our group. From 2010 to 2013, autochthonous and allochthonous cases of CVL were reported in the municipalities of Mangaratiba, Marica, Niteroi, Barra Mansa, Cachoeiras de Macacu, Volta Redonda, Resende and Rio de Janeiro. These reports demonstrate that CVL is in intense geographical expansion around the state; therefore, a joint effort by public agencies, veterinarians and researchers is needed in order to minimize and/or even prevent the dispersion of this disease. PMID:26603233

  5. Adaptation of a malaria surveillance system for use in a visceral leishmaniasis elimination programme.

    Science.gov (United States)

    Foster, Geraldine M; Dunkley, Sophie; Deb, Rinki M; Thomsen, Edward; Coleman, Marlize; Dhariwal, A C; Das Gupta, R K; Srikantiah, Sridhar; Das, Pradeep; Coleman, Michael

    2017-05-01

    Successful public practice relies on generation and use of high-quality data. A data surveillance system (the Disease Data Management System [DDMS]) in use for malaria was adapted for use in the Indian visceral leishmaniasis elimination programme. A situational analysis identified the data flows in current use. Taxonomic trees for the vector of visceral leishmaniasis in India, Phlebotomus argentipes, were incorporated into the DDMS to allow entry of quality assurance and insecticide susceptibility data. A new quality assurance module was created to collate the concentration of DDT that was applied to walls during the indoor residual spraying (IRS) vector control programme. The DDMS was implemented in Bihar State and used to collate and manage data from sentinel sites in eight districts. Quality assurance data showed that DDT was under-applied to walls during IRS; this, combined with insecticide susceptibility data showing widespread vector resistance to DDT prompted a national policy change to using compression pumps and alpha-cypermethrin insecticide for IRS. The adapted DDMS centralises programmatic data and enhances evidence-based decision making and active policy change. Moving forward, further modules of the system will be implemented, allowing extended data capture and streamlined transmission of key information to decision makers. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  6. GEOGRAPHICAL EXPANSION OF CANINE VISCERAL LEISHMANIASIS IN RIO DE JANEIRO STATE, BRAZIL

    Directory of Open Access Journals (Sweden)

    Denise Amaro da SILVA

    2015-10-01

    Full Text Available SUMMARY Visceral Leishmaniasis (VL is a vector-borne disease that affects humans, and domestic and wild animals. It is caused by the protozoan Leishmania (Leishmania infantum (syn = Leishmania chagasi. The domestic dog (Canis familiaris is considered the main reservoir of the etiologic agent of VL in domestic and peridomestic environments. In the past three years, although control actions involving domestic dogs are routinely performed in endemic areas of the Rio de Janeiro State, new cases of canine visceral leishmaniasis (CVL have been reported in several municipalities. The objective of this short communication was to describe the geographical expansion of CVL in the Rio de Janeiro State, Brazil, through its reports in the scientific literature and studies performed by our group. From 2010 to 2013, autochthonous and allochthonous cases of CVL were reported in the municipalities of Mangaratiba, Marica, Niteroi, Barra Mansa, Cachoeiras de Macacu, Volta Redonda, Resende and Rio de Janeiro. These reports demonstrate that CVL is in intense geographical expansion around the state; therefore, a joint effort by public agencies, veterinarians and researchers is needed in order to minimize and/or even prevent the dispersion of this disease.

  7. Age structure of owned dogs under compulsory culling in a visceral leishmaniasis endemic area.

    Science.gov (United States)

    Bortoletto, Danielly Vieira; Utsunomiya, Yuri Tani; Perri, Silvia Helena Venturoli; Ferreira, Fernando; Nunes, Cáris Maroni

    2016-09-05

    The age structure of the dog population is essential for planning and evaluating control programs for zoonotic diseases. We analyzed data of an owned-dog census in order to characterize, for the first time, the structure of a dog population under compulsory culling in a visceral leishmaniasis endemic area (Panorama, São Paulo State, Brazil) that recorded a dog-culling rate of 28% in the year of the study. Data on 1,329 households and 1,671 owned dogs revealed an owned dog:human ratio of 1:7. The mean age of dogs was estimated at 1.73 years; the age pyramid indicated high birth and mortality rates at the first year of age with an estimated cumulative mortality of 78% at the third year of age and expected life span of 2.75 years. In spite of the high mortality, a growth projection simulation suggested that the population has potential to grow in a logarithmic scale over the years. The estimated parameters can be further applied in models to maximize the impact and minimize financial inputs of visceral leishmaniasis control measures.

  8. TLR4 and NKT cell synergy in immunotherapy against visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Subir Karmakar

    Full Text Available NKT cells play an important role in autoimmune diseases, tumor surveillance, and infectious diseases, providing in most cases protection against infection. NKT cells are reactive to CD1d presented glycolipid antigens. They can modulate immune responses by promoting the secretion of type 1, type 2, or immune regulatory cytokines. Pathogen-derived signals to dendritic cells mediated via Toll like Receptors (TLR can be modulated by activated invariant Natural Killer T (iNKT cells. The terminal β-(1-4-galactose residues of glycans can modulate host responsiveness in a T helper type-1 direction via IFN-γ and TLRs. We have attempted to develop a defined immunotherapeutic, based on the cooperative action of a TLR ligand and iNKT cell using a mouse model of visceral leishmaniasis. We evaluated the anti-Leishmania immune responses and the protective efficacy of the β-(1-4-galactose terminal NKT cell ligand glycosphingophospholipid (GSPL antigen of L. donovani parasites. Our results suggest that TLR4 can function as an upstream sensor for GSPL and provoke intracellular inflammatory signaling necessary for parasite killing. Treatment with GSPL was able to induce a strong effective T cell response that contributed to effective control of acute parasite burden and led to undetectable parasite persistence in the infected animals. These studies for the first time demonstrate the interactions between a TLR ligand and iNKT cell activation in visceral leishmaniasis immunotherapeutic.

  9. GEOGRAPHICAL EXPANSION OF CANINE VISCERAL LEISHMANIASIS IN RIO DE JANEIRO STATE, BRAZIL.

    Science.gov (United States)

    Silva, Denise Amaro da; Madeira, Maria de Fátima; Figueiredo, Fabiano Borges

    2015-01-01

    Visceral Leishmaniasis (VL) is a vector-borne disease that affects humans, and domestic and wild animals. It is caused by the protozoan Leishmania (Leishmania) infantum (syn = Leishmania chagasi). The domestic dog (Canis familiaris) is considered the main reservoir of the etiologic agent of VL in domestic and peridomestic environments. In the past three years, although control actions involving domestic dogs are routinely performed in endemic areas of the Rio de Janeiro State, new cases of canine visceral leishmaniasis (CVL) have been reported in several municipalities. The objective of this short communication was to describe the geographical expansion of CVL in the Rio de Janeiro State, Brazil, through its reports in the scientific literature and studies performed by our group. From 2010 to 2013, autochthonous and allochthonous cases of CVL were reported in the municipalities of Mangaratiba, Marica, Niteroi, Barra Mansa, Cachoeiras de Macacu, Volta Redonda, Resende and Rio de Janeiro. These reports demonstrate that CVL is in intense geographical expansion around the state; therefore, a joint effort by public agencies, veterinarians and researchers is needed in order to minimize and/or even prevent the dispersion of this disease.

  10. Comparison of serological assays for the diagnosis of canine visceral leishmaniasis in animals presenting different clinical manifestations

    NARCIS (Netherlands)

    Ferreira, Eduardo de Castro; de Lana, Marta; Carneiro, Mariangela; Reis, Alexandre Barbosa; Paes, Daniela Vieira; da Silva, Eduardo Sergio; Schallig, Henk; Ferreira Gontijo, Celia Maria

    2007-01-01

    Three serological methods, indirect fluorescent immunoassay (IFI), enzyme-linked immunosorbent assay (ELISA) and direct agglutination test (DAT) that are commonly employed in the diagnosis of canine visceral leishmaniasis (CVL), have been assessed. A total of 234 domestic dogs, drawn from an area in

  11. Sero-epidemiological assessment and diagnosis of visceral leishmaniasis in an endemic locality using Fast Agglutination Screening Test (FAST)

    NARCIS (Netherlands)

    Hailu, A.; Kroon, C. C. M.; Schoone, G. J.; Berhe, N.; Schallig, H. D. F. H.; Kager, P. A.

    2002-01-01

    The Fast Agglutination Screening Test (FAST) was employed on sera obtained from an endemic area of visceral leishmaniasis in southwestern Ethiopia, in February 2000. The study involved (i) active case detection among 1575 residents of two villages; and (ii) passive case detection in an outpatient

  12. Epidemiology and clinical manifestations of visceral and cutaneous leishmaniasis in Baringo District, Rift Valley, Kenya. A literature review

    NARCIS (Netherlands)

    Schaefer, K. U.; Kurtzhals, J. A.; Sherwood, J. A.; Githure, J. I.; Kager, P. A.; Muller, A. S.

    1994-01-01

    Visceral leishmaniasis (VL), caused by Leishmania donovani, is endemic in Baringo District, Kenya. The disease has a focal distribution in the dry, hot areas below 1500 metres. Infections may be characterized as follows: 1) asymptomatic, 2) subclinical and self-limiting (not medically identifiable),

  13. 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.

  14. Oral manifestations in the American tegumentary leishmaniasis.

    Science.gov (United States)

    da Costa, Daniel Cesar Silva; Palmeiro, Mariana Reuter; Moreira, João Soares; Martins, Ana Cristina da Costa; da Silva, Aline Fagundes; Madeira, Maria de Fátima; Quintella, Leonardo Pereira; Confort, Eliame Mouta; Schubach, Armando de Oliveira; Silva, Fátima da Conceição; Valete-Rosalino, Cláudia Maria

    2014-01-01

    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.

  15. Visceral leishmaniasis in the state of Sao Paulo, Brazil: spatial and space-time analysis.

    Science.gov (United States)

    Cardim, Marisa Furtado Mozini; Guirado, Marluci Monteiro; Dibo, Margareth Regina; Chiaravalloti, Francisco

    2016-08-11

    To perform both space and space-time evaluations of visceral leishmaniasis in humans in the state of Sao Paulo, Brazil. The population considered in the study comprised autochthonous cases of visceral leishmaniasis and deaths resulting from it in Sao Paulo, between 1999 and 2013. The analysis considered the western region of the state as its studied area. Thematic maps were created to show visceral leishmaniasis dissemination in humans in the municipality. Spatial analysis tools Kernel and Kernel ratio were used to respectively obtain the distribution of cases and deaths and the distribution of incidence and mortality. Scan statistics were used in order to identify spatial and space-time clusters of cases and deaths. The visceral leishmaniasis cases in humans, during the studied period, were observed to occur in the western portion of Sao Paulo, and their territorial extension mainly followed the eastbound course of the Marechal Rondon highway. The incidences were characterized as two sequences of concentric ellipses of decreasing intensities. The first and more intense one was found to have its epicenter in the municipality of Castilho (where the Marechal Rondon highway crosses the border of the state of Mato Grosso do Sul) and the second one in Bauru. Mortality was found to have a similar behavior to incidence. The spatial and space-time clusters of cases were observed to coincide with the two areas of highest incidence. Both the space-time clusters identified, even without coinciding in time, were started three years after the human cases were detected and had the same duration, that is, six years. The expansion of visceral leishmaniasis in Sao Paulo has been taking place in an eastbound direction, focusing on the role of highways, especially Marechal Rondon, in this process. The space-time analysis detected the disease occurred in cycles, in different spaces and time periods. These meetings, if considered, may contribute to the adoption of actions that aim to

  16. Mathematical modelling for Zoonotic Visceral Leishmaniasis dynamics: A new analysis considering updated parameters and notified human Brazilian data

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    Helio Junji Shimozako

    2017-05-01

    Full Text Available Brazil is one of the highest endemic countries for Zoonotic Visceral Leishmaniasis: according to the Brazilian Ministry of Health, the annual number of new human cases and deaths due to this disease has been increasing for the last 20 years. In addition, regarding the Americas, the specific relationship between canine and human for Visceral Leishmaniasis dynamics is still not well understood. In this work we propose a new model for Zoonotic Visceral Leishmaniasis, based on the models previously published by Burattini et al. (1998 and Ribas et al. (2013. Herein, we modeled the disease dynamics using a modified set of differential equations from those two authors, considering the same assumptions (inclusion of human, dog and sandfly populations, all constants over time. From this set of equations we were able to calculate the basic reproduction number R0 and to analyze the stability and sensitivity of the system to the parameters variability. As main result, when the stability of the system is reached, the normalized reporting human cases rate is estimated in 9.12E-08/day. This estimation is very close to the 2015 report from Araçatuba city, 5.69E-08/day. We also observed from stability and sensitivity analysis that the activity of sandfly population is critical to introduction and maintenance of Zoonotic Visceral Leishmaniasis in the population. In addition, the importance of dog as source of infection concentrates on latent dog, since it does not show clinical symptoms and signs and, therefore, has a great contribution to disease dissemination. As conclusion, considering the presently ethical issues regarding to elimination of positive dog in Brazil and the highly sensitivity of disease dynamics on sandfly population, we recommend that the sandfly population control should be prioritized. Keywords: Zoonotic Visceral Leishmaniasis, Disease dynamics, Mathematical modelling, Epidemiology

  17. Canine Visceral Leishmaniasis: Important Factors in Maintenance of the disease in the city of Mirassol D'Oeste-Mt

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    Angela Pinheiro Carneiro

    2011-06-01

    Full Text Available Visceral Leishmaniasis was initially considered a disease associated with rural areas, but due to various environmental changes such as deforestation, urbanization, intensive migration process and endemic areas expansion, this disease is affecting humans and animals in urban and rural areas. In Brazil, there are severe endemic and epidemic occurrences of Visceral Leishmaniasis. In recent years the disease has spread through several states that had no cases of infected people and animals. Canine Visceral Leishmaniasis coexists with the human disease in all known outbreaks, but is more prevalent in humans. In Mirassol D'Oeste, Mato Grosso, for six consecutive years, cases of sick people have been reported, including deaths. Several serologically positive dogs and the presence of the Visceral Leishmaniasis transmission vectors characterized the city as conducive to disease development. This work aimed at assessing the status of canine visceral leishmaniasis transmission in two sections of Mirassol D'Oeste city, where 38 canine blood samples were collected in each of them and tested by RIFI and ELISA tests. The number of seropositive dogs amounted to 15 animals, 8 living in Jardim São Paulo section and 7, in Planalto section. There were no significant differences between the number of infected dogs in the two sections (x2 = 0.058, p = 0.9712, df = 1. The socioeconomic characteristics examined are distinct and a visible difference in the housing and life quality of residents was also observed. Possibly, these factors may be influencing the maintenance of the disease in Mirassol D'Oeste.

  18. Rapid tests for the diagnosis of visceral leishmaniasis in patients with suspected disease

    Science.gov (United States)

    Boelaert, Marleen; Verdonck, Kristien; Menten, Joris; Sunyoto, Temmy; van Griensven, Johan; Chappuis, Francois; Rijal, Suman

    2014-01-01

    Background The diagnosis of visceral leishmaniasis (VL) in patients with fever and a large spleen relies on showing Leishmania parasites in tissue samples and on serological tests. Parasitological techniques are invasive, require sophisticated laboratories, consume time, or lack accuracy. Recently, rapid diagnostic tests that are easy to perform have become available. Objectives To determine the diagnostic accuracy of rapid tests for diagnosing VL in patients with suspected disease presenting at health services in endemic areas. Search methods We searched MEDLINE, EMBASE, LILACS, CIDG SR, CENTRAL, SCI-expanded, Medion, Arif, CCT, and the WHO trials register on 3 December 2013, without applying language or date limits. Selection criteria This review includes original, phase III, diagnostic accuracy studies of rapid tests in patients clinically suspected to have VL. As reference standards, we accepted: (1) direct smear or culture of spleen aspirate; (2) composite reference standard based on one or more of the following: parasitology, serology, or response to treatment; and (3) latent class analysis. Data collection and analysis Two review authors independently extracted data and assessed quality of included studies using the QUADAS-2 tool. Discrepancies were resolved by a third author. We carried out a meta-analysis to estimate sensitivity and specificity of rapid tests, using a bivariate normal model with a complementary log-log link function. We analysed each index test separately. As possible sources of heterogeneity, we explored: geographical area, commercial brand of index test, type of reference standard, disease prevalence, study size, and risk of bias (QUADAS-2). We also undertook a sensitivity analysis to assess the influence of imperfect reference standards. Main results Twenty-four studies containing information about five index tests (rK39 immunochromatographic test (ICT), KAtex latex agglutination test in urine, FAST agglutination test, rK26 ICT, and r

  19. Transmission potential, skin inflammatory response, and parasitism of symptomatic and asymptomatic dogs with visceral leishmaniasis

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    Goto H

    2008-11-01

    Full Text Available Abstract Background Visceral leishmaniasis in Brazil is caused by the protozoan Leishmania (Leishmania chagasi and it is transmitted by sandfly of the genus Lutzomyia. Dogs are an important domestic reservoir, and control of the transmission of visceral leishmaniasis (VL to humans includes the elimination of infected dogs. However, though dogs are considered to be an important element in the transmission cycle of Leishmania, the identification of infected dogs representing an immediate risk for transmission has not been properly evaluated. Since it is not possible to treat infected dogs, they are sacrificed when a diagnosis of VL is established, a measure that is difficult to accomplish in highly endemic areas. In such areas, parameters that allow for easy identification of reservoirs that represents an immediate risk for transmission is of great importance for the control of VL transmission. In this study we aimed to identify clinical parameters, reinforced by pathological parameters that characterize dogs with potential to transmit the parasite to the vector. Results The major clinical manifestations of visceral leishmaniasis in dogs from an endemic area were onicogriphosis, skin lesions, conjunctivitis, lymphadenopathy, and weight loss. The transmission potential of these dogs was assessed by xenodiagnosis using Lutzomyia longipalpis. Six of nine symptomatic dogs were infective to Lutzomyia longipalpis while none of the five asymptomatic dogs were infective to the sandfly. Leishmania amastigotes were present in the skin of all clinically symptomatic dogs, but absent in asymptomatic dogs. Higher parasite loads were observed in the ear and ungueal region, and lower in abdomen. The inflammatory infiltrate was more intense in the ears and ungueal regions of both symptomatic and asymptomatic dogs. In clinically affected dogs in which few or none Leishmania amastigotes were observed, the inflammatory infiltrate was constituted mainly of lymphocytes

  20. Canine Visceral Leishmaniasis in Rio de Janeiro, Brazil: clinical, parasitological, therapeutical and epidemiological findings (1977-1983

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    Mauro C. A. Marzochi

    1985-09-01

    Full Text Available Forty dogs from the periphery of the city of Rio de Janeiro were studied. All dogs where diagnosed as positive for leishmaniasis either parasitologically and/or serologically. Among them, 19 came from areas where only Visceral Leishmaniasis (VL occurs (Realengo, Bangu, Senador Camará. Clinical signs of the disease were seen in 36.8% of the cases, including emaciation - 100%, lymphadenopathy and depilation - 85.7%. The other 21 dogs came from an area (Campo Grande where both diseases (VL, and American Cutaneous Leishmaniasis - ACL occur. Clinical signs of the disease, mainly cutaneous or mucocutaneous ulcers were seen in 76.2% of the cases. Leishmania parasites were found in 39 cases: 22% in viscera, 42.5% in viscera and normal skin and 35% in cutaneous or mucocutaneous ulcers. All the Leishmania stocks isolated from dogs which came from Realengo, Bangu, Senador Camará (VL area, and from Campo Grande (VL + ACL area were characterized as L. donovani (except in one case according to their schizodeme, zymodeme and serodeme. The only stock characterized as L. b. braziliensis, was isolated from the lymph node of a dog from Campo Grande with visceral disease and without skin lesions. Antimony therapy attempted in eight Leishmania donovani positive dogs was unsuccessful.Durante inquéritos caninos realizados na periferia da cidade do Rio de Janeiro, foram estudados clínica e laboratorialmente 40 cães. Todos apresentavam diagnóstico parasitológico e/ou sorológico de leishmaniose. Dentre esses, 19 procediam de áreas de ocorrência de leishmaniose visceral (LV - Realengo, Bangu e Senador Camará. Sinais clínicos sugestivos da infecção foram observados em 36,8% deles (incluindo emagrecimento - 100%, linfadenopatia e depilação - 85,7%. Outros 21 cães procediam da área de Campo Grande onde tanto a LV como a leishmaniose tegumentar americana (LTA ocorrem. Sinais clínicos da infecção por Leishmania, principalmente ulcerações cutâneas e

  1. Visceral Leishmaniasis

    Science.gov (United States)

    2011-06-01

    nitric oxide killing. These properties of sandfly saliva are the focus of current research on an antileishmania vaccine.11 At the site of inoculation...patients, classic parasitologic diagnostic methods are preferred. For ex- ample, cultures or amplification of parasite specific DNA by PCR of the buffy... parasitologic diagnostic methods are satisfactory. In endemic areas, VL should never be overlooked in the differential diagnosis of immunocom- promised

  2. Interstitial pulmonary alterations in visceral leishmaniasis: evaluation with high-resolution computed tomography; Alteracoes pulmonares intersticiais na leishmaniose visceral: avaliacao pela tomografia computadorizada de alta resolucao

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    Costa, Norma Selma Santos; Cerri, Giovanni Guido [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia

    1999-08-01

    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 most 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 in the secondary pulmonary lobule and that the involvement in the parenchymal interstitium represents the findings reported by pathological studies in visceral leishmaniasis. (author)

  3. A microculture technique for isolating live Leishmania parasites from peripheral blood of visceral leishmaniasis patients.

    Science.gov (United States)

    Hide, M; Singh, R; Kumar, B; Bañuls, A L; Sundar, S

    2007-06-01

    Current procedures for diagnosing Leishmania parasites from patients involve invasive and dangerous tissue aspiration. We have developed a non-invasive and highly sensitive microculture method that can isolate parasites from the buffy coat of the patient's peripheral blood. The parasites were cultured in 96-well culture plates. Nineteen parasitologically proven visceral leishmaniasis (VL) patients were included in the study. Using this technique, we were able to isolate parasites from 16 (84%) samples. However, all 19 (100%) samples were positive on culture of splenic aspirates. We conclude that this technique is useful for the isolation and cryoconservation of parasites from patients' blood. This simple method could be tried as a first-instance alternative before other more sensitive procedures such as splenic aspirate; however, negative results should be confirmed by tests with higher sensitivity.

  4. [Survey on a new case of visceral leishmaniasis in Shanxi Province].

    Science.gov (United States)

    Cai, Hui-Xia; Zuo, Su-Jun; Xu, Wen-Xing; Wu, Wei-Ping; Li, Jun; Xu, Ke-Jun

    2012-06-30

    A new case of visceral leishmaniasis (kala-azar) was reported by Changzhi CDC of Shanxi Province in September 2011. The case was investigated clinically and epidemiologically. The patient was a two-year-old boy who lived in Huangnian Town of Changzhi County in Shanxi Province. Clinical examination showed hepatosplenomegaly, consistent decrease of blood cells and Leishman-Donovan body in the bone marrow smear. The rK39 immune diagnosis test showed strongly positive. The case was diagnosed as kala-azar. After one course treatment of sodium stibogluconate, the patient's condition improved markedly. There were no cases of kala-azar in this region historically. Blood samples of 17 individuals and 5 domestic animals including 3 dogs were all negative in the rK39 immunodiagnostic test. It is speculated that the potential risk of kala-azar transmission exists in this region.

  5. [Object-oriented remote sensing image classification in epidemiological studies of visceral leishmaniasis in urban areas].

    Science.gov (United States)

    Almeida, Andréa Sobral de; Werneck, Guilherme Loureiro; Resendes, Ana Paula da Costa

    2014-08-01

    This study explored the use of object-oriented classification of remote sensing imagery in epidemiological studies of visceral leishmaniasis (VL) in urban areas. To obtain temperature and environmental information, an object-oriented classification approach was applied to Landsat 5 TM scenes from the city of Teresina, Piauí State, Brazil. For 1993-1996, VL incidence rates correlated positively with census tracts covered by dense vegetation, grass/pasture, and bare soil and negatively with areas covered by water and densely populated areas. In 2001-2006, positive correlations were found with dense vegetation, grass/pasture, bare soil, and densely populated areas and negative correlations with occupied urban areas with some vegetation. Land surface temperature correlated negatively with VL incidence in both periods. Object-oriented classification can be useful to characterize landscape features associated with VL in urban areas and to help identify risk areas in order to prioritize interventions.

  6. Development of Leishmania vaccines in the era of visceral leishmaniasis elimination.

    Science.gov (United States)

    Engwerda, Christian R; Matlashewski, Greg

    2015-07-01

    A visceral leishmaniasis (VL) elimination target set for the Indian subcontinent in 2005 is being met in many endemic areas without a vaccine. This begs a question: is a VL vaccine needed if elimination targets can be met with current control programs? Here, we argue that a vaccine will be critical if the success of recent VL control efforts are to be sustained. However, not only do we require a safe and effective vaccine, but we also need to know how this should be used for maximum impact. In particular, identifying appropriate target populations to vaccinate will be crucial. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Protein malnutrition impairs the immune response and influences the severity of infection in a hamster model of chronic visceral leishmaniasis.

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    Eugenia Carrillo

    Full Text Available Leishmaniasis remains one of the world's most devastating neglected tropical diseases. It mainly affects developing countries, where it often co-exists with chronic malnutrition, one of the main risk factors for developing the disease. Few studies have been published, however, on the relationship between leishmaniasis progression and malnutrition. The present paper reports the influence of protein malnutrition on the immune response and visceral disease development in adult hamsters infected with Leishmania infantum fed either standard or low protein diets. The low protein diet induced severe malnutrition in these animals, and upon infection with L. infantum 33% had severe visceral leishmaniasis compared to only 8% of animals fed the standard diet. The infected, malnourished animals showed notable leukocyte depletion, mild specific antibody responses, impairment of lymphoproliferation, presence of parasites in blood (16.67% of the hamsters and significant increase of the splenic parasite burden. Animals fed standard diet suffered agranulocytosis and monocytopenia, but showed stronger specific immune responses and had lower parasite loads than their malnourished counterparts. The present results show that protein malnutrition promotes visceral leishmaniasis and provide clues regarding the mechanisms underlying the impairment of the immune system.

  8. Serological diagnosis of canine visceral leishmaniasis in Brazil: systematic review and meta-analysis.

    Science.gov (United States)

    Peixoto, Henry Maia; de Oliveira, Maria Regina Fernandes; Romero, Gustavo Adolfo Sierra

    2015-03-01

    To evaluate the quality and accuracy of serological diagnosis of canine visceral leishmaniasis in the Americas. A systematic review found original studies in the databases MEDLINE, EMBASE and LILACS up to November 2012 and in complementary sources up to February 2013. Studies were evaluated in accordance with QUADAS 2 and STARD parameters and recommended in accordance with GRADE parameters. Meta-analysis was carried out with Meta-DiSc software, using the random-effect model. Two hundred and eighty-four studies were identified, of which 25 met the inclusion criteria, comprising the final synthesis. All but one was conducted in Brazil, and only two were judged to be of good quality. 15 studies involving immuno-enzymatic tests with crude antigens (cELISA), 11 studies on indirect immunofluorescence tests (IFAT) and three on the immunochromatographic dual-path platform (DPP) test were meta-analysed. The combined results for sensitivity and specificity were cELISA: 0.89 (CI 95% 0.87-0.91) and 0.87 (CI 95% 0.86-0.88); IFAT: 0.88 (CI 95% 0.85-0.91) and 0.63 (CI 95% 0.61-0.65); and DPP: 0.83 (CI 95% 0.78-0.88) and 0.73 (CI 95% 0.70-0.75). Enzyme-linked immunosorbent assay with crude antigens and DPP tests have moderate accuracy for the diagnosis of canine visceral leishmaniasis, and the quality of the design, implementation and analysis of validation studies on diagnostic tests for this disease urgently require improvement. The recommendation for use of the evaluated tests is based on evidence that is scarce and restricted to Brazil. © 2014 John Wiley & Sons Ltd.

  9. Socioeconomic and behavioural risk factors for infection of visceral leishmaniasis gedaref state – Sudan 2015

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    Adam Suleiman Abaker

    2017-01-01

    Full Text Available Background Visceral leishmaniasis (VL (known as kala azar is associated with low socioeconomic status, and patients are among the poorest. In Sudan visceral leishmaniasis is one of the most important infectious diseases with an estimated 20,000 cases annually; 80% in Gedaref State. The social, economic, and behavioral factors play an important role in establishing both individual and population-wide vulnerability to the disease. Methods A descriptive cross-sectional community based study was conducted at Barbar Elfugara village to determine the socioeconomic and behavioral risk factors among head of the households regarding infection with VL. A sample size of 224 heads of households was determined using statistical formula. Data were collected using questionnaire, observation check list and reviewing records. SPSS was used for analyzing data and chi-square test for the association between different variables. Results The main risk factors of kala azar were gender {males were affected more than twice females (24.4%:9.1%}; the age group {<20 yrs (42.9%}. Other factors were illiteracy (30.1%, occupation mainly farmers (28.2%, poverty (39.1%, large families (31% and living in one house room (45.5%. The results showed that the respondents were highly aware of kala azar (97.3%, the majority (90.8% believed that kala azar is transmitted by an insect but only (55.5% of them were aware of the sand fly. The respondents showed poor knowledge of breeding sites (25.5% and biting time (34.5%. Consistent use of insecticide treated nets and sleeping inside habit were strongly protective (P=0.01 (P=0.00. Conclusion The study showed that the low socioeconomic status and poor knowledge of KA transmission are the major risk factors for KA infection in the area.

  10. Behavioral aspects of Lutzomyia longipalpis (Diptera: Psychodidae) in urban area endemic for visceral leishmaniasis.

    Science.gov (United States)

    De Oliveira, E F; Silva, E A; Casaril, A E; Fernandes, C E S; Paranhos Filho, A C; Gamarra, R M; Ribeiro, A A; Brazil, R P; Oliveira, A G

    2013-03-01

    The study of some of the behavioral aspects of the main vector of Leishmania infantum chagasi Cunha & Chagas in the Americas, Lutzomyia longipalpis (Lutz & Neiva), such as dispersion, population size, and vector survival rates, is important for the elucidation of the mechanisms of visceral leishmaniasis transmission. These parameters were studied by means of capture-mark-release-recapture experiments in an urban area of Campo Grande municipality, an endemic area of visceral leishmaniasis, situated in Mato Grosso do Sul state, Brazil. Six capture-mark-release-recapture experiments were undertaken between November 2009 and November 2010 and once in January 2012 with a view to assessing the population size and survival rate of Lu. longipalpis. The insects were released in a peridomicile surrounded by 13 residences. The recaptures were undertaken with automatic light traps for four consecutive weeks after release in the surrounding area. In total, 3,354 sand flies were captured, marked, and released. The overall recapture rate during the capture-mark-release-recapture experiments was 4.23%, of which 92.45% were recaptured at the release site, indicating limited dispersal. The greatest distance recorded from the release site was 165 m for males and 241 m for females. The male daily survival rate, calculated on the basis of regressions from the numbers of marked recaptured insects during the 15 successive days after release was 0.897. The estimated male population size measured by the Lincoln Index was 10,947.127. Though Lu. longipalpis presented a limited dispersion the physical barriers typical of urban environments did not prevent the sand flies from flying long distances.

  11. Ecology of Lutzomyia longipalpis in an area of visceral leishmaniasis transmission in north-eastern Brazil.

    Science.gov (United States)

    Costa, Pietra Lemos; Dantas-Torres, Filipe; da Silva, Fernando José; Guimarães, Vanessa Cristina Fitipaldi Veloso; Gaudêncio, Kamila; Brandão-Filho, Sinval Pinto

    2013-05-01

    Visceral leishmaniasis is a major public health issue in South America, where the disease is rapidly spreading. Changes in ecology and distribution of the principal vector, Lutzomyia longipalpis are among the factors accounting for the increasing incidence of the disease in this region. However, information about the ecology of L. longipalpis is still incipient, which may directly impair the implementation of effective control programs. Herein, the ecology of L. longipalpis was studied in a focus of visceral leishmaniasis in north-eastern Brazil. From August 2009 to August 2010, phlebotomine sand flies were monthly collected in four localities using CDC light traps (~37 per month) and a lantern-baited Shannon trap with mouth aspirators. A total of 24,226 phlebotomine sand flies were collected with light traps and 375 with mouth aspirators. The most abundant species was L. longipalpis, representing 97.9% of the specimens collected with light traps and 91.5% with the mouth aspirator. Other species (Lutzomyia evandroi, Lutzomyia lenti and Lutzomyia sallesi) were found in low numbers. Most phlebotomine sand flies (94.6%) were collected at chicken coops and corrals. No significant correlation was found between the monthly abundance of phlebotomine sand flies and the monthly averages of temperature, relative humidity or rainfall. However, interestingly enough, 82.4% of L. longipalpis specimens were collected in months when relative humidity surpassed 75%. This study points out that this vector is well adapted to live in different habitats and to different climate conditions. It also suggests that some north-eastern populations of L. longipalpis may be more xerotolerant than southern populations. Further studies to assess the relationship between microclimate and L. longipalpis density in different Brazilian regions are advised. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Situational Analysis of Visceral Leishmaniasis in the Most Important Endemic Area of the Disease in Iran

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    Eslam Moradi-Asl

    2017-12-01

    Full Text Available Background: Visceral leishmaniasis is one of the most important vector borne diseases in the world, transmitted by sand flies. Despite efforts to prevent the spread of the disease, cases continue worldwide. In Iran, the disease usually occurs in children under 10 years.  In the absence of timely diagnosis and treatment, the mortality rate is 95–100%. The main objective of this study was to determine the spatial and temporal distribution of visceral leishmaniasis as well as its correlation with climatic factors for determining high-risk areas in an endemic focus in northwestern Iran.Methods: In this cross-sectional study, data on VL cases were collected from local health centers in Ardabil Prov­ince, Iran during 2001–2015 to establish a geodatabase using ArcGIS10.3. Data analysis was conducted using SPSS23 and ArcMap Spatial Analyst. MaxEnt model was used to determine ecologically suitable nichesfor the disease.Results: Two hotspots were found in Meshkinshahr and Germi counties with 59% and 23% of total cases, respec­tively. There was an increase in the incidence rate of VL in Ardabil County from 2.9 in 2009 to 9.2/100,000 population in 2015. There was no spa­tial autocorrelation between county and total number of cases (P> 0.05. Higher NDVI, lower altitude and southern as­pects had positive effects on the presence probability of VL.Conclusion: The number of cases of this disease have been rising since 2013 and doubled in 2015. According to the derived distribution maps, the disease is spreading to new locations such as Ardabil and Namin counties.

  13. Sandflies in an urban area of transmission of visceral leishmaniasis in midwest Brazil.

    Science.gov (United States)

    Dorval, Maria Elizabeth Cavalheiros; Oshiro, Elisa Teruya; Brilhante, Andreia Fernandes; Nunes, Vânia Lúcia Brandão; Cristaldo, Geucira; Lima Júnior, Manoel Sebastião Costa; Galati, Eunice Aparecida Bianchi

    2016-01-01

    The phlebotomine fauna of Campo Grande city, capital of Mato Grosso do Sul state in Brazil, an endemic area for visceral leishmaniasis, has been thoroughly investigated, but all the insect collections were undertaken with automatic light traps. The present study sought to investigate the fauna in this city using Shannon and Disney traps, having human beings and hamsters, respectively, as bait. Both types of traps were installed in forest fragment and peridomiciliary areas in the period from 2007 to 2009. The phlebotomine females were analyzed by PCR for Leishmania identification. Lutzomyia longipalpis was the only species collected in the peridomiciles and rendered a total of 574 specimens with a 5.2:1 male:female ratio. A total of eight species were attracted to the two traps (one of each type) installed in the forest fragment, including: Bichromomyia flaviscutellata, Evandromyia bourrouli, Evandromyia lenti, Lutzomyia longipalpis, Nyssomyia whitmani, Pintomyia christenseni, Psathyromyia bigeniculata, and Sciopemyia sordellii. A total of 143 specimens were collected, Bi. flaviscutellata accounting for 81% and Lu. longipalpis for 1.4% of them. In one female of Lu. longipalpis collected in a Disney trap installed in a peridomicile, Leishmania (Leishmania) infantum DNA was found, thus strengthening the hypothesis that the transmission of leishmaniasis is in fact occurring in the anthropic environment. © M.E.C. Dorval et al., published by EDP Sciences, 2016.

  14. [Clinical and epidemiological features of visceral leishmaniasis in the Republic of Crimea].

    Science.gov (United States)

    Baranets, M S; Ermak, T N; Ponirovsky, E N

    The paper analyzes official statistical data, as well as visceral leishmaniasis (VL) cases who have visited the Clinical Center, I.M. Sechenov First Moscow State Medical University, and the results of parasitological studies of the materials submitted to the Reference Center for Monitoring of Leishmaniasis, E.I. Martsinovsky Institute of Medical Parasitology, Tropical and Vector-Borne Diseases. Account is taken of the observations made by the Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, and of the literature data available in Russian and foreign (Ukraine) scientific journals and monographs. During the period of 1932 to 2015, a total of 14 VL cases acquired in the Crimea were notified, of which there were 4 cases of VL concurrent with HIV infection. The majority of infections occurred in the eastern part of the peninsula. Given that many areas of Crimea have the status of recreation and annually receive millions of vacationists, it is necessary to conduct a more in-depth study of all aspects of this infection.

  15. Vaccination with Leishmania histone H1-pulsed dendritic cells confers protection in murine visceral leishmaniasis.

    Science.gov (United States)

    Agallou, Maria; Smirlis, Despina; Soteriadou, Ketty P; Karagouni, Evdokia

    2012-07-20

    Visceral leishmaniasis is the most severe form of leishmaniases affecting millions of people worldwide often resulting in death despite optimal therapy. Thus, there is an urgent need for the development of effective anti-infective vaccine(s). In the present study, we evaluated the prophylactic value of bone marrow-derived dendritic cells (BM-DCs) pulsed with the Leishmania (L.) infantum histone H1. We developed fully mature BM-DCs characterized by enhanced capacity of IL-12 production after ex vivo pulsing with GST-LeishH1. Intravenous administration of these BM-DCs in naive BALB/c mice resulted in antigen-specific spleenocyte proliferation and IgG1 isotype antibody production and conferred protection against experimental challenge with L. infantum independently of CpG oligonucleotides (ODNs) co-administration. Protection was associated with a pronounced enhancement of parasite-specific IFNγ-producing cells and reduction of cells producing IL-10, whereas IL-4 production was comparable in protected and non-protected mice. The polarization of immune responses to Th1 type was further confirmed by the elevation of parasite-specific IgG2a/IgG1 ratio in protected mice. The above data indicate the immunostimulatory capacity of Leishmania histone H1 and further support its exploitation as a candidate protein for vaccine development against leishmaniasis. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. A Novel Molecular Test to Diagnose Canine Visceral Leishmaniasis at the Point of Care

    Science.gov (United States)

    Castellanos-Gonzalez, Alejandro; Saldarriaga, Omar A.; Tartaglino, Lilian; Gacek, Rosana; Temple, Elissa; Sparks, Hayley; Melby, Peter C.; Travi, Bruno L.

    2015-01-01

    Dogs are the principal reservoir hosts of zoonotic visceral leishmaniasis (VL) but current serological methods are not sensitive enough to detect all subclinically infected animals, which is crucial to VL control programs. Polymerase chain reaction (PCR) methods have greater sensitivity but require expensive equipment and trained personnel, impairing its implementation in endemic areas. We developed a diagnostic test that uses isothermal recombinase polymerase amplification (RPA) to detect Leishmania infantum. This method was coupled with lateral flow (LF) reading with the naked eye to be adapted as a point-of-care test. The L. infantum RPA-LF had an analytical sensitivity similar to real time-PCR, detecting DNA of 0.1 parasites spiked in dog blood, which was equivalent to 40 parasites/mL. There was no cross amplification with dog or human DNA or with Leishmania braziliensis, Leishmania amazonensis, or Trypanosoma cruzi. The test also amplified Leishmania donovani strains (N = 7). In a group of clinically normal dogs (N = 30), RPA-LF detected more subclinical infections than rK39 strip test, a standard serological method (50% versus 13.3% positivity, respectively; P = 0.005). Also, RPA-LF detected L. infantum in noninvasive mucosal samples of dogs with a sensitivity comparable to blood samples. This novel molecular test may have a positive impact in leishmaniasis control programs. PMID:26240156

  17. Sodium stibogluconate and paromomycin for treating visceral leishmaniasis under routine conditions in eastern Sudan.

    Science.gov (United States)

    Atia, Atia M; Mumina, Ann; Tayler-Smith, Katherine; Boulle, Philippa; Alcoba, Gabriel; Elhag, Mousab Siddig; Alnour, Mubarak; Shah, Safieh; Chappuis, François; van Griensven, Johan; Zachariah, Rony

    2015-12-01

    Among patients with primary and relapse visceral leishmaniasis (VL) in eastern Sudan, we determined the proportion eligible for treatment with sodium stibogluconate and paromomycin (SSG/PM) and, of these, their demographic and clinical characteristics; initial treatment outcomes including adverse side effects requiring treatment discontinuation; treatment outcomes by 6 months; and risk factors associated with initial (slow responders) and late treatment failure (relapses and post-kala-azar dermal leishmaniasis, PKDL). A retrospective cohort study in Tabarak Allah Hospital, Gedaref Province, eastern Sudan, from July 2011 to January 2014. Of 1252 individuals diagnosed with VL (1151 primary and 101 relapses), 65% were eligible for SSG/PM including 83% children, almost half of them malnourished and anaemic. About 4% of individuals discontinued treatment due to side effects; 0.7% died during treatment. Initial cure was achieved in 93% of 774 primary cases and 77% of 35 relapse cases (P Sudan. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  18. Canine visceral leishmaniasis in urban and rural areas of Northeast Brazil.

    Science.gov (United States)

    Queiroz, Paula V S; Monteiro, Glória R G; Macedo, Virgínia P S; Rocha, Maria A C; Batista, Leopoldina M M; Queiroz, José W; Jerônimo, Selma M B; Ximenes, Maria F F M

    2009-04-01

    The purpose of this study was to determine the clinical and laboratory profiles of canine leishmaniasis in two distinct areas. Dogs from urban and rural areas were examined. The population studied in the metropolitan area included 54 dogs. Of these, 20 (37%) animals did not present with any signs suggestive of visceral leishmaniasis (VL). Among these, only eight were confirmed negative by ELISA (rK39 and CE) and 12 dogs, clinically negative for leishmaniasis, were seropositive by ELISA (rK39 and CE). Thinness, conjunctivitis and onychogryphosis were the most frequent clinical signs in the urban areas, followed by crusty lesions, alopecia, ulcerated lesions, hyperkeratosis and exfoliation. In the metropolitan area human VL cases occurred mainly in 1991, 1992, 1999 and 2000. In the rural areas the ELISA rK39 test detected a seroprevalence of 11.3% and ELISA CE (Leishmania crude extract) of 20.6%. Thirty-nine dogs were examined 6 months after the first visit. Serological exams using rK39 antigen showed seroconversion of only one dog, whereas Leishmania CE showed seroconversion of 13 (33.4%) dogs. In this rural environment 83.3% of the positive dogs were asymptomatic. Lutzomyia intermedia and Lu. longipalpis were the most predominant sandfly vector species. Amastigotes were identified in spleen and liver fragments of symptomatic necropsied animals. PCR amplification of DNA isolated from promastigote culture indicated that the species was Leishmania chagasi. This finding suggests that delayed diagnosis and euthanasia of potentially infectious animals may occur with an increased transmission risk to sandflies and subsequently to humans.

  19. Clinical characteristics and spatial distribution of Visceral leishmaniasis in children in São Paulo state: an emerging focus of Visceral leishmaniasis in Brazil

    Science.gov (United States)

    Naufal Spir, Patricia Rodrigues; Prestes-Carneiro, Luiz Euribel; Fonseca, Elivelton Silva; Dayse, Aline; Giuffrida, Rogério

    2017-01-01

    Background: Visceral leishmaniasis (VL) is an emerging zoonosis, and Brazil harbors about 90% of those infected in Latin America. Since 1998, the disease has been spreading quickly in São Paulo state, and the western region is considered an emerging focus of VL in Brazil. Our aim was to evaluate the clinical characteristics and spatial distribution of VL in children referred to a public tertiary hospital located in the western region of São Paulo state, Brazil. Methods: Medical records of children up to 18 years of age who were diagnosed with VL between January 2006 and December 2010 were reviewed. Geospatial analysis was performed using the ArcGIS 10.2 platform. Results: Sixty-three patients were enrolled in the study; the median age was 3.3 ± 3.3 years. The median time interval between the onset of clinical symptoms and diagnosis was 16.1 ± 11.1 days, and the median time in the pediatric ward was 18.0 ± 9.4 days. Liposomal amphotericin B was the first-line treatment in 90.5% of the patients and 9.6% relapsed. One patient died (1.6%), and 19% were submitted to the pediatric intensive care unit. Conclusion: The short interval between the onset of symptoms, diagnosis, and treatment and the reduced number of days of hospitalization certainly influenced the small number of deaths, relapses, and severity among the children infected with VL. However, the disease is spreading fast in the western region of São Paulo state. Thus, integrated actions and effective monitoring of the disease are needed to complement curative practices. PMID:28221822

  20. Citometria de fluxo no diagnóstico da leishmaniose visceral canina Flow cytometry used in canine visceral leishmaniasis diagnosis

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    A.V. Carvalho Neta

    2006-08-01

    Full Text Available Descreve-se a padronização de nova metodologia para detecção de anticorpos antiformas promastigotas fixadas de L. (L. chagasi, por citometria de fluxo (AAPF-IgG, sua aplicabilidade e desempenho na identificação de casos de leishmaniose visceral canina (LVC. Foram avaliados dois grupos de cães classificados pela reação de imunofluorescência indireta (RIFI, como: não reatores (NR, n=10 e reatores (R, n=50 dos quais foram coletadas amostras de sangue (soro para realização dos testes laboratoriais. Os resultados relacionados ao estabelecimento, aplicabilidade e desempenho da metodologia AAPF-IgG demonstraram que essa metodologia possibilita a identificação de uma região de reatividade diferencial entre cães NR e R, no soro diluído a 1:2048 e o valor de 20% de parasitos fluorescentes positivos (PPFP como ponto de corte entre resultados positivos e negativos, mostrando que a AAPF-IgG aplica-se na identificação de casos de LVC, possibilitando distinguir 96% de cães R como positivos e 100% de cães NR como negativos. Esses resultados em conjunto sugerem que a utilização da AAPF-IgG pode ser um novo instrumento para ensaios clínicos de diagnóstico sorológico da LVC.The current study evaluated the standardization of a new methodology for detection of anti-fixed L. (L. chagasi promastigote antibodies by flow cytometry (AAPF-IgG, as well its applicability and performance in the identification of cases of Canine Visceral Leishmaniasis (CVL. Two groups of dogs were classified by RIFI (gold standard as no reactors (NR, n=10 and reactors (R, n=50. Blood samples were collected and used for the laboratorial tests (RIFI and AAPF-IgG. The results showed that the new AAPF-IgG assay makes possible the identification of an area of differential reactivity between dogs NR and R at the dilution of 1:2048 and 20% of percentage of positive fluorescent parasite as the cut point among positive and negative results. The AAPF-IgG assay was able to

  1. Epidemiological aspects of human and canine visceral leishmaniasis in Venezuela Aspectos epidemiológicos de la leishmaniasis visceral humana y canina en Venezuela

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    Olga Zerpa

    2003-04-01

    Full Text Available OBJECTIVE: To report recent data on the distribution of human and canine visceral leishmaniasis (VL in Venezuela, and to highlight problems associated with effective control measures. METHODS: We report the number of cases, incidence rate, age and sex distribution, and mortality rates for human VL (HVL for the period of 1995 through 2000, based on National Registry of Leishmaniasis data. We carried out serological studies on a total of 3 025 domestic dogs from the 12 states in Venezuela reporting cases of human VL in this 1995-2000 period and also from the state of Yaracuy, where cases were reported earlier during the decade of the 1990s. RESULTS: From 1995 through 2000, 242 cases of HVL were reported from 12 states, in various sections of Venezuela. There was a relatively stable national incidence rate of 0.2 cases per 100 000 persons per year. Of the 242 cases, 26.0% were from Margarita Island, one of the three islands that make up the state of Nueva Esparta (Margarita Island was the only one of the Nueva Esparta islands that had HVL cases. Over the 1995-2000 period, the annual incidence rates for Nueva Esparta ranged from 1.7 to 3.8 cases per 100000 population. Males in Venezuela were more frequently affected (59.5% than were females (40.5%. In terms of age, 67.7% of the VL patients were OBJETIVOS: Dar a conocer datos recientes acerca de la distribución de la leishmaniasis visceral (LV humana y canina en Venezuela y resaltar los problemas que se asocian con la aplicación de buenas medidas de control. MÉTODOS: Damos a conocer el número de casos, la tasa de incidencia, la distribución por edad y sexo y las tasas de mortalidad de la LV humana (LVH durante el período de 1995 a 2000, según datos obtenidos del Registro Nacional de Leishmaniasis. Llevamos a cabo pruebas serológicas en un total de 3 025 perros domésticos de los 12 estados de Venezuela que notificaron casos de LV en este período, y también de Yaracuy, donde se notificaron

  2. Molecular and Serological Evidence of Leishmania Infection in Stray Dogs from Visceral Leishmaniasis-Endemic Areas of Bangladesh.

    Science.gov (United States)

    Akter, Shirin; Alam, Mohammad Zahangir; Nakao, Ryo; Yasin, Golam; Kato, Hirotomo; Katakura, Ken

    2016-10-05

    Visceral leishmaniasis (VL), or kala-azar, is mainly caused by two closely related Leishmania species, Leishmania infantum and Leishmania donovani Leishmania infantum is responsible for zoonotic VL, with dogs as the main reservoir host in the Mediterranean, the Middle East, Asia, and South America. In the Indian subcontinent, VL is caused by L. donovani and is considered anthroponotic, although the only known vector, the sand fly, is zoophilic in nature. The role of domestic and stray dogs in VL transmission is still unclear in this area. We screened 50 stray dogs from VL-endemic areas of Bangladesh for serological and molecular evidence of Leishmania infection. We detected anti-Leishmania antibodies in six (12%) dog serum samples using rK39 immunochromatographic tests. We observed Leishmania kinetoplast DNA in 10 (20%) buffy coat DNA samples by real-time polymerase chain reaction (PCR), five of which were positive based on internal transcribed spacer 1-PCR. A sequencing analysis of the amplified products confirmed that the parasitic DNA was derived from L. donovani Our findings support the hypothesis that stray dogs are an animal reservoir for L. donovani in this endemic region. Further studies are required to determine the precise role of dogs in the epidemiology of VL in Bangladesh. © The American Society of Tropical Medicine and Hygiene.

  3. Canine visceral leishmaniasis in the metropolitan area of São Paulo: Pintomyia fischeri as potential vector of Leishmania infantum

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    Galvis-Ovallos Fredy

    2017-01-01

    Full Text Available American visceral leishmaniasis is a zoonosis caused by Leishmania infantum and transmitted mainly by Lutzomyia longipalpis. However, canine cases have been reported in the absence of this species in the Greater São Paulo region, where Pintomyia fischeri and Migonemyia migonei are the predominant species. This raises the suspicion that they could be acting as vectors. Therefore, this study sought to investigate specific vector capacity parameters of these species and to compare them with those of Lu. longipalpis s.l. Among these parameters the blood feeding rate, the survival, and the susceptibility to the development of Le. infantum were evaluated for the three species, and the attractiveness of dogs to Pi. fischeri and Mg. migonei was evaluated. The estimated interval between blood meals was shorter for Lu. longipalpis s.l, followed by Pi. fischeri and Mg. migonei. The infection rate with Le. infantum flagellates in Lu. longipalpis was 9.8%, in Pi. fischeri 4.8%, and in Mg. migonei nil. The respective infective life expectancies (days of Lu. longipalpis, Mg. migonei, and Pi. fischeri were 2.4, 1.94, and 1.68. Both Pi. fischeri and Mg. migonei were captured in the kennel with a predominance (95% of Pi. fischeri. Considering the great attractiveness of dogs to Pi. fischeri, its susceptibility to infection by Le. infantum, infective life expectancies, and predominance in Greater São Paulo, this study presents evidence of Pi. fischeri as a potential vector of this parasite in the region.

  4. Canine Visceral Leishmaniasis in Wild Canines (Fox, Jackal, and Wolf) in Northeastern Iran Using Parasitological, Serological, and Molecular Methods

    OpenAIRE

    Mohebali, Mehdi; Arzamani, Kourosh; Zarei, Zabiholah; Akhoundi, Behnaz; Hajjaran, Homa; Raeghi, Saber; Heidari, Zahra; Motavalli-Haghi, Seyed Mousa; Elikaee, Samira; Mousazadeh-Mojarrad, Ahmad; Kakoei, Zahra

    2016-01-01

    Background: Although many studies had been conducted on various aspects of canine visceral leishmaniasis (CVL) in domestic dogs in the endemic areas of Iran, investigations on CVL in wild canines are rare.Methods: This is a cross-sectional study was conducted from December 2012 to 2013 in northeast of Iran where human VL is endemic. Wild canines were trapped around the areas where human VL cases had been previously identified. Wild canines were collected and examined both clinically and serol...

  5. Sensitivity of PCR and real-time PCR for the diagnosis of human visceral leishmaniasis using peripheral blood

    OpenAIRE

    da Costa Lima, Manoel Sebastião; Zorzenon, Denielly Christina Rodrigues; Dorval, Maria Elizabeth Cavalheiros; Pontes, Elenir Rose Jardim Cury; Oshiro, Elisa Teruya; Cunha, Rodrigo; Andreotti, Renato; Matos, Maria de Fatima Cepa

    2013-01-01

    Objective: To evaluate the effectiveness of PCR and real-time PCR for the diagnosis of human visceral leishmaniasis using peripheral blood samples. Methods: DNA extraction was performed using Promega Wizard襅 Genomic kits. PCR employing RV1/RV2 primers yielded 1 45-bp amplicons. Real-time PCR was performed with the same primers and SYBR Green ROX Plus mix. These techniques were used to analyze 100 peripheral blood samples from patients with clinical signs of the disease. Results...

  6. Type I signal peptidase from Leishmania is a target of the immune response in human cutaneous and visceral leishmaniasis.

    Science.gov (United States)

    Rafati, Sima; Salmanian, Ali-Hatef; Taheri, Tahere; Masina, Slavica; Schaff, Cedric; Taslimi, Yasaman; Fasel, Nicolas

    2004-05-01

    The gene encoding type I signal peptidase (Lmjsp) has been cloned from Leishmania major. Lmjsp encodes a protein of 180 amino residues with a predicted molecular mass of 20.5 kDa. Comparison of the protein sequence with those of known type I signal peptidases indicates homology in five conserved domains A-E which are known to be important, or essential, for catalytic activity. Southern blot hybridisation analysis indicates that there is a single copy of the Lmjsp gene. A recombinant SPase protein and a synthetic peptide of the L. major signal peptidase were used to examine the presence of specific antibodies in sera from either recovered or active individuals of both cutaneous and visceral leishmaniasis. This evaluation demonstrated that sera from cutaneous and visceral forms of leishmaniasis are highly reactive to both the recombinant and synthetic signal peptidase antigens. Therefore, the Leishmania signal peptidase, albeit localised intracellularly, is a significant target of the Leishmania specific immune response and highlights its potential use for serodiagnosis of cutaneous and visceral leishmaniasis.

  7. Effectiveness of dog collars impregnated with 4% deltamethrin in controlling visceral leishmaniasis in Lutzomyia longipalpis (Diptera: Psychodidade: Phlebotominae) populations.

    Science.gov (United States)

    Silva, Rafaella Albuquerque E; Andrade, Andrey José de; Quint, Bruno Beust; Raffoul, Gabriel Elias Salmen; Werneck, Guilherme Loureiro; Rangel, Elizabeth Ferreira; Romero, Gustavo Adolfo Sierra

    2018-03-26

    There is little information on the effect of using deltamethrin-impregnated dog collars for the control of canine visceral leishmaniasis. The objective of this study was to evaluate the effectiveness of the use of 4% deltamethrin-impregnated collars (Scalibor®) in controlling visceral leishmaniasis in Lutzomyia longipalpis by comparing populations in intervention and non-intervention areas. Phlebotomine flies were captured over 30 months in four neighbourhoods with intense visceral leishmaniasis transmission in Fortaleza and Montes Claros. We calculated the rates of domicile infestation, relative abundance of Lu. longipalpis, and Lu. longipalpis distribution in each site, capture location (intra- and peridomestic locations) and area (intervention and non-intervention areas). In the control area in Fortaleza, the relative abundance of Lu. longipalpis was 415 specimens at each capture site, whereas in the intervention area it was 159.25; in Montes Claros, the relative abundance was 5,660 specimens per capture site in the control area, whereas in the intervention area it was 2,499.4. The use of dog collars was associated with a reduction in captured insects of 15% (p = 0.004) and 60% (p < 0.001) in Montes Claros and Fortaleza, respectively. We observed a lower vector abundance in the intervention areas, suggesting an effect of the insecticide-impregnated collars.

  8. Generation of growth arrested Leishmania amastigotes: a tool to develop live attenuated vaccine candidates against visceral leishmaniasis.

    Science.gov (United States)

    Selvapandiyan, Angamuthu; Dey, Ranadhir; Gannavaram, Sreenivas; Solanki, Sumit; Salotra, Poonam; Nakhasi, Hira L

    2014-06-30

    Visceral leishmaniasis (VL) is fatal if not treated and is prevalent widely in the tropical and sub-tropical regions of world. VL is caused by the protozoan parasite Leishmania donovani or Leishmania infantum. Although several second generation vaccines have been licensed to protect dogs against VL, there are no effective vaccines against human VL [1]. Since people cured of leishmaniasis develop lifelong protection, development of live attenuated Leishmania parasites as vaccines, which can have controlled infection, may be a close surrogate to leishmanization. This can be achieved by deletion of genes involved in the regulation of growth and/or virulence of the parasite. Such mutant parasites generally do not revert to virulence in animal models even under conditions of induced immune suppression due to complete deletion of the essential gene(s). In the Leishmania life cycle, the intracellular amastigote form is the virulent form and causes disease in the mammalian hosts. We developed centrin gene deleted L. donovani parasites that displayed attenuated growth only in the amastigote stage and were found safe and efficacious against virulent challenge in the experimental animal models. Thus, targeting genes differentially expressed in the amastigote stage would potentially attenuate only the amastigote stage and hence controlled infectivity may be effective in developing immunity. This review lays out the strategies for attenuation of the growth of the amastigote form of Leishmania for use as live vaccine against leishmaniasis, with a focus on visceral leishmaniasis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Pre-clinical antigenicity studies of an innovative multivalent vaccine for human visceral leishmaniasis.

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    Pedro Cecílio

    2017-11-01

    Full Text Available The notion that previous infection by Leishmania spp. in endemic areas leads to robust anti-Leishmania immunity, supports vaccination as a potentially effective approach to prevent disease development. Nevertheless, to date there is no vaccine available for human leishmaniasis. We optimized and assessed in vivo the safety and immunogenicity of an innovative vaccine candidate against human visceral leishmaniasis (VL, consisting of Virus-Like Particles (VLP loaded with three different recombinant proteins (LJL143 from Lutzomyia longipalpis saliva as the vector-derived (VD component, and KMP11 and LeishF3+, as parasite-derived (PD antigens and adjuvanted with GLA-SE, a TLR4 agonist. No apparent adverse reactions were observed during the experimental time-frame, which together with the normal hematological parameters detected seems to point to the safety of the formulation. Furthermore, measurements of antigen-specific cellular and humoral responses, generally higher in immunized versus control groups, confirmed the immunogenicity of the vaccine formulation. Interestingly, the immune responses against the VD protein were reproducibly more robust than those elicited against leishmanial antigens, and were apparently not caused by immunodominance of the VD antigen. Remarkably, priming with the VD protein alone and boosting with the complete vaccine candidate contributed towards an increase of the immune responses to the PD antigens, assessed in the form of increased ex vivo CD4+ and CD8+ T cell proliferation against both the PD antigens and total Leishmania antigen (TLA. Overall, our immunogenicity data indicate that this innovative vaccine formulation represents a promising anti-Leishmania vaccine whose efficacy deserves to be tested in the context of the "natural infection".

  10. Visceral leishmaniasis in eastern Sudan: parasite identification in humans and dogs; host-parasite relationships.

    Science.gov (United States)

    Dereure, Jacques; El-Safi, Sayda Hassan; Bucheton, Bruno; Boni, Mickaël; Kheir, Musa Mohamed; Davoust, Bernard; Pratlong, Francine; Feugier, Eric; Lambert, Monique; Dessein, Alain; Dedet, Jean Pierre

    2003-10-01

    In 1996, an epidemic outbreak of visceral leishmaniasis (VL) started in Barbar el Fugara, a village in Gedarif State (eastern Sudan). From 1997 to 2000, regular epidemiological studies were carried out in the human population, as well as in mammals and sand flies. In symptomatic patients, 46/69 lymph node, 6/20 post kala-azar dermal leishmaniasis (PKDL) and 1/4 cutaneous cultures in NNN medium were positive. In 69 dogs, 23/79 lymph node cultures were positive. In other mammals (47 rodents, five donkeys, one mongoose and one monkey) spleen and/or blood cultures were negative. Characterization of isolated strains (by starch gel electrophoresis and isoelectrofocusing) identified three zymodemes of Leishmania donovani, two of L. infantum and two of L. archibaldi complexes from patient samples and three zymodemes of L. donovani, three of L. infantum and two of L. archibaldi complexes from dog samples. Five of them were present in both man and dog. For the first time, a strain from a PKDL case was identified as L. infantum, and a child had the same L. infantum zymodeme in VL and in subsequent PKDL. Blood samples from dogs were studied by immunofluorescent antibody test (IFAT). The seroprevalence in dogs was 72.5%, 74.3% and 42.9% in 1998, 1999 and 2000, respectively. By using CDC miniature light traps 12 745 sand flies were collected and then identified. Phlebotomus papatasi (7%) and P. orientalis (5%) were sympatric, mainly inside homes (85% and 75%, respectively). These results, the relative stability of seroprevalence in dogs and the intradomiciliar presence of P. orientalis, known as a vector of VL in Sudan, suggest several hypotheses: (i) man is responsible for the disease in dogs, (ii) the dog is the reservoir of VL, (iii) the dog is an intermediate host between a possible sylvatic cycle and the anthroponotic cycle. More extensive studies are needed to assess the transmission cycle of VL in this area of Sudan.

  11. Pre-clinical antigenicity studies of an innovative multivalent vaccine for human visceral leishmaniasis.

    Science.gov (United States)

    Cecílio, Pedro; Pérez-Cabezas, Begoña; Fernández, Laura; Moreno, Javier; Carrillo, Eugenia; Requena, José M; Fichera, Epifanio; Reed, Steven G; Coler, Rhea N; Kamhawi, Shaden; Oliveira, Fabiano; Valenzuela, Jesus G; Gradoni, Luigi; Glueck, Reinhard; Gupta, Gaurav; Cordeiro-da-Silva, Anabela

    2017-11-01

    The notion that previous infection by Leishmania spp. in endemic areas leads to robust anti-Leishmania immunity, supports vaccination as a potentially effective approach to prevent disease development. Nevertheless, to date there is no vaccine available for human leishmaniasis. We optimized and assessed in vivo the safety and immunogenicity of an innovative vaccine candidate against human visceral leishmaniasis (VL), consisting of Virus-Like Particles (VLP) loaded with three different recombinant proteins (LJL143 from Lutzomyia longipalpis saliva as the vector-derived (VD) component, and KMP11 and LeishF3+, as parasite-derived (PD) antigens) and adjuvanted with GLA-SE, a TLR4 agonist. No apparent adverse reactions were observed during the experimental time-frame, which together with the normal hematological parameters detected seems to point to the safety of the formulation. Furthermore, measurements of antigen-specific cellular and humoral responses, generally higher in immunized versus control groups, confirmed the immunogenicity of the vaccine formulation. Interestingly, the immune responses against the VD protein were reproducibly more robust than those elicited against leishmanial antigens, and were apparently not caused by immunodominance of the VD antigen. Remarkably, priming with the VD protein alone and boosting with the complete vaccine candidate contributed towards an increase of the immune responses to the PD antigens, assessed in the form of increased ex vivo CD4+ and CD8+ T cell proliferation against both the PD antigens and total Leishmania antigen (TLA). Overall, our immunogenicity data indicate that this innovative vaccine formulation represents a promising anti-Leishmania vaccine whose efficacy deserves to be tested in the context of the "natural infection".

  12. Spatial correlations of population and ecological factors with distribution of visceral leishmaniasis cases in southwestern Iran.

    Science.gov (United States)

    Ghatee, Mohammad Amin; Sharifi, Iraj; Haghdoost, Ali Akbar; Kanannejad, Zahra; Taabody, Zahra; Hatam, Gholamreza; Abdollahipanah, Abbas

    2013-09-01

    Leishmaniasis as a dynamic disease may be markedly influenced by demographic and ecological factors. A geospatial information system study was developed to determine the distribution of visceral leishmaniasis (VL) cases in relation to population, climatic and environmental factors in Fars province, southwest of Iran. The dwelling addresses of 217 VL patients were obtained from hospital files. A hazard map produced by unifying buffers (5 km) around nomads travel routes (NTR) was developed to survey the effect of close proximity to NTR on the distribution of VL. Mean annual rainfall (MAR), mean annual temperature (MAT), four months temperature mean (T4), elevation, slope and landcover were climatic and environmental factors that have been analysed. Finally, data of dwelling foci were extracted from maps and analysed using logistic regression models. Close proximity to NTR was the most important factor influenced on the disease distribution. Climatic factors were in second rank. Among them, temperature especially T4 is the most effective variable and rainfall was also shown to be another effective climatic agent. Most cases of VL were reported from temperate and semiarid areas in western and central regions while arid condition was a confined factor. The environmental factor of landcovers including urban, dry farm and thin forest regions was revealed as the third rank effective factor. Altitude importance was only shown when its effect was studied independently from other factors. These findings present the distribution of VL in Fars province is influenced by combination of ecological and nomads demographical variables although closeness to NTR and nomads role in distribution and continuance of kala-azar are the most important factors.

  13. Epidemiology of visceral leishmaniasis among children in Gadarif hospital, eastern Sudan

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    Mohammed Ahmed A. Ahmed

    2016-12-01

    Full Text Available Abstract Background Since 1900s, visceral leishmaniasis (VL has been among the most important health problems in Sudan, particularly in the endemic areas such as eastern and central regions. Methods This was a cross sectional, hospital-based study conducted from 1st January 2015 to 31st December 2015 to investigate the epidemiological factors of VL in Gadarif hospital, eastern Sudan. Results During the study period there were 47 identified children with VL among 145 suspected cases. The most common clinical presentations were fever (47, 100%, pallor (47, 100%, weight loss (40, 85.1%, splenomegaly (37, 78.7%, lymphadenopathy (33, 70.2%, vomiting (32, 68% cough (28, 59%, loss of appetite (22, 46.8%, diarrhoea (17, 36.1% and jaundice (5, 10.6%. With regard to the outcome after short term follow up 37 patients (78.8% improved without complications, while 3 (6.4%, 2 (4.3%, 2 (4.3%, 1 (2.1%, 1 (2.1% and 1 (2.1% developed pneumonia, otitis media, septicaemia, urinary tract infection, parasitic infestation and PKDL respectively. Lower mean of haemoglobin level was observed among the VL cases in comparison with the suspected cases (in whom VL was excluded haemoglobin level {8.9 (3.1 Vs 11 (6.3, P = 0.021}. Again more proportion of anaemic (47 (100% Vs 14 (14.2%, P = 0.000 and severely anaemic (23 (48.9% Vs 2 (2%, P = 0.006 patients was detected among the infected children. Using logistic regression analyses there was significant association between rural residence (CI = 1.5–24, OR = 19.1, P = 0.023, male gender (CI = 6.6–18.7, OR = 6.4, P = 0.001 and VL among children. Conclusions While there is an advance in prevention and management of visceral leishmaniasis our results indicate that VL is still a public health problem with its severe complications among children in eastern Sudan.

  14. American cutaneous leishmaniasis in infancy and childhood.

    Science.gov (United States)

    Paniz-Mondolfi, Alberto E; Talhari, Carolina; García Bustos, María F; Rosales, Tamara; Villamil-Gomez, Wilmer E; Marquez, Marilianna; Pérez Alvarez, Alexandra M; Tálamo Sánchez, Alejandra I; Rodriguez-Morales, Alfonso J

    2017-12-01

    Infant and young child skin diseases are among the most common features of morbidity throughout the tropics. Because the skin is directly exposed to the environment, it is considerably affected by climatic and local conditions such as vectors and microorganisms, as in the case of leishmaniasis. In America the observed magnitude of cutaneous leishmaniasis in children has led to the study of increased risk of exposure of this group due to the possibility of peri- and intradomiciliary transmission. The present review pretends to make a concrete approach all through the broad and main figures of this parasitic disease, including the clinical, physiopathological, epidemiological, diagnostic, and therapeutic aspects, in order to be used as a practical source of reference for pediatricians leading with tropical cutaneous pathology in the region. © 2017 The International Society of Dermatology.

  15. Visceral Leishmaniasis: A Differential Diagnosis to Remember after Bone Marrow Transplantation

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    Margarida Dantas Brito

    2014-01-01

    Full Text Available 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. Allogeneic SCT was performed with peripheral blood stem cells from an unrelated Portuguese matched donor. In the following months, patient developed mild fluctuating cytopenias, mostly thrombocytopenia (between 60 and 80∗109/L. The only significant complaint was intermittent tiredness. The common causes for thrombocytopenia in this setting were excluded—no evidence of graft versus host disease, no signs of viral or bacterial infection, and no signs of relapsed disease/dysplastic changes. The bone marrow smear performed 12 months after transplantation revealed an unsuspected diagnosis: a massive bone marrow infiltration with amastigotes.

  16. Historical overview of infantile visceral leishmaniasis in El Agamy, Alexandria, Egypt.

    Science.gov (United States)

    Kassem, Hala A; Beier, John C; El Sawaf, Bahira M

    2017-12-01

    Infantile visceral leishmaniasis (IVL) is considered a rare and neglected disease in Egypt. An outbreak of the disease in El Agamy, Alexandria occurred in 1982 although the disease was previously reported 80 years before. Epidemiological and entomological studies were conducted ever since the 1982 outbreak to identify human cases, the parasite, reservoir host and the sand fly vector. Leishmania infantum MON-98, a new and unique zymodeme, was responsible of the disease. Stray dogs acted as the reservoir host and Phlebotomus langeroni was the proven vector. The parasite isolates from human cases were identical to the parasite isolates from the reservoir host and the sand fly vector. The El Agamy focus in 1982 was basically a rural Bedouin setting of recently built cement houses surrounded by lime stone fences. The numbers of human cases of IVL in this area have been declining, with the last reported case in 2005. This coincides with the completion of irregular urbanization of El Agamy which resulted in the disappearance of P. langeroni. In this review, we characterize the old focus of IVL in El Agamy based on published literature to identify factors underlying the appearance and disappearance of the disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Epidemiological and immunological aspects of human visceral leishmaniasis on Margarita Island, Venezuela.

    Science.gov (United States)

    Zerpa, Olga; Ulrich, Marian; Benitez, Margarita; Avila, Concepción; Rodríguez, Vestalia; Centeno, Marta; Belizario, Doris; Reed, Steven G; Convit, Jacinto

    2002-12-01

    Sixty-five patients were diagnosed with visceral leishmaniasis (VL) on Margarita Island in the decade from 1990 to1999; 86.2% were <= 3 years old. All were leishmanin-negative at diagnosis. Evaluation of 23 cured patients in 1999 revealed that 22/23 had converted to leishmanin-positive; five had persisting antibodies to rK39 antigen, with no clinical evidence of disease. Leishmanin tests were positive in 20.2% of 1,643 healthy individuals from 417 households in endemic areas. Of the positive reactors, 39.8% were identified in 35 (8.4%) of the households, 15 of which had an antecedent case of VL, a serologically positive dog or both. Weak serological activity to rK39 antigen was detected in 3 of 488 human sera from the endemic areas. The presence of micro-foci of intense peri-urban transmission and the apparent absence of other Trypanosomatidae causing human disease offer a unique opportunity for the study of reservoirs, alternative vectors and evaluation of control measures on the Island.

  18. Photodynamic vaccination of hamsters with inducible suicidal mutants of Leishmania amazonensis elicits immunity against visceral leishmaniasis

    Science.gov (United States)

    Kumari, Shraddha; Samant, Mukesh; Khare, Prashant; Misra, Pragya; Dutta, Sujoy; Kolli, Bala Krishna; Sharma, Sharad; Chang, Kwang Poo; Dube, Anuradha

    2016-01-01

    Leishmania, naturally residing in the phagolysosomes of macrophages, is a suitable carrier for vaccine delivery. Genetic complementation of these trypanosomatid protozoa to partially rectify their defective heme-biosynthesis renders them inducible with δ-aminolevulinate to develop porphyria for selective photolysis, leaving infected host-cells unscathed. Delivery of released “vaccines” to antigen-presenting cells is thus expected to enhance immune response, while their self-destruction presents added advantages of safety. Such suicidal-L. amazonensis was found to confer immunoprophylaxis and immunotherapy on hamsters against L. donovani. Neither heat-killed nor live parasites without suicidal induction were effective. Photodynamic vaccination of hamsters with the suicidal-mutants reduced the parasite loads by 99% and suppressed the development of disease. These suppressions were accompanied by an increase in Leishmania-specific delayed-type hypersensitivity and lymphoproliferation as well as in the levels of splenic iNOS, IFN-γ and IL-12 expressions and of Leishmania-specific IgG2 in the serum. Moreover, a single intravenous administration of T-cells from vaccinated hamsters was shown to confer on naïve animals an effective cellular immunity against L. donovani challenges. The absence of lesion development at vaccination sites and parasites in the draining lymphnodes, spleen and liver further indicates that the suicidal mutants provide a safe platform for vaccine delivery against experimental visceral leishmaniasis. PMID:19053149

  19. First Molecular Characterization of Leishmania Species Causing Visceral Leishmaniasis among Children in Yemen.

    Science.gov (United States)

    Mahdy, Mohammed A K; Al-Mekhlafi, Abdulsalam M; Abdul-Ghani, Rashad; Saif-Ali, Reyadh; Al-Mekhlafi, Hesham M; Al-Eryani, Samira M; Lim, Yvonne A L; Mahmud, Rohela

    2016-01-01

    Visceral leishmaniasis (VL) is a debilitating, often fatal disease caused by Leishmania donovani complex; however, it is a neglected tropical disease. L. donovani complex comprises two closely related species, L. donovani that is mostly anthroponotic and L. infantum that is zoonotic. Differentiation between these two species is critical due to the differences in their epidemiology and pathology. However, they cannot be differentiated morphologically, and their speciation using isoenzyme-based methods poses a difficult task and may be unreliable. Molecular characterization is now the most reliable method to differentiate between them and to determine their phylogenetic relationships. The present study aims to characterize Leishmania species isolated from bone marrows of Yemeni pediatric patients using sequence analysis of the ribosomal internal transcribed spacer-1 (ITS1) gene. Out of 41 isolates from Giemsa-stained bone marrow smears, 25 isolates were successfully amplified by nested polymerase chain reaction and sequenced in both directions. Phylogenetic analysis using neighbor joining method placed all study isolates in one cluster with L. donovani complex (99% bootstrap). The analysis of ITS1 for microsatellite repeat numbers identified L. infantum in 11 isolates and L. donovani in 14 isolates. These data suggest the possibility of both anthroponotic and zoonotic transmission of VL-causing Leishmania species in Yemen. Exploring the possible animal reservoir hosts is therefore needed for effective control to be achieved.

  20. Human anti-saliva immune response following experimental exposure to the visceral leishmaniasis vector, Lutzomyia longipalpis.

    Science.gov (United States)

    Vinhas, Vera; Andrade, Bruno B; Paes, Fábio; Bomura, Andréa; Clarencio, Jorge; Miranda, José C; Báfica, André; Barral, Aldina; Barral-Netto, Manoel

    2007-11-01

    Experiments in animals verified that phlebotomine saliva enhances Leishmania infection, and vaccination with saliva prevents disease. We have shown that individuals from an endemic area of visceral leishmaniasis displayed robust antibody responses to saliva from the vector Lutzomyia longipalpis, which correlated with anti-parasite cell-mediated immunity. Here, we explored human anti-saliva responses following exposure to sand flies, using an in vivo bite model in which normal volunteers were exposed four times to 30 laboratory-reared Lu. longipalpis. Following the third exposure, normal volunteers developed diverse dermatological reactions at the site of insect bite. Serum from normal volunteers displayed high levels of anti-salivary gland sonicate IgG1, IgG4 and IgE as well as several salivary gland proteins. Furthermore, following in vitro stimulation with salivary gland sonicate, there was an increased frequency of CD4(+)CD25(+) and CD8(+)CD25(+) T cells as well as IFN-gamma and IL-10 synthesis. Strikingly, 1 year after the first exposure, PBMC from the volunteers displayed recall IFN-gamma responses that correlated with a significant reduction in infection rates using a macrophage-lymphocyte autologous culture. Together, these data suggest that human immunization against sand fly saliva is feasible and recall responses are obtained even 1 year after exposure, opening perspectives for vaccination in man.

  1. IL-17A promotes susceptibility during experimental visceral leishmaniasis caused by Leishmania donovani.

    Science.gov (United States)

    Terrazas, Cesar; Varikuti, Sanjay; Kimble, Jennifer; Moretti, Ellen; Boyaka, Prosper N; Satoskar, Abhay R

    2016-03-01

    Leishmania donovani is an intracellular parasite that infects professional phagocytes and causes visceral leishmaniasis (VL). The immune response during VL has been extensively studied in the context of T-helper (Th)1 and Th2 responses. Immunity against this parasite is dependent on IFN-γ production and subsequent macrophage activation, and the Th2 response promotes granuloma formation. The cytokine IL-17A is associated with neutrophilic inflammation. Depletion of neutrophils during experimental VL results in enhanced parasitic loads. Furthermore, although patients resistant to VL showed enhanced levels of IL-17A in circulation, little is known about the role of IL-17A during VL infection. Here, we used IL-17A-deficient mice and IL-17A reporter mice to address the role of IL-17A during VL. IL-17A(-/-) mice were highly resistant to VL infection, showing decreased parasites in the liver and spleen. This unexpected phenotype was associated with enhanced IFN-γ production by T cells and decreased accumulation of neutrophils and monocytes, resulting in reduced number of granulomas. We also found γδ T and Th17 cells as the main IL-17A(+) cells during VL infection. Our data reveal an unexpected role of IL-17A rendering susceptibility against L. donovani by regulating the IFN-γ response and promoting detrimental inflammation. © FASEB.

  2. Leishmania infantum Induces the Release of sTREM-1 in Visceral Leishmaniasis

    Science.gov (United States)

    Bomfim, Lays G. S.; Magalhães, Lucas S.; Santos-Filho, Marcello A. A.; Peres, Nalu T. A.; Corrêa, Cristiane B.; Tanajura, Diego M.; Silva, Angela M.; Lipscomb, Michael W.; Borges, Valéria M.; Jesus, Amélia R.; Almeida, Roque P.; de Moura, Tatiana R.

    2017-01-01

    Visceral leishmaniasis (VL) is a systemic transmissible disease that remains to be a major global health problem. The inflammatory response during VL is characterized by the release of several cytokines and other pro-inflammatory mediators. Triggering Receptor Expressed on Myeloid Cells (TREM) are a group of evolutionarily conserved membrane-bound surface receptors expressed on neutrophils and monocytes. Engagement of TREM-1 directs intracellular signaling events that drive cytokine production, degranulation, and phagocytosis. In certain inflammatory-associated diseases, TREM-1 can also be found as a soluble form (sTREM-1), which can negatively regulate TREM-1 receptor signaling. In these studies, we now find that high levels of circulating sTREM-1 correlate directly with VL disease severity. In particular, high levels of sTREM-1 were observed in non-survivor VL patients. Furthermore, these levels of sTREM-1 positively correlated with liver size and negatively correlated with leukocyte counts and hemoglobin concentration. Moreover, we found that neutrophils exposure in vitro to Leishmania infantum modulates TREM-1, DAP12, and IL-8 gene expression, while also increasing release of sTREM-1. Finally, results revealed that higher sTREM-1 levels are associated with increasing parasite ratio. Taken together, these studies suggest that L. infantum may modulate TREM-1 in neutrophils and high levels of this molecule is associated with severe VL. PMID:29201022

  3. Lutzomyia longipalpis behavior and control at an urban visceral leishmaniasis focus in Argentina.

    Science.gov (United States)

    Santini, Maria Soledad; Salomón, Oscar Daniel; Acardi, Soraya Alejandra; Sandoval, Enrique Adolfo; Tartaglino, Lilian

    2010-01-01

    During the earlier stages of visceral leishmaniasis transmission in Posadas City, Misiones, both the night activity and attraction to humans of Lutzomyia longipalpis were assessed, in order to provide preliminary recommendations. The impact of peridomestic deltamethrin spraying performed by local officials was also evaluated. Although Lu. longipalpis were found in traps located over a dog the entire night, 90% of the females were captured from 20.30h to 1.30h, and only landed on a human when he was at a distance of 1.5 m from the dog. Peridomestic spraying of deltamethrin (25 mg/m²) reduced the sand fly capture up to seven days post-intervention without dispersion in the border of the sprayed areas. These results support the recommendations about time-space focus of the protection measures: first half of the night, in the backyard, with pets and domestic animals kept at least 5 m from humans. The deltamethrin as it was used did not seem very effective in this scenario; neither did the eventual use of bed nets, at least in adults, due to the place/hour of sand fly higher activity. This study strengthens the need for a multidisciplinary approach to develop prevention strategies based both on biological and anthropological studies.

  4. Comparison of clinical samples for visceral Leishmaniasis diagnosis in asymptomatic dogs by PCR hybridization

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Sidney A.; Ituassu, Leonardo T.; Melo, Maria N. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Parasitologia], e-mail: saninoalmeida@gmail.com, e-mail: Itituassu@yahoo.com.br, e-mail: melo@icb.ufmg.br; Leite, Rodrigo S.; Andrade, Antero S.R. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN-CNEN/MG), Belo Horizonte, MG (Brazil)], e-mail: rleite2005@gmail.com, e-mail: antero@cdtn.br

    2009-07-01

    The canine visceral leishmaniasis (CVL) diagnosis still represents a challenge because of complexity of this disease. The aim of present study was to compare different clinical samples for diagnosis of CVL by Polymerase Chain Reaction (PCR) combined with hybridization of {sup 32}P labeled probes. Bone marrow (BM), skin biopsy (SB), peripheral blood (PB) and conjunctival swab (CS) were used in this work. With this purpose 40 asymptomatic dogs, all positive by parasitological test, were obtained. From each animal were collected SB with sterile punches from ear internal surface, 1.0 mL of PB, BM aspirates from sternum and CS from both lower eyelid. Each clinical sample was submitted to suitable DNA purification process and PCR-hybridization assays. The positive results obtained with PCR were 55%, 25%, 30% and 22.5% for CS, BM, SB and PB respectively while the PCR followed by hybridization showed a positivity of 87.5%, 50%, 45% and 27.5% respectively. The hybridization assay was able to increase the PCR positivity in all kinds of clinical samples. The best performance was obtained using CS samples. We concluded that the PCR associated with DNA radioactive probes was a very sensitive tool for diagnosis of CVL in asymptomatic dogs and the CS has an important potential for regular screening of dogs. (author)

  5. Autoantibodies in a Three-Year-Old Girl with Visceral Leishmaniasis: A Potential Diagnostic Pitfall

    Directory of Open Access Journals (Sweden)

    Gholamreza Pouladfar

    2016-01-01

    Full Text Available Visceral leishmaniasis (VL, a life-threatening parasitic infection, is endemic in the Mediterranean region. Diagnosis of VL is based on epidemiologic, clinical, and laboratory findings. However, sometimes, clinical features and laboratory findings overlap with those of autoimmune diseases. In some cases, autoantibodies are detected in patients with VL and this could be a potential diagnostic pitfall. In this study, we have reported on a three-year-old girl from a VL-endemic area in Iran, who presented with prolonged fever and splenomegaly. Bone marrow examination, serologic tests, and the molecular PCR assay were performed; however, results were inconclusive. The levels of anti-double stranded DNA, cytoplasmic antineutrophil cytoplasmic autoantibody, and perinuclear antineutrophil cytoplasmic autoantibody were elevated and, at the end, splenic biopsy was performed. The splenic tissue PCR test detected the DNA of Leishmania infantum. The patient’s condition improved with anti-Leishmania therapy, and the autoantibodies disappeared within the following four months. Clinical presentations and laboratory findings of VL and autoimmune diseases may overlap in some patients.

  6. Estimation of under-reported visceral Leishmaniasis (Vl cases in Bihar: a Bayesian approach

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    A Ranjan

    2013-12-01

    Full Text Available Background: Visceral leishmaniasis (VL is a major health problem in the state of Bihar and adjoining areas in India. In absence of any active surveillance mechanism for the disease, there seems to be gross under-reporting of VL cases. Objective: The objective of this study was to estimate extent of under-reporting of VL cases in Bihar using pooled analysis of published papers. Method: We calculated the pooled common ratio (RRMH based on three studies and combined it with a prior distribution of ratio using inverse-variance weighting method. Bayesian method was used to estimate the posterior distribution of the “under-reporting factor” (ratio of unreported to reported cases. Results: The posterior distribution of ratio of unreported to reported cases yielded a mean of 3.558, with 95% posterior limits of 2.81 and 4.50. Conclusion: Bayesian approach gives evidence to the fact that the total number of VL cases in the state may be nearly more than three times that of currently reported figures. 

  7. Abundance of Lutzomyia longipalpis in urban households as risk factor of transmission of visceral leishmaniasis.

    Science.gov (United States)

    Vianna, Elisa Neves; Morais, Maria Helena Franco; Almeida, Andréa Sobral de; Sabroza, Paulo Chagastelles; Reis, Ilka Afonso; Dias, Edelberto Santos; Carneiro, Mariângela

    2016-05-01

    Urban occurrence of human and canine visceral leishmaniasis (VL) is linked to households with characteristics conducive to the presence of sand flies. This study proposes an ad hoc classification of households according to the environmental characteristics of receptivity to phlebotominae and an entomological study to validate the proposal. Here we describe the phlebotominae population found in intra- and peridomiciliary environments and analyse the spatiotemporal distribution of the VL vector Lutzomyia longipalpis of households receptive to VL. In the region, 153 households were classified into levels of receptivity to VL followed by entomological surveys in 40 of those properties. Kruskal-Wallis verified the relationship between the households' classification and sand fly abundance and Kernel analysis evaluated L. longipalpis spatial distribution: of the 740 sand flies were captured, 91% were L. longipalpis; 82% were found peridomiciliary whilst the remaining 18% were found intradomiciliary. No statistically significant association was found between sandflies and households levels. L. longipalpis counts were concentrated in areas of high vulnerability and some specific households were responsible for the persistence of the infestation. L. longipalpis prevails over other sand fly species for urban VL transmission. The entomological study may help target the surveillance and vector control strategies to domiciles initiating and/or maintaining VL outbreaks.

  8. Ecology of Lutzomyia longipalpis and Lutzomyia migonei in an endemic area for visceral leishmaniasis.

    Science.gov (United States)

    Silva, Rafaella Albuquerque; Santos, Fabricio Kassio Moura; Sousa, Lindemberg Caranha de; Rangel, Elizabeth Ferreira; Bevilaqua, Claudia Maria Leal

    2014-01-01

    The main vector for visceral leishmaniasis (VL) in Brazil is Lutzomyia longipalpis. However, the absence of L. longipalpis in a region of autochthonous VL demonstrates the participation of other species in the transmission of the parasite. Studies conducted in La Banda, Argentina, and São Vicente Férrer, Pernambuco State, Brazil, have correlated the absence of L. longipalpis and the presence of L. migonei with autochthonous cases of VL. In São Vicente Férrer, Pernambuco, there was evidence for the natural infection of L. migonei with Leishmania infantum chagasi. Thus, the objective of this work was to assess the ecology of the sand flies L. longipalpis and L. migonei in Fortaleza, an endemic area for VL. Insect capture was conducted at 22 sampling points distributed across four regions of Fortaleza. In total, 32,403 sand flies were captured; of these, 18,166 (56%) were identified as L. longipalpis and 14,237 (44%) as L. migonei. There were significant density differences found between the vectors at each sampling site (indoors and outdoors) (p longipalpis are distributed throughout Fortaleza, where they have adapted to an indoor environment, and suggest that L. migonei may share the role as a vector with L. longipalpis in the transmission of VL in Fortaleza.

  9. Comparison of clinical samples for visceral Leishmaniasis diagnosis in asymptomatic dogs by PCR hybridization

    International Nuclear Information System (INIS)

    Ferreira, Sidney A.; Ituassu, Leonardo T.; Melo, Maria N.

    2009-01-01

    The canine visceral leishmaniasis (CVL) diagnosis still represents a challenge because of complexity of this disease. The aim of present study was to compare different clinical samples for diagnosis of CVL by Polymerase Chain Reaction (PCR) combined with hybridization of 32 P labeled probes. Bone marrow (BM), skin biopsy (SB), peripheral blood (PB) and conjunctival swab (CS) were used in this work. With this purpose 40 asymptomatic dogs, all positive by parasitological test, were obtained. From each animal were collected SB with sterile punches from ear internal surface, 1.0 mL of PB, BM aspirates from sternum and CS from both lower eyelid. Each clinical sample was submitted to suitable DNA purification process and PCR-hybridization assays. The positive results obtained with PCR were 55%, 25%, 30% and 22.5% for CS, BM, SB and PB respectively while the PCR followed by hybridization showed a positivity of 87.5%, 50%, 45% and 27.5% respectively. The hybridization assay was able to increase the PCR positivity in all kinds of clinical samples. The best performance was obtained using CS samples. We concluded that the PCR associated with DNA radioactive probes was a very sensitive tool for diagnosis of CVL in asymptomatic dogs and the CS has an important potential for regular screening of dogs. (author)

  10. [Comparative study of diagnostic methods for visceral leishmaniasis in dogs from Ilha Solteira, SP].

    Science.gov (United States)

    de Assis, Juliana; de Queiroz, Nina Marí Gual Pimenta; da Silveira, Rita de Cássia Vieira; Nunes, Cáris Maroni; Oliveira, Trícia Maria Ferreira de Sousa; Junior, Antonio Carlos Faconti de Noronha; Neves, Maria Francisca; Machado, Rosangela Zacarias; Buzetti, Wilma Aparecida Starke

    2010-01-01

    The purpose of the present work was a comparative study of diagnostic methods for Canine Visceral Leishmaniasis (CVL) using serological methods, enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody test (IFAT), histochemical (HE) and immunohistochemical (IMHC) tests using spleen, lymph node and liver canine tissues. In addition, Polymerase Chain Reaction (PCR) was done in blood and in tissues in order to compare and confirm no conclusive and negative diagnosis by the methods above. For this study, 34 dogs were divided according to clinical signs in asymptomatic, oligosymptomatic and polisymptomatic Leishmania-infected dogs euthanized by Zoonotic Disease Control Center (CCZ) from Ilha Solteira, SP, Brazil. The positivism indexes of ELISA, IMHC, IFAT and HE were 65.0, 62.0, 56.0 and 56.0%, respectively with the highest numbers of positive dogs in polisymptomatic (92.0%) followed by oligosymptomatic (57.0%) and asymptomatic dogs (12.5%). Furthermore, PCR confirmed the positive results and detected DNA in tissues from 100% of negative dogs and 89.0% suspects raising the animal positivism index up to 97.0%. In conclusion, PCR was the most sensitive and a valuable method for a definitive CVL diagnosis.

  11. Canine visceral leishmaniasis in Iran: A systematic review and meta-analysis.

    Science.gov (United States)

    Shokri, Azar; Fakhar, Mahdi; Teshnizi, Saeed Hosseini

    2017-01-01

    Visceral leishmaniasis is considered an endemic zoonosis in some parts of Iran and dogs are main reservoirs, which play role in the transmission cycle of human leishmaniasis. This systematic review and meta-analysis was performed to determine the prevalence of canine visceral leishmaniasis (CVL) in Iran. Data were systematically collected from 1982 to 2015 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, Iran medex and Scientific Information Database (SID). A total of 39 articles concerning dogs, 6 articles on jackals, 4 articles on wolves and 4 articles on foxes, reporting the prevalence of CVL from different regions of Iran fulfilled our eligibility criteria. Totally, 19903 dogs, 151 jackals, 42 wolves and 44 foxes were examined and the overall prevalence rate of CVL in Iran was estimated to be as following: in dogs 16% (95% CI: 13-19%), in jackals 10% (95% CI: 5-15%), in wolves 10% (95% CI: 5-15%) and in foxes 10% (95% CI: 1k19%), respectively. There was a significant difference in infection rate between male and female dogs, the infection in males 9% (95% CI: 8.8-10.5%) was more than females 7% (95% CI: 5.5-7.5%) (p=0.024). Also, the rate of infection was significantly higher in older dogs than younger ones (p<0.047) while in dogs younger than 1year was 12% (95% CI: 6-18%), in 1-2 years 10% (95% CI: 6-14%), in 3-5 years 16% (95% CI: 9-22%) and in those which were over 7 years 31% (95% CI: 19-44%), respectively. Our meta- regression analysis revealed the significant correlation between stray and owned dogs: the infection rate in stray 10% (95% CI: 5-4%) was higher than those owned 6% (95% CI: 3- 8%) (p=0.037). Also, the prevalence of infection in rural dogs 36% (95% CI: -1-72%) is significantly higher than urban dogs, 19% (95% CI:-1-40%) (p=0.013). Although most (81%) of infected dogs had no clinical signs (asymptomatic), meta-regression analysis showed that the infection rate in

  12. Molecular characterization of Leishmania infantum in domestic cats in a region of Brazil endemic for human and canine visceral leishmaniasis.

    Science.gov (United States)

    Metzdorf, Isabel Parizotto; da Costa Lima, Manoel Sebastião; de Fatima Cepa Matos, Maria; de Souza Filho, Antonio Francisco; de Souza Tsujisaki, Rosianne A; Franco, Karina Garcia; Shapiro, Julie Teresa; de Almeida Borges, Fernando

    2017-02-01

    Leishmaniasis is a "neglected tropical disease" and serious public health issue in Brazil. While dogs are recognized as particularly important reservoirs, recent reports of domestic cats infected with Leishmania sp. in urban areas suggest their participation in the epidemiological chain of the parasite in endemic areas. The aim of this study was to screen domestic cats for Leishmania sp. infection in an area where human and canine visceral leishmaniasis are endemic, followed by the identification of the species circulating in cats. We collected peripheral blood, lymph-node aspirates and bone marrow from 100 adult animals, both male and female, and analyzed the samples using cytological and molecular (PCR) detection techniques. We detected Leishmania in 6% of animals, which were then analyzed by RFLP-PCR to identify the species. Leishmania infantum (synonym: L. chagasi), a species responsible for visceral leishmaniasis in humans and other animals, was identified from all six samples. Amastigotes were observed in the peripheral blood, bone marrow and lymph-node aspirates in 4 of the 6 PCR-positive animals. The presence of infected cats in endemic areas should not be neglected, because it demonstrates the potential role of these animals in the biological cycle of the pathogen. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Description of six autochthonous cases of canine visceral leishmaniasis diagnosed in Pedregulho (São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Cássia Regina de Abreu

    Full Text Available Visceral leishmaniasis is an infectious disease of chronic, emerging and zoonotic nature that presents various degrees of severity. In Brazil, this illness is caused by Leishmania infantum (Leishmania chagasi, which is transmitted by the bite of the sand fly Lutzomyia longipalpis, and dogs are its main reservoir. Given the increasing spread of this disease across Brazil, the aim of this study was to report on six cases of canine visceral leishmaniasis, diagnosed in June 2013, in the city of Pedregulho, State of São Paulo, considered to be a non-endemic area and free of phlebotomine sand flies. The diagnosis was based on clinical signs of the patients and additional tests (serological and parasitological. It was concluded that the diagnosis of leishmaniasis is complex because the clinical signs are similar to other systemic diseases, thus justifying the importance of parasitological test of bone marrow, considered "gold standard", in the confirmation of the disease. In addition, the area was not, until now, considered risk place, despite notification.

  14. Visceral leishmaniasis patients display altered composition and maturity of neutrophils as well as impaired neutrophil effector functions

    Directory of Open Access Journals (Sweden)

    Endalew Yizengaw

    2016-11-01

    Full Text Available Immunologically, active visceral leishmaniasis (VL is characterised by profound immunosuppression, severe systemic inflammatory responses and an impaired capacity to control parasite replication. Neutrophils are highly versatile cells, which play a crucial role in the induction as well as the resolution of inflammation, the control of pathogen replication and the regulation of immune responses. Neutrophil functions have been investigated in human cutaneous leishmaniasis, however, their role in human visceral leishmaniasis is poorly understood.In the present study we evaluated the activation status and effector functions of neutrophils in patients with active VL and after successful anti-leishmanial treatment. Our results show that neutrophils are highly activated and have degranulated; high levels of arginase, myeloperoxidase and elastase, all contained in neutrophils’ granules, were found in the plasma of VL patients. In addition, we show that a large proportion of these cells are immature. We also analysed effector functions of neutrophils that are essential for pathogen clearance and show that neutrophils have an impaired capacity to release neutrophil extracellular traps, produce reactive oxygen species and phagocytose bacterial particles, but not Leishmania parasites.Our results suggest that impaired effector functions, increased activation and immaturity of neutrophils play a key role in the pathogenesis of VL.

  15. Direct Agglutination Test and Enzyme Linked Immunosorbent Assay with Urine Samples for the Diagnosis of Visceral Leishma-niasis

    Directory of Open Access Journals (Sweden)

    Sarkari B

    2007-07-01

    Full Text Available Background: Visceral leishmaniasis (VL or Kala azar is an infectious disease caused by various species of Leishmania parasites. The aim of this study was to detect and compare the presence of anti-Leishmania antibodies in the urine of vis-ceral leishmaniasis patients using ELISA and DAT methods."nMethods: A total of 30 urine samples were collected from VL patients referred to Shiraz (southeast of Iran hospitals. Moreover 31 urine samples were collected from healthy individuals and patients with other diseases such as malaria, brucellosis, hydatidosis and cutaneous leishmaniasis. Collected samples were examined to detect anti-Leishmania antibod-ies in urine, using ELISA and DAT."nResults: Anti-Leishmania antibody was detected in urine of 18 out of 30 (60% VL patients by DAT while ELISA detected anti-Leishmania antibodies in urine of 28 out of 30 (93.3% of VL cases. Sensitivity and specificity of urine-based DAT was 60% and 83.9%, respectively while sensitivity and specificity of urine-based ELISA were 93.3% and 93.5%, corre-spondingly. "nConclusion: Urine-based DAT and ELISA have a reasonable specificity and sensitivity in diagnosis of VL. Accordingly, urine-based ELISA might be a suitable alternative for serum based assays for diagnosis of VL.

  16. Herramientas no invasivas en Venezuela: comparación entre las pruebas inmunoserológicas DAT, rK26 y rK39 en el diagnóstico de leishmaniasis visceral

    NARCIS (Netherlands)

    Terán-Ángel, Guillermo; Rodríguez, Vestalia; Silva, Rosilved; Zerpa, Olga; Schallig, Henk; Ulrich, Marian; Cabrera, Maira

    2010-01-01

    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. The aim was to compare three serodiagnostic tools for human

  17. Th1-biased immunomodulation and therapeutic potential of Artemisia annua in murine visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Mohammad Islamuddin

    2015-01-01

    Full Text Available In the absence of vaccines and limitations of currently available chemotherapy, development of safe and efficacious drugs is urgently needed for visceral leishmaniasis (VL that is fatal, if left untreated. Earlier we reported in vitro apoptotic antileishmanial activity of n-hexane fractions of Artemisia annua leaves (AAL and seeds (AAS against Leishmania donovani. In the present study, we investigated the immunostimulatory and therapeutic efficacy of AAL and AAS.Ten-weeks post infection, BALB/c mice were orally administered AAL and AAS for ten consecutive days. Significant reduction in hepatic (86.67% and 89.12% and splenic (95.45% and 95.84% parasite burden with decrease in spleen weight was observed. AAL and AAS treated mice induced the strongest DTH response, as well as three-fold decrease in IgG1 and two-fold increase in IgG2a levels, as compared to infected controls. Cytometric bead array further affirmed the elicitation of Th1 immune response as indicated by increased levels of IFN-γ, and low levels of Th2 cytokines (IL-4 and IL-10 in serum as well as in culture supernatant of lymphocytes from treated mice. Lymphoproliferative response, IFN-γ producing CD4+ and CD8+ T lymphocytes and nitrite levels were significantly enhanced upon antigen recall in vitro. The co-expression of CD80 and CD86 on macrophages was significantly augmented. CD8+ T cells exhibited CD62Llow and CD44hi phenotype, signifying induction of immunological memory in AAL and AAS treated groups. Serum enzyme markers were in the normal range indicating inertness against nephro- and hepato-toxicity.Our results establish the two-prong antileishmanial efficacy of AAL and AAS for cure against L. donovani that is dependent on both the direct leishmanicidal action as well as switching-on of Th1-biased protective cell-mediated immunity with generation of memory. AAL and AAS could represent adjunct therapies for the treatment of leishmaniasis, either alone or in combination with

  18. Mimotope-based vaccines of Leishmania infantum antigens and their protective efficacy against visceral leishmaniasis.

    Science.gov (United States)

    Costa, Lourena Emanuele; Goulart, Luiz Ricardo; Pereira, Nathália Cristina de Jesus; Lima, Mayara Ingrid Sousa; Duarte, Mariana Costa; Martins, Vivian Tamietti; Lage, Paula Sousa; Menezes-Souza, Daniel; Ribeiro, Tatiana Gomes; Melo, Maria Norma; Fernandes, Ana Paula; Soto, Manuel; Tavares, Carlos Alberto Pereira; Chávez-Fumagalli, Miguel Angel; Coelho, Eduardo Antonio Ferraz

    2014-01-01

    The development of cost-effective prophylactic strategies to prevent leishmaniasis has become a high-priority. The present study has used the phage display technology to identify new immunogens, which were evaluated as vaccines in the murine model of visceral leishmaniasis (VL). Epitope-based immunogens, represented by phage-fused peptides that mimic Leishmania infantum antigens, were selected according to their affinity to antibodies from asymptomatic and symptomatic VL dogs' sera. Twenty phage clones were selected after three selection cycles, and were evaluated by means of in vitro assays of the immune stimulation of spleen cells derived from naive and chronically infected with L. infantum BALB/c mice. Clones that were able to induce specific Th1 immune response, represented by high levels of IFN-γ and low levels of IL-4 were selected, and based on their selectivity and specificity, two clones, namely B10 and C01, were further employed in the vaccination protocols. BALB/c mice vaccinated with clones plus saponin showed both a high and specific production of IFN-γ, IL-12, and GM-CSF after in vitro stimulation with individual clones or L. infantum extracts. Additionally, these animals, when compared to control groups (saline, saponin, wild-type phage plus saponin, or non-relevant phage clone plus saponin), showed significant reductions in the parasite burden in the liver, spleen, bone marrow, and paws' draining lymph nodes. Protection was associated with an IL-12-dependent production of IFN-γ, mainly by CD8+ T cells, against parasite proteins. These animals also presented decreased parasite-mediated IL-4 and IL-10 responses, and increased levels of parasite-specific IgG2a antibodies. This study describes two phage clones that mimic L. infantum antigens, which were directly used as immunogens in vaccines and presented Th1-type immune responses, and that significantly reduced the parasite burden. This is the first study that describes phage-displayed peptides as

  19. Mimotope-based vaccines of Leishmania infantum antigens and their protective efficacy against visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Lourena Emanuele Costa

    Full Text Available BACKGROUND: The development of cost-effective prophylactic strategies to prevent leishmaniasis has become a high-priority. The present study has used the phage display technology to identify new immunogens, which were evaluated as vaccines in the murine model of visceral leishmaniasis (VL. Epitope-based immunogens, represented by phage-fused peptides that mimic Leishmania infantum antigens, were selected according to their affinity to antibodies from asymptomatic and symptomatic VL dogs' sera. METHODOLOGY/MAIN FINDINGS: Twenty phage clones were selected after three selection cycles, and were evaluated by means of in vitro assays of the immune stimulation of spleen cells derived from naive and chronically infected with L. infantum BALB/c mice. Clones that were able to induce specific Th1 immune response, represented by high levels of IFN-γ and low levels of IL-4 were selected, and based on their selectivity and specificity, two clones, namely B10 and C01, were further employed in the vaccination protocols. BALB/c mice vaccinated with clones plus saponin showed both a high and specific production of IFN-γ, IL-12, and GM-CSF after in vitro stimulation with individual clones or L. infantum extracts. Additionally, these animals, when compared to control groups (saline, saponin, wild-type phage plus saponin, or non-relevant phage clone plus saponin, showed significant reductions in the parasite burden in the liver, spleen, bone marrow, and paws' draining lymph nodes. Protection was associated with an IL-12-dependent production of IFN-γ, mainly by CD8+ T cells, against parasite proteins. These animals also presented decreased parasite-mediated IL-4 and IL-10 responses, and increased levels of parasite-specific IgG2a antibodies. CONCLUSIONS/SIGNIFICANCE: This study describes two phage clones that mimic L. infantum antigens, which were directly used as immunogens in vaccines and presented Th1-type immune responses, and that significantly reduced the

  20. 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. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. Dichotomy of the human T cell response to Leishmania antigens. II. Absent or Th2-like response to gp63 and Th1-like response to lipophosphoglycan-associated protein in cells from cured visceral leishmaniasis patients

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Hey, A S; Jardim, A

    1994-01-01

    The T cell response to different Leishmania donovani antigens was investigated using peripheral blood mononuclear cells (PBMC) from Kenyans cured of visceral leishmaniasis and non-exposed Danes. Crude promastigote and amastigote antigens both induced proliferation and interferon-gamma (IFN-gamma)...... in patients cured of visceral leishmaniasis differs from the Th1-like response to the same antigen observed in patients cured of cutaneous leishmaniasis....

  2. Leishmanicidal activities of Artemisia annua leaf essential oil against Visceral Leishmaniasis.

    Science.gov (United States)

    Islamuddin, Mohammad; Chouhan, Garima; Tyagi, Maujiram; Abdin, Malik Z; Sahal, Dinkar; Afrin, Farhat

    2014-01-01

    Visceral leishmaniasis (VL), the second-most dreaded parasitic disease after malaria, is currently endemic in 88 countries. Dramatic increases in the rates of infection, drug resistance, and non-availability of safe vaccines have highlighted the need for identification of novel and inexpensive anti-leishmanial agents from natural sources. In this study, we showed the leishmanicidal effect of essential oil from Artemisia annua leaves (AALEO) against Leishmania donovani in vitro and in vivo. AALEO was extracted by hydrodistillation and characterized by GC-MS, the most abundant compounds were found to be camphor (52.06 %) followed by β-caryophyllene (10.95 %). AALEO exhibited significant leishmanicidal activity against L. donovani, with 50 % inhibitory concentration of 14.63 ± 1.49 μg ml(-1) and 7.3 ± 1.85 μg ml(-1), respectively, against the promastigotes and intracellular amastigotes. The effect was mediated through programmed cell death as confirmed by externalization of phosphatidylserine, DNA nicking by TdT-mediated dUTP nick-end labeling assay, dyskinetoplastidy, cell cycle arrest at sub-G0-G1 phase, loss of mitochondrial membrane potential and reactive oxygen species generation in promastigotes and nitric oxide generation in ex vivo model. AALEO presented no cytotoxic effects against mammalian macrophages even at 200 μg ml(-1). Intra-peritoneal administration of AALEO (200 mg/ kg.b.w.) to infected BALB/c mice reduced the parasite burden by almost 90% in the liver and spleen with significant reduction in weight. There was no hepato- or nephro-toxicity as demonstrated by normal levels of serum enzymes. The promising antileishmanial activity shown by camphor-rich AALEO may provide a new lead in the treatment of VL.

  3. Leishmanicidal activities of Artemisia annua leaf essential oil against Visceral Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Mohammad eIslamuddin

    2014-11-01

    Full Text Available Visceral leishmaniasis (VL, the second-most dreaded parasitic disease after malaria, is currently endemic in 88 countries. Dramatic increases in the rates of infection, drug resistance and non-availability of safe vaccines have highlighted the need for identification of novel and inexpensive anti-leishmanial agents from natural sources. In this study, we showed the leishmanicidal effect of essential oil from Artemisia annua leaves (AALEO against Leishmania donovani in vitro and in vivo. AALEO was extracted by hydrodistillation and characterized by GC-MS, the most abundant compounds were found to be camphor (52.06 % followed by β-caryophyllene (10.95 %. AALEO exhibited significant leishmanicidal activity against L. donovani, with 50 % inhibitory concentration of 14.63 ± 1.49 µg ml-1 and 7.3 ± 1.85 µg ml─1, respectively, against the promastigotes and intracellular amastigotes. The effect was mediated through programmed cell death as confirmed by externalization of phosphatidylserine, DNA nicking by TdT-mediated dUTP nick-end labelling (TUNEL assay, dyskinetoplastidy, cell cycle arrest at sub-G0–G1 phase, loss of mitochondrial membrane potential and reactive oxygen species (ROS generation in promastigotes and nitric oxide (NO generation in ex vivo model. AALEO presented no cytotoxic effects against mammalian macrophages even at 200 µg ml─1. Intra-peritoneal administration of AALEO (200 mg/ kg.b.w. to infected BALB/c mice reduced the parasite burden by almost 90 % in the liver and spleen with significant reduction in weight. There was no hepato- or nephro-toxicity as demonstrated by normal levels of serum enzymes. The promising antileishmanial activity shown by camphor-rich AALEO may provide a new lead in the treatment of VL.

  4. [Epidemiological, clinical and biological features of infantile visceral leishmaniasis at Kairouan hospital (Tunisia): about 240 cases].

    Science.gov (United States)

    Aissi, W; Ben Hellel, K; Habboul, Z; Ben Sghaier, I; Harrat, Z; Bouratbine, A; Aoun, K

    2015-10-01

    Visceral leishmaniasis (VL) is an important health problem in Tunisia. It is most common in children under five years of age. The governorate of Kairouan (central Tunisia) is one of the most affected foci. The aim of this study was to update the epidemiological, clinical and biological features of the disease. The study concerned all VL cases admitted in the pediatric department of Kairouan hospital during 10 years (from 2004 to 2013). For every patient included in this study and when available, data such as sex, age, geographical origin and the condition of the patient at admission (clinical and biological findings) were collected. The myelogram results were also exploited as well as results of serology, culture, Real-Time polymerase chain reaction (PCR) and isoenzymatic typing of Leishmania isolates. Two hundred and forty cases were recorded. Rural cases (87.1%) were more prevalent than urban ones (12.9%). Age ranged from 2 months to 13 years (median, 18 months). The female/male sex ratio was 1.03. The diagnosis delays ranged from 1 day to 8 months (median, 15 days). The most common clinical symptoms at admission were splenomegaly (97.9%), fever (79.9%) and hepatomegaly (47.3%). The principal biological disturbances were anemia (91.7%), thrombocytopenia (83.9%) and leucopenia (56.1%). Among the different biological tools used for diagnosis confirmation, PCR was the most sensitive (100%). All 43 typed stocks corresponded to Leishmania (L.) infantum species. Although zymodeme MON-1 was predictably the most frequent (27 cases), L. infantum MON-24 and MON-80 were responsible of no negligible numbers of cases (11 and 5 cases respectively). The present study gave an updated epidemiological, clinical and biological profile of infantile VL in Tunisia. The diagnosis delays were considerably shortened compared to previous reports. However, an even earlier diagnosis of cases is needed to improve the disease prognosis. Real-Time PCR showed to be helpful in VL management.

  5. Sandflies (Diptera: Psychodidae) in a focus of visceral leishmaniasis in White Nile, Sudan.

    Science.gov (United States)

    Widaa, Sally Osman; Ahmed, Khalid Awadelkarim; Bari, Amel Ahmed Elsheikh; Ali, Mayada Mohmmedelhassan; Ibrahim, Mihad Abdelaal; Bashir, Mohammed Ahmed; Mastour, Ahmed Hamid Awadelkarim; Yagi, Zakkiah Algali; Hassan, Mo'awia Mukhtar

    2012-06-01

    Visceral leishmaniasis (VL) has been known to occur since the 1980s on the western bank of the White Nile River (Central Sudan), 150 km south of Khartoum, and has resulted in high mortality. The most recent outbreak of the disease in this area began in 2006. Entomological surveys were carried out during May 2008, June 2010 and May and July 2011 in the White Nile area. Sandflies were collected using Centers for Disease Control light traps and sticky oil traps in the village of Kadaba and the nearby woodland. Phlebotomus females were dissected for the presence of Leishmania promastigotes. A total of 17,387 sandflies, including six species of Phlebotomus and 10 species of Sergentomyia, were identified. The Phlebotomus species recorded were Phlebotomus orientalis, Phlebotomus papatasi, Phlebotomus bergeroti, Phlebotomus duboscqi, Phlebotomus rodhaini and Phlebotomus saevus. P. orientalis was collected in both habitats. The relative abundance of P. orientalis in the woodland habitat was higher than that recorded in the village habitat. In the woodland habitat, there was a notable increase in the relative abundance of P. orientalis during the surveys conducted in 2008 and 2010 compared to 2011. None of the 311 P. orientalis females dissected were infected with Leishmania promastigotes, although relatively high parous rates were recorded in both habitats. Based on the distribution of P. orientalis recorded in this study, this species is the most likely vector of VL in the endemic focus in the White Nile area. Further investigation is required to elucidate the seasonal abundance and distribution of the vector, as well as the transmission season of VL in both habitats so that appropriate control strategies for the vector can be designed.

  6. Ethics in the publication of studies on human visceral leishmaniasis in Brazilian periodicals.

    Science.gov (United States)

    Malafaia, Guilherme; Rodrigues, Aline Sueli de Lima; Talvani, André

    2011-02-01

    To analyze ethical aspects of Brazilian articles on human visceral leishmaniasis, published after Resolution CNS 196/1996, and to analyze the policy on Brazilian periodicals on research ethics. An explanatory study with a bibliographical and documental nature was conducted. Selection of publications on research involving human beings since 1996 was performed in the SciELO Brazil database. Gaps associated with editorial policies on medical periodicals, based on information obtained from the "Instructions to authors" section of each periodical, were analyzed. While there were no articles on the compliance with ethical aspects in the first four-year period (from 1997 to 2000), 75% fulfilled at least one of the ethical requirements evaluated in the first year (2009) of a subsequent four-year period (from 2009 to 2012). A total of six out of 11 periodicals indicated that the information about ethical aspects should be mentioned in the body of the article. There were three periodicals that required a letter or document, informing about compliance with these aspects and signed by the author(s), to be sent; two that requested a copy of the document used to obtain the free and informed consent; one that clarified the need of a copy to authorize the approval by the Committee on Ethics in Research; and four in which no requirements of ethical aspects were found. There was an improvement in the description of compliance with ethical aspects found in articles. Standardization of ethical requirements for human research in Brazilian periodicals is suggested. This could promote compliance with the presuppositions of documents regulating human research.

  7. Latent class analysis of diagnostic tests for visceral leishmaniasis in Brazil.

    Science.gov (United States)

    Machado de Assis, Tália Santana; Rabello, Ana; Werneck, Guilherme Loureiro

    2012-10-01

    To estimate the sensitivities and specificities of different diagnostic tests for visceral leishmaniasis (VL) using latent class analysis (LCA).   This study was performed using data from a prospective study conducted in four Brazilian states from May 2004 to May 2007. Five diagnostic tests for VL were evaluated in 285 VL cases and 119 non-cases: microscopy, indirect fluorescence antibody test (IFAT), enzyme-linked immunosorbent assay using recombinant K39 antigen (rK39-ELISA), direct agglutination test (DAT) and the rK39 rapid test. Microscopy showed sensitivity of 77.0% (CI: 71.5-81.5) and specificity of 99.0% (CI: 94.0-99.7). The IFAT and the DAT showed similar sensitivities, 88.3% (CI: 84.0-92.0) and 88.5% (CI: 84.1-92.0), respectively, but the DAT had a higher specificity (95.4%, CI: 89.2-98.1) than did the IFAT (83.0%, CI: 75.0-88.2). The rK39-ELISA and the rK39 rapid test showed sensitivities of 99.0% (CI: 96.3-99.6) and 94.0% (CI: 90.1-96.3), and specificities of 82.5% (CI: 75.0-88.3) and 100% (CI: 97.0-100.0%), respectively. Considering the lack of an adequate reference standard, LCA proved to be a useful tool in validating diagnostic methods for VL. The DAT and the rK39 rapid test showed better performance. Thus, clinically suspected cases of VL in a Brazilian endemic area could be treated based on the positivity of one of these tests. © 2012 Blackwell Publishing Ltd.

  8. Immunomodulatory Therapy of Visceral Leishmaniasis in Human Immunodeficiency Virus-Coinfected Patients

    Directory of Open Access Journals (Sweden)

    Wim Adriaensen

    2018-01-01

    Full Text Available Patients with visceral leishmaniasis (VL–human immunodeficiency virus (HIV coinfection experience increased drug toxicity and treatment failure rates compared to VL patients, with more frequent VL relapse and death. In the era of VL elimination strategies, HIV coinfection is progressively becoming a key challenge, because HIV-coinfected patients respond poorly to conventional VL treatment and play an important role in parasite transmission. With limited chemotherapeutic options and a paucity of novel anti-parasitic drugs, new interventions that target host immunity may offer an effective alternative. In this review, we first summarize current views on how VL immunopathology is significantly affected by HIV coinfection. We then review current clinical and promising preclinical immunomodulatory interventions in the field of VL and discuss how these may operate in the context of a concurrent HIV infection. Caveats are formulated as these interventions may unpredictably impact the delicate balance between boosting of beneficial VL-specific responses and deleterious immune activation/hyperinflammation, activation of latent provirus or increased HIV-susceptibility of target cells. Evidence is lacking to prioritize a target molecule and a more detailed account of the immunological status induced by the coinfection as well as surrogate markers of cure and protection are still required. We do, however, argue that virologically suppressed VL patients with a recovered immune system, in whom effective antiretroviral therapy alone is not able to restore protective immunity, can be considered a relevant target group for an immunomodulatory intervention. Finally, we provide perspectives on the translation of novel theories on synergistic immune cell cross-talk into an effective treatment strategy for VL–HIV-coinfected patients.

  9. The household costs of visceral leishmaniasis care in south-eastern Nepal.

    Directory of Open Access Journals (Sweden)

    Surendra Uranw

    Full Text Available BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL is an important public health problem in south-eastern Nepal affecting very poor rural communities. Since 2005, Nepal is involved in a regional initiative to eliminate VL. This study assessed the economic impact of VL on households and examined whether the intensified VL control efforts induced by the government resulted in a decrease in household costs. METHODS: Between August and September 2010, a household survey was conducted among 168 patients that had been treated for VL within 12 months prior to the survey in five districts in south-eastern Nepal. We collected data on health-seeking behaviour, direct and indirect costs and coping strategies. RESULTS: The median total cost of one episode of VL was US$ 165 or 11% of annual household income. The median delay between the onset of symptoms and presentation to a qualified provider was 25 days. Once the patient presented to a qualified provider, the delay to correct diagnosis was minimal (median 3 days. Direct and indirect costs (income losses represented 47% and 53% of total costs respectively. Households used multiple strategies to cope with the cost of illness, mainly mobilizing cash/savings (71% or taking a loan (56%. CONCLUSIONS: The provision of free VL diagnosis and drugs by the Nepalese control programme has been an important policy measure to reduce the cost of VL to households. But despite the free VL drugs, the economic burden is still important for households. More effort should be put into reducing indirect costs, in particular the length of treatment, and preventing the transmission of VL through vector control.

  10. Relative risk of visceral leishmaniasis in Brazil: a spatial analysis in urban area.

    Directory of Open Access Journals (Sweden)

    Valdelaine Etelvina Miranda de Araújo

    2013-11-01

    Full Text Available BACKGROUND: Visceral leishmaniasis (VL is a vector-borne disease whose factors involved in transmission are poorly understood, especially in more urban and densely populated counties. In Brazil, the VL urbanization is a challenge for the control program. The goals were to identify the greater risk areas for human VL and the risk factors involved in transmission. METHODOLOGY: This is an ecological study on the relative risk of human VL. Spatial units of analysis were the coverage areas of the Basic Health Units (146 small-areas of Belo Horizonte, Minas Gerais State, Brazil. Human VL cases, from 2007 to 2009 (n = 412, were obtained in the Brazilian Reportable Disease Information System. Bayesian approach was used to model the relative risk of VL including potential risk factors involved in transmission (canine infection, socioeconomic and environmental features and to identify the small-areas of greater risk to human VL. PRINCIPAL FINDINGS: The relative risk of VL was shown to be correlated with income, education, and the number of infected dogs per inhabitants. The estimates of relative risk of VL were higher than 1.0 in 54% of the areas (79/146. The spatial modeling highlighted 14 areas with the highest relative risk of VL and 12 of them are concentrated in the northern region of the city. CONCLUSIONS: The spatial analysis used in this study is useful for the identification of small-areas according to risk of human VL and presents operational applicability in control and surveillance program in an urban environment with an unequal spatial distribution of the disease. Thus the frequent monitoring of relative risk of human VL in small-areas is important to direct and prioritize the actions of the control program in urban environment, especially in big cities.

  11. Clinical aspects of paediatric visceral leishmaniasis in North-west Ethiopia.

    Science.gov (United States)

    Diro, Ermias; Lynen, Lutgarde; Gebregziabiher, Berhane; Assefa, Abraham; Lakew, Wubishet; Belew, Zewdu; Hailu, Asrat; Boelaert, Marleen; van Griensven, Johan

    2015-01-01

    Visceral leishmaniasis (VL) in north-west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients. A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011-2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted. A total of 122 children with VL were detected during the study period with median age of 8.5 years (IQR 5-12 years); 23% were under 5 years. Eighty-five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5-year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20 mg/kg/day for 30 days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6 months could not be determined because of a high loss to follow-up (80.2%). While HIV co-infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended. © 2014 John Wiley & Sons Ltd.

  12. Experimental infection of dogs with Leishmania and saliva as a model to study Canine Visceral Leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Dirceu Joaquim Costa

    Full Text Available BACKGROUND: Canine Visceral Leishmaniasis (CVL is a zoonotic disease caused by Leishmania infantum, transmitted by the bite of Lutzomyia longipalpis sand flies. Dogs are the main domestic reservoir of the parasite. The establishment of an experimental model that partially reproduces natural infection in dogs is very important to test vaccine candidates, mainly regarding those that use salivary proteins from the vector and new therapeutical approaches. METHODOLOGY/PRINCIPAL FINDINGS: In this report, we describe an experimental infection in dogs, using intradermal injection of Leishmania infantum plus salivary gland homogenate (SGH of Lutzomyia longipalpis. Thirty-five dogs were infected with 1×10(7 parasites combined with five pairs of Lutzomyia longipalpis salivary glands and followed for 450 days after infection and clinical, immunological and parasitological parameters were evaluated. Two hundred and ten days after infection we observed that 31,4% of dogs did not display detectable levels of anti-Leishmania antibodies but all presented different numbers of parasites in the lymph nodes. Animals with a positive xenodiagnosis had at least 3,35×10(5 parasites in their lymph nodes. An increase of IFN-γ and IL-10 levels was detected during infection. Twenty two percent of dogs developed symptoms of CVL during infection. CONCLUSION: The infection model described here shows some degree of similarity when compared with naturally infected dogs opening new perspectives for the study of CVL using an experimental model that employs the combination of parasites and sand fly saliva both present during natural transmission.

  13. Visceral leishmaniasis-hepatitis B/C coinfections: a rising necessity to triage patients for treatment.

    Science.gov (United States)

    A, Abubakr O; M, Mohamed M; A, Hatim A; Elamin, Mohamed Y; Younis, Brima M; E, Mona E; Musa, Ahmed M; Elhassan, Ahmed M; G, Eltahir A

    2014-01-01

    Visceral leishmaniasis (VL) is a life-threatening infection caused by Leishmania species. In Sudan, VL is caused by L donovani. Most drugs used to treat VL, especially pentavalent antimony compounds (sodium stibogluconate, SSG), are potentially hepatotoxic. A number of fatal catastrophes happened because patients with VL-hepatitis B/C coinfection were indiscriminately treated with SSG in settings where VL and viral hepatitis coexist. This study aimed to study biochemical and hematological parameters of patients with VL-hepatitis B/C coinfections with the aim to modify treatment protocols to reduce coinfection.added morbidity and mortality. This was a prospective analytical, hospital-based, and case-controlled study. The study was done at Kassab Hospital and Professor Elhassan Centre for tropical medicine during the period of February 2008 to April 2013. Following informed consent by the participants, 78 parasitologically confirmed VL patients with either hepatitis B or C or both and 528 sex- and age-unmatched VL patients without hepatitis B/C coinfection (control group) were enrolled sequentially. Diagnosis of hepatitis B or C was made using immunochromatographic test kits and confirmed by an enzyme-linked immunosorbent assay. VL patients with hepatitis B/C coinfections had significantly increased levels of AST, ALT, and total bilirubin compared to the control group (P=.0001 for all), with significantly decreased levels of albumin and platelets counts (P=.0029 for both). VL-hepatitis B/C coinfections are an emerging entity that needs anti-leishmanial treatment modification. Alternative treatments like paromomycin and amphotericin B (AmBisome) could be reserved for these patients.

  14. Immunomodulatory Therapy of Visceral Leishmaniasis in Human Immunodeficiency Virus-Coinfected Patients

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    Adriaensen, Wim; Dorlo, Thomas P. C.; Vanham, Guido; Kestens, Luc; Kaye, Paul M.; van Griensven, Johan

    2018-01-01

    Patients with visceral leishmaniasis (VL)–human immunodeficiency virus (HIV) coinfection experience increased drug toxicity and treatment failure rates compared to VL patients, with more frequent VL relapse and death. In the era of VL elimination strategies, HIV coinfection is progressively becoming a key challenge, because HIV-coinfected patients respond poorly to conventional VL treatment and play an important role in parasite transmission. With limited chemotherapeutic options and a paucity of novel anti-parasitic drugs, new interventions that target host immunity may offer an effective alternative. In this review, we first summarize current views on how VL immunopathology is significantly affected by HIV coinfection. We then review current clinical and promising preclinical immunomodulatory interventions in the field of VL and discuss how these may operate in the context of a concurrent HIV infection. Caveats are formulated as these interventions may unpredictably impact the delicate balance between boosting of beneficial VL-specific responses and deleterious immune activation/hyperinflammation, activation of latent provirus or increased HIV-susceptibility of target cells. Evidence is lacking to prioritize a target molecule and a more detailed account of the immunological status induced by the coinfection as well as surrogate markers of cure and protection are still required. We do, however, argue that virologically suppressed VL patients with a recovered immune system, in whom effective antiretroviral therapy alone is not able to restore protective immunity, can be considered a relevant target group for an immunomodulatory intervention. Finally, we provide perspectives on the translation of novel theories on synergistic immune cell cross-talk into an effective treatment strategy for VL–HIV-coinfected patients. PMID:29375567

  15. Epidemiologic aspects of an emerging focus of visceral leishmaniasis in Tbilisi, Georgia.

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    Ekaterina Giorgobiani

    2011-12-01

    Full Text Available BACKGROUND: Over the last 15 years, visceral leishmaniasis (VL has emerged as a public health concern in Tbilisi, the capital of Georgia. METHODOLOGY/PRINCIPAL FINDINGS: Seroepidemiological surveys were conducted to determine the prevalence and incidence of infection in children and dogs within the main focus of VL, and to identify risk factors associated with human infection. Of 4,250 children investigated, 7.3% were positive by direct agglutination test in a baseline survey; an apparent incidence rate of 6.0% was estimated by one year follow-up. None of the seropositive children progressed to VL during the survey. Increased seropositivity at one year was predicted by presence at baseline of clustered flying insects (OR = 1.49; P = 0.001, perceived satisfactory sanitation (OR = 1.65; P<0.001, stray dogs (OR = 1.33; P = 0.023, and by persistent fever during the 6 months prior to baseline survey (OR = 14.2; P<0.001. Overall, 18.2% (107/588 of domestic and 15.3% (110/718 of stray dogs were seropositive by the rk39 dipstick test. Clinical VL signs were found in 1.3% of domestic and 2.9% of stray, seropositive dogs. Parasites isolated from human and dog samples were identified by PCR and phylogenetic analysis of the Leishmania 70 kDa heat-shock protein (HSP70 gene as Leishmania infantum. CONCLUSIONS/SIGNIFICANCE: There is an active focus of L. infantum transmission in Tbilisi with a high prevalence of human and canine infections.

  16. Studies on the arginase, 5'-nucleotidase and lysozyme activity by monocytes from visceral leishmaniasis patients.

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    Kumar, Pramod; Kumar, Ramesh; Pandey, Haushila; Sundar, Shyam; Pai, Kalpana

    2012-04-01

    Intracellular pathogenic protozoan infection like visceral leishmaniasis is considered in terms of the overall inflammatory response and the complex cellular interactions leading to formation of the activated macrophage. Analysis of the development of activation is facilitated when operationally defined stage of activation are characterized using a library of objective markers. There is a role of arginase in the immune response supporting its involvement in macrophage effector mechanism in vitro and in vivo. 5'-Nucleotidase a plasma membrane component has been cited as a biochemical correlate of macrophage function in an altered morphological and biochemical state of activation and stimulation. Depression in 5'-nucleotidase activity has been generally referred to as a characteristic marker of activated macrophages. Lysozyme or lysosomal enzymes are released into the endocytic or autophagic vacuole macrophage where they serve the purpose of intracellular digestion of engulfed or segregated materials. In the present study, we have studied levels of arginase and 5'-nucleotidase (marker for macrophage activation) in monocytes of active VL patients and healthy controls. Lysozyme a secretary product of macrophages was also measured in supernatants collected from monocytes of active VL patients and healthy controls. Elevated levels of 5'-nucleotidase were observed in supernatants of monocytes from active VL patients as compared to healthy controls. Low levels of arginase and lysozyme production by monocytes isolated from VL patients were observed as compared to healthy controls. Our studies suggest that low levels of arginase and elevated 5'-nucleotidase activity could be one of the mechanisms in the pathology of VL infection. Low lysozyme activity in patients may account for persistence of Leishmania parasites in VL infections.

  17. Evaluation of a prototype flow cytometry test for serodiagnosis of canine visceral leishmaniasis.

    Science.gov (United States)

    Ker, Henrique Gama; Coura-Vital, Wendel; Aguiar-Soares, Rodrigo Dian de Oliveira; Roatt, Bruno Mendes; das Dores Moreira, Nádia; Carneiro, Cláudia Martins; Machado, Evandro Marques de Menezes; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis; Giunchetti, Rodolfo Cordeiro; Araújo, Márcio Sobreira Silva; Coelho, Eduardo Antonio Ferraz; da Silveira-Lemos, Denise; Reis, Alexandre Barbosa

    2013-12-01

    Diagnosing canine visceral leishmaniasis (CVL) is a critical challenge since conventional immunoserological tests still present some deficiencies. The current study evaluated a prototype flow cytometry serology test, using antigens and fluorescent antibodies that had been stored for 1 year at 4°C, on a broad range of serum samples. Noninfected control dogs and Leishmania infantum-infected dogs were tested, and the prototype test showed excellent performance in differentiating these groups with high sensitivity, specificity, positive and negative predictive values, and accuracy (100% in all analyses). When the CVL group was evaluated according to the dogs' clinical status, the prototype test showed outstanding accuracy in all groups with positive serology (asymptomatic II, oligosymptomatic, and symptomatic). However, in dogs which had positive results by PCR-restriction fragment length polymorphism (RFLP) but negative results by conventional serology (asymptomatic I), serological reactivity was not observed. Additionally, sera from 40 dogs immunized with different vaccines (Leishmune, Leish-Tec, or LBSap) did not present serological reactivity in the prototype test. Eighty-eight dogs infected with other pathogens (Trypanosoma cruzi, Leishmania braziliensis, Ehrlichia canis, and Babesia canis) were used to determine cross-reactivity and specificity, and the prototype test performed well, particularly in dogs infected with B. canis and E. canis (100% and 93.3% specificities, respectively). In conclusion, our data reinforce the potential of the prototype test for use as a commercial kit and highlight its outstanding performance even after storage for 1 year at 4°C. Moreover, the prototype test efficiently provided accurate CVL serodiagnosis with an absence of false-positive results in vaccinated dogs and minor cross-reactivity against other canine pathogens.

  18. A proposition on the genetic history of visceral Leishmaniasis:glimpses from the side of parasite

    International Nuclear Information System (INIS)

    Ibrahim, Muntasir E.

    1999-01-01

    The recorded history of diseases affecting man, contains hardly any reliable information on their state beyond few centuries ago. This is particularly true for diseases having symptoms common to others as is typically the case of visceral Leishmaniasis. Our increased understanding of the biology and epidemiology of VL during the last hundred years or so, nevertheless, raise more questions than answers. For example: what is the possible role played by such disease in shaping the population structure and range of expaion of their human host. Could resistance of certain populations to disease be explained by the distribution of less virulent parasite strains e.g. (Leishmania infantum) or by ancient episodes of strong selection? data obtained from molecular analysis of parasites isolated from patients in Sudan, indicates that the current outbreak is probably a recent event caused by stocks of closely related parasites. More recently, mitochondrial hapoltypes analysis gave further support to the homogeneity of these parasite populations. Cladistic analysis of Leishmania donovani strains from different continents make a clear distinction between two clades; one containing parasites of the infantum group in different continents and the other includes members of the donovani group in Africa and Asia. Furthermore, we did not encounter-a-presence-of Leishmania infantum specific sequence within paraite population sampled in the areas, covered by the outbreaks. The parasites from Sudan presented with the most ancestral haplotypes. The disease in Sudan may have passed through short periods of protraction and expansion, which may have resulted in stability of the parasite genetic population structure, but rather a fragile host-parasite relationship. Studying host sequence may reveal equally interesting situations and shed more light on these-aspects.(Author)

  19. Human Visceral Leishmaniasis in Kermanshah Province, Western Iran, During 2011-2012

    Science.gov (United States)

    Hamzavi, Y; Hamzeh, B; Mohebali, M; Akhoundi, B; Ajhang, Kh; Khademi, N; Ghadiri, K; Bashiri, H; Pajhouhan, M

    2012-01-01

    Background Visceral leishmaniasis (VL) or kala-azar is a parasitic disease caused by the species of Leishmania donovani complex. It is endemic in some parts of provinces of Iran. According to the reported cases of VL in Kermanshah Province in recent years, this study was conducted to determine the seroprevalence of VL in high risk villages of the province. Methods Totally, 1622 serum samples obtained from children under 15 years old and 178 from adults in 22 villages of studied areas. Serum samples were examined by direct agglutination test (DAT) for the detection of anti-Leishmania antibodies. Data were analyzed using SPSS software ver.11.5. Results Only 6 serum samples (0.33%) showed anti-Leishmania antibodies against L.infantum at titers ≥ 1/3200. Four of the seropositive cases had a history of kala-azar and Leishman bodies were seen in their bone marrows. The highest (0.5%) and lowest (0.29%) seroprevalence was seen in the age groups of 5-9 and 10-14 years old, respectively. None of the adults were seropositive. There were not any significant differences between the rate of seropositivity in males (0.36%) and females (0.31%). 66.7% of seropositive individuals showed clinical manifestations. The most important symptoms in Kala-azar patients were fever, hepato-spleenomegally and anemia. Conclusion Kala-azar is occurred sporadically in Kermanshah Province. But presence of significant number of positive sera confirms the necessity for attention of people and clinicians to kala-azar. PMID:23323091

  20. Killed but metabolically active Leishmania infantum as a novel whole-cell vaccine for visceral leishmaniasis.

    Science.gov (United States)

    Bruhn, Kevin W; Birnbaum, Ron; Haskell, Jacquelyn; Vanchinathan, Veena; Greger, Stephanie; Narayan, Rupa; Chang, Pei-Lin; Tran, Thu Anh; Hickerson, Suzanne M; Beverley, Stephen M; Wilson, Mary E; Craft, Noah

    2012-04-01

    There are currently no effective vaccines for visceral leishmaniasis, the second most deadly parasitic infection in the world. Here, we describe a novel whole-cell vaccine approach using Leishmania infantum chagasi promastigotes treated with the psoralen compound amotosalen (S-59) and low doses of UV A radiation. This treatment generates permanent, covalent DNA cross-links within parasites and results in Leishmania organisms termed killed but metabolically active (KBMA). In this report, we characterize the in vitro growth characteristics of both KBMA L. major and KBMA L. infantum chagasi. Concentrations of S-59 that generate optimally attenuated parasites were identified. Like live L. infantum chagasi, KBMA L. infantum chagasi parasites were able to initially enter liver cells in vivo after intravenous infection. However, whereas live L. infantum chagasi infection leads to hepatosplenomegaly in mice after 6 months, KBMA L. infantum chagasi parasites were undetectable in the organs of mice at this time point. In vitro, KBMA L. infantum chagasi retained the ability to enter macrophages and induce nitric oxide production. These characteristics of KBMA L. infantum chagasi correlated with the ability to prophylactically protect mice via subcutaneous vaccination at levels similar to vaccination with live, virulent organisms. Splenocytes from mice vaccinated with either live L. infantum chagasi or KBMA L. infantum chagasi displayed similar cytokine patterns in vitro. These results suggest that KBMA technology is a potentially safe and effective novel vaccine strategy against the intracellular protozoan L. infantum chagasi. This approach may represent a new method for whole-cell vaccination against other complex intracellular pathogens.

  1. Low castes have poor access to visceral leishmaniasis treatment in Bihar, India.

    Science.gov (United States)

    Pascual Martínez, F; Picado, A; Roddy, P; Palma, P

    2012-05-01

    Bihar, the poorest state in India, concentrates most of the visceral leishmaniasis (VL) cases in the country. A large proportion of the poor rural communities where VL is endemic are marginalized by their socio-economic status, intrinsically related to the caste system. In this study, we evaluated whether people from low socio-economic strata had difficulties accessing VL treatment in Bihar. As a secondary outcome, we evaluated whether people delaying their VL treatment had poorer clinical indicators at admission. Data on 2187 patients with VL treated by Médecins Sans Frontières (MSF) in Vaishali district from July 2007 to December 2008 were analysed. Patients who reported having onset of symptoms ≥8 weeks before admission were defined as 'late presenters'. Logistic regression models were used to evaluate whether low castes had higher risk to be 'late presenters' compared to the rest of castes and whether 'late presenters' had poorer indicators at admission (i.e. haemoglobin level, spleen size). After adjusting for age, gender and distance to VL treatment facility, Mushars (the lowest caste in Bihar) had twice the odds to be 'late presenters' compared to the rest of castes (OR 2.05, 95% CI: 1.24-2.38). Subjects that had VL symptoms for ≥8 weeks had a larger spleen and lower haemoglobin level than those that were treated earlier. Low castes have poor access to VL treatment in Bihar, and late presenters have poorer clinical indicators at admission. These findings have implications at individual and community levels and should stimulate targeted VL control programmes to ensure that marginalized communities in Bihar are properly treated. © 2012 Blackwell Publishing Ltd.

  2. Determinants of Visceral Leishmaniasis: A Case-Control Study in Gedaref State, Sudan.

    Directory of Open Access Journals (Sweden)

    Fabienne Nackers

    2015-11-01

    Full Text Available Improving knowledge on local determinants of visceral leishmaniasis (VL is crucial to guide the development of relevant control strategies. This study aimed to identify individual and household level determinants of primary VL in 24 highly endemic villages of Tabarak Allah hospital's catchment area, Gedaref State, Sudan.From September 2012 to July 2013, in an unmatched case-control design, 198 patients with primary VL were compared to 801 controls free of VL symptoms and with a negative VL rapid test. Using random spatial sampling, controls were selected with a distribution of age, sex and village of residence proportionate to the distribution of the target population. Data were collected using a structured questionnaire.Children and men were at higher risk of VL. Reporting VL patient(s in the household in the previous year was the strongest VL risk factor. In a multivariate analysis, VL risk increased with household size, sleep location (outside the yard, not in the farm, evening outdoor activities in the rainy season (playing, watching TV, radio listening, use of ground nut oil as animal repellent and of smoke of Acacia seyal as indoor repellent, presence of dogs in the yard at night, Acacia nilotica in the yard's immediate surroundings and of a forest at eye range. VL risk appeared to decrease with the use of drinking water sources other than the village water tank, a buffer distance from the adjacent house yard, and with the presence of animals other than dogs in the yard at night. In contrast with previous studies, housing factors, mosquito-net use, black cotton soil, ethnicity, socioeconomic index, presence of Balanites aegyptica and Azadirachta indica in the yard were not independent VL determinants.Although these results do not provide evidence of causality, they provide useful suggestions for guiding further intervention studies on VL preventive measures.

  3. Investigation of asymptomatic visceral leishmaniasis cases using western blot in an endemic area in Turkey.

    Science.gov (United States)

    Sakru, Nermin; Korkmaz, Metin; Ozbel, Yusuf; Ertabaklar, Hatice; Sengul, Mustafa; Toz, Seray Ozensoy

    2007-01-01

    In Turkey, Leishmania infantum is responsible for human visceral leishmaniasis (VL), which is seen mainly in the Aegean, Mediterranean, and Central Anatolia Regions. This study aimed to determine asymptomatic infections in an endemic area of VL in Turkey using the western blot technique. A total of 82 persons including children and adults were chosen randomly in Denizli province which is one of the endemic sites for VL. Serum samples were collected and screened using indirect immunofluorescent test (IFAT), enzyme-linked immunosorbent assay (ELISA) and western blot (WB). One year later, 35 of the 82 persons were sampled and screened serologically for the second time. Seven out of 82 samples were found to be positive by western blot analysis with the presence of 14 and/or 18 kDa bands. Two of these seven sera were also positive by IFAT, but only one of these two was positive by ELISA. Only one person showing seropositivity with all three tests had clinical symptoms and was diagnosed as VL with the presence of amastigotes in bone marrow aspirate. Because six people, including the one found to be seropositive in all two tests, had no clinical symptoms, they were accepted as asymptomatic carriers. The ratio of asymptomatic infection was calculated as 7.41% (6/81) in the region. In the second sampling, the western blot revealed antibodies against the same antigens in all seven subjects. Our findings showed that the presence of antibodies against 14 and 18 kDa antigens are important for the diagnosis of symptomatic and asymptomatic infections. Western blot was found to be effective in the detection of asymptomatic persons in the epidemiological studies in endemic areas.

  4. Determinants of Visceral Leishmaniasis: A Case-Control Study in Gedaref State, Sudan

    Science.gov (United States)

    Salih, Niven; Elhag, Mousab Siddig; Elbadawi, Mobarak Elnour; Hammam, Omer; Mumina, Ann; Atia, Atia Abdalla; Etard, Jean-François; Ritmeijer, Koert; Chappuis, François

    2015-01-01

    Background Improving knowledge on local determinants of visceral leishmaniasis (VL) is crucial to guide the development of relevant control strategies. This study aimed to identify individual and household level determinants of primary VL in 24 highly endemic villages of Tabarak Allah hospital’s catchment area, Gedaref State, Sudan. Methods From September 2012 to July 2013, in an unmatched case-control design, 198 patients with primary VL were compared to 801 controls free of VL symptoms and with a negative VL rapid test. Using random spatial sampling, controls were selected with a distribution of age, sex and village of residence proportionate to the distribution of the target population. Data were collected using a structured questionnaire. Results Children and men were at higher risk of VL. Reporting VL patient(s) in the household in the previous year was the strongest VL risk factor. In a multivariate analysis, VL risk increased with household size, sleep location (outside the yard, not in the farm), evening outdoor activities in the rainy season (playing, watching TV, radio listening), use of ground nut oil as animal repellent and of smoke of Acacia seyal as indoor repellent, presence of dogs in the yard at night, Acacia nilotica in the yard’s immediate surroundings and of a forest at eye range. VL risk appeared to decrease with the use of drinking water sources other than the village water tank, a buffer distance from the adjacent house yard, and with the presence of animals other than dogs in the yard at night. In contrast with previous studies, housing factors, mosquito-net use, black cotton soil, ethnicity, socioeconomic index, presence of Balanites aegyptica and Azadirachta indica in the yard were not independent VL determinants. Discussion and conclusion Although these results do not provide evidence of causality, they provide useful suggestions for guiding further intervention studies on VL preventive measures. PMID:26544177

  5. Isolation of Leishmania infantum, zymodeme MON-1 from canine and human visceral leishmaniasis on Margarita Island, Venezuela.

    Science.gov (United States)

    Zerpa, O; Pratlong, F; Ulrich, M; Convit, J

    2001-10-01

    An increase in the incidence of human visceral leishmaniasis (HVL) has been detected in recent years on Margarita Island, located off the NE coast of Venezuela. Recent studies have revealed reactivity to rK39 antigen (Leishmania chagasi) in 20% of 541 sera from domestic dogs in endemic communities; PCR reactions were positive using primers for the L. donovani complex. Here we report that isolates from human and canine infection, identified by isoenzyme analysis, correspond to L. infantum, zymodeme MON-1. This appears to be the first isolation and identification of an isolate from HVL on Margarita Island and demonstrates the presence of this zymodeme in the canine population.

  6. Severe clinical presentation of visceral leishmaniasis in naturally infected dogs with disruption of the splenic white pulp.

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    Isadora S Lima

    Full Text Available In this work, we investigated the association between the disruption of splenic lymphoid tissue and the severity of visceral leishmaniasis in dogs. Clinical and laboratory data from 206 dogs were reviewed. Spleen sections collected during the euthanasia of these animals were analyzed, and the splenic lymphoid tissue samples were classified as well organized (spleen type 1, slightly disorganized (spleen type 2, or moderately to extensively disorganized (spleen type 3. Of 199 dogs with evidence of Leishmania infection, 54 (27% had spleen type 1, 99 (50% had spleen type 2, and 46 (23% had spleen type 3. The number of clinical signs associated with visceral leishmaniasis was significantly higher in the animals with evidence of Leishmania infection and spleen type 2 or 3 than in the animals with spleen type 1. Alopecia, anemia, dehydration, dermatitis, lymphadenopathy, and onychogryphosis were all more frequent among animals with evidence of Leishmania infection and spleen type 3 than among the dogs with evidence of Leishmania infection and spleen type 1. The association between the severity of canine visceral leishmaniasis and the disorganization of the splenic lymphoid tissue was even more evident in the group of animals with positive spleen culture. Conjunctivitis and ulceration were also more common in the animals with spleen type 3 than in the animals with spleen type 1. The serum levels (median, interquartile range of albumin (1.8, 1.4-2.3 g/dL and creatinine (0.7, 0.4-0.8 mg/dL were significantly lower and the serum levels of aspartate aminotransferase were significantly higher (57, 39-95 U in animals with spleen type 3 than in animals with spleen type 1 (2.8, 2.4-3.4 g/dL; 0.9, 0.7-1.2 mg/dL and 23, 20-32 U, respectively. Our data confirm the hypothesis that disruption of the splenic lymphoid tissue is associated with a more severe clinical presentation of canine visceral leishmaniasis.

  7. [Investigation of the prevalence of visceral leishmaniasis by the microculture method and IFAT in dogs in Kirikkale.].

    Science.gov (United States)

    Aydenizöz, Meral; Yağci, Buğrahan Bekir; Ozkan, Ayşegül Taylan; Aydenizöz, Meral; Yağci, Buğrahan Bekir; Ozkan, Ayşegül Taylan; Duru, Sibel Yasa; Gazyağci, Aycan Nuriye

    2010-01-01

    This study was carried out in order to compare the seroprevalence of visceral leishmaniasis in dogs from different areas of Kirikkale between 2006-2008 using the microculture method (MCM) which is a new method, and the indirect fluorescent antigen test (IFAT). All of the blood collected from total of 50 dogs was found to be negative by MCM. Only one male Beagle strain dog (3 years old) was found to be seropositive at 1/128 titers (2%) for anti-Leishmania infantum IgG antibodies by IFAT.

  8. A comprehensive analysis of LACK (Leishmania homologue of receptors for activated C kinase) in the context of Visceral Leishmaniasis.

    Science.gov (United States)

    Sinha, Sukrat; Kumar, Abhay; Sundaram, Shanthy

    2013-01-01

    The Leishmania homologue of activated C kinase (LACK) a known T cell epitope from soluble Leishmania antigens (SLA) that confers protection against Leishmania challenge. This antigen has been found to be highly conserved among Leishmania strains. LACK has been shown to be protective against L. donovani challenge. A comprehensive analysis of several LACK sequences was completed. The analysis shows a high level of conservation, lower variability and higher antigenicity in specific portions of the LACK protein. This information provides insights for the potential consideration of LACK as a putative candidate in the context of visceral Leishmaniasis vaccine target.

  9. Dilema ético y epidemiológico sobre el tratamiento de perros para la leishmaniasis visceral en América Latina

    OpenAIRE

    Bruno L. Travi

    2014-01-01

    En las Américas hay entre 4.500 y 6.800 casos anuales de leishmaniasis visceral grave y se estima que la mortalidad varía entre 7 y 10 %. Sin embargo, el subregistro y las infecciones subclínicas enmascaran la importancia epidemiológica real de la leishmaniasis visceral. Los esfuerzos de control que típicamente se han enfocado en la aspersión de insecticidas contra los flebotomíneos vectores y el sacrificio de perros, han arrojado resultados dispares. No obstante, miles de perros se sacrifica...

  10. 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).

  11. Leishmania infection in humans, dogs and sandflies in a visceral leishmaniasis endemic area in Maranhão, Brazil.

    Science.gov (United States)

    Felipe, Ilana Mirian Almeida; Aquino, Dorlene Maria Cardoso de; Kuppinger, Oliver; Santos, Max Diego Cruz; Rangel, Maurício Eduardo Salgado; Barbosa, David Soeiro; Barral, Aldina; Werneck, Guilherme Loureiro; Caldas, Arlene de Jesus Mendes

    2011-03-01

    Leishmania infection in humans, dogs and sandflies was examined in the endemic visceral leishmaniasis (VL) municipality of Raposa, state of Maranhão, Brazil. In this study, we examined Leishmania chagasi infection in the blood serum of both humans and Canis familiaris and the natural Leishmania sp. infection rate in the sandfly vector, Lutzomyia longipalpis. Enzyme-linked immunosorbent assay, indirect immunofluorescence reaction and polymerase chain reaction were performed to detect Leishmania infections in humans, dogs and sandflies, respectively. Overall, 186 out of 986 studied human beings were infected with L. chagasi parasites, representing an infection prevalence of 18.9%. An even higher infection rate was detected in dogs, where 66 (47.8%) out of 138 were infected. Among all Lu. longipalpis captured (n = 1,881), only 26.7% were females. The Leishmania infection frequency for the vector Lu. longipalpis was 1.56%. Remarkably, all infected sandflies were found in the peridomiciliary area. Furthermore, a high incidence of asymptomatic forms of VL in the human and canine populations was observed. The results of this study suggest autochthonous transmission of L. chagasi in this endemic area for visceral leishmaniasis because infection by Leishmania sp. was identified in all important elements of the transmission chain.

  12. The poorest of the poor: a poverty appraisal of households affected by visceral leishmaniasis in Bihar, India.

    Science.gov (United States)

    Boelaert, M; Meheus, F; Sanchez, A; Singh, S P; Vanlerberghe, V; Picado, A; Meessen, B; Sundar, S

    2009-06-01

    To provide data about wealth distribution in visceral leishmaniasis (VL)-affected communities compared to that of the general population of Bihar State, India. After extensive disease risk mapping, 16 clusters with high VL transmission were selected in Bihar. An exhaustive census of all households in the clusters was conducted and socio-economic household characteristics were documented by questionnaire. Data on the general Bihar population taken from the National Family Health Survey of India were used for comparison. An asset index was developed based on Principal Components Analysis and the distribution of this asset index for the VL communities was compared with that of the general population of Bihar. 83% of households in communities with high VL attack rates belonged to the two lowest quintiles of the Bihar wealth distribution. All socio-economic indicators showed significantly lower wealth for those households. Visceral leishmaniasis clearly affects the poorest of the poor in India. They are most vulnerable, as this vector-born disease is linked to poor housing and unhealthy habitats. The disease leads the affected households to more destitution because of its impact on household income and wealth. Support for the present VL elimination initiative is important in the fight against poverty.

  13. Cationic solid-lipid nanoparticles are as efficient as electroporation in DNA vaccination against visceral leishmaniasis in mice.

    Science.gov (United States)

    Saljoughian, N; Zahedifard, F; Doroud, D; Doustdari, F; Vasei, M; Papadopoulou, B; Rafati, S

    2013-12-01

    The use of an appropriate delivery system has recently emerged as a promising approach for the development of effective vaccination against visceral leishmaniasis (VL). Here, we compare two vaccine delivery systems, namely electroporation and cationic solid-lipid nanoparticle (cSLN) formulation, to administer a DNA vaccine harbouring the L. donovani A2 antigen along with L. infantum cysteine proteinases [CPA and CPB without its unusual C-terminal extension (CPB(-CTE) )] and evaluate their potential against L. infantum challenge. Prime-boost administration of the pcDNA-A2-CPA-CPB(-CTE) delivered by either electroporation or cSLN formulation protects BALB/c mice against L. infantum challenge and that protective immunity is associated with high levels of IFN-γ and lower levels of IL-10 production, leading to a strong Th1 immune response. At all time points, the ratio of IFN-γ: IL-10 induced upon restimulation with rA2-rCPA-rCPB and F/T antigens was significantly higher in vaccinated animals. Moreover, Th2-efficient protection was elicited through a high humoral immune response. Nitric oxide production, parasite burden and histopathological analysis were also in concordance with other findings. Overall, these data indicate that similar to the electroporation delivery system, cSLNs as a nanoscale vehicle of Leishmania antigens could improve immune response, hence indicating the promise of these strategies against visceral leishmaniasis. © 2013 John Wiley & Sons Ltd.

  14. Genetically Engineered Ascorbic acid-deficient Live Mutants of Leishmania donovani induce long lasting Protective Immunity against Visceral Leishmaniasis.

    Science.gov (United States)

    Anand, Sneha; Madhubala, Rentala

    2015-06-02

    Visceral leishmaniasis caused by Leishmania donovani is the most severe systemic form of the disease. There are still no vaccines available for humans and there are limitations associated with the current therapeutic regimens for leishmaniasis. Recently, we reported functional importance of Arabino-1, 4-lactone oxidase (ALO) enzyme from L. donovani involved in ascorbate biosynthesis pathway. In this study, we have shown that ΔALO parasites do not affect the ability of null mutants to invade visceral organs but severely impair parasite persistence beyond 16 week in BALB/c mice and hence are safe as an immunogen. Both short term (5 week) and long term (20 week) immunization with ΔALO parasites conferred sustained protection against virulent challenge in BALB/c mice, activated splenocytes and resulted in induction of pro-inflammatory cytokine response. Protection in immunized mice after challenge correlated with the stimulation of IFN-γ producing CD4(+) and CD8(+) T cells. Antigen-mediated cell immunity correlated with robust nitrite and superoxide generation, macrophage-derived oxidants critical in controlling Leishmania infection. Our data shows that live attenuated ΔALO parasites are safe, induce protective immunity and can provide sustained protection against Leishmania donovani. We further conclude that the parasites attenuated in their anti-oxidative defence mechanism can be exploited as vaccine candidates.

  15. [Study of 71 cases of visceral leishmaniasis diagnosed at the Mustapha University Hospital (Algiers) from 1998 to 2009].

    Science.gov (United States)

    Zait, H; Ferhani, Y; Achir, I; Hamrioui, B

    2012-03-01

    The authors retrospectively studied the epidemiological, clinical, diagnostic and therapeutic aspects of 71 cases of visceral leishmaniasis from 1998 to 2009. The diagnosis was made by finding Leishmania amastigotes in bone marrows smears and/or by serology. Most cases occur in winter (35.2%) and in spring (36.6%). The source areas are endemic ones located in the north of Algeria (74.6%) and more rarely arid or semi-arid climate areas (8.4%). 88.7% of patients are children. The sex ratio is 1.53. The clinical characteristics are: fever (77.4%), paleness (43.6%); splenomegaly (83%), hepatomegaly (57.7%). The biological anomalies are: anemia (56.3%), thrombocytopenia (33.8%), and leucopenia (28.1%). N-methylglucamine (Glucantime(®)) was most often prescribed (70.4%). Four deaths (5.6%) were recorded. Visceral leishmaniasis remains a pediatric affection but does not spare adults. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  16. A third generation vaccine for human visceral leishmaniasis and post kala azar dermal leishmaniasis: First-in-human trial of ChAd63-KH.

    Science.gov (United States)

    Osman, Mohamed; Mistry, Anoop; Keding, Ada; Gabe, Rhian; Cook, Elizabeth; Forrester, Sarah; Wiggins, Rebecca; Di Marco, Stefania; Colloca, Stefano; Siani, Loredana; Cortese, Riccardo; Smith, Deborah F; Aebischer, Toni; Kaye, Paul M; Lacey, Charles J

    2017-05-01

    Visceral leishmaniasis (VL or kala azar) is the most serious form of human leishmaniasis, responsible for over 20,000 deaths annually, and post kala azar dermal leishmaniasis (PKDL) is a stigmatizing skin condition that often occurs in patients after successful treatment for VL. Lack of effective or appropriately targeted cell mediated immunity, including CD8+ T cell responses, underlies the progression of VL and progression to PKDL, and can limit the therapeutic efficacy of anti-leishmanial drugs. Hence, in addition to the need for prophylactic vaccines against leishmaniasis, the development of therapeutic vaccines for use alone or in combined immuno-chemotherapy has been identified as an unmet clinical need. Here, we report the first clinical trial of a third-generation leishmaniasis vaccine, developed intentionally to induce Leishmania-specific CD8+ T cells. We conducted a first-in-human dose escalation Phase I trial in 20 healthy volunteers to assess the safety, tolerability and immunogenicity of a prime-only adenoviral vaccine for human VL and PKDL. ChAd63-KH is a replication defective simian adenovirus expressing a novel synthetic gene (KH) encoding two Leishmania proteins KMP-11 and HASPB. Uniquely, the latter was engineered to reflect repeat domain polymorphisms and arrangements identified from clinical isolates. We monitored innate immune responses by whole blood RNA-Seq and antigen specific CD8+ T cell responses by IFNγ ELISPOT and intracellular flow cytometry. ChAd63-KH was safe at intramuscular doses of 1x1010 and 7.5x1010 vp. Whole blood transcriptomic profiling indicated that ChAd63-KH induced innate immune responses characterized by an interferon signature and the presence of activated dendritic cells. Broad and quantitatively robust CD8+ T cell responses were induced by vaccination in 100% (20/20) of vaccinated subjects. The results of this study support the further development of ChAd63-KH as a novel third generation vaccine for VL and PKDL. This

  17. Thick Smear Is a Good Substitute for the Thin Smear in Parasitological Confirmation of Canine Visceral Leishmaniasis

    Science.gov (United States)

    de Mello, Cintia Xavier; Figueiredo, Fabiano Borges; Mendes Júnior, Artur Augusto Velho; Miranda, Luciana de Freitas Campos; de Oliveira, Raquel de Vasconcellos Carvalhaes; Madeira, Maria de Fátima

    2016-01-01

    Although direct examination methods are important for diagnosing leishmaniasis, such methods are often neglected because of their low sensitivity relative to other techniques. Our study aimed to evaluate the performance of bone marrow (BM) thick smears and cytocentrifugation tests as alternatives to direct examination for diagnosing canine visceral leishmaniasis (CVL). Ninety-two dogs exhibiting leishmaniasis seroreactivity were evaluated. The animals were euthanized; and healthy skin, spleen, popliteal lymph node, and BM puncture samples were cultured. BM cultures were used as the reference standard. Of the 92 dogs studied, 85.9% exhibited positive cultures, and Leishmania infantum (synonym Leishmania chagasi) was confirmed in all positive culture cases. The sensitivity rates for cytocentrifugation as well as thin and thick smears were 47.1%, 52.8%, and 77%, respectively. However, no association between the dogs' clinical status and culture or direct examination results was found. To our knowledge, this was the first study to use thick smears and cytocentrifugation for diagnosing CVL. Our results indicate that BM thick smears have a good sensitivity and their use reduces the time required to read slides. Therefore, thick smears can provide a rapid and safe alternative to parasitological confirmation of seroreactive dogs. PMID:27162266

  18. Canine-Based Strategies for Prevention and Control of Visceral Leishmaniasis in Brazil.

    Directory of Open Access Journals (Sweden)

    Anaiá P Sevá

    Full Text Available Visceral leishmaniasis (VL is a zoonosis found worldwide. Its incidence has increased in Brazil in recent years, representing a serious public and animal health problem. The strategies applied in Brazil are questionable and are not sufficient to control the disease. Thus, we have compared the efficacy of some of the currently available strategies focused on dogs to prevent and control zoonotic VL in endemic areas by optimizing a mathematical model. The simulations showed that the elimination of seropositive dogs, the use of insecticide-impregnated dog collars, and the vaccination of dogs significantly contribute to reducing the prevalence of infection in both canines and humans. The use of insecticide-impregnated collars presented the highest level of efficacy mainly because it directly affected the force of infection and vector-dog contact. In addition, when used at a coverage rate of 90%, insecticide-impregnated collar was able to decrease the prevalence of seropositive dogs and humans to zero; moreover, because of the easy application and acceptance by the targeted population, these collars may be considered the most feasible for inclusion in public policies among the three simulated measures. Vaccination and euthanasia were efficacious, but the latter method is strongly criticized on ethical grounds, and both methods present difficulties for inclusion in public policies. When we compared the use of euthanasia and vaccination at coverages of 70 and 90%, respectively, the proportion of infected populations were similar. However, on evaluating the implications of both of these methods, particularly the negative aspects of culling dogs and the proportion of animals protected by vaccination, the latter measure appears to be the better option if the total cost is not significantly higher. The comparison of complications and advantages of different control strategies allows us to analyze the optimal measure and offer strategies to veterinary and

  19. Utilizing Remote Sensing to Explore Hydrological and Climatic Factors of Visceral Leishmaniasis in South Sudan

    Science.gov (United States)

    Kruczkiewicz, A.; Sweeney, A.; Reid, C.; Seaman, J.; Abubakar, A.; Ritmeijer, K.; Jensen, K.; Schroeder, R.; McDonald, K. C.; Lessel, J.; Thomson, M. C.; Elnaiem, D.; Ceccato, P.

    2014-12-01

    Recent epidemics of visceral leishmaniasis (VL) in Sudan and South Sudan (locally known as Kala Azar) have caused an estimated 100,000 deaths and have renewed the impetus for defining the ecological boundaries of this vector borne disease. In the past 30 years outbreaks have occurred cyclically within this country, but recent shifts in endemicity have necessitated a more robust understanding of the drivers of the disease. Previous work (e.g. Gebre-Michael et al., 2004; Ashford & Thomson, 1991; Hoogstraal & Heyneman, 1969) has suggested that the primary biological vector in this region, the female sand fly Phlebotomus orientalis, exhibits sensitivities to environmental and climatic variables. Results of this study showed a relationship between precipitation and inundation during months of the transmission season (April-July) and the number of confirmed cases in the following September-January period. Particular months of the transmission season with below-average precipitation were better indicators of lagged reports of VL than others. During VL epidemics (2009, 2010, 2011) the month of June exhibited below average precipitation. The two largest epidemics (2010, 2011) were associated with years of below average precipitation in the month of April. Inundation during April-July (AMJJ) also exhibited a strong inverse relationship with reported VL cases in the following September- January (SONDJ). This relationship was best explored when comparing the VL case data of a specific medical center to the inundation anomalies. Results are typified by the Lankien Medical Center analysis where below average inundation during April displays an inverse relationship with VL cases in the following SONDJ. Drought may lead to below average inundation, which could allow for soils to maintain their fissures, thus maintaining the sand fly breeding habitat, resulting in a sustained breeding season for the sandflies (Quate, 1964). Above-average precipitation and inundation might have the

  20. [Investigation on the Outbreak of Visceral Leishmaniasis in 2014 in Jiashi County of Xinjiang].

    Science.gov (United States)

    OSMAN, Yisilayin; SIMAYI, Adili; KEYUMU, Kaisuer; ABLIMIT, Maimaitiaili; JI, Fang; HOU, Yan-yan; ZHANG, Song; MAIMAITIYIMIN, Yalikun; JUMAHUN, Ruziguli

    2015-10-01

    To understand the epidemiological characteristics of visceral leishmaniasis (VL) outbreak in Jiashi County of Xinjiang Uygur Autonomous Region in 2014, and provide basis for VL prevention and control strategies. Data on VL epidemic situation in Xinjiang from July 1, 2009 to June 30, 2015 were collected from Chinese CDC Infectious Disease Reporting Information Management System (reporting system). On-site epidemiological investigation was conducted in October, 2014, among children under 3 years in 23 villages in Gholtoghrak Township and Koxawat Township in Jiashi County, regions that had dramatically increased reports of VL cases from July 1. For suspected cases who showed symptoms such as fever and hepato-splenomegaly, blood (20 μl) was collected through fingerstick (with parental guardian consent) for rk39 immunochromatographic strip testing. Chil- dren with positive results were given sodium stibogluconate treatment (6x200 mg/kg, intravenously). A total of 637 VL cases were reported in Xinjiang from July 1, 2009 to June 30, 2015. Among the 192 cases reported from July 1, 2014 to June 30, 2015 in Xinjiang, cases from Jiashi County occupied 86.46% (166/192) of the cases. The number of VL cases in Jiashi County showed a trend of increase since the first report in August, with a total number of 114 in October, November and December. The 166 cases in Jiashi County had an age range of 23 days-8 years, with those under one year accounting for 95.18%(158/166). The 113 cases in Gholtoghrak Township of the County had an age range of 23 days-3 years, with those under one year accounting for 96.46% (109/113). The age--distribution of VL casess in the County accorded with the characteristic of the desert type. On-site investigation of 833 children in the 23 villiages revealed 11 children with positive results of rk39 immunochromatographic strip testing out of 14 suspected cases, all recovered after one course of sodium stibogluconate treatment. In 2014, VL outbreak occurs in

  1. Evaluating the accuracy of molecular diagnostic testing for canine visceral leishmaniasis using latent class analysis.

    Directory of Open Access Journals (Sweden)

    Manuela da Silva Solcà

    Full Text Available Host tissues affected by Leishmania infantum have differing degrees of parasitism. Previously, the use of different biological tissues to detect L. infantum DNA in dogs has provided variable results. The present study was conducted to evaluate the accuracy of molecular diagnostic testing (qPCR in dogs from an endemic area for canine visceral leishmaniasis (CVL by determining which tissue type provided the highest rate of parasite DNA detection. Fifty-one symptomatic dogs were tested for CVL using serological, parasitological and molecular methods. Latent class analysis (LCA was performed for accuracy evaluation of these methods. qPCR detected parasite DNA in 100% of these animals from at least one of the following tissues: splenic and bone marrow aspirates, lymph node and skin fragments, blood and conjunctival swabs. Using latent variable as gold standard, the qPCR achieved a sensitivity of 95.8% (CI 90.4-100 in splenic aspirate; 79.2% (CI 68-90.3 in lymph nodes; 77.3% (CI 64.5-90.1 in skin; 75% (CI 63.1-86.9 in blood; 50% (CI 30-70 in bone marrow; 37.5% (CI 24.2-50.8 in left-eye; and 29.2% (CI 16.7-41.6 in right-eye conjunctival swabs. The accuracy of qPCR using splenic aspirates was further evaluated in a random larger sample (n = 800, collected from dogs during a prevalence study. The specificity achieved by qPCR was 76.7% (CI 73.7-79.6 for splenic aspirates obtained from the greater sample. The sensitivity accomplished by this technique was 95% (CI 93.5-96.5 that was higher than those obtained for the other diagnostic tests and was similar to that observed in the smaller sampling study. This confirms that the splenic aspirate is the most effective type of tissue for detecting L. infantum infection. Additionally, we demonstrated that LCA could be used to generate a suitable gold standard for comparative CVL testing.

  2. Risk analysis and prediction of visceral leishmaniasis dispersion in São Paulo State, Brazil.

    Directory of Open Access Journals (Sweden)

    Anaiá da Paixão Sevá

    2017-02-01

    Full Text Available Visceral leishmaniasis (VL is an important neglected disease caused by a protozoan parasite, and represents a serious public health problem in many parts of the world. It is zoonotic in Europe and Latin America, where infected dogs constitute the main domestic reservoir for the parasite and play a key role in VL transmission to humans. In Brazil this disease is caused by the protozoan Leishmania infantum chagasi, and is transmitted by the sand fly Lutzomyia longipalpis. Despite programs aimed at eliminating infection sources, the disease continues to spread throughout the Country. VL in São Paulo State, Brazil, first appeared in the northwestern region, spreading in a southeasterly direction over time. We integrate data on the VL vector, infected dogs and infected human dispersion from 1999 to 2013 through an innovative spatial temporal Bayesian model in conjunction with geographic information system. This model is used to infer the drivers of the invasion process and predict the future progression of VL through the State. We found that vector dispersion was influenced by vector presence in nearby municipalities at the previous time step, proximity to the Bolívia-Brazil gas pipeline, and high temperatures (i.e., annual average between 20 and 23°C. Key factors affecting infected dog dispersion included proximity to the Marechal Rondon Highway, high temperatures, and presence of the competent vector within the same municipality. Finally, vector presence, presence of infected dogs, and rainfall (approx. 270 to 540mm/year drove the dispersion of human VL cases. Surprisingly, economic factors exhibited no noticeable influence on disease dispersion. Based on these drivers and stochastic simulations, we identified which municipalities are most likely to be invaded by vectors and infected hosts in the future. Prioritizing prevention and control strategies within the identified municipalities may help halt the spread of VL while reducing monitoring

  3. Risk analysis and prediction of visceral leishmaniasis dispersion in São Paulo State, Brazil.

    Science.gov (United States)

    Sevá, Anaiá da Paixão; Mao, Liang; Galvis-Ovallos, Fredy; Tucker Lima, Joanna Marie; Valle, Denis

    2017-02-01

    Visceral leishmaniasis (VL) is an important neglected disease caused by a protozoan parasite, and represents a serious public health problem in many parts of the world. It is zoonotic in Europe and Latin America, where infected dogs constitute the main domestic reservoir for the parasite and play a key role in VL transmission to humans. In Brazil this disease is caused by the protozoan Leishmania infantum chagasi, and is transmitted by the sand fly Lutzomyia longipalpis. Despite programs aimed at eliminating infection sources, the disease continues to spread throughout the Country. VL in São Paulo State, Brazil, first appeared in the northwestern region, spreading in a southeasterly direction over time. We integrate data on the VL vector, infected dogs and infected human dispersion from 1999 to 2013 through an innovative spatial temporal Bayesian model in conjunction with geographic information system. This model is used to infer the drivers of the invasion process and predict the future progression of VL through the State. We found that vector dispersion was influenced by vector presence in nearby municipalities at the previous time step, proximity to the Bolívia-Brazil gas pipeline, and high temperatures (i.e., annual average between 20 and 23°C). Key factors affecting infected dog dispersion included proximity to the Marechal Rondon Highway, high temperatures, and presence of the competent vector within the same municipality. Finally, vector presence, presence of infected dogs, and rainfall (approx. 270 to 540mm/year) drove the dispersion of human VL cases. Surprisingly, economic factors exhibited no noticeable influence on disease dispersion. Based on these drivers and stochastic simulations, we identified which municipalities are most likely to be invaded by vectors and infected hosts in the future. Prioritizing prevention and control strategies within the identified municipalities may help halt the spread of VL while reducing monitoring costs. Our results

  4. Comparative evaluation of blood and serum samples in rapid immunochromatographic tests for visceral leishmaniasis.

    Science.gov (United States)

    Kumar, Dinesh; Khanal, Basudha; Tiwary, Puja; Mudavath, Shyam Lal; Tiwary, Narendra K; Singh, Rupa; Koirala, Kanika; Boelaert, Marleen; Rijal, Suman; Sundar, Shyam

    2013-12-01

    Rapid diagnostic tests (RDTs) based on the detection of specific antibodies in serum are commonly used for the diagnosis of visceral leishmaniasis (VL). Several commercial kits are available, and some of them allow the use of whole-blood samples instead of serum. An RDT is much more user-friendly for blood samples than for serum samples. In this study, we examined the sensitivities and specificities of six different commercially available immunochromatographic tests for their accuracy in detecting Leishmania infection in whole blood and serum of parasitologically confirmed VL cases. This study was performed in areas of India and Nepal where VL is endemic. A total of 177 confirmed VL cases, 208 healthy controls from areas of endemicity (EHCs), 26 malaria patients (MP), and 37 tuberculosis (TB) patients were enrolled. The reproducibilities of the blood and serum results and between-reader and between-laboratory results were tested. In India, the sensitivities of all the RDTs ranged between 94.7 and 100.0%, with no significant differences between whole blood and serum. The specificities ranged between 92.4 and 100.0%, except for the specificity of the Onsite Leishmania Ab RevB kit, which was lower (33.6 to 42.0%). No differences in specificities were observed for blood and serum. In Nepal, the sensitivities of all the test kits, for whole-blood as well as serum samples, ranged between 96.3 and 100.0%, and the specificities ranged between 90.1 and 96.1%, again with the exception of that of the Onsite Leishmania Ab RevB test, which was markedly lower (48.7 to 49.3%). The diagnostic accuracies of all the tests, except for one brand, were excellent for the whole-blood and serum samples. We conclude that whole blood is an adequate alternative for serum in RDTs for VL, with sensitivities and specificities comparable to those obtained in serum samples, provided that the test kit is of overall good quality.

  5. Epidemiological characteristics of visceral leishmaniasis in Morocco (1990-2014): an update.

    Science.gov (United States)

    Mniouil, Meryem; Fellah, Hajiba; Amarir, Fatima; Et-Touys, Abdeslamd; Bekhti, Khadija; Adlaoui, El Bachir; Bakri, Youssef; Nhammi, Haddou; Sadak, Abderrahim; Sebti, Faiza

    2017-06-01

    Leishmaniases are parasitic diseases frequent in the Mediterranean Basin. Visceral leishmaniasis (VL) is a notifiable parasitic disease that increased in incidence in Morocco over the past few years and has recently emerged in several new foci, causing a public health problem in Morocco. The aim of this study is to describe the spatio-temporal distribution of VL in Morocco between 1990 and 2014 period in order to highlight important features and trends of VL and its epidemiology and to assess whether the activity of the unit reflects the situation of the disease at the national level and whether it could constitute an indicator of public health relevance. Two thousand four hundred and twenty one cases were reported in Morocco between 1990 and 2014 with an average annual reported incidence rate of 0.4 cases per 100.000 inhabitants. Before 1996 the average annual incidence of VL was 50 cases on average. After this date the number of cases increased and then remained stable with around 100-150 cases per year. Children whose age varies between 1 and 4 years old are the most affected with 1327 (74%) of total cases; nevertheless the adult starts to be affected by the disease. In 2000, 65% of positive cases of VL are concentrated at both northern regions: Taza-Al Hoceima- Taounate with 45% of cases, Tanger- Tetouan mainly represented by Chefchaoun with 20% of cases. The Fez-Boulemane region located in the center recorded 12% of cases. Throughout the years the map VL distribution has been progressively changed and spatial spread of the disease to the center is noted in 2007. 2014 has been marked by an even greater extension of the disease to the center and south of Morocco. Nationally in 2014, 34 of 75 provinces and prefectures are affected compared to 2000, when 22 out of 82 provinces and prefectures were affected. Leishmania infantum was identified the causative agent based on species- specific PCR-Lei70 assay. VL remains a sporadically endemic parasitic disease in

  6. Treatment of visceral leishmaniasis in a patient with AIDS with antimony and gamma-interferon: remission and prevention of relapse by maintenance therapy with weekly pentamidine

    NARCIS (Netherlands)

    Lustig, V.; Kager, P. A.; Meenhorst, P. L.

    1995-01-01

    A 41-year-old AIDS patient with fever, nightly perspiration, diarrhoea, anaemia and leukopenia was diagnosed as having visceral leishmaniasis (VL). After 8 weeks of antimony treatment combined with gamma-interferon, given in 2 courses of 3 and 5 weeks, 12 weeks apart, the bone marrow revealed no

  7. Genome-wide scan for visceral leishmaniasis in mixed-breed dogs identifies candidate genes involved in T helper cells and macrophage signaling

    Science.gov (United States)

    We conducted a genome-wide scan for visceral leishmaniasis in mixed-breed dogs from a highly endemic area in Brazil using 149,648 single nucleotide polymorphism (SNP) markers genotyped in 20 cases and 28 controls. Using a mixed model approach, we found two candidate loci on canine autosomes 1 and 2....

  8. Leishmania-specific T cells expressing interferon-¿(IFN-¿) and IL-10 upon activation are expanded in individuals cured of visceral leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, K; Kemp, M; Kharazmi, A

    1999-01-01

    Peripheral blood mononuclear cells (PBMC) from patients who have recovered from visceral leishmaniasis often respond to Leishmania antigens in vitro by production of both IL-4, IFN-gamma and IL-10. In order to establish the cellular sources of these cytokines, we activated cells from individuals...... with a history of visceral leishmaniasis with Leishmania antigen for 6 days in culture, and identified cytokine production at the single-cell level by flow cytometry. The cytokines were only found in CD3+ cells and among these mainly within the CD4+ subset. The percentage of cytokine-producing cells was compared...... in Leishmania-activated PBMC cultures from the previous patients and from individuals living in a village where leishmaniasis does not occur. The percentage of IL-10- and IFN-gamma-containing cells was significantly higher in the previous patients than in the controls, indicating that Leishmania-specific T...

  9. Leishmaniasis

    Science.gov (United States)

    ... What is the FOD? Foundation Levels of Giving Governance By-Laws Committees Committee Service Conflict of Interest ... in which leishmaniasis is found range from rain forests in Central and South America (sometimes referred to ...

  10. Comparison of molecular methods for visceral leishmaniasis diagnosis in asymptomatic dogs

    Energy Technology Data Exchange (ETDEWEB)

    Carregal, Virginia M.; Leite, Rodrigo S.; Andrade, Antero S.R., E-mail: antero@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Lab. de Radiobiologia; Melo, Maria N., E-mail: melo@icb.ufmg.br [Universidade Federal de Minas Gerais (ICB/UFMG), Belo Horizonte, MG (Brazil). Inst. de Ciencias Biologicas. Dept. de Parasitologia

    2011-07-01

    Visceral Leishmaniasis (VL) is a serious public health problem in Brazil. In the urban area dog is the main source of infection and VL control in Brazil involves the elimination of infected dogs. Serological tests are used for routine surveys, but they present problems of specificity and sensitivity. In addition, serologic test performance depends on infection status and an important limitation in VL control programs is the inability to identify asymptomatic dogs because these tests are insufficiently sensitive. Molecular methods as the kPCR PCR - hybridization are useful in the diagnosis and identification of Leishmania species. The kDNA PCR - hybridization uses radioactive probes to improve the sensibility of the PCR and allow the discrimination between Leishmania species. The aim of this work was compare the sensibility of the method kDNA PCR - Hybridization with different PCR methods, in different clinical samples, for VL diagnosis in asymptomatic animals. Bone marrow, peripheral blood, conjunctival swab and skin biopsies had been analyzed by the methods kDNA PCR - hybridization, kDNA semi nested PCR (kDNA snPCR), Leishmania nested PCR (LnPCR) e Internal Transcribed Spacer 1 nested PCR (ITS-1 nPCR). Thirty positive asymptomatic dogs with positive serologic and parasitologic tests were used. Six not infected dogs had been used as controls. The DNA extraction from swabs was performed by Phenol-Chloroform method. Commercial kits had been used for DNA extraction of peripheral blood, bone marrow and skin biopsies. The kDNA PCR - hybridization detected 5/30 (16.7 %) positive dogs for peripheral blood, 17/30 (57%) for skin, 19/30 (63.3 %) for bone marrow and 21/30 (70%) for conjunctival swab. The kDNA snPCR found 7/30 (23.3%) positive dogs for peripheral blood, 17/30 (57%) for skin, 12/30 (40%) for bone marrow and 24/30 (80%) samples of conjunctival swab. The LnPCR method detected 9/30 (30%) positive dogs for the samples of peripheral blood, 15/30 (50%) for bone

  11. Comparison of molecular methods for visceral leishmaniasis diagnosis in asymptomatic dogs

    International Nuclear Information System (INIS)

    Carregal, Virginia M.; Leite, Rodrigo S.; Andrade, Antero S.R.; Melo, Maria N.

    2011-01-01

    Visceral Leishmaniasis (VL) is a serious public health problem in Brazil. In the urban area dog is the main source of infection and VL control in Brazil involves the elimination of infected dogs. Serological tests are used for routine surveys, but they present problems of specificity and sensitivity. In addition, serologic test performance depends on infection status and an important limitation in VL control programs is the inability to identify asymptomatic dogs because these tests are insufficiently sensitive. Molecular methods as the kPCR PCR - hybridization are useful in the diagnosis and identification of Leishmania species. The kDNA PCR - hybridization uses radioactive probes to improve the sensibility of the PCR and allow the discrimination between Leishmania species. The aim of this work was compare the sensibility of the method kDNA PCR - Hybridization with different PCR methods, in different clinical samples, for VL diagnosis in asymptomatic animals. Bone marrow, peripheral blood, conjunctival swab and skin biopsies had been analyzed by the methods kDNA PCR - hybridization, kDNA semi nested PCR (kDNA snPCR), Leishmania nested PCR (LnPCR) e Internal Transcribed Spacer 1 nested PCR (ITS-1 nPCR). Thirty positive asymptomatic dogs with positive serologic and parasitologic tests were used. Six not infected dogs had been used as controls. The DNA extraction from swabs was performed by Phenol-Chloroform method. Commercial kits had been used for DNA extraction of peripheral blood, bone marrow and skin biopsies. The kDNA PCR - hybridization detected 5/30 (16.7 %) positive dogs for peripheral blood, 17/30 (57%) for skin, 19/30 (63.3 %) for bone marrow and 21/30 (70%) for conjunctival swab. The kDNA snPCR found 7/30 (23.3%) positive dogs for peripheral blood, 17/30 (57%) for skin, 12/30 (40%) for bone marrow and 24/30 (80%) samples of conjunctival swab. The LnPCR method detected 9/30 (30%) positive dogs for the samples of peripheral blood, 15/30 (50%) for bone

  12. Participation of ticks in the infectious cycle of canine visceral leishmaniasis, in Teresina, Piauí, Brazil.

    Science.gov (United States)

    Campos, José Henrique Furtado; Costa, Francisco Assis Lima

    2014-01-01

    In this study, we detected Leishmania spp. infection in R. sanguineus collected from dogs that were naturally infected with L. (L.) infantum. We examined 35 dogs of both sexes and unknown ages. The infected dogs were serologically positive by the immunofluorescence antibody test (IFAT), enzyme-linked immunosorbent assay (ELISA), and Quick Test-DPP (Dual Path Platform), as well as parasitological examination of a positive skin biopsy or sternal bone marrow aspiration. Ten negative dogs were included as controls. The ticks that infested these dogs were collected in pools of 10 adult females per animal. The PCR was performed with specific primers for Leishmania spp., which amplified a 720-bp fragment. Of the 35 analyzed samples, a product was observed in eight samples (8/35; 22.9%). We conclude that the presence of parasite DNA suggests that ticks participate in the zoonotic cycle of canine visceral leishmaniasis, in the city of Teresina, Piauí.

  13. Acceptance and potential barriers to effective use of diagnostic tests for visceral leishmaniasis in an urban area in Brazil

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    Tália Machado de Assis

    2016-04-01

    Full Text Available Abstract: INTRODUCTION: Acceptance of the IT LEISH(r and direct agglutination test- made in the Laboratório de Pesquisas Clínicas (DAT-LPC by healthcare professionals and patients suspected of visceral leishmaniasis (VL in Ribeirão das Neves was evaluated. METHODS: Ninety-two patients and 47 professionals completed three questionnaires. RESULTS: Eighty-eight (96% patients considered fingertip blood collection a positive test feature, and 86% (37 and 91% of professionals considered the IT LEISH(r easy to perform and interpret, respectively. All professionals classified the DAT-LPC as simple and easy. CONCLUSIONS: Patients and healthcare professionals in Ribeirão das Neves demonstrated a high degree of acceptance of the IT LEISH(r and DAT-LPC.

  14. Impact of urbanization on the sand fly Phlebotomus langeroni nitzulescu in an old focus of visceral leishmaniasis in Egypt.

    Science.gov (United States)

    Kassem, Hala A; El Nogoumy, Nihad N; El Sawaf, Bahira M

    2012-12-01

    Changes in the environment often cause changes in disease transmission. Land use change especially urbanization can have a huge impact on transmission of vector-borne diseases. This study investigated the effect of urban development on the abundance of sand flies, in an old endemic focus of infantile visceral leishmaniasis in the north coast of Egypt. Sand fly abundance obtained in this study was compared to those obtained in 1984. In context remote sensing techniques are used to identify landscape features that might have influenced the spatial distribution of the sand fly vector in the area. In 2005, sand flies were completely absent from El Agamy. Sand fly habitat in El Agamy entirely changed and was replaced by urban settlements. Through the analysis of satellite imagery taken before and after, land use/land cover modification together with entomological data, the factors underlying the bionomics of sand flies are discussed.

  15. [Evaluation of the organization of health services as a strategy for the prevention and control of visceral leishmaniasis].

    Science.gov (United States)

    Barbosa, Miriam Nogueira; Guimarães, Eliete Albano de Azevedo; Luz, Zélia Maria Profeta da

    2016-01-01

    to evaluate the organization of health services as a strategy for the prevention and control of visceral leishmaniasis (VL) in Ribeirão das Neves, Minas Gerais, Brazil, from 2010 to 2012. this was a case study evaluation of the degree of implementation of a strategy for the integration of health care services, control of zoonosis and epidemiological surveillance; it consisted of observing the work process, interviewing health professionals and analysing secondary data from information systems. implementation was partially adequate (84%); in terms of structure, the human resources component had the worst evaluation (64%) whilst in terms of work process, evaluation was 80% for reorganization of care and 77% for surveillance; in the period 2010-2012 there was a 20% increase in reported cases of VL and a 20% reduction in the time interval between reporting a case and starting treatment. the strategy contributed to the improvement of the organization of VL prevention and control actions.

  16. Dilema ético y epidemiológico sobre el tratamiento de perros para la leishmaniasis visceral en América Latina

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    Bruno L. Travi

    2014-03-01

    Full Text Available En las Américas hay entre 4.500 y 6.800 casos anuales de leishmaniasis visceral grave y se estima que la mortalidad varía entre 7 y 10 %. Sin embargo, el subregistro y las infecciones subclínicas enmascaran la importancia epidemiológica real de la leishmaniasis visceral. Los esfuerzos de control que típicamente se han enfocado en la aspersión de insecticidas contra los flebotomíneos vectores y el sacrificio de perros, han arrojado resultados dispares. No obstante, miles de perros se sacrifican cada año en países endémicos para leishmaniasis visceral. Además, los lineamientos actuales de los programas de control de la leishmaniasis han prohibido el tratamiento de perros con medicamentos de uso humano, mientras que otras drogas resultan en altas tasas de recaída. La sociedad requiere que los programas de control tengan un manejo más humanitario enfocado a limitar el sacrificio canino. Hay una necesidad urgente de promover la tenencia responsable de los perros y apoyar la investigación en: a terapias veterinarias novedosas, b diagnósticos moleculares de bajo costo y c determinación de los umbrales de capacidad infecciosa canina para el manejo adecuado del reservorio.

  17. Avaliação da leishmaniose visceral canina em Poxoréo, Estado do Mato Grosso, Brazil Canine visceral leishmaniasis evaluation in Poxoréo, Mato Grosso State, Brazil

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    Márcia Ávila A. de Azevedo

    2008-09-01

    Full Text Available O cão doméstico desempenha importante papel como reservatório na transmissão da leishmaniose visceral ao homem, zoonose de grande importância em saúde pública. Realizou-se avaliação epidemiológica da leishmaniose visceral em 1.112 cães domiciliados no município de Poxoréo, estado do Mato Grosso e observou-se prevalência de 7,8%. Observou-se ainda associação estatisticamente significativa entre a prevalência de leishmaniose visceral canina e as variáveis faixa etária, presença de sinais clínicos e presença de outra espécie animal co-habitando com os cães avaliados, tendo sido as galinhas mais freqüentemente observadas entre os animais soropositivos. O sexo, a coleta de lixo domiciliar bem como a renda familiar não apresentaram associação estatisticamente significativa com a prevalência da leishmaniose visceral canina. A análise dos resultados sugere que cães com idade superior a sete anos e a , presença de outra espécie animal co-habitando com os cães podem ser fatores de risco para a leishmaniose visceral canina.Dogs play an important role as reservoir in the domestic cycle of visceral leishmaniasis, a serious public health problem. An epidemiological survey in 1,112 dogs was conducted at the Municipality of Poxoréo State of Mato Grosso, Brazil, using indirect immunofluorescence antibody test where the prevalence was 7.8%. Significant association was found between prevalence of canine visceral leishmaniasis and age of the dogs. Clinical signs and presence of other animals in the backyard, like chicken being more likely associated with seropositivity. Gender, garbage collection in the residence and family financial income were not associated with visceral leishmaniasis prevalence. Analysis of the results suggests that dogs aging more than 7 years and presence of another animal species co-inhabiting with the dogs may be risk factors for canine visceral leishmaniasis.

  18. Awareness of visceral leishmaniasis and its relationship to canine infection in riverside endemic areas in Northeastern Brazil

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    Kalidia Felipe de Lima Costa

    2014-10-01

    Full Text Available Introduction An awareness of visceral leishmaniasis (VL is necessary to encourage the population to participate in prevention and control in collaboration with more efficient, centrally organized health programs. The aim of this study was to evaluate the awareness of the riverside population regarding VL and the association between awareness and the prevalence of canine visceral leishmaniasis (CVL. Methods In total, 71 people living in riverside areas in the City of Mossoró in State of Rio Grande do Norte participated of the study, and 71 dogs were tested for CVL by polymerase chain reaction (PCR. Association analysis of several variables related to knowledge of the riverside population regarding CVL positivity was performed, yielding odds ratios (OR and 95% confidence intervals (CI, and significance was determined using chi-square (χ2 and Fisher's exact tests. Results Among individuals whose dogs tested positive for CVL, 60% did not know the cure for CVL, and these subjects were three times more likely to have a dog test positive for CVL than those who were aware the cure for CVL. Knowledge of CVL cure was the only variable that remained in the logistic model after the successive removal of variables, with an adjusted OR of 3.11 (95%CI: 1.1-8,799; p=0.032. Conclusions Insufficient awareness regarding VL in riverside areas with CVL-positive dogs was associated with increased rates of canine infection, which suggests that changes in habits and the adoption of attitudes and preventive practices may contribute to the control and prevention of this disease. This study reinforces the need to invest in better health education programs regarding VL.

  19. Serological tests fail to discriminate dogs with visceral leishmaniasis that transmit Leishmania infantum to the vector Lutzomyia longipalpis

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    Ivete Lopes de Mendonça

    Full Text Available Abstract INTRODUCTION The control of reservoirs for Leishmania infantum -induced zoonotic visceral leishmaniasis requires the identification of dogs posing a population risk. Here, we assessed the performance of several assays to identify Lutzomyia longipalpis infectious dogs. METHODS We evaluated 99 dogs that were positive for visceral leishmaniasis based on parasite identification. Serological analyses were performed using an enzyme-linked immunosorbent assay, immunofluorescence antibody tests in 1:40 and 1:80 dilutions, rapid dual path platform tests, immunochromatographic assay with a recombinant rK39 antigen, fast agglutination screening tests, and direct agglutination tests. We also performed PCR to analyze peripheral blood and xenodiagnosis. RESULTS Forty-six dogs infected at least one L. longipalpis specimen. Although the serological test sensitivities were above 85% for detecting L. longipalpis infectious dogs, none showed a satisfactory performance, as both specificity (0.06 to 13% and the area under the receiver operating characteristic curve (45 to 53% were low. The PCR results were also weak, with a sensitivity of 30%, specificity of 72%, and an area under the receiver operating characteristic curve of 51%. The infected L. longipalpis proportion was higher among asymptomatic dogs than symptomatic dogs. Among the symptomatic dogs, those with ulceration-free skin diseases were more infectious, with an odds ratio of 9.3 (confidence interval of 1.10 - 428.5. The larger the number of insects fed, the greater the detected infectiousness. CONCLUSIONS Our study supports the imperative to develop novel technologies for identifying the infectious dogs that transmit L. infantum for the benefit of public health.

  20. Larval breeding sites of Lutzomyia longipalpis (Diptera: Psychodidae) in visceral leishmaniasis endemic urban areas in Southeastern Brazil.

    Science.gov (United States)

    Casanova, Cláudio; Andrighetti, Maria T M; Sampaio, Susy M P; Marcoris, Maria L G; Colla-Jacques, Fernanda E; Prado, Angelo P

    2013-01-01

    The scarcity of information on the immature stages of sand flies and their preferred breeding sites has resulted in the focus of vectorial control on the adult stage using residual insecticide house-spraying. This strategy, along with the treatment of human cases and the euthanasia of infected dogs, has proven inefficient and visceral leishmaniasis continues to expand in Brazil. Identifying the breeding sites of sand flies is essential to the understanding of the vector's population dynamic and could be used to develop novel control strategies. In the present study, an intensive search for the breeding sites of Lutzomyia longipalpis was conducted in urban and peri-urban areas of two municipalities, Promissão and Dracena, which are endemic for visceral leishmaniasis in São Paulo State, Brazil. During an exploratory period, a total of 962 soil emergence traps were used to investigate possible peridomiciliary breeding site microhabitats such as: leaf litter under tree, chicken sheds, other animal sheds and uncovered debris. A total of 160 sand flies were collected and 148 (92.5%) were L. longipalpis. In Promissão the proportion of chicken sheds positive was significantly higher than in leaf litter under trees. Chicken shed microhabitats presented the highest density of L. longipalpis in both municipalities: 17.29 and 5.71 individuals per square meter sampled in Promissão and Dracena respectively. A contagious spatial distribution pattern of L. longipalpis was identified in the emergence traps located in the chicken sheds. The results indicate that chicken sheds are the preferential breeding site for L. longipalpis in the present study areas. Thus, control measures targeting the immature stages in chicken sheds could have a great effect on reducing the number of adult flies and consequently the transmission rate of Leishmania (Leishmania) infantum chagasi.

  1. Serological tests fail to discriminate dogs with visceral leishmaniasis that transmit Leishmania infantum to the vector Lutzomyia longipalpis.

    Science.gov (United States)

    Mendonça, Ivete Lopes de; Batista, Joilson Ferreira; Werneck, Guilherme Loureiro; Soares, Maria Regiane Araújo; Costa, Dorcas Lamounier; Costa, Carlos Henrique Nery

    2017-01-01

    The control of reservoirs for Leishmania infantum -induced zoonotic visceral leishmaniasis requires the identification of dogs posing a population risk. Here, we assessed the performance of several assays to identify Lutzomyia longipalpis infectious dogs. We evaluated 99 dogs that were positive for visceral leishmaniasis based on parasite identification. Serological analyses were performed using an enzyme-linked immunosorbent assay, immunofluorescence antibody tests in 1:40 and 1:80 dilutions, rapid dual path platform tests, immunochromatographic assay with a recombinant rK39 antigen, fast agglutination screening tests, and direct agglutination tests. We also performed PCR to analyze peripheral blood and xenodiagnosis. Forty-six dogs infected at least one L. longipalpis specimen. Although the serological test sensitivities were above 85% for detecting L. longipalpis infectious dogs, none showed a satisfactory performance, as both specificity (0.06 to 13%) and the area under the receiver operating characteristic curve (45 to 53%) were low. The PCR results were also weak, with a sensitivity of 30%, specificity of 72%, and an area under the receiver operating characteristic curve of 51%. The infected L. longipalpis proportion was higher among asymptomatic dogs than symptomatic dogs. Among the symptomatic dogs, those with ulceration-free skin diseases were more infectious, with an odds ratio of 9.3 (confidence interval of 1.10 - 428.5). The larger the number of insects fed, the greater the detected infectiousness. Our study supports the imperative to develop novel technologies for identifying the infectious dogs that transmit L. infantum for the benefit of public health.

  2. Acylated and deacylated saponins of Quillaja saponaria mixture as adjuvants for the FML-vaccine against visceral leishmaniasis.

    Science.gov (United States)

    Oliveira-Freitas, E; Casas, C P; Borja-Cabrera, G P; Santos, F N; Nico, D; Souza, L O P; Tinoco, L W; da Silva, B P; Palatnik, M; Parente, J P; Palatnik-de-Sousa, C B

    2006-05-01

    The adjuvant of the FML-vaccine against murine and canine visceral leishmaniasis, the Riedel de Haen saponin mixture, was fractionated by ion exchange chromatography on DEAE-cellulose to afford one TLC homogeneous Quillaja saponaria Molina QS21 saponin fraction (18.0%), a mixture of two deacylsaponins (19.4%), sucrose (39.9%), sucrose and glucose (19.7%), rutin (0.8%) and quercetin (2.2%), that were identified by comparison of 1H and 13C NMR spectroscopy. The QS21 shows the typical aldehyde group in C-23 (65% equatorial) and a normonoterpene moiety acylated in C-28. The deacylsaponins show the aldehyde group but do not have the normonoterpene moiety. Balb/c mice were vaccinated with 150 microg of FML antigen of Leishmania donovani and 100 microg of each obtained fraction and further challenged by infection with 10(8) amastigotes of Leishmania chagasi. The safety analysis and the effect on humoral and cellular immune responses and in clinical signs showed that the QS21 saponin and the deacylsaponins are the most active adjuvant compounds of the Riedel the Haen saponin mixture. Both induced the highest and non-significantly different increases in DTH, CD4+ T lymphocytes in spleen, IFN-gamma in vitro, body weight gain and the most pronounced reduction of parasite burden in liver (95% for QS21 and 86% for deacylsaponins; p>0.05). While the QS21 showed mild toxicity, significant adjuvant effect on the anti-FML humoral response before and after infection, and decrease in liver relative weight, the deacylsaponins showed no toxicity, less haemolysis and antibody and DTH responses increased mainly after infection, still inducing a stronger Leishmania-specific in vitro splenocyte proliferation. Our results confirm in the Riedel de Haen saponin extract the presence of deacylsaponins normonoterpene-deprivated which are non-toxic and capable of inducing a specific and strong immunoprotective response in vaccination against murine visceral leishmaniasis.

  3. A New Model of Progressive Visceral Leishmaniasis in Hamsters by Natural Transmission via Bites of Vector Sand Flies

    Science.gov (United States)

    Aslan, Hamide; Dey, Ranadhir; Meneses, Claudio; Castrovinci, Philip; Jeronimo, Selma Maria Bezerra; Oliva, Gætano; Fischer, Laurent; Duncan, Robert C.; Nakhasi, Hira L.; Valenzuela, Jesus G.; Kamhawi, Shaden

    2013-01-01

    Background. Visceral leishmaniasis (VL) is transmitted by sand flies. Protection of needle-challenged vaccinated mice was abrogated in vector-initiated cutaneous leishmaniasis, highlighting the importance of developing natural transmission models for VL. Methods. We used Lutzomyia longipalpis to transmit Leishmania infantum or Leishmania donovani to hamsters. Vector-initiated infections were monitored and compared with intracardiac infections. Body weights were recorded weekly. Organ parasite loads and parasite pick-up by flies were assessed in sick hamsters. Results. Vector-transmitted L. infantum and L. donovani caused ≥5-fold increase in spleen weight compared with uninfected organs and had geometric mean parasite loads (GMPL) comparable to intracardiac inoculation of 107–108 parasites, although vector-initiated disease progression was slower and weight loss was greater. Only vector-initiated L. infantum infections caused cutaneous lesions at transmission and distal sites. Importantly, 45.6%, 50.0%, and 33.3% of sand flies feeding on ear, mouth, and testicular lesions, respectively, were parasite-positive. Successful transmission was associated with a high mean percent of metacyclics (66%–82%) rather than total GMPL (2.0 × 104–8.0 × 104) per midgut. Conclusions. This model provides an improved platform to study initial immune events at the bite site, parasite tropism, and pathogenesis and to test drugs and vaccines against naturally acquired VL. PMID:23288926

  4. Epidemiological aspects and spatial distribution of human and canine visceral leishmaniasis in an endemic area in northeastern Brazil.

    Science.gov (United States)

    Campos, Roseane; Santos, Márcio; Tunon, Gabriel; Cunha, Luana; Magalhães, Lucas; Moraes, Juliana; Ramalho, Danielle; Lima, Sanmy; Pacheco, José Antônio; Lipscomb, Michael; Ribeiro de Jesus, Amélia; Pacheco de Almeida, Roque

    2017-05-11

    Visceral leishmaniasis (VL) is a systemic disease endemic in tropical countries and transmitted through sand flies. In particular, Canis familiaris (or domesticated dogs) are believed to be a major urban reservoir for the parasite causing the disease Leishmania. The average number of human VL cases was 58 per year in the state of Sergipe. The city of Aracaju, capital of Sergipe in Northeastern Brazil, had 159 cases of VL in humans. Correlatively, the percentage of serologically positive dogs for leishmaniasis increased from 4.73% in 2008 to 12.69% in 2014. Thus, these studies aimed to delineate the spatial distribution and epidemiological aspects of human and canine VL as mutually supportive for increased incidence. The number of human cases of VL and the frequency of canine positive serology for VL both increased between 2008 and 2014. Spatial distribution analyses mapped areas of the city with the highest concentration of human and canine VL cases. The neighbourhoods that showed the highest disease frequency were located on the outskirts of the city and in urbanised areas or subjected to development. Exponential increase in VL-positive dogs further suggests that the disease is expanding in urban areas, where it can serve as a reservoir for transmission of dogs to humans via the sand fly vector.

  5. Immunotherapy Using Autoclaved L. Major Antigens and M. Vaccae with Meglumine Antimoniate, for the Treatment of Experimental Canine Visceral Leishmaniasis

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    Sh Jamshidi

    2011-09-01

    Full Text Available Background: To evaluate immunotherapy against canine visceral leishmaniasis, Leishmania ma­jor antigen and heat-killed Mycobacterium vaccae (SRL172 were used as stimulators of immune de­fense mechanisms and the results were compared with standard chemotherapy meglumine antimoni­ate.Methods: Nineteen mongrel dogs aging 1-3 years old were used in this experiment. Infection was carried out in 15 out of 19 dogs using L. infantum, isolated from a naturally infected poly-symptomatic dog.Results: All the cases showed positive serologic results by direct agglutination test during 30-60 days following inoculation. In the first group, which was under chemotherapy (GlucantimeR, one of the members showed recurrence of the disease despite rapid effect of the therapeutic protocol. Im­munotherapy using SRL172 caused complete cleaning of the parasite in group 2, but the speed was less than Glucantime. Immunotherapy using L. major antigen combined with M. vaccae in group 3 and combine administration of immunotherapy and chemotherapy in group 4 both were with relapsing of one case in each group. Group 5 and 6 were consisted of positive and negative con­trol dogs, respectively.Conclusion: Immunotherapy seems to be an adjuvant in treatment of canine leishmaniasis but it needs more investigation for final confirmation.

  6. Epidemiological aspects and spatial distribution of human and canine visceral leishmaniasis in an endemic area in northeastern Brazil

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    Roseane Campos

    2017-05-01

    Full Text Available Visceral leishmaniasis (VL is a systemic disease endemic in tropical countries and transmitted through sand flies. In particular, Canis familiaris (or domesticated dogs are believed to be a major urban reservoir for the parasite causing the disease Leishmania. The average number of human VL cases was 58 per year in the state of Sergipe. The city of Aracaju, capital of Sergipe in Northeastern Brazil, had 159 cases of VL in humans. Correlatively, the percentage of serologically positive dogs for leishmaniasis increased from 4.73% in 2008 to 12.69% in 2014. Thus, these studies aimed to delineate the spatial distribution and epidemiological aspects of human and canine VL as mutually supportive for increased incidence. The number of human cases of VL and the frequency of canine positive serology for VL both increased between 2008 and 2014. Spatial distribution analyses mapped areas of the city with the highest concentration of human and canine VL cases. The neighbourhoods that showed the highest disease frequency were located on the outskirts of the city and in urbanised areas or subjected to development. Exponential increase in VL-positive dogs further suggests that the disease is expanding in urban areas, where it can serve as a reservoir for transmission of dogs to humans via the sand fly vector.

  7. Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae) in the region of Saquarema: potential area of visceral leishmaniasis transmission in the state of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Brazil, Reginaldo Peçanha; Pontes, Michelle Cristina de Queiroz; Passos, Wagner Lança; Fuzari, Andressa Alencaste; Brazil, Beatriz Gomes

    2012-02-01

    Lutzomyia longipalpis is the main vector of Leishmania infantum chagasi in the Americas. Phlebotomine captures were conducted during 2008 and 2009 in a rural area endemic for cutaneous leishmaniasis located in the municipality of Saquarema, Rio de Janeiro. Among other species captured, we observed the presence of Lutzomyia longipalpis. This is the first report of the occurrence of Lutzomyia longipalpis in this region, demonstrating the potential risk of visceral leishmaniasis transmission in the coastal area of the State of Rio de Janeiro. Therefore, active vigilance by all municipalities in the area is necessary.

  8. Análise Espacial da Leishmaniose Visceral Americana no Município de Presidente Prudente: Abordagem Geográfica da Saúde Ambiental | Spatial Analysis of American Visceral Leishmaniasis in the Municipality of Presidente Prudente: A Geographical Approach to E

    Directory of Open Access Journals (Sweden)

    Patricia Sayuri Silvestre Matsumoto

    2014-05-01

    Full Text Available Normal 0 21 false false false PT-BR X-NONE X-NONE Introdução: A Leishmaniose Visceral Americana (LVA é uma zoonose grave. Atinge animais e homens e pode ser fatal. A mortalidade acentuada se dá, sobretudo, devido às condições de precariedade de diagnóstico e tratamento da doença e, por isso, é caracterizada como doença negligenciada. Desde 1990 a LVA vem se disseminando para novas áreas e aumentando sua frequência no estado de São Paulo. Em Presidente Prudente, município do oeste paulista, a enfermidade apareceu em meados de 2009 e vem se espalhando rapidamente entre a população canina, o que tem sido condição prévia para que haja a ocorrência em casos humanos. Pensando na problemática da LVA neste município, a proposta desta pesquisa é analisar a distribuição espacial dos casos de LVA caninos, identificando padrões espaciais da doença. Sabendo onde houve a confirmação de casos de LVA, também se pretende analisar o seu entorno, através de correlações da doença com o ambiente. Metodologia/Desenvolvimento: Para a análise da distribuição espacial dos casos de LVA canina no município de Presidente Prudente foi gerado um banco de dados georreferenciado. O mapeamento se deu por meio da ferramenta de geocodificação de endereços, que consiste em associar o banco de dados (tabela que se quer mapear ao banco de dados de vias por endereço já previamente georreferenciada. A ferramenta faz associações através de comparação de endereços e marca os pontos nas ruas conforme a localização do evento pontual. Após a espacialização dos dados, pretende-se aplicar técnicas em análise espacial, de modo a identificar padrões da doença no município. Também se pretende aplicar geoestatística no censo canino que está sendo cadastrado. Após o mapeamento e a identificação dos locais afetados com LVA, será feito um levantamento biogeográfico, com a intenção de encontrar correlações ambientais que

  9. [Expansion of the distribution of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae) in the department of Caldas: Increased risk of visceral leishmaniasis].

    Science.gov (United States)

    Acosta, Luz Adriana; Mondragón-Shem, Karina; Vergara, Daniela; Vélez-Mira, Andrés; Cadena, Horacio; Carrillo-Bonilla, Lina

    2013-01-01

    Diverse taxonomical and molecular studies suggest that Lutzomyia longipalpis , main vector of visceral leishmaniasis in Latin America, is a complex of species widely distributed throughout the continent and adapted to different habitats. To carry out entomological surveillance in the area of influence of the Miel I Hydroelectric Plant. Adhesive traps were used in a transect covering an area of approximately 400 km for the capture of insects, which were then identified using the Young and Duncan taxonomical key. This study reports the presence of Lutzomyia longipalpis in the municipalities of Norcasia at an altitude of 392 masl, and in Marquetalia at 1,387 masl. We suggest that the increase in the geographical and altitudinal distribution could be related to the existence of the Lu. longipalpis species complex, or to environmental factors, such as the rise in temperature due to global climate changes, which create the establishment of Lu. longipalpis , generating a new epidemiological risk for new visceral leishmaniasis foci in the country.

  10. Serological markers of sand fly exposure to evaluate insecticidal nets against visceral leishmaniasis in India and Nepal: a cluster-randomi trial

    DEFF Research Database (Denmark)

    Gidwani, K; Picado, A; Rijal, S

    2011-01-01

    and Nepal we tested the effect of LNs on sand fly biting by measuring the antibody response of subjects to the saliva of Leishmania donovani vector Phlebotomus argentipes and the sympatric (non-vector) Phlebotomus papatasi. Fifteen to 20 individuals above 15 years of age from 26 VL endemic clusters were......Background: Visceral leishmaniasis is the world’ second largest vector-borne parasitic killer and a neglected tropical disease, prevalent in poor communities. Long-lasting insecticidal nets (LNs) are a low cost proven vector intervention method for malaria control; however, their effectiveness...... against visceral leishmaniasis (VL) is unknown. This study quantified the effect of LNs on exposure to the sand fly vector of VL in India and Nepal during a two year community intervention trial. Methods: As part of a paired-cluster randomized controlled clinical trial in VL-endemic regions of India...

  11. Tratamento da Leishmaniose Tegumentar Americana Treatment of american cutaneous leishmaniasis

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    Edson Borges de Lima

    2007-04-01

    Full Text Available A leishmaniose tegumentar americana é doença infecciosa da pele e mucosa, cujo agente etiológico é um protozoário do gênero Leishmania. Seu tratamento é desafio porque as drogas disponíveis apresentam elevada toxicidade, e nenhuma delas é bastante eficaz. A recidiva, a falha terapêutica em pacientes imunodeprimidos e a resistência ao tratamento são fatores que motivam a busca de uma droga ideal.American cutaneous leishmaniasis is an infectious disease of the skin and mucosa caused by a protozoon of the genus Leishmania. Its treatment is a challenge since the drugs available are highly toxic and none is completely effective. Recurrence, therapeutic failure in immunosuppressed patients and treatment resistance are some factors that encourage searching an ideal drug.

  12. Immunogenicity and Efficacy of Live L. tarentolae Expressing KMP11-NTGP96-GFP Fusion as a Vaccine Candidate against Experimental Visceral Leishmaniasis Caused by L. infantum

    Directory of Open Access Journals (Sweden)

    Vahid NASIRI

    2016-10-01

    Full Text Available Background: The aim of present study was to evaluate the protective efficacy of live recombinant L. tarentolae expressing KMP11-NTGP96-GFP fusion as candidates for live engineered recombinant vaccine against visceral leishmaniasis in BALB/c mice.Methods: KMP-11 and NT-GP96 genes cloned into the pJET1.2/blunt cloning vector and then into pEGFP-N1 expression vector. The KMP-11, NT-GP96 and GFP fused in pEGFP-N1 and subcloned into Leishmanian pLEXSY-neo vector. Finally this construct was transferred to L. tarentolae by electroporation. Tranfection was confirmed by SDS-PAGE, WESTERN blot, flowcytometry and RT-PCR. Protective efficacy of this construct was evaluated as a vaccine candidate against visceral leishmaniasis. Parasite burden, humoral and cellular immune responses were assessed before and at 4 weeks after challenge.Results: KMP- NT-Gp96-GFP Fusion was cloned successfully into pLEXSY -neo vector and this construct successfully transferred to L. tarentolae. Finding indicated that immunization with L. tarentolae tarentolae-KMP11-NTGP96-GFP provides significant protection against visceral leishmaniasis and was able to induce an increased expression of IFN-γ and IgG2a. Following challenge, a reduced parasite load in the spleen of the KMP11-NTGP96-GFP immunized group was detected.Conclusion: The present study is the first to use a combination of a Leishmania antigen with an immunologic antigen in live recombinant L. tarentolae and results suggest that L. tarentolae-KMP11-NTGP96-GFP could be considered as a potential tool in vaccination against visceral leishmaniasis and this vaccination strategy could provide a potent rout for future vaccine development. 

  13. Species composition of phlebotomine sand flies and bionomics of Phlebotomus orientalis (Diptera: Psychodidae) in an endemic focus of visceral leishmaniasis in Tahtay Adiyabo district, Northern Ethiopia

    OpenAIRE

    Gebresilassie, Araya; Kirstein, Oscar David; Yared, Solomon; Aklilu, Essayas; Moncaz, Aviad; Tekie, Habte; Balkew, Meshesha; Warburg, Alon; Hailu, Asrat; Gebre-Michael, Teshome

    2015-01-01

    Background Visceral leishmaniasis (VL) is a neglected tropical disease, which is strongly associated with poverty. VL caused by Leishmania donovani and transmitted by Phlebotomus orientalis is endemic in various remote areas of north and north-west Ethiopia. The present study was designed to determine the sand fly fauna and bionomics of P. orientalis in the VL endemic focus of Tahtay Adiyabo district. Methods Sand flies were collected using CDC light traps (n?=?602), sticky traps (n?=?9,350) ...

  14. Evaluation of an enzyme-linked immunosorbent assay based on crude leishmania histone proteins for serodiagnosis of human infantile visceral leishmaniasis.

    OpenAIRE

    Lakhal, Sami; Mekki, Salima; Ben-Abda, Imène; Mousli, Mohamed; Amri, Fethi; Aoun, Karim; Bouratbine, Aïda

    2012-01-01

    International audience; Human visceral leishmaniasis (VL) is routinely diagnosed by detecting IgG that specifically binds to Leishmania antigens. The enzyme-linked immunosorbent assay (ELISA) remains a widely used method. However, the biggest challenge remains the choice of antigen with the highest specificity and sensitivity. This study is aimed at assessing the diagnostic performances of crude Leishmania histone (CLH) protein-based ELISAs in Mediterranean VL patients. The CLH proteins were ...

  15. Factores de riesgo, representaciones y prácticas asociadas con la leishmaniasis visceral humana en un foco urbano emergente en Posadas, Argentina

    Directory of Open Access Journals (Sweden)

    Karen López

    2016-04-01

    Conclusión. Se observó que la pobreza estructural constituía un factor social determinante del riesgo, y que aumentaba la probabilidad de contacto entre humanos y vectores por la mala calidad de la vivienda y el hacinamiento. El factor de riesgo más importante para la leishmaniasis visceral humana fue la tenencia en el domicilio de perros con la enfermedad.

  16. Urbanization of visceral leishmaniasis (kala-azar in Fortaleza, Ceará, Brazil Urbanización de la leishmaniasis visceral (kala-azar en Fortaleza, Ceará, Brasil

    Directory of Open Access Journals (Sweden)

    Polianna Lemos Moura Moreira Albuquerque

    2009-10-01

    Full Text Available OBJECTIVES: Visceral leishmaniasis (VL is endemic in Brazil and appears to occur in epidemic form in the state of Ceará. Few epidemiologic studies have been done on VL in this state. The aim of this study is to establish the epidemiologic pattern of VL in Fortaleza City and to show how urbanization has occurred in recent years. METHODS: Data were obtained from the State Health Department of Fortaleza, Ceará, and included all cases of VL registered in Fortaleza from January 2001 to December 2006. RESULTS: There were a marked increase and an elevated incidence of cases of VL in urban areas. Children and young people were the most affected group. CONCLUSION: The epidemic occurrence of VL in the region must convince authorities to adopt more adequate policies of disease control.OBJETIVOS: La leishmaniasis visceral (LV es endémica en Brasil y suele ocurrir en forma epidémica en el estado de Ceará. Se han realizado pocos estudios epidemiológicos sobre LV en ese estado. El objetivo de este estudio es establecer el patrón epidemiológico de LV en la ciudad de Fortaleza y mostrar cómo ha ocurrido la urbanización de esta enfermedad en los últimos años. MÉTODOS: Los datos se obtuvieron del Departamento Estatal de Salud de Fortaleza, Ceará, y abarcaron todos los casos de LV registrados en esa ciudad entre enero de 2001 y diciembre de 2006. RESULTADOS: Se observó un marcado incremento y una elevada incidencia de LV en las áreas urbanas. Los niños y jóvenes fueron los grupos más afectados. CONCLUSIÓN: La ocurrencia de epidemias de LV en la región debe convencer a las autoridades para que adopten políticas más apropiadas para el control de esta enfermedad.

  17. Common variants in the HLA-DRB1-HLA-DQA1 HLA class II region are associated with susceptibility to visceral leishmaniasis.

    Science.gov (United States)

    Fakiola, Michaela; Strange, Amy; Cordell, Heather J; Miller, E Nancy; Pirinen, Matti; Su, Zhan; Mishra, Anshuman; Mehrotra, Sanjana; Monteiro, Gloria R; Band, Gavin; Bellenguez, Céline; Dronov, Serge; Edkins, Sarah; Freeman, Colin; Giannoulatou, Eleni; Gray, Emma; Hunt, Sarah E; Lacerda, Henio G; Langford, Cordelia; Pearson, Richard; Pontes, Núbia N; Rai, Madhukar; Singh, Shri P; Smith, Linda; Sousa, Olivia; Vukcevic, Damjan; Bramon, Elvira; Brown, Matthew A; Casas, Juan P; Corvin, Aiden; Duncanson, Audrey; Jankowski, Janusz; Markus, Hugh S; Mathew, Christopher G; Palmer, Colin N A; Plomin, Robert; Rautanen, Anna; Sawcer, Stephen J; Trembath, Richard C; Viswanathan, Ananth C; Wood, Nicholas W; Wilson, Mary E; Deloukas, Panos; Peltonen, Leena; Christiansen, Frank; Witt, Campbell; Jeronimo, Selma M B; Sundar, Shyam; Spencer, Chris C A; Blackwell, Jenefer M; Donnelly, Peter

    2013-02-01

    To identify susceptibility loci for visceral leishmaniasis, we undertook genome-wide association studies in two populations: 989 cases and 1,089 controls from India and 357 cases in 308 Brazilian families (1,970 individuals). The HLA-DRB1-HLA-DQA1 locus was the only region to show strong evidence of association in both populations. Replication at this region was undertaken in a second Indian population comprising 941 cases and 990 controls, and combined analysis across the three cohorts for rs9271858 at this locus showed P(combined) = 2.76 × 10(-17) and odds ratio (OR) = 1.41, 95% confidence interval (CI) = 1.30-1.52. A conditional analysis provided evidence for multiple associations within the HLA-DRB1-HLA-DQA1 region, and a model in which risk differed between three groups of haplotypes better explained the signal and was significant in the Indian discovery and replication cohorts. In conclusion, the HLA-DRB1-HLA-DQA1 HLA class II region contributes to visceral leishmaniasis susceptibility in India and Brazil, suggesting shared genetic risk factors for visceral leishmaniasis that cross the epidemiological divides of geography and parasite species.

  18. Diversity of Sand Flies (Diptera: Psychodidae) in Endemic Focus of Visceral Leishmaniasis in Azar Shahr District, East Azarbaijan Province, North West of Iran.

    Science.gov (United States)

    Hazratian, Teimour; Vatandoost, Hasan; Oshaghi, Mohammad Ali; Yaghoobi-Ershadi, Mohammad Reza; Fallah, Esmael; Rafizadeh, Sayena; Shirzadi, Mohammad Reza; Shayeghi, Mansoreh; Akbarzadeh, Kameran; Rassi, Yavar

    2016-09-01

    There are nearly 1000 species of Phlebotomine sand flies in 6 genera, of which only two, Phlebotomus in the old world and Lutzomyia in the new world are medically important. Globally, leishmaniasis prevalent in 98 countries and affects estimated 12 million people with almost two million new cases per year. Some rural areas of Azarshahr District in East Azarbaijan Province have been reported to be endemic for visceral leishmaniasis. This study is the first attempt to determine the species diversity and density in a new focus of visceral leishmaniasis in Azarshahr District, East Azarbaijan Province, Iran. Sand flies were collected form indoor and outdoor biweekly using sticky traps. Diversity index of the collected sand flies within different villages were estimated by the Shannon-Weaver. The activity of the sand flies extended from April to October with one peak in August. Diversity of sand flies within study area were estimated as 0.917, 1.867, 1.339, 1.673, and 1.562 in Almalodash, Jaragil, Segaiesh, Amirdizaj, and Germezgol Vvillages, respectively. Identifying the diversity and seasonal abundance of the collected species is of importance for prediction of the period of maximum risk for leishmaniasis transmission and for the successful implementation of a control program. Species diversity is one of the most important factors in ecological studies.

  19. 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.

  20. Leishmaniose visceral canina em três bairros de Uruguaiana - RS | Canine visceral leishmaniasis in three districts of Uruguaiana - RS

    Directory of Open Access Journals (Sweden)

    Laura Ilarraz Massia

    2016-02-01

    Full Text Available Este estudo teve como objetivo descrever a situação da Leishmaniose visceral canina (LCV em Uruguaiana quanto aos casos confirmados a partir de 2009 e à existência de associação entre o perfil socioeconômico e nível de conhecimento da população sobre a enfermidade em três bairros do município. Apesar da maioria dos entrevistados informar possuir conhecimento sobre a LVC, observou-se dificuldade em adotar uma das medidas preconizadas para a prevenção da doença (poder comprar a coleira. Houve associação entre renda e conhecimento sobre LVC (p = 0,04, poder comprar a coleira (p = 0,00 e limpar o pátio (p = 0,01. Entretanto, não se observou associação entre esta variável e achar que existe tratamento (p = 0,14 ou possuir pátio cercado (p = 0,13. Verificou-se também associação entre grau de escolaridade e conhecimento sobre LVC, poder comprar a coleira e achar que existe tratamento (p = 0,00. As informações resultantes da pesquisa podem auxiliar na condução de políticas públicas para a prevenção e controle da LVC. ================================================= This study aimed to describe the situation of LVC in Uruguaiana about the confirmed cases from 2009 and the existence of association between socioeconomic status and people’s level of knowledge about the disease in three districts of the municipality. Although the majority of respondents report having knowledge of the LVC, it found it difficult to adopt one of the measures recommend for the prevention of disease (to buy the collar. There was an association between income and knowledge of LVC (p = 0.04, to buy the collar (p = 0.00 and clean the patio (p = 0.01. However, there was no association between this variable and find that no treatment (p = 0.14 or own fenced yard (p = 0.13. It was also found association between level of education and knowledge of LVC, to buy the collar and you think there is treatment (p = 0.00. The resulting research information

  1. Dichotomy of the human T cell response to Leishmania antigens. II. Absent or Th2-like response to gp63 and Th1-like response to lipophosphoglycan-associated protein in cells from cured visceral leishmaniasis patients

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Hey, A S; Jardim, A

    1994-01-01

    The T cell response to different Leishmania donovani antigens was investigated using peripheral blood mononuclear cells (PBMC) from Kenyans cured of visceral leishmaniasis and non-exposed Danes. Crude promastigote and amastigote antigens both induced proliferation and interferon-gamma (IFN...... in five of 17 samples from cured patients. Four of the five responding cultures produced IL-4, i.e. the response to this antigen was of the Th2 type. Furthermore, sera from acutely ill visceral leishmaniasis patients contained high levels of IgG antibodies to gp63. The Th2-like response to gp63...... in patients cured of visceral leishmaniasis differs from the Th1-like response to the same antigen observed in patients cured of cutaneous leishmaniasis....

  2. Seroprevalence of CANINE LEISHMANIASIS AND American trypanosomiasis in dogs from Grenada, West Indies

    Science.gov (United States)

    Canine leishmaniasis and American trypanosomiasis (AT) are caused by related hemoflagellated parasites, Leishmania spp. and Trypanosoma cruzi, which share several common host species. Dogs are reservoirs for human infections with both pathogens. We determined the prevalence of antibodies to Leishman...

  3. Diagnosis of visceral Leishmaniasis in asymptomatic dogs by the KDNA PCR-hybridization assay using noninvasive samples

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Rodrigo Souza; Andrade, Antero Silva Ribeiro de [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Lab. de Radiobiologia], e-mail: rleite2005@gmail.com; Ferreira, Sydney de Almeida; Ituassu, Leonardo Trindade; Melo, Maria Norma de [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Centro de Ciencias Biologicas. Dept. de Parasitologia], e-mail: saninoalmeida@gmail.com

    2009-07-01

    The visceral leishmaniasis (VL) in Brazil is caused by Leishmania (Leishmania) chagasi and the asymptomatic dogs may transmit the parasite to sand flies vectors. The VL epidemiological control in Brazil involves the elimination of seropositive dogs, insecticide treatment and systematic treatment of human cases. Therefore, the accurate diagnosis is important in order to avoid the disease transmission or unnecessary culling of dogs. Serological tests are used for screening of dogs. However, these techniques present limitations. The Polymerase Chain Reaction (PCR) is an attractive alternative to the diagnosis in this context; but non-invasive samplings have great importance because they are simpler, painless and less resisted by dog-owners. This study aimed at evaluating conjunctival swab (CS) for canine VL diagnosis. In this methodology a sterile cotton swab is used to sampling the dog conjunctiva in both eyes. Thirty asymptomatic seropositive dogs were used. The samples were analyzed by the kDNA PCR-hybridization procedure in which the PCR products are hybridized with cloned kDNA mini-circles labeled with {sup 32}P[]dCTP. In addition, blood (B) was collected from each animal. L. chagasi was identified in 90% of CS samples and 13,6% of B samples. The high sensitivity obtained with asymptomatic dogs, in which the diagnosis is more difficult due the low number of parasites in the samples, allow concluding that the conjunctival swab associated to the kDNA PCR-hybridization assay provides a valuable alternative tool for the direct diagnosis of canine leishmaniasis. (author)

  4. Environmental suitability for Lutzomyia longipalpis in a subtropical city with a recently established visceral leishmaniasis transmission cycle, Argentina.

    Science.gov (United States)

    Berrozpe, Pablo; Lamattina, Daniela; Santini, María Soledad; Araujo, Analía Vanesa; Utgés, María Eugenia; Salomón, Oscar Daniel

    2017-10-01

    Visceral leishmaniasis (VL) is an endemic disease in northeastern Argentina including the Corrientes province, where the presence of the vector and canine cases of VL were recently confirmed in December 2008. The objective of this study was to assess the modelling of micro- and macro-habitat variables to evaluate the urban environmental suitability for the spatial distribution of Lutzomyia longipalpis presence and abundance in an urban scenario. Sampling of 45 sites distributed throughout Corrientes city (Argentina) was carried out using REDILA-BL minilight traps in December 2013. The sampled specimens were identified according to methods described by Galati (2003). The analysis of variables derived from the processing of satellite images (macro-habitat variables) and from the entomological sampling and surveys (micro-habitat variables) was performed using the statistical software R. Three generalised linear models were constructed composed of micro- and macro-habitat variables to explain the spatial distribution of the abundance of Lu. longipalpis and one composed of micro-habitat variables to explain the occurrence of the vector. A total of 609 phlebotominae belonging to five species were collected, of which 56% were Lu. longipalpis. In addition, the presence of Nyssomyia neivai and Migonemya migonei, which are vectors of tegumentary leishmaniasis, were also documented and represented 34.81% and 6.74% of the collections, respectively. The explanatory variable normalised difference vegetation index (NDVI) described the abundance distribution, whereas the presence of farmyard animals was important for explaining both the abundance and the occurrence of the vector. The results contribute to the identification of variables that can be used to establish priority areas for entomological surveillance and provide an efficient transfer tool for the control and prevention of vector-borne diseases.

  5. Seasonality of sand flies (Diptera: Psychodidae) and Leishmania DNA detection in vector species in an area with endemic visceral leishmaniasis

    Science.gov (United States)

    Saraiva, Lara; Leite, Camila Gonçalves; Lima, Ana Cristina Vianna Mariano da Rocha; de Carvalho, Luiz Otávio Alves; Pereira, Agnes Antônia Sampaio; Rugani, Jerônimo Marteleto Nunes; Rego, Felipe Dutra; Gontijo, Célia Maria Ferreira; Andrade, José Dilermando

    2017-01-01

    BACKGROUND Leishmaniases are a serious health problem in southeast Brazil, including the city of Belo Horizonte (BH), Minas Gerais state (MG), where there are high rates of incidence and mortality due to visceral leishmaniases. BH is divided into nine sanitary districts (SD) of which one, the Venda Nova SD, was selected for this study because it has high rates of positivity for canine leishmaniasis and high incidence of human leishmaniasis. OBJECTIVES This study aimed to survey the sand fly fauna in Venda Nova SD from August 2011 to July 2013 and perform a descriptive analysis of the vector population. METHODS The sampling was carried out using automatic HP light traps at all covered areas of the Venda Nova SD, in a total of eighteen light traps. Sampled specimens were identified following Galati (2003), and females were submitted to molecular techniques for the detection and identification of Leishmania DNA. A simple environmental description was done for it area and Kernel estimation was used to infer vector density for each study site. FINDINGS A total of 2,427 sand fly specimens belonging to eight species and five genera were collected of which 95.3% were Lutzomyia longipalpis. The seasonal variation curve was delineated by this species. Lu. longipalpis was the most abundant at all collection points and in all months of the study, and exhibited a natural infection rate of 1.01% for Leishmania infantum and 1.77% for Leishmania braziliensis. MAIN CONCLUSIONS The results show the presence and adaptation of Lu. longipalpis to the anthropic environment of BH and reinforces its role as the main vector of L. infantum in the region. PMID:28327794

  6. Diagnosis of visceral Leishmaniasis in asymptomatic dogs by the KDNA PCR-hybridization assay using noninvasive samples

    International Nuclear Information System (INIS)

    Leite, Rodrigo Souza; Andrade, Antero Silva Ribeiro de; Ferreira, Sydney de Almeida; Ituassu, Leonardo Trindade; Melo, Maria Norma de

    2009-01-01

    The visceral leishmaniasis (VL) in Brazil is caused by Leishmania (Leishmania) chagasi and the asymptomatic dogs may transmit the parasite to sand flies vectors. The VL epidemiological control in Brazil involves the elimination of seropositive dogs, insecticide treatment and systematic treatment of human cases. Therefore, the accurate diagnosis is important in order to avoid the disease transmission or unnecessary culling of dogs. Serological tests are used for screening of dogs. However, these techniques present limitations. The Polymerase Chain Reaction (PCR) is an attractive alternative to the diagnosis in this context; but non-invasive samplings have great importance because they are simpler, painless and less resisted by dog-owners. This study aimed at evaluating conjunctival swab (CS) for canine VL diagnosis. In this methodology a sterile cotton swab is used to sampling the dog conjunctiva in both eyes. Thirty asymptomatic seropositive dogs were used. The samples were analyzed by the kDNA PCR-hybridization procedure in which the PCR products are hybridized with cloned kDNA mini-circles labeled with 32 P[]dCTP. In addition, blood (B) was collected from each animal. L. chagasi was identified in 90% of CS samples and 13,6% of B samples. The high sensitivity obtained with asymptomatic dogs, in which the diagnosis is more difficult due the low number of parasites in the samples, allow concluding that the conjunctival swab associated to the kDNA PCR-hybridization assay provides a valuable alternative tool for the direct diagnosis of canine leishmaniasis. (author)

  7. Seasonality of sand flies (Diptera: Psychodidae) and Leishmania DNA detection in vector species in an area with endemic visceral leishmaniasis.

    Science.gov (United States)

    Saraiva, Lara; Leite, Camila Gonçalves; Lima, Ana Cristina Vianna Mariano da Rocha; Carvalho, Luiz Otávio Alves de; Pereira, Agnes Antônia Sampaio; Rugani, Jerônimo Marteleto Nunes; Rego, Felipe Dutra; Gontijo, Célia Maria Ferreira; Andrade, José Dilermando

    2017-04-01

    Leishmaniases are a serious health problem in southeast Brazil, including the city of Belo Horizonte (BH), Minas Gerais state (MG), where there are high rates of incidence and mortality due to visceral leishmaniases. BH is divided into nine sanitary districts (SD) of which one, the Venda Nova SD, was selected for this study because it has high rates of positivity for canine leishmaniasis and high incidence of human leishmaniasis. This study aimed to survey the sand fly fauna in Venda Nova SD from August 2011 to July 2013 and perform a descriptive analysis of the vector population. The sampling was carried out using automatic HP light traps at all covered areas of the Venda Nova SD, in a total of eighteen light traps. Sampled specimens were identified following Galati (2003), and females were submitted to molecular techniques for the detection and identification of Leishmania DNA. A simple environmental description was done for it area and Kernel estimation was used to infer vector density for each study site. A total of 2,427 sand fly specimens belonging to eight species and five genera were collected of which 95.3% were Lutzomyia longipalpis. The seasonal variation curve was delineated by this species. Lu. longipalpis was the most abundant at all collection points and in all months of the study, and exhibited a natural infection rate of 1.01% for Leishmania infantum and 1.77% for Leishmania braziliensis. The results show the presence and adaptation of Lu. longipalpis to the anthropic environment of BH and reinforces its role as the main vector of L. infantum in the region.

  8. Biomarkers of safety and immune protection for genetically modified live attenuated leishmania vaccines against visceral leishmaniasis - discovery and implications.

    Science.gov (United States)

    Gannavaram, Sreenivas; Dey, Ranadhir; Avishek, Kumar; Selvapandiyan, Angamuthu; Salotra, Poonam; Nakhasi, Hira L

    2014-01-01

    Despite intense efforts there is no safe and efficacious vaccine against visceral leishmaniasis, which is fatal and endemic in many tropical countries. A major shortcoming in the vaccine development against blood-borne parasitic agents such as Leishmania is the inadequate predictive power of the early immune responses mounted in the host against the experimental vaccines. Often immune correlates derived from in-bred animal models do not yield immune markers of protection that can be readily extrapolated to humans. The limited efficacy of vaccines based on DNA, subunit, heat killed parasites has led to the realization that acquisition of durable immunity against the protozoan parasites requires a controlled infection with a live attenuated organism. Recent success of irradiated malaria parasites as a vaccine candidate further strengthens this approach to vaccination. We developed several gene deletion mutants in Leishmania donovani as potential live attenuated vaccines and reported extensively on the immunogenicity of LdCentrin1 deleted mutant in mice, hamsters, and dogs. Additional limited studies using genetically modified live attenuated Leishmania parasites as vaccine candidates have been reported. However, for the live attenuated parasite vaccines, the primary barrier against widespread use remains the absence of clear biomarkers associated with protection and safety. Recent studies in evaluation of vaccines, e.g., influenza and yellow fever vaccines, using systems biology tools demonstrated the power of such strategies in understanding the immunological mechanisms that underpin a protective phenotype. Applying similar tools in isolated human tissues such as PBMCs from healthy individuals infected with live attenuated parasites such as LdCen(-/-) in vitro followed by human microarray hybridization experiments will enable us to understand how early vaccine-induced gene expression profiles and the associated immune responses are coordinately regulated in normal

  9. Biomarkers of Safety and Immune Protection for Genetically Modified Live Attenuated Leishmania Vaccines Against Visceral Leishmaniasis – Discovery and Implications

    Science.gov (United States)

    Gannavaram, Sreenivas; Dey, Ranadhir; Avishek, Kumar; Selvapandiyan, Angamuthu; Salotra, Poonam; Nakhasi, Hira L.

    2014-01-01

    Despite intense efforts there is no safe and efficacious vaccine against visceral leishmaniasis, which is fatal and endemic in many tropical countries. A major shortcoming in the vaccine development against blood-borne parasitic agents such as Leishmania is the inadequate predictive power of the early immune responses mounted in the host against the experimental vaccines. Often immune correlates derived from in-bred animal models do not yield immune markers of protection that can be readily extrapolated to humans. The limited efficacy of vaccines based on DNA, subunit, heat killed parasites has led to the realization that acquisition of durable immunity against the protozoan parasites requires a controlled infection with a live attenuated organism. Recent success of irradiated malaria parasites as a vaccine candidate further strengthens this approach to vaccination. We developed several gene deletion mutants in Leishmania donovani as potential live attenuated vaccines and reported extensively on the immunogenicity of LdCentrin1 deleted mutant in mice, hamsters, and dogs. Additional limited studies using genetically modified live attenuated Leishmania parasites as vaccine candidates have been reported. However, for the live attenuated parasite vaccines, the primary barrier against widespread use remains the absence of clear biomarkers associated with protection and safety. Recent studies in evaluation of vaccines, e.g., influenza and yellow fever vaccines, using systems biology tools demonstrated the power of such strategies in understanding the immunological mechanisms that underpin a protective phenotype. Applying similar tools in isolated human tissues such as PBMCs from healthy individuals infected with live attenuated parasites such as LdCen−/− in vitro followed by human microarray hybridization experiments will enable us to understand how early vaccine-induced gene expression profiles and the associated immune responses are coordinately regulated in normal

  10. A Vaccine Therapy for Canine Visceral Leishmaniasis Promoted Significant Improvement of Clinical and Immune Status with Reduction in Parasite Burden

    Science.gov (United States)

    Roatt, Bruno Mendes; Aguiar-Soares, Rodrigo Dian de Oliveira; Reis, Levi Eduardo Soares; Cardoso, Jamille Mirelle de Oliveira; Mathias, Fernando Augusto Siqueira; de Brito, Rory Cristiane Fortes; da Silva, Sydnei Magno; Gontijo, Nelder De Figueiredo; Ferreira, Sidney de Almeida; Valenzuela, Jesus G.; Corrêa-Oliveira, Rodrigo; Giunchetti, Rodolfo Cordeiro; Reis, Alexandre Barbosa

    2017-01-01

    Herein, we evaluated the treatment strategy employing a therapeutic heterologous vaccine composed of antigens of Leishmania braziliensis associated with MPL adjuvant (LBMPL vaccine) for visceral leishmaniasis (VL) in symptomatic dogs naturally infected by Leishmania infantum. Sixteen dogs received immunotherapy with MPL adjuvant (n = 6) or with a vaccine composed of antigens of L. braziliensis associated with MPL (LBMPL vaccine therapy, n = 10). Dogs were submitted to an immunotherapeutic scheme consisting of 3 series composed of 10 subcutaneous doses with 10-day interval between each series. The animals were evaluated before (T0) and 90 days after treatment (T90) for their biochemical/hematological, immunological, clinical, and parasitological variables. Our major results showed that the vaccine therapy with LBMPL was able to restore and normalize main biochemical (urea, AST, ALP, and bilirubin) and hematological (erythrocytes, hemoglobin, hematocrit, and platelets) parameters. In addition, in an ex vivo analysis using flow cytometry, dogs treated with LBMPL vaccine showed increased CD3+ T lymphocytes and their subpopulations (TCD4+ and TCD8+), reduction of CD21+ B lymphocytes, increased NK cells (CD5−CD16+) and CD14+ monocytes. Under in vitro conditions, the animals developed a strong antigen-specific lymphoproliferation mainly by TCD4+ and TCD8+ cells; increasing in both TCD4+IFN-γ+ and TCD8+IFN-γ+ as well as reduction of TCD4+IL-4+ and TCD8+IL-4+ lymphocytes with an increased production of TNF-α and reduced levels of IL-10. Concerning the clinical signs of canine visceral leishmaniasis, the animals showed an important reduction in the number and intensity of the disease signs; increase body weight as well as reduction of splenomegaly. In addition, the LBMPL immunotherapy also promoted a reduction in parasite burden assessed by real-time PCR. In the bone marrow, we observed seven times less parasites in LBMPL animals compared with MPL group. The

  11. The role of rk39 serologic test in the diagnosis of visceral leishmaniasis in a Tertiary Hospital, Northern Ethiopia.

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    Kiros, Yazezew Kebede; Regassa, Bethlhem Feleke

    2017-04-26

    The study is done in Ayder Referral Hospital in Northern Ethiopia. Ethiopia is one of the countries where visceral leishmaniasis (VL) is endemic. Diagnosis of VL in Ethiopia is primarily based on rK39 immunochromatographic (rk39-ICT) strip. This test has been shown to have variable sensitivity and specificity in different countries. Hence the objective of the study is to determine the sensitivity and specificity of rk39-ICT in the diagnosis of VL in our set up. The study participants were VL suspected patients admitted to the hospital. A cross sectional study design was used. The study was conducted from January 14, 2013 to June 26, 2015. The rK39-ICT strip used was the InBios brand. Ethical clearance was obtained from the IRB of the college and written consent was obtained from the individual patients. A total of 62 VL suspects were involved in the study. The mean age was 26.3 years (SD = 6.94 years) with a median age of 25.5 years. Sixty-one (98.4%) of the patients was males. The rK39-ICT was positive in 50 (80.6%) of the patients. Splenic aspiration was positive in 44 (71%) of the patients. In 37 (59.7%) of the patients both rK39 and splenic aspiration were positive. Thirteen (21%) of the patients had positive rK39 but negative splenic aspiration. Five (8.1%) of the patients had both negative rK39 and splenic aspiration however seven (11.3%) of the patients had rk39 negative but splenic aspiration positive. The sensitivity, specificity, positive predictive value and the negative predictive value of rK39-ICT, taking splenic aspiration as a gold standard test, is 84.1% (95% CI 69.9-93.4%), 27.8% (95% CI 9.7-53.5%), 74.0% (95% CI 60-85.4%) and 41.7% (95% CI 15.2-72.3%) respectively. Sensitivity of rK39-ICT is low and its specificity is poor in our set up. Significant number of patients with confirmed VL did not have travel history to endemic areas. We recommend that the rK39-ICT needs improvement for clinical use in our set up and case definition for visceral

  12. Decrease of the incidence of human and canine visceral leishmaniasis after dog vaccination with Leishmune in Brazilian endemic areas.

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    Palatnik-de-Sousa, Clarisa B; Silva-Antunes, Ilce; Morgado, Adilson de Aguiar; Menz, Ingrid; Palatnik, Marcos; Lavor, Carlile

    2009-06-02

    Leishmune, the first prophylactic vaccine licensed against canine visceral leishmaniasis (CVL), has been used in Brazil since 2004, where seropositive dogs are sacrificed in order to control human visceral leishmaniasis (VL). We demonstrate here that vaccination with Leishmune does not interfere with the serological control campaign (110,000 dogs). Only 1.3% of positivity (76 among 5860) was detected among Leishmune uninfected vaccinees. We also analyzed the possible additive effect of Leishmune vaccination over dog culling, on the decrease of the incidence of CVL and VL in two Brazilian endemic areas, from 2004 to 2006. In Araçatuba, a 25% of decline was seen in CVL with a 61% decline in human cases, indicating the additive effect of Leishmune vaccination of 5.7% of the healthy dogs (1419 dogs), on regular dog culling. In Belo Horizonte (BH), rising curves of canine and human incidence were observed in the districts of Barreiro, Venda Nova and Noroeste, while the canine and human incidence of Centro Sul, Leste, Nordeste, Norte, Pampulha and Oeste, started to decrease or maintained a stabilized plateau after Leishmune vaccination. Among the districts showing a percent decrease of human incidence (-36.5%), Centro Sul and Pampulha showed the highest dog vaccination percents (63.27% and 27.27%, respectively) and the lowest dog incidence (-3.36% and 1.89%, respectively). They were followed by Oeste, that vaccinated 25.30% of the animals and experienced an increase of only 12.86% of dog incidence and by Leste and Nordeste, with lower proportions of vaccinees (11.72% and 10.76%, respectively) and probably because of that, slightly higher canine incidences (42.77% and 35.73%). The only exception was found in Norte district where the reduced human and canine incidence were not correlated to Leishmune vaccination. Much lower proportions of dogs were vaccinated in Venda Nova (4.35%), Noroeste (10.27%) and Barreiro (0.09%) districts, which according to that exhibited very

  13. Cytokine expression in the duodenal mucosa of patients with visceral leishmaniasis Expressão de citocinas na mucosa duodenal de pacientes com leishmaniose visceral

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    Kleber Giovanni Luz

    2010-08-01

    Full Text Available INTRODUCTION: Visceral leishmaniasis (VL is a neglected tropical disease with a complex immune response in different organs. This pattern of organ-specific immune response has never been evaluated in the gastrointestinal tract. The aim of this study was to determine the in situ immune response in duodenal biopsies on patients with VL. METHODS: A case-control study was conducted on 13 patients with VL in comparison with nine controls. The immune response was evaluated using immunohistochemistry, for CD4, CD8, CD68, IL-4, IFN-γ, TNF-α and IL-10. Histological findings from the villi, crypts and inflammatory process were analyzed. RESULTS: All the cases of VL presented Leishmania antigens. No antigen was detected in the control group. The villus size was greater in the VL patients (p INTRODUÇÃO: Leishmaniose visceral (LV é uma doença tropical negligenciada com uma resposta imune complexa em diferentes órgãos. Este padrão de resposta imune órgão-específica nunca foi avaliada no trato gastrointestinal. O objetivo deste estudo foi determinar a resposta imune in situ em biópsias duodenais de pacientes com LV. MÉTODOS: Um estudo de caso controle com 13 pacientes com LV foi comparado com 9 controles. A resposta imune foi avaliada por imunohistoquímica para CD4, CD8, CD68, IL-4, IFN-γ, TNF-α e IL-10. Achados histológicos nos vilos, criptas e processo inflamatório foram analisados. RESULTADOS: Todos os casos de LV apresentaram antígenos de Leishmania. Nenhum antígeno foi encontrado no grupo controle. O tamanho do vilo foi maior em pacientes com LV (p < 0,05. CD68 (macrófagos e CD4 estavam aumentados em pacientes com LV (p < 0,05. Nenhuma diferença foi demonstrada na expressão de CD8, TNF-α, IL-10 e IL-4. O número de células expressando IFN-γ foi mais baixo que no grupo controle (p < 0,05. CONCLUSÕES: Baixos níveis de citocinas foram encontrados no trato gastrointestinal de pacientes com LV. Este padrão não foi encontrado em

  14. Outbreak of autochthonous canine visceral leishmaniasis in Santa Catarina, Brazil Surto autóctone de leishmaniose visceral canina no Estado de Santa Catarina

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    Mário Steindel

    2013-04-01

    Full Text Available The present study reports the first outbreak of autochthonous canine visceral leishmaniasis in Florianópolis, Santa Catarina, southern Brazil. Following the report of two cases of CVL, the Control Center of Zoonotic Diseases conducted a serological survey by ELISA and IFAT assays in seven districts of the Santa Catarina Island. Eleven seropositive dogs of autochthonous transmission were used in the present study. Infection by Leishmania sp. was confirmed by parasitological examination of bone marrow, liver, spleen and lymph nodes, culture in Schneider's medium and PCR. Leishmania sp. isolates were characterized by PCR-RFLP and hybridization with specific probes, allowing for the identification of Leishmania infantum. Autochthonous transmission of this disease in an area with high tourist traffic presents a major public health concern and signifies the emergence of an important zoonosis in southern Brazil. Therefore, the implementation of surveillance and control measures is imperative to prevent the spread of the disease among the canine population as well as transmission to the human population.O presente estudo relata o primeiro surto autóctone de leishmaniose visceral canina (LCV em Florianópolis, Santa Catarina, Brasil. Durante levantamento soro-epidemiológico realizado pelo Centro de Controle de Doenças Zoonóticas (CCZ envolvendo 2.124 cães, 29 (1,37% foram soropositivos para VL (ELISA + RIFI. Onze cães positivos por transmissão autóctone foram utilizados no presente estudo. A confirmação da infecção por Leishmania sp. foi realizada pelo exame parasitológico da medula óssea, fígado, baço e linfonodos, cultura em meio Schneider e PCR. Os isolados de Leishmania sp. foram caracterizados por PCR-RFLP e hibridação com sondas específicas, permitindo a identificação de Leishmania infantum. A transmissão autóctone da LCV em uma área com grande fluxo turístico como Florianópolis representa um preocupante risco à saúde p

  15. Nível sérico da vitamina A em crianças portadoras de leishmaniose visceral Vitamin A serum level in children with visceral leishmaniasis

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    Kleber Giovanni Luz

    2001-01-01

    Full Text Available A vitamina A tem sido considerada uma vitamina anti-infecciosa e sua deficiência está associada a um maior risco de infecções graves, como ocorre por exemplo no sarampo. Nos países em desenvolvimento a hipovitaminose A é um grave problema de saúde pública. O objetivo deste estudo é quantificar o nível sérico da vitamina A em pacientes pediátricos portadores da leismaniose visceral (LV. Amostras de sangue foram coletadas de 22 crianças portadoras de LV, estocadas em freezer e posteriormente, quantificado o nível de vitamina A usando-se a cromatrografia líquída de alta eficiência, nove irmãos assintomáticos dos pacientes foram usados como controles. A média do nível sérico da vitamina A nos portadores de LV foi de 21,38µg/100ml e no grupo controle foi de 31,39µg/100ml. Entre os pacientes estudados com LV a média do nível sérico de vitamina A encontrado foi significativamente menor, utilizando-se o teste t de Student para um pVitamin A is considered an anti-infectious disease vitamin, and its deficiency is associated with severe infections such as in measles. In developing countries the low concentrations of vitamin A are a public health problem. The aim of this study is to describe serum vitamin A concentrations among children with visceral leishmaniasis (VL. Blood sample was collected from 22 children with VL, and stored in a freezer, 9 siblings, with no clinical signs of the VL patients had their blood collected for a control group. Samples were assayed by high performance liquid chromatography. The median vitamin A concentration in the LV group was 21.38µg/100ml and in the control group it was 31.39µg/100. The mean in the LV was statistically lower than in the control group, using Student's t test, p<0.01.

  16. Dispersal of Lutzomyia longipalpis and expansion of canine and human visceral leishmaniasis in São Paulo State, Brazil.

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    Oliveira, Agda Maria; Vieira, Carolina Portugal; Dibo, Margareth Regina; Guirado, Marluci Monteiro; Rodas, Lilian Aparecida Colebrusco; Chiaravalloti-Neto, Francisco

    2016-12-01

    Visceral leishmaniasis (VL), a neglected disease, is a serious public health problem that affects millions of people worldwide. The objectives of the study were to evaluate the sensitivity of Lutzomyia longipalpis and canine VL (CVL) autochthony early detection and describe the spatial and temporal dispersal of vector and expansion of VL in a Brazilian state. We obtained data on the leishmaniasis vector and VL cases in São Paulo State (SP), Brazil, from the Division of Endemic Disease Control and from the Epidemiological Surveillance Center of the São Paulo State Department of Health. Data were analyzed for 645 municipalities and 63 microregions and presented as thematic and flow maps. Following the verified presence of L. longipalpis in Araçatuba in 1997, the first autochthonous cases of canine VL (CVL) (1998) and of human VL (HVL) (1999) in São Paulo were reported, both in Araçatuba. From 1997 to 2014, the urban presence of the leishmaniasis vector was verified in 167 (25.9%) municipalities with cases of CVL reported in 108 (16.7%) and cases of HVL in 84 (13%). The sensitivities for vector presence early detection in relation to the identification of CVL and HVL autochthony were, respectively, equal to 76.4 and 92.5%. The sensitivity for CVL autochthony early detection in relation to the HVL autochthony identification was 75.8%. Vector dispersal and expansion of CVL and HVL were from the northwest to the southeast of the state, primarily flanking the Marechal Rondon highway at a constant rate of progression of 10, seven, and six new municipalities affected per year, respectively. We concluded that the sensitivity for vector presence and CVL autochthony presented reasonable accuracy and most of the time the vector presence and, specially, the CVL and HVL autochthony were identified in the main cities of the microregions of SP. Vector dispersal and expansion of VL started in 1997 near the state border of SP with the state of Mato Grosso do Sul. It has advanced

  17. Detection of Leishmania spp. in Bats from an Area of Brazil Endemic for Visceral Leishmaniasis.

    Science.gov (United States)

    de Rezende, M B; Herrera, H M; Carvalho, C M E; Carvalho Anjos, E A; Ramos, C A N; de Araújo, F R; Torres, J M; de Oliveira, C E

    2017-12-01

    The multihost parasites Leishmania spp. infect a broad range of wild mammalian species including bats. Several species of bats have adapted to a variety of food resources and shelters in urban areas. This study aimed to detect Leishmania spp. DNA in bats present in forest fragments located in metropolitan areas endemic for leishmaniasis in Campo Grande, Mato Grosso do Sul (MS), Brazil. Blood samples were obtained from 80 individuals, including eight species of Phyllostomidae and one species of Vespertilionidae. Thirty of the 80 bats were positive for Leishmania spp. using conventional PCR, all belonging to the family Phyllostomidae. Eighteen samples tested by real-time PCR (qPCR) using specific primers for the kDNA of Leishmania infantum were positive. To the best of our knowledge, this is the first report detecting Leishmania spp. in Platyrrhinus incarum in addition to being the first reported detection of L. infantum in the bat species Phyllostomus discolor, Platyrrhinus lineatus, Artibeus planirostris and Artibeus lituratus. Our results show that bats can host Leishmania spp. in areas endemic for leishmaniasis, which must be taken into account in disease control operations by public health authorities. © 2017 Blackwell Verlag GmbH.

  18. Canine Visceral Leishmaniasis in Wild Canines (Fox, Jackal, and Wolf) in Northeastern Iran Using Parasitological, Serological, and Molecular Methods.

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    Mohebali, Mehdi; Arzamani, Kourosh; Zarei, Zabiholah; Akhoundi, Behnaz; Hajjaran, Homa; Raeghi, Saber; Heidari, Zahra; Motavalli-Haghi, Seyed Mousa; Elikaee, Samira; Mousazadeh-Mojarrad, Ahmad; Kakoei, Zahra

    2016-12-01

    Although many studies had been conducted on various aspects of canine visceral leishmaniasis (CVL) in domestic dogs in the endemic areas of Iran, investigations on CVL in wild canines are rare. This is a cross-sectional study was conducted from December 2012 to 2013 in northeast of Iran where human VL is endemic. Wild canines were trapped around the areas where human VL cases had been previously identified. Wild canines were collected and examined both clinically and serologically using direct agglutination test (DAT). Microscopically examinations were performed in all the seropositive wild canines for the presence of the amastigote form of Leishmania spp. Some Leishmania sp. which had been isolated from the spleens of wild canines, were examined analyzed by conventional PCR and sequencing techniques using α-tubulin and GAPDH genes. Altogether, 84 wild canines including foxes ( Vulpes vulpes , n=21), Jackals ( Canis aureus , n=60) and wolves ( Canis lupus , n=3) were collected. Four foxes and seven jackals showed anti- Leishmania infantum antibodies with titers of 1:320-1:20480 in DAT. Furthermore, one fox and one jackal were parasitologically (microscopy and culture) positive and L. infantum was confirmed by sequence analysis. The present study showed that sylvatic cycle of L. infantum had been established in the studied endemic areas of VL in northeastern Iran.

  19. The fucose-mannose ligand-ELISA in the diagnosis and prognosis of canine visceral leishmaniasis in Brazil.

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    Cabrera, G P; Da Silva, V O; Da Costa, R T; Reis, A B; Mayrink, W; Genaro, O; Palatnik-de-Sousa, C B

    1999-08-01

    The fucose-mannose ligand (FML)-ELISA assay showed a sensitivity of 100% and a specificity of 100% in diagnosis of canine visceral leishmaniasis (CVL) (kala-azar) in sera from naturally infected dogs from São Gonçalo do Amaranto, Rio Grande de Norte, Brazil. The overall prevalence of antibodies to Leishmania in the endemic area was 23% (79 of 343). Seroreactivity detected by a Leishmania chagasi immunofluorescent (IF) assay was much lower (2.9%) and similar to the percentage of dogs with kala-azar symptoms (2.6%). Twenty-one of 21 asymptomatic, FML-seropositive animals died of kala-azar in a period ranging from 0 to 6 months after diagnosis. The predictive value was 100% for the FML-ELISA, 43% for an L. mexicana ELISA, and 24% for the L. mexicana and L. chagasi IF assays, respectively. In experimentally infected dogs, all assays detected seropositivity between 90 and 120 days after infection. Since the current strategy for control of CVL is based on detection and destruction of infected dogs, the highly predictive, sensitive, and specific FML-ELISA represents a useful tool for field control of the disease.

  20. Canine Visceral Leishmaniasis in Wild Canines (Fox, Jackal, and Wolf in Northeastern Iran Using Parasitological, Serological, and Molecular Methods

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    Mehdi Mohebali

    2016-10-01

    Full Text Available Background: Although many studies had been conducted on various aspects of canine visceral leishmaniasis (CVL in domestic dogs in the endemic areas of Iran, investigations on CVL in wild canines are rare.Methods: This is a cross-sectional study was conducted from December 2012 to 2013 in northeast of Iran where human VL is endemic. Wild canines were trapped around the areas where human VL cases had been previously identified. Wild canines were collected and examined both clinically and serologically using direct agglutination test (DAT. Microscopically examinations were performed in all the seropositive wild canines for the presence of the amastigote form of Leishmania spp. Some Leishmania sp. which had been isolated from the spleens of wild canines, were examined analyzed by conventional PCR and sequencing techniques using α-tubulin and GAPDH genes.Results: Altogether, 84 wild canines including foxes (Vulpes vulpes, n=21, Jackals (Canis aureus, n=60 and wolves (Canis lupus, n=3 were collected. Four foxes and seven jackals showed anti-Leishmania infantum antibodies with titers of 1:320–1:20480 in DAT. Furthermore, one fox and one jackal were parasitologically (microscopy and culture positive and L. infantum was confirmed by sequence analysis.Conclusion: The present study showed that sylvatic cycle of L. infantum had been established in the studied endemic areas of VL in northeastern Iran.

  1. Spatial modeling using mixed models: an ecologic study of visceral leishmaniasis in Teresina, Piauí State, Brazil

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    Werneck Guilherme L.

    2002-01-01

    Full Text Available Most ecologic studies use geographical areas as units of observation. Because data from areas close to one another tend to be more alike than those from distant areas, estimation of effect size and confidence intervals should consider spatial autocorrelation of measurements. In this report we demonstrate a method for modeling spatial autocorrelation within a mixed model framework, using data on environmental and socioeconomic determinants of the incidence of visceral leishmaniasis (VL in the city of Teresina, Piauí, Brazil. A model with a spherical covariance structure indicated significant spatial autocorrelation in the data and yielded a better fit than one assuming independent observations. While both models showed a positive association between VL incidence and residence in a favela (slum or in areas with green vegetation, values for the fixed effects and standard errors differed substantially between the models. Exploration of the data's spatial correlation structure through the semivariogram should precede the use of these models. Our findings support the hypothesis of spatial dependence of VL rates and indicate that it might be useful to model spatial correlation in order to obtain more accurate point and standard error estimates.

  2. The value of a new microculture method for diagnosis of visceral leishmaniasis by using bone marrow and peripheral blood.

    Science.gov (United States)

    Allahverdiyev, Adil M; Bagirova, Malahat; Uzun, Soner; Alabaz, Derya; Aksaray, Necmi; Kocabas, Emine; Koksal, Fatih

    2005-08-01

    We have demonstrated that the microculture method (MCM) enables the diagnosis of visceral leishmaniasis (VL) with samples from both the bone marrow (BM) and peripheral blood (PB). The MCM is superior to the traditional culture method (TCM) as determined by its higher sensitivity in the detection of promastigotes and the more rapid time for emergence of promastigotes. The sensitivity of MCM (100% in BMs and 77.8-100% in PB) was considerably higher than that of the TCM (37.5-100% in BMs and 0-100% in PB) according to decreasing parasite density (P < 0.05). The concentration of parasites in buffy coats has increased the sensitivity of both methods, especially that of the MCM. Detection of promastigotes by MCM requires lower amounts of culture media (25-50 microL) and shorter incubation periods (2-7 days) than TCM (2.5-3.5 mL and 15-35 days, respectively). MCM was found to be valuable with the advantages of simplicity and sensitivity, in addition to being cost-effective in the routine diagnosis for VL in Adana Turkey.

  3. IDENTIFICATION OF CANINE VISCERAL LEISHMANIASIS IN A PREVIOUSLY UNAFFECTED AREA BY CONVENTIONAL DIAGNOSTIC TECHNIQUES AND CELL-BLOCK FIXATION

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    Tuanne Rotti ABRANTES

    2016-01-01

    Full Text Available After the report of a second case of canine visceral leishmaniasis (CVL in São Bento da Lagoa, Itaipuaçu, in the municipality of Maricá, Rio de Janeiro State, an epidemiological survey was carried out, through active search, totaling 145 dogs. Indirect immunofluorescence assay (IFA, enzyme-linked immunosorbent assay (ELISA, and rapid chromatographic immunoassay based on dual-path platform (DPP(r were used to perform the serological examinations. The parasitological diagnosis of cutaneous fragments was performed by parasitological culture, histopathology, and immunohistochemistry. In the serological assessment, 21 dogs were seropositive by IFA, 17 by ELISA, and 11 by DPP(r, with sensitivity of 66.7%, 66.7% and 50%, and specificity of 87.2%, 90.2% and 94%, respectively for each technique. The immunohistochemistry of bone marrow using the cell-block technique presented the best results, with six positive dogs found, three of which tested negative by the other parasitological techniques. Leishmania sp. was isolated by parasitological culture in three dogs. The detection of autochthonous Leishmania infantum in Itaipuaçu, and the high prevalence of seropositive dogs confirm the circulation of this parasite in the study area and alert for the risk of expansion in the State of Rio de Janeiro.

  4. Emergence of a new focus of visceral leishmaniasis due to Leishmania infantum in Golestan Province, north-eastern of Iran.

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    Fakhar, Mahdi; Asadi Kia, A; Gohardehi, Sh; Sharif, M; Mohebali, M; Akhoundi, B; Pagheh, A; Dadimoghadam, Y; Cheraghali, F

    2014-09-01

    Over the last decade, a few cases of visceral leishmaniasis (VL) have been reported in some districts of the province of Golestan, in north-eastern Iran. The aim of the present study was to investigate the prevalence of Leishmania infantum infection among humans and domestic dogs by using direct agglutination test (DAT) and PCR assays in the eastern zone of the province. Between 2011 and 2012, blood samples were randomly collected from 450 humans and 50 domestic dogs, in the eastern zone of Golestan Province including 7 villages from Marave-tappeh district where new cases of human VL had been recorded there. Each of these samples was tested for anti-Leishmania antibodies, in DAT, and for L. infantum kinetoplast DNA on whole blood, in PCR-based assays. A total of 450 human samples, 6 (1.33 %) were found seropositive and 13 (2.8 %) was found PCR-positive. Of the 50 dog samples, 16 (32 %) were found seropositive and 15 (30 %) were PCR-positive. All PCR-positive dogs were found seropositive except one as well as 6 (46.2 %) PCR-positive humans were also found seropositive. Moreover, the species of L. infantum was detected in all PCR-positive samples. The high prevalence of VL in the study areas offer it has emerged as an endemic focus in the province. Further investigations on the vectors, reservoirs and human population are recommended.

  5. Immunomodulatory role of interleukin-10 in visceral leishmaniasis: defective activation of protein kinase C-mediated signal transduction events.

    Science.gov (United States)

    Bhattacharyya, S; Ghosh, S; Jhonson, P L; Bhattacharya, S K; Majumdar, S

    2001-03-01

    Leishmania donovani, an intracellular protozoan parasite, challenges host defense mechanisms by impairing the signal transduction of macrophages. In this study we investigated whether interleukin-10 (IL-10)-mediated alteration of signaling events in a murine model of visceral leishmaniasis is associated with macrophage deactivation. Primary in vitro cultures of macrophages infected with leishmanial parasites markedly elevated the endogenous release of IL-10. Treatment with either L. donovani or recombinant IL-10 (rIL-10) inhibited both the activity and expression of the Ca2+-dependent protein kinase C (PKC) isoform. However, preincubation with neutralizing anti-IL-10 monoclonal antibody (MAb) restored the PKC activity in the parasitized macrophage. Furthermore, we observed that coincubation of macrophages with rIL-10 and L. donovani increased the intracellular parasite burden, which was abrogated by anti-IL-10 MAb. Consistent with these observations, generation of superoxide (O2-) and nitric oxide and the release of murine tumor necrosis factor-alpha were attenuated in response to L. donovani or rIL-10 treatment. On the other hand, preincubation of the infected macrophages with neutralizing anti-IL-10 MAb significantly blocked the inhibition of nitric oxide and murine tumor necrosis factor-alpha release by the infected macrophages. These findings imply that infection with L. donovani induces endogenous secretion of murine IL-10, which in turn facilitates the intracellular survival of the protozoan and orchestrates several immunomodulatory roles via selective impairment of PKC-mediated signal transduction.

  6. An rK28-Based Immunoenzymatic Assay for the Diagnosis of Canine Visceral Leishmaniasis in Latin America

    Science.gov (United States)

    Lauricella, Marta Alicia; Maidana, Cristina Graciela; Frias, Victoria Fragueiro; Romagosa, Carlo M.; Negri, Vanesa; Benedetti, Ruben; Sinagra, Angel J.; Luna, Concepcion; Tartaglino, Lilian; Laucella, Susana; Reed, Steven G.; Riarte, Adelina R.

    2016-01-01

    Direct observation of Leishmania parasites in tissue aspirates has shown low sensitivity for the detection of canine visceral leishmaniasis (VL). Therefore in the last quarter century immunoenzymatic tests have been developed to improve diagnosis. The purpose of this study was to develop a fast recombinant K28 antigen, naked-eye qualitative enzyme-linked immunosorbent assay (VL Ql-ELISA) and a quantitative version (VL Qt-ELISA), and to display it in a kit format, whose cutoff value (0.156) was selected as the most adequate one to differentiate reactive from nonreactive samples. Considering 167 cases and 300 controls, sensitivity was 91% for both assays and specificity was 100% and 98.7% in Ql-ELISA and Qt-ELISA, respectively. Positive predictive values were 100% and 97.4% for Ql-ELISA and Qt-ELISA, respectively, and negative predictive values were 95.2% for both ELISAs. Reagent stability, reliability studies, including periodic repetitions and retest of samples, cutoff selection, and comparison of rK28 ELISAs with rK39 immunochromatographic test, were the international criteria that supported the quality in both kits. The performance of both ELISA kits in this work confirmed their validity and emphasized their usefulness for low-to-medium complexity laboratories. PMID:27162270

  7. Development and Assessment of Loop-Mediated Isothermal Amplification (LAMP) Assay for the Diagnosis of Human Visceral Leishmaniasis in Iran.

    Science.gov (United States)

    Ghasemian, Mehrdad; Gharavi, Mohammad Javad; Akhlaghi, Lame; Mohebali, Mehdi; Meamar, Ahmad Reza; Aryan, Ehsan; Oormazdi, Hormozd

    2014-03-01

    Parasitological methods for the diagnosis of Visceral leishmaniasis (VL) require invasive procedures, so serological and molecular approaches have been developed but are not generally applicable in the field. We evaluated a loop mediated isothermal amplification (LAMP) assay using blood from VL patients and compared it to nested PCR. Forty-seven subjects with clinical features (fever, hepatosplenomegaly and anemia) were confirmed positive for VL by the direct agglutination test (DAT) at titers >3200. Forty DAT negative individuals from non-endemic areas with no clinical signs or symptoms of VL served as controls. A LAMP assay was performed using a set of six primers targeting Leishmania infantum kinetoplast DNA (kDNA) minicircle gene under isothermal (64 °C) conditions. For nested PCR we used primers targeting the kDNA minicircle gene. The LAMP assay provided a detection limit of 1 parasite in 1 ml of peripheral blood and detected L. infantum DNA in 44 of 47 DAT-confirmed VL cases, with diagnostic sensitivity of 93.6% (95% CI). No L. infantum DNA was amplified in controls, indicating a specificity of 100%. The nested PCR yielded sensitivity of 96% (95% CI) and a specificity of 100% (95% CI). The LAMP assay gave results similar to those of nested PCR but in a shorter time. The LAMP method is simple; requires no sophisticated equipment; has a short reaction time; and results, indicated by turbidity of the reaction mixture, are observable with the naked eye.

  8. Development and Assessment of Loop-Mediated Isothermal Amplification (LAMP Assay for the Diagnosis of Human Visceral Leishmaniasis in Iran.

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    Mehrdad Ghasemian

    2014-03-01

    Full Text Available Parasitological methods for the diagnosis of Visceral leishmaniasis (VL require invasive procedures, so serological and molecular approaches have been developed but are not generally applicable in the field. We evaluated a loop mediated isothermal amplification (LAMP assay using blood from VL patients and compared it to nested PCR.Forty-seven subjects with clinical features (fever, hepatosplenomegaly and anemia were confirmed positive for VL by the direct agglutination test (DAT at titers >3200. Forty DAT negative individuals from non-endemic areas with no clinical signs or symptoms of VL served as controls. A LAMP assay was performed using a set of six primers targeting Leishmania infantum kinetoplast DNA (kDNA minicircle gene under isothermal (64 °C conditions. For nested PCR we used primers targeting the kDNA minicircle gene.The LAMP assay provided a detection limit of 1 parasite in 1 ml of peripheral blood and detected L. infantum DNA in 44 of 47 DAT-confirmed VL cases, with diagnostic sensitivity of 93.6% (95% CI. No L. infantum DNA was amplified in controls, indicating a specificity of 100%. The nested PCR yielded sensitivity of 96% (95% CI and a specificity of 100% (95% CI.The LAMP assay gave results similar to those of nested PCR but in a shorter time. The LAMP method is simple; requires no sophisticated equipment; has a short reaction time; and results, indicated by turbidity of the reaction mixture, are observable with the naked eye.

  9. Ecological niches and blood sources of sand fly in an endemic focus of visceral leishmaniasis in Jiuzhaigou, Sichuan, China.

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    Chen, Huiying; Li, Kaili; Shi, Hua; Zhang, Yong; Ha, Yu; Wang, Yan; Jiang, Jinjin; Wang, Yubin; Yang, Zhenzhou; Xu, Jiannong; Ma, Yajun

    2016-04-13

    Sand fly Phlebotomus chinensis is a principle vector for the visceral leishmaniasis (VL) in China with a wide geographic distribution. Jiuzhaigou, Sichuan is a mountain type endemic area of VL in China. Long term effective control efforts in the region have successfully reduced VL transmission. To assess the current status of the sand flies and their ecological aspects in the region, a survey was conducted in the summer of 2014 and 2015. Sand fly specimens were collected by light traps in a village and blood sources were identified by PCR and sequencing of the mitochondrial cytochrome b gene. In a rock cave, 65.2 %-79.8 % of collected sand flies were male. On a rabbit farm, 92.9 %-98.8 % of specimens were female. In pig pens, 61.1 % of specimens were female. Some females had visible blood residues. The feeding rate was 49.4 % from the pig pens, 12.3 % from the cave, and only 1.7 % from the rabbit farm. Pig, rabbit, chicken, dog, and human blood were detected in the fed specimens. Swine blood, present in all tested samples, was a preferred blood source, while chicken and dog blood were present in a third of the samples. In Jiuzhaigou County, Sichuan Province of China, the considerable sandfly density and the peridomestic feeding behavior all increases the risk of VL transmission, and insecticide spraying in animal sheds could be exploited to reduce sand fly populations in human surroundings.

  10. Clinical and Microbiological Characteristics of Visceral Leishmaniasis Outbreak in a Northern Italian Nonendemic Area: A Retrospective Observational Study

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    E. Franceschini

    2016-01-01

    Full Text Available Background. Visceral leishmaniasis (VL caused by Leishmania infantum is endemic in the Mediterranean area. In the last decades a northward spread of the parasite has been observed in Italy. This paper describes a VL outbreak in Modena province (Emilia-Romagna, Northern Italy between 2012 and 2015. Methods. Retrospective, observational study to evaluate epidemiological, microbiological characteristics, and clinical management of VL in patients referring to Policlinico Modena Hospital. Results. Sixteen cases of VL occurred in the study period. An immunosuppressive condition was present in 81.3%. Clinical presentation included anemia, fever, leukopenia, thrombocytopenia, and hepatosplenomegaly. Serology was positive in 73.3% of cases, peripheral blood PCR in 92.3%, and bone marrow blood PCR in 100%. Culture was positive in 3/6 cases (50% and all the isolates were identified as L. infantum by ITS1/ITS2 sequencing. The median time between symptom onset and diagnosis was 22 days (range 6–131 days. All patients were treated with liposomal amphotericin b. 18.8% had a VL recurrence and were treated with miltefosine. Attributable mortality was 6.3%. Conclusions. VL due to L. infantum could determine periodical outbreaks, as the one described; thus it is important to include VL in the differential diagnosis of fever of unknown origin, even in low-endemic areas.

  11. Occurrence of Lutzomyia longipalpis (Phlebotominae) and canine visceral leishmaniasis in a rural area of Ilha Solteira, SP, Brazil.

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    Spada, Julio Cesar Pereira; Silva, Diogo Tiago da; Martins, Kennya Rozy Real; Rodas, Lílian Aparecida Colebrusco; Alves, Maria Luana; Faria, Glaucia Amorim; Buzutti, Marcelo Costa; Silva, Hélio Ricardo; Starke-Buzetti, Wilma Aparecida

    2014-01-01

    This study aimed to investigate the occurrence of Lutzomyia longipalpis and also the canine visceral leishmaniasis (CVL) in a rural area of Ilha Solteira, state of São Paulo. Blood samples were collected from 32 dogs from different rural properties (small farms) and were analyzed by ELISA and the indirect immunofluorescence antibody test (IFAT) in order to diagnose CVL. From these serological tests, 31.25% of the dogs were positive for CVL and these were distributed in 66.7% (8/12) of the rural properties, which were positive for L. longipalpis. CDC (Center for Disease Control and Prevention) light traps were installed in 12 properties (one per property) and insects were caught on three consecutive days per month for one year. L. longipalpis was present on 100% of the rural properties visited, at least once during the twelve-month interval, totaling 64 males and 25 females. The insects were more numerous after the peak of the rain, but the association between prevalence of peridomestic vectors and the climatic data (precipitation, relative air humidity and temperature) and the occurrences of CVL among dogs on each rural property were not statistical significant (p longipalpis indicate that more attention is necessairy for the control of this disease in the rural area studied.

  12. Occurrence of Lutzomyia longipalpis Lutz & Neiva 1912 and Cerdocyon thous Linnaeus 1977, in a visceral leishmaniasis endemic area in Brazil.

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    Araujo Soares, Maria Regiane; Lopes Antunes, Jadson Emanuel; de Mendonça, Ivete Lopes; Lima, Rogério Nora; Nery Costa, Carlos Henrique

    2017-10-01

    Cerdocyon thous presents a wide geographic distribution in Brazil and its role as a possible Leishmania infantum reservoir in a visceral leishmaniasis (VL) transmission cycle regardless of dogs (Canis familiaris) has been discussed. From this perspective, this work describes the occurrence and use of the habitat by Cerdocyon thous in a Lutzomyia longipalpis occurrence area Teresina (Piaui - Brazil), VL endemic region. Three specimens of C. thous were monitored with the use of radio telemetry and trails and footprints, seeking to find possible natural dens in order to collect the sanflies from the site. Luminous CDC and Damasceno traps were simultaneously installed at the visited sites, where two specimens of L. longipalpis and one L. termitophila were captured. The identification of the dens and trails, allows us to infer that the dens are not used only by the C. thous. Finding the VL vector in natural C. thous natural dens, reinforces the hypothesis of transmission of Le. infantum in the outskirts of the large urban centers, in a cycle that independs from dogs. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. IDENTIFICATION OF CANINE VISCERAL LEISHMANIASIS IN A PREVIOUSLY UNAFFECTED AREA BY CONVENTIONAL DIAGNOSTIC TECHNIQUES AND CELL-BLOCK FIXATION

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    ABRANTES, Tuanne Rotti; MADEIRA, Maria de Fátima; da SILVA, Denise Amaro; PERIÉ, Carolina dos Santos F. S.; V. MENDES, Artur Augusto; MENEZES, Rodrigo Caldas; SILVA, Valmir Laurentino; FIGUEIREDO, Fabiano Borges

    2016-01-01

    After the report of a second case of canine visceral leishmaniasis (CVL) in São Bento da Lagoa, Itaipuaçu, in the municipality of Maricá, Rio de Janeiro State, an epidemiological survey was carried out, through active search, totaling 145 dogs. Indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and rapid chromatographic immunoassay based on dual-path platform (DPP(r)) were used to perform the serological examinations. The parasitological diagnosis of cutaneous fragments was performed by parasitological culture, histopathology, and immunohistochemistry. In the serological assessment, 21 dogs were seropositive by IFA, 17 by ELISA, and 11 by DPP(r), with sensitivity of 66.7%, 66.7% and 50%, and specificity of 87.2%, 90.2% and 94%, respectively for each technique. The immunohistochemistry of bone marrow using the cell-block technique presented the best results, with six positive dogs found, three of which tested negative by the other parasitological techniques. Leishmania sp. was isolated by parasitological culture in three dogs. The detection of autochthonous Leishmania infantum in Itaipuaçu, and the high prevalence of seropositive dogs confirm the circulation of this parasite in the study area and alert for the risk of expansion in the State of Rio de Janeiro. PMID:26910449

  14. Improved Canine and Human Visceral Leishmaniasis Immunodiagnosis Using Combinations of Synthetic Peptides in Enzyme-Linked Immunosorbent Assay

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    Costa, Míriam Maria; Penido, Marcos; dos Santos, Mariana Silva; Doro, Daniel; de Freitas, Eloísa; Michalick, Marilene Susan Marques; Grimaldi, Gabriel; Gazzinelli, Ricardo Tostes; Fernandes, Ana Paula

    2012-01-01

    Background Zoonotic visceral leishmaniasis (VL) is a severe infectious disease caused by protozoan parasites of the genus Leishmania and the domestic dogs are the main urban parasite reservoir hosts. In Brazil, indirect fluorescence antibody tests (IFAT) and indirect enzyme linked immunosorbent assay (ELISA) using promastigote extracts are widely used in epidemiological surveys. However, their sensitivity and specificity have often been compromised by the use of complex mixtures of antigens, which reduces their accuracy allowing the maintenance of infected animals that favors transmission to humans. In this context, the use of combinations of defined peptides appears favorable. Therefore, they were tested by combinations of five peptides derived from the previously described Leishmania diagnostic antigens A2, NH, LACK and K39. Methodology/Principal Findings Combinations of peptides derived A2, NH, LACK and K39 antigens were used in ELISA with sera from 44 human patients and 106 dogs. Improved sensitivities and specificities, close to 100%, were obtained for both sera of patients and dogs. Moreover, high sensitivity and specificity were observed even for canine sera presenting low IFAT anti-Leishmania antibody titers or from asymptomatic animals. Conclusions/Significance The use of combinations of B cell predicted synthetic peptides derived from antigens A2, NH, LACK and K39 may provide an alternative for improved sensitivities and specificities for immunodiagnostic assays of VL. PMID:22629475

  15. Immunological changes in canine peripheral blood leukocytes triggered by immunization with first or second generation vaccines against canine visceral leishmaniasis.

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    Araújo, Márcio Sobreira Silva; de Andrade, Renata Aline; Sathler-Avelar, Renato; Magalhães, Camila Paula; Carvalho, Andréa Teixeira; Andrade, Mariléia Chaves; Campolina, Sabrina Sidney; Mello, Maria Norma; Vianna, Leonardo Rocha; Mayrink, Wilson; Reis, Alexandre Barbosa; Malaquias, Luiz Cosme Cotta; Rocha, Luciana Morais; Martins-Filho, Olindo Assis

    2011-05-15

    In this study, we summarized the major phenotypic/functional aspects of circulating leukocytes following canine immunization with Leishvaccine and Leishmune®. Our findings showed that Leishvaccine triggered early changes in the innate immunity (neutrophils and eosinophils) with late alterations on monocytes. Conversely, Leishmune(®) induced early phenotypic changes in both, neutrophils and monocytes. Moreover, Leishvaccine triggered mixed activation-related phenotypic changes on T-cells (CD4+ and CD8+ and B-lymphocytes, whereas Leishmune(®) promoted a selective response, mainly associated with CD8+ T-cell activation. Mixed cytokine profile (IFN-γ/IL-4) was observed in Leishvaccine immunized dogs whereas a selective pro-inflammatory pattern (IFN-γ/NO) was induced by Leishmune® vaccination. The distinct immunological profile triggered by Leishvaccine and Leishmune® may be a direct consequence of the distinct biochemical composition of these immunobiological, i.e. complex versus purified Leishmania antigen along with Bacillus Calmette-Guérin (BCG) versus saponin adjuvant. Both immunobiologicals are able to activate phagocytes and CD8+ T-cells and therefore could be considered as a putative vaccines against canine visceral leishmaniasis (CVL). Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Histological study of cell migration in the dermis of hamsters after immunisation with two different vaccines against visceral leishmaniasis.

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    Moreira, Nádia das Dores; Giunchetti, Rodolfo Cordeiro; Carneiro, Cláudia Martins; Vitoriano-Souza, Juliana; Roatt, Bruno Mendes; Malaquias, Luiz Cosme Cotta; Corrêa-Oliveira, Rodrigo; Reis, Alexandre Barbosa

    2009-04-15

    Vaccine candidates, including live and/or killed parasites, Leishmania-purified fractions, defined recombinant antigens and antigen-encoding DNA-plasmids have been proposed to use as vaccine anti-Leishmania. More recently, the hamsters have been used to pre-selection of antigens candidate to apply in further experiments using canine model. In this report we evaluated the kinetics of cell migration in dermal inflammatory infiltrate, circulating leukocytes and the presence of nitric oxide (NO)/induced nitric oxide synthase during the early (1-24h) and late (48-168h) periods following inoculation of hamsters with antigenic components of anti-canine visceral leishmaniasis vaccines Leishmune and Leishmania braziliensis antigen (LB) with and without saponin (Sap) adjuvant. Our results show that LB caused an early reduction of lymphocytes in the dermis while Sap and LBSap triggered a late recruitment, suggesting the role of the adjuvant in the traffic of antigen-presenting cells and the induction of lymphocyte migration. In that manner our results suggest that the kinetics of cell migration on hamster model may be of value in the selection of vaccine antigens prior the tests in dogs particularly in respect of the toxicity of the preparations.

  17. Polymerase chain reaction of peripheral blood as a tool for the diagnosis of visceral leishmaniasis in children

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    Thiago Leite Fraga

    2010-05-01

    Full Text Available The diagnosis of visceral leishmaniasis (VL generally requires the use of invasive tests for the collection of infected tissue (aspirates of bone marrow, spleen, liver or lymph nodes. This difficulty has led to the search for safer and less painful techniques to confirm the occurrence of the disease in children. Polymerase chain reaction (PCR is a method that is advantageous in that it allows the use of peripheral blood samples for diagnosis. This paper reports the utilisation of PCR on peripheral blood samples to diagnose VL in 45 children in Mato Grosso do Sul, Brazil. This technique is compared with methods carried out using tissue collected by invasive procedures, including direct microscopy, culture and detection of Leishmania DNA by PCR in bone marrow aspirates. The results show that PCR of peripheral blood provides great sensitivity (95.6% that is similar to that from the PCR of bone marrow aspirates (91.1% and higher than that achieved with microscopy (80% or culture (26.7% methods. PCR of peripheral blood proved to be a suitable tool for the diagnosis of VL in children because it is highly sensitive and safe, with tissue collection being less invasive than in traditional tests.

  18. Transmission of visceral leishmaniasis in dogs in a risk area of the metropolitan region of Belo Horizonte, Minas Gerais, Brazil

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    E.G.P. Lopes

    Full Text Available ABSTRACT Visceral leishmaniasis (VL has spread rapidly across cities in the metropolitan region of Belo Horizonte. The aim of this study was to investigate VL dynamics in a prospective cohort study of dogs in Juatuba, between 2010 and 2011, to confirm the incidence of Leishmania infantum, and to assess possible risk factors associated with infection. An observational and prospective closed cohort study was performed using serology testing in dogs, randomly selected from the whole municipality. All seronegative dogs, or dogs with inconclusive results were monitored using indirect immunofluorescence (IIF at 6-month intervals. The dog's owners completed a semi-structured questionnaire to assess possible causal factors of seroconversion, and the responses were assessed using logistic regression. The canine incidence coefficient was 206/1,000 dogs per year (CI: 178-238, and a cluster was identified in an area with a high concentration of seropositive dogs, but a low overall canine population. Large dogs were identified as a risk factor and the following variables were identified as protection factors: dogs aged over 4 years, daily peridomicile cleaning, and better socioeconomic conditions. VL is spreading over a large area in Juatuba in a short period of time.

  19. Leucine rich repeats are the main epitopes in Leishmania infantum PSA during canine and human visceral leishmaniasis.

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    Boceta, C; Alonso, C; Jiménez-Ruiz, A

    2000-02-01

    The PSA protein is one of the major antigens of the surface of the Leishmania infantum parasite membrane. We describe the immune humoral response against the PSA in dogs and human patients with visceral leishmaniasis caused by L. infantum. The immunodominant region of the PSA was determined by subcloning, expression and purification of three fragments covering the complete protein. The analysis revealed that the antibodies are mostly directed against the central region, which is formed exclusively by leucine rich repeats. This region is recognized by 100% of the sera from the infected dogs and 40% of the human sera. These percentages are significantly higher than those observed when the complete protein was used as antigen. The analysis of the isotype of the G immunoglobulins raised against the immunodominant determinants of the PSA indicates that both IgG1 and IgG2 classes are produced during natural infections but that the IgG2 predominates over that of the IgG1.

  20. Sero-prevalence of visceral leishmaniasis (VL among dogs in VL endemic areas of Mymensingh district, Bangladesh

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    Ariful Islam

    2017-09-01

    Full Text Available Objective: The present study was conducted to determine the sero-prevalence of canine visceral leishmaniasis (VL among street and owned dogs at Trishal Upazila of Mymensingh district, Bangladesh. Material and methods: Blood was collected asceptically from targeted dogs and serum was separated out using standard centrifigation method. The rK39-antigen-based dipstick test was used to detect anti-leishmania antibodies in serum. Results: The study revealed that 35% of the dogs in the study area were sero-positive for L. donovani. Living status of the dogs (street or owned was a potential risk factor and sero-prevalence was significantly higher in free roaming street dogs (P=0.009 and dogs with skin lesions and enlarged lymph nodes (P<0.05. The female and adult dogs were more susceptible. Conclusion: VL is an important zoonotic disease wich is transmissible to humans by the bite of phlebotomine sand fly. Dogs are the main reservoir. The higher sero-prevalence of VL indicates the potential rule of dogs to maintain the zoonosis wich need to be explored more specifically by isolation and typing of the parasite. [J Adv Vet Anim Res 2017; 4(3.000: 241-248

  1. Immunogenicity and efficacy of single antigen Gp63, polytope and polytopeHSP70 DNA vaccines against visceral Leishmaniasis in experimental mouse model.

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    Rakhee Sachdeva

    2009-12-01

    Full Text Available Polytope approach of genetic immunization is a promising strategy for the prevention of infectious disease as it is capable of generating effective cell mediated immunity by delivering the T cell epitopes assembled in series. Leishmaniasis is a significant world wide health problem for which no vaccine exists. In this study we have compared immunogenicity and efficacy of three types of DNA vaccines: single antigen Gp63 (Gp63/pcDNA, polytope (Poly/pcDNA and Polytope fused with hsp70 (Poly/hsp/pcDNA against visceral leishmaniasis in susceptible BALB/c mice. Mice vaccinated with these plasmids generated strong Th1 immune response as seen by dominating IFN-gamma over IL-10 cytokine. Interestingly, cytotoxic responses generated by polytope DNA plasmid fused with hsp70 of Leishmania donovani were significantly higher when compared to polytope and single antigen Gp63 vaccine. Challenge studies revealed that the parasite load in liver and spleen was significantly lower with Poly/hsp/pcDNA vaccination compared to other vaccines. Therefore, our study indicates that polytope DNA vaccine is a feasible, practical and effective approach for visceral leishmaniasis.

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

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    Carlos Henrique Nery Costa

    2008-12-01

    Full Text Available 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 research on the ecological and molecular determinants of Leishmania chagasi transmission. Investment of public funds should focus on the development of a human vaccine, since such a vaccine now appears to be within reach. Even small effects from a vaccine could substantially reduce the impact of the disease, which in the last quarter century has challenged and defeated both the scientific community and the public health field around the world.As hipóteses ou explicações apresentadas até o momento para o processo de urbanização da leishmaniose visceral americana são insatisfatórias. Uma hipótese alternativa é a de que mudanças na ecologia e biologia do vetor, Lutzomyia longipalpis, poderiam explicar as feições epidemiológicas urbanas da doença. De forma a suprir lacunas no conhecimento sobre esse processo de urbanização, destacam-se algumas linhas de pesquisa prioritárias: a investigação do papel de cães na amplificação da transmissão da doença nas cidades, ensaios de campo com novos inseticidas, investigação dos determinantes ecológicos ou moleculares que participam da transmissão de Leishmania chagasi. Esforços com investimentos públicos devem ser feitos para o desenvolvimento de vacinas para humanos, pois uma vacina não parece estar tão distante. Resultados vacinais mesmo modestos podem reduzir substancialmente o impacto dessa doença que, no último quarto de século, desafiou e venceu a ciência e a saúde pública mundo

  3. Diversity and altitudinal distribution of phlebotomine sand flies (Diptera: Psychodidae) in visceral leishmaniasis endemic areas of northwest Ethiopia.

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    Yared, Solomon; Gebresilassie, Araya; Akililu, Essayas; Deribe, Kebede; Balkew, Meshesha; Warburg, Alon; Hailu, Asrat; Gebre-Michael, Teshome

    2017-12-01

    The Leishmaniases are caused by the protozoan parasites of the genus Leishmania and are transmitted to humans by the bite of infected female phlebotomine sand flies. Both visceral and cutaneous leishmaniases are widely distributed in different parts of Ethiopia. The aim of this study was to determine the diversity and altitudinal distribution of phlebotomine sand flies from Kafta Humera to Gondar town in northwest Ethiopia. Seven localities were selected with distinct altitudinal variations between 550m above sea level (m a.s.l) and 2300m a.s.l. In each locality, sand flies were collected using standard CDC light traps and sticky traps during the active sand fly season from December 2012 to May 2013. Shannon-Weiner species diversity index and Jaccard's coefficient were used to estimate species diversity and similarity between altitudes and localities, respectively. A total of 89,044 sand flies (41,798 males and 47, 246 females) were collected from the seven localities/towns throughout the study period. Twenty-two species belonging to 11 species in the genus Phlebotomus and 11 species in the genus Sergentomyia were documented. Of these, Sergentomyia clydei (25.87%), S. schwetzi (25.21%), S. africana (24.65%), S. bedfordi (8.89%), Phlebotomus orientalis (6.43%), and S. antennata (4.8%) were the most prevalent species. The remaining 10 Phlebotomus species and six Sergentomyia were less frequent catches. In CDC light trap and sticky trap, higher species diversity and richness for both male and female sand flies was observed at low altitude ranging from 550 to 699m a.s.l in Adebay village in Kafta Humera district whereas low species richness and high evenness of both sexes were also observed in an altitude 1950-2300m a.s.l. The results revealed that the presence of leishmaniasis vectors such as P. orientalis, P. longipes, P. papatasi, and P. duboscqi in different altitudes in northwest Ethiopia. P. orientalis a vector of L. donovani, occurred between altitude 500-1100m

  4. Evidence That Lipopolisaccharide May Contribute to the Cytokine Storm and Cellular Activation in Patients with Visceral Leishmaniasis

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    Santos-Oliveira, Joanna R.; Regis, Eduardo G.; Leal, Cássia R. B.; Cunha, Rivaldo V.; Bozza, Patrícia T.; Da-Cruz, Alda M.

    2011-01-01

    Background Visceral leishmaniasis (VL) is characterized by parasite-specific immunosuppression besides an intense pro-inflammatory response. Lipopolisaccharide (LPS) has been implicated in the immune activation of T-cell deficient diseases such as HIV/AIDS and idiopathic lymphocytopenia. The source of LPS is gram-negative bacteria that enter the circulation because of immunological mucosal barrier breakdown. As gut parasitization also occurs in VL, it was hypothesized that LPS may be elevated in leishmaniasis, contributing to cell activation. Methodology/Principal Findings Flow cytometry analysis and immunoassays (ELISA and luminex micro-beads system) were used to quantify T-cells and soluble factors. Higher LPS and soluble CD14 levels were observed in active VL in comparison to healthy subjects, indicating that LPS was bioactive; there was a positive correlation between these molecules (r = 0.61;p<0.05). Interestingly, LPS was negatively correlated with CD4+ (r = −0.71;p<0.01) and CD8+ T-cells (r = −0.65;p<0.05). Moreover, higher levels of activation-associated molecules (HLA-DR, CD38, CD25) were seen on T lymphocytes, which were positively associated with LPS levels. Pro-inflammatory cytokines and macrophage migration inhibitory factor (MIF) were also augmented in VL patients. Consistent with the higher immune activation status, LPS levels were positively correlated with the inflammatory cytokines IL-6 (r = 0.63;p<0.05), IL-8 (r = 0.89;p<0.05), and MIF (r = 0.64;p<0.05). Also, higher plasma intestinal fatty acid binding protein (IFABP) levels were observed in VL patients, which correlated with LPS levels (r = 0.57;p<0.05). Conclusions/Significance Elevated levels of LPS in VL, in correlation with T-cell activation and elevated pro-inflammatory cytokines and MIF indicate that this bacterial product may contribute to the impairment in immune effector function. The cytokine storm and chronic immune hyperactivation status may

  5. Recombinant NAD-dependent SIR-2 protein of Leishmania donovani: immunobiochemical characterization as a potential vaccine against visceral leishmaniasis.

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    Baharia, Rajendra K; Tandon, Rati; Sharma, Tanuj; Suthar, Manish K; Das, Sanchita; Siddiqi, Mohammad Imran; Saxena, Jitendra Kumar; Sundar, Shaym; Sunder, Shyam; Dube, Anuradha

    2015-03-01

    The development of a vaccine conferring long-lasting immunity remains a challenge against visceral leishmaniasis (VL). Immunoproteomic characterization of Leishmania donovani proteins led to the identification of a novel protein NAD+-dependent Silent Information regulatory-2 (SIR2 family or sirtuin) protein (LdSir2RP) as one of the potent immunostimulatory proteins. Proteins of the SIR2 family are characterized by a conserved catalytic domain that exerts unique NAD-dependent deacetylase activity. In the present study, an immunobiochemical characterization of LdSir2RP and further evaluation of its immunogenicity and prophylactic potential was done to assess for its possible involvement as a vaccine candidate against leishmaniasis. LdSir2RP was successfully cloned, expressed and purified. The gene was present as a monomeric protein of ~45 kDa and further established by the crosslinking experiment. rLdSir2RP shown cytosolic localization in L. donovani and demonstrating NAD+-dependent deacetylase activity. Bioinformatic analysis also confirmed that LdSir2RP protein has NAD binding domain. The rLdSir2RP was further assessed for its cellular response by lymphoproliferative assay and cytokine ELISA in cured Leishmania patients and hamsters (Mesocricetus auratus) in comparison to soluble Leishmania antigen and it was observed to stimulate the production of IFN-γ, IL-12 and TNF-α significantly but not the IL-4 and IL-10. The naïve hamsters when vaccinated with rLdSir2RP alongwith BCG resisted the L. donovani challenge to the tune of ~75% and generated strong IL-12 and IFN-γ mediated Th1 type immune response thereof. The efficacy was further supported by remarkable increase in IgG2 antibody level which is indicative of Th1 type of protective response. Further, with a possible implication in vaccine design against VL, identification of potential T-cell epitopes of rLdSir2RP was done using computational approach. The immunobiochemical characterization strongly suggest the

  6. A comparative evaluation of efficacy of chemotherapy, immunotherapy and immunochemotherapy in visceral leishmaniasis-an experimental study.

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    Joshi, Jyoti; Malla, Nancy; Kaur, Sukhbir

    2014-08-01

    Visceral leishmaniasis (VL) represents the second most challenging infectious disease worldwide, leading to nearly 500,000 new cases and 60,000 deaths annually. Ninety per cent of VL cases occur in five countries namely Bangladesh, India, Nepal, Sudan and Brazil. No licensed vaccine is available till date against any form of leishmaniasis. High toxicity and increasing resistance to the current chemotherapeutic regimens have further complicated the situation in VL endemic regions of the world. To combat this situation, immunochemotherapy can provide a solution. In the present study, an attempt has been made to assess the in vivo antileishmanial efficacy of chemotherapy, immunotherapy and immunochemotherapy with the use of a first generation antigen Killed Leishmania donovani (KLD) along with a standard drug sodium stibogluconate (SSG) and a newly tested antileishmanial cisplatin. Inbred BALB/c mice were infected with 10(7) promastigotes/0.1 ml of Leishmania donovani. A month after infection, these animals were given specific immunotherapy (KLD/KLD+MPL-A) or chemotherapy (SSG/cisplatin) or immunochemotherapy (SSG+KLD/SSG+KLD+MPL-A/cisplatin+KLD/cisplatin+KLD+MPL-A). Animals were sacrificed on 1, 15 and 30(th) day post treatment. The efficacy of these combinations was assessed in terms of parasite load and by immunological investigations. Infected mice and normal mice served as controls. Results showed that combination of drug and KLD significantly reduced the parasite burden, enhanced the DTH (Delayed Type Hypersensitivity) responses, showed increased levels of IgG2a and decreased levels of IgG1 as compared to mice given chemotherapy or immunotherapy alone. Further maximum protection was provided by SSG+KLD+MPL-A and it was most effective as depicted by 98.5% reduction in parasite load, a potent increase in IFN-γ levels and a significant decrease in IL-10 and IL-4 levels thus skewing the immune response towards Th1 type. Hence, immunochemotherapy is more effective

  7. Therapeutic Vaccination With Recombinant Adenovirus Reduces Splenic Parasite Burden in Experimental Visceral Leishmaniasis

    Science.gov (United States)

    Maroof, Asher; Brown, Najmeeyah; Smith, Barbara; Hodgkinson, Michael R.; Maxwell, Alice; Losch, Florian O.; Fritz, Ulrike; Walden, Peter; Lacey, Charles N. J.; Smith, Deborah F.; Aebischer, Toni

    2012-01-01

    Therapeutic vaccines, when used alone or in combination therapy with antileishmanial drugs, may have an important place in the control of a variety of forms of human leishmaniasis. Here, we describe the development of an adenovirus-based vaccine (Ad5-KH) comprising a synthetic haspb gene linked to a kmp11 gene via a viral 2A sequence. In nonvaccinated Leishmania donovani–infected BALB/c mice, HASPB- and KMP11-specific CD8+ T cell responses were undetectable, although IgG1 and IgG2a antibodies were evident. After therapeutic vaccination, antibody responses were boosted, and IFNγ+CD8+ T cell responses, particularly to HASPB, became apparent. A single vaccination with Ad5-KH inhibited splenic parasite growth by ∼66%, a level of efficacy comparable to that observed in early stage testing of clinically approved antileishmanial drugs in this model. These studies indicate the usefulness of adenoviral vectors to deliver leishmanial antigens in a potent and host protective manner to animals with existing L. donovani infection. PMID:22301630

  8. Pancreatic involvement in co-infection visceral leishmaniasis and HIV: histological and ultrastructural aspects

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    CHEHTER Ethel Zimberg

    2001-01-01

    Full Text Available The involvement of the gastrointestinal tract in the co-infection of HIV and Leishmania is rarely reported. We report the case of an HIV-infected adult man co-infected with a disseminated form of leishmaniasis involving the liver, lymph nodes, spleen and, as a feature reported for the first time in the English literature, the pancreas. Light microscopy showed amastigote forms of Leishmania in pancreatic macrophages and immunohistochemical staining revealed antigens for Leishmania and also for HIV p24. Microscopic and ultrastructural analysis revealed severe acinar atrophy, decreased zymogen granules in the acinar cytoplasm and also nuclear abnormalities such as pyknosis, hyperchromatism and thickened chromatin. These findings might correspond to the histologic pattern of protein-energy malnutrition in the pancreas as shown in our previous study in pancreas with AIDS and no Leishmania. In this particular case, the protein-energy malnutrition may be due to cirrhosis, or, Leishmania or HIV infection or all mixed. We believe that this case represents the morphologic substratum of the protein energy malnutrition in pancreas induced by the HIV infection. Further studies are needed to elucidate these issues.

  9. Pneumocystis carinii pneumonia, pulmonary tuberculosis and visceral leishmaniasis in an adult HIV negative patient

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    Antonio Carlos Toledo Jr.

    Full Text Available This is a case report of a 29 year old male with pneumocystis pneumonia and tuberculosis, and who was initially suspected of having HIV infection, based on risk factor analyses, but was subsequently shown to be HIV negative. The patient arrived at the hospital with fever, cough, weight loss, loss of appetite, pallor, and arthralgia. In addition, he was jaundiced and had cervical lymphadenopathy and mild heptosplenomegaly. He had interstitial infiltrates of the lung, sputum smears positive for Mycobacterium tuberculosis and Pneumocystis carinii, and stool tests were positive for Strongyloides stercoralis and Schistosoma mansoni. He was diagnosed as having AIDS, and was treated for tuberculosis, pneumocystosis, and strongyloidiasis with a good response. The patient did not receive anti-retroviral therapy, pending outcome of the HIV tests. A month later, he was re-examined and found to have worsening hepatosplenomegaly, pancytopenia, fever, and continued weight loss. At this time, it was determined that his HIV ELISA antibody tests were negative. A bone marrow aspirate was done and revealed amastigotes of leishmania, and a bone marrow culture was positive for Leishmania species. He was treated with pentavalent antimony, 20 mg daily for 20 days, with complete remission of symptoms and weight gain. This case demonstrates that immunosuppression from leishmaniasis and tuberculosis may lead to pneumocystosis, and be misdiagnosed as HIV infection. The occurrence of opportunistic infections in severely ill patients without HIV must always be considered and alternate causes of immunosuppression sought.

  10. Leishmania-specific T cells expressing interferon-¿(IFN-¿) and IL-10 upon activation are expanded in individuals cured of visceral leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, K; Kemp, M; Kharazmi, A

    1999-01-01

    Peripheral blood mononuclear cells (PBMC) from patients who have recovered from visceral leishmaniasis often respond to Leishmania antigens in vitro by production of both IL-4, IFN-gamma and IL-10. In order to establish the cellular sources of these cytokines, we activated cells from individuals...... in Leishmania-activated PBMC cultures from the previous patients and from individuals living in a village where leishmaniasis does not occur. The percentage of IL-10- and IFN-gamma-containing cells was significantly higher in the previous patients than in the controls, indicating that Leishmania-specific T...... cells producing IL-10 and/or IFN-gamma had been expanded as a result of the infection. The cytokine-producing cells in the previous patients could be divided into three types: (i) cells producing IFN-gamma only; (ii) cells producing IL-4 only; and (iii) cells producing IFN-gamma and IL-10 simultaneously...

  11. High frequency of visceral leishmaniasis in dogs under veterinary clinical care in an intense transmission area in the state of Tocantins, Brazil

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    Helcileia Dias Santos

    Full Text Available ABSTRACT: A direct search for parasites were used as the diagnostic test to determine the frequency of Leishmania spp. infection in dogs ( Canis lupus familiaris under veterinary clinical care in the city of Araguaína, Tocantins, Brazil. For this approach, lymph node cell samples were collected using needle aspiration from 649 dogs of different breeds and ages. Two hundred and sixty four (40.7% dogs tested positive for amastigote forms of Leishmania spp. Furthermore, 202 (76.5% dogs that tested positive showed some clinical sign of disease, while 62 (28.4% dogs were asymptomatic. Dogs <2 years old or those that lived alongside poultry species in peri-domicile areas had a greater chance of infection (P<0.05. Our results revealed the importance of frequently monitoring leishmaniasis in dogs, and the need to train veterinary professionals who work in high-transmission areas on the clinical diagnosis of canine visceral leishmaniasis.

  12. Lutzomyia longipalpis behavior and control at an urban visceral leishmaniasis focus in Argentina Comportamento e controle de Lutzomyia longipalpis em foco de leishmaniose visceral urbana na Argentina

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    Maria Soledad Santini

    2010-08-01

    Full Text Available During the earlier stages of visceral leishmaniasis transmission in Posadas City, Misiones, both the night activity and attraction to humans of Lutzomyia longipalpis were assessed, in order to provide preliminary recommendations. The impact of peridomestic deltamethrin spraying performed by local officials was also evaluated. Although Lu. longipalpis were found in traps located over a dog the entire night, 90% of the females were captured from 20.30h to 1.30h, and only landed on a human when he was at a distance of 1.5 m from the dog. Peridomestic spraying of deltamethrin (25 mg/m² reduced the sand fly capture up to seven days post-intervention without dispersion in the border of the sprayed areas. These results support the recommendations about time-space focus of the protection measures: first half of the night, in the backyard, with pets and domestic animals kept at least 5 m from humans. The deltamethrin as it was used did not seem very effective in this scenario; neither did the eventual use of bed nets, at least in adults, due to the place/hour of sand fly higher activity. This study strengthens the need for a multidisciplinary approach to develop prevention strategies based both on biological and anthropological studies.Durante os estádios precoces de transmissão da leishmaniose visceral na cidade de Posadas, Misiones, foi avaliada a atividade noturna da Lutzomyia longipalpis e a atração pelos seres humanos, para fornecer recomendações preliminares. O impacto do inseticida deltametrina peridoméstico, e a borrifação executada por funcionários locais, também foi avaliada. Embora existam Lu. longipalpis atingindo as armadilhas localizadas perto de um cão durante toda a noite, 90% das fêmeas foram capturadas a partir das 20.30h até 1.30h, e só atinge seres humanos quando estão a 1,5 m do cão. A borrifação peridoméstica com deltametrina (25 mg/m² reduziu a área de captura da mosca da areia, até sete dias após a

  13. A case-control study of microenvironmental risk factors for urban visceral leishmaniasis in a large city in Brazil, 1999-2000 Estudio de casos y controles sobre factores microambientales de riesgo de leishmaniasis visceral urbana en una gran urbe de Brasil, 1999-2000

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    Claudia Di Lorenzo Oliveira

    2006-12-01

    Full Text Available OBJECTIVES: We investigated potential microenvironmental risk factors for visceral leishmaniasis in urban and suburban areas, and developed risk scores to characterize the household and the neighborhood. These scores may be useful to identify microenvironments within cities that place residents at greater risk of visceral leishmaniasis. METHODS: In this case-control study, cases were all persons with visceral leishmaniasis reported from July 1999 through December 2000 in the Belo Horizonte metropolitan area, Brazil. Two kinds of controls-neighborhood and hospital-were used. Cases and controls were matched by age (±2 years. We developed four scores to characterize the microenvironment (indoor, outdoor, animal indoor, and animal outdoor, and also considered the level of urbanization of the area. RESULTS: A total of 106 neighborhood controls and 60 hospital controls were identified for 109 cases. Among the cases, 69 (63.3% were men and 40 (36.7% were women. Most cases were under 15 years old (64.2%, and 39 (35.8% were 15 years old or more. The outdoor score [odds ratio (OR = 1.49; 95% confidence interval (CI = 1.03-2.14] and animal outdoor scores (OR = 1.79[95% CI 1.21-2.65] were significantly associated with the odds of visceral leishmaniasis in our sample. We also found a significant interaction between sex and age. Compared to females 15 years old or more, males 15 years old or more were more likely to have visceral leishmaniasis (OR = 7.02[95% CI 2.20-22.20]. CONCLUSIONS: Animals in the neighborhood were associated with a greater odds of visceral leishmaniasis. Cases were more likely than controls to live in transitional or rural areas, although this difference was not statistically significant, possibly because of the small sample size.OBJETIVOS: Se investigaron los posibles factores microambientales de riesgo de leishmaniasis visceral en áreas urbanas y suburbanas y se elaboraron sistemas de puntuación del riesgo para caracterizar los

  14. Sand Flies of the Subgenus Adlerius (Diptera: Psychodidae) in an Endemic Focus of Visceral Leishmaniasis and Introduction of Phlebotomus (Adlerius) comatus as a New Record for Iran.

    Science.gov (United States)

    Zahraei-Ramazani, Ali Reza; Kumar, Dinesh; Yaghoobi-Ershadi, Mohammad Reza; Naghian, Abdollah; Jafari, Reza; Shirzadi, Mohammad Reza; Abdoli, Hamid; Soleimani, Hassan; Shareghi, Niloofar; Ghanei, Maryam; Arandian, Mohammad Hossein; Hanafi-Bojd, Ahmad Ali

    2013-01-01

    Sand flies of subgenus Adlerius has a wide geographical distribution in Iran and are mostly found in wild form in mountainous areas. They are always considered as probable vectors of visceral leishmaniasis. The objective of this study was to determine the Adlerius species and its composition in an endemic focus of zoonotic visceral leishmaniasis in northwest of the country. Sand flies were collected from 6 different areas of Azarbaijan-e-Sharqi Province using sticky paper traps from August to September which is active season for sand flies in this area, in 2009. The flies were mounted and identified. The length of third antennal segments, ascoid, labrum, coxite, surstyle, style, aedeagus, genital filament, genital pump, width of style, and the end of aedeagus were measured and the number of costal hairs group was also counted as the morphological characters. A total of 30 adult sand flies, (26 males and 4 females) including Phlebotomus halepensis (46.8%), P. longiductus (13.3%), P. balcanicus (23.3%), P. comatus (3.3%), and Adlerius spp. (13.3%) belong to subgenus Adlerius were identified respectively in 6 counties. One P. comatus male was captured in front of a cave located in the hillside of a mountain covered with the vegetation in Varzeqan area. The presence of at least 5 species of the subgenus Adlerius in Azarbaijan-e-Sharqi Province, an endemic focus of zoonotic visceral leishmaniasis in Iran, shows that the risk of parasite transmission among man and reservoir animals is high during the active season of sand flies. P. comatus is a new record for Iran and needs to be added to the list of Iranian phlebotomines of subgenus Adlerius.

  15. Sand Flies of the Subgenus Adlerius (Diptera: Psychodidae in an Endemic Focus of Visceral Leishmaniasis and Introduction of Phlebotomus (Adlerius comatus as a New Record for Iran.

    Directory of Open Access Journals (Sweden)

    Ali Reza Zahraei-Ramazani

    2013-06-01

    Full Text Available Sand flies of subgenus Adlerius has a wide geographical distribution in Iran and are mostly found in wild form in mountainous areas. They are always considered as probable vectors of visceral leishmaniasis. The objective of this study was to determine the Adlerius species and its composition in an endemic focus of zoonotic visceral leishmaniasis in northwest of the country.Sand flies were collected from 6 different areas of Azarbaijan-e-Sharqi Province using sticky paper traps from August to September which is active season for sand flies in this area, in 2009. The flies were mounted and identified. The length of third antennal segments, ascoid, labrum, coxite, surstyle, style, aedeagus, genital filament, genital pump, width of style, and the end of aedeagus were measured and the number of costal hairs group was also counted as the morphological characters.A total of 30 adult sand flies, (26 males and 4 females including Phlebotomus halepensis (46.8%, P. longiductus (13.3%, P. balcanicus (23.3%, P. comatus (3.3%, and Adlerius spp. (13.3% belong to subgenus Adlerius were identified respectively in 6 counties. One P. comatus male was captured in front of a cave located in the hillside of a mountain covered with the vegetation in Varzeqan area.The presence of at least 5 species of the subgenus Adlerius in Azarbaijan-e-Sharqi Province, an endemic focus of zoonotic visceral leishmaniasis in Iran, shows that the risk of parasite transmission among man and reservoir animals is high during the active season of sand flies. P. comatus is a new record for Iran and needs to be added to the list of Iranian phlebotomines of subgenus Adlerius.

  16. Visceral leishmaniasis relapse hazard is linked to reduced miltefosine exposure in patients from Eastern Africa: a population pharmacokinetic/pharmacodynamic study.

    Science.gov (United States)

    Dorlo, Thomas P C; Kip, Anke E; Younis, Brima M; Ellis, Sally J; Alves, Fabiana; Beijnen, Jos H; Njenga, Simon; Kirigi, George; Hailu, Asrat; Olobo, Joseph; Musa, Ahmed M; Balasegaram, Manica; Wasunna, Monique; Karlsson, Mats O; Khalil, Eltahir A G

    2017-11-01

    Low efficacy of miltefosine in the treatment of visceral leishmaniasis was recently observed in Eastern Africa. To describe the pharmacokinetics and establish a pharmacokinetic/pharmacodynamic relationship for miltefosine in Eastern African patients with visceral leishmaniasis, using a time-to-event approach to model relapse of disease. Miltefosine plasma concentrations from 95 patients (48 monotherapy versus 47 combination therapy) were included in the population pharmacokinetic model using non-linear mixed effects modelling. Subsequently a time-to-event model was developed to model the time of clinical relapse. Various summary pharmacokinetic parameters (various AUCs, Time > EC50, Time > EC90), normalized within each treatment arm to allow simultaneous analysis, were evaluated as relapse hazard-changing covariates. A two-compartment population model with first-order absorption fitted the miltefosine pharmacokinetic data adequately. Relative bioavailability was reduced (-74%, relative standard error 4.7%) during the first week of treatment of the monotherapy arm but only the first day of the shorter combination regimen. Time to the relapse of infection could be described using a constant baseline hazard (baseline 1.8 relapses/year, relative standard error 72.7%). Miltefosine Time > EC90 improved the model significantly when added in a maximum effect function on the baseline hazard (half maximal effect with Time > EC90 6.97 days for monotherapy). Miltefosine drug exposure was found to be decreased in Eastern African patients with visceral leishmaniasis, due to a (transient) initial lower bioavailability. Relapse hazard was inversely linked to miltefosine exposure. Significantly lower miltefosine exposure was observed in children compared with adults, further urging the need for implementation of dose adaptations for children. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  17. The genetic structure of Leishmania infantum populations in Brazil and its possible association with the transmission cycle of visceral leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Gabriel Eduardo Melim Ferreira

    Full Text Available Leishmania infantum is the etiologic agent of visceral leishmaniasis (VL in the Americas, Mediterranean basin and West and Central Asia. Although the geographic structure of L. infantum populations from the Old World have been described, few studies have addressed the population structure of this parasite in the Neotropical region. We employed 14 microsatellites to analyze the population structure of the L. infantum strains isolated from humans and dogs from most of the Brazilian states endemic for VL and from Paraguay. The results indicate a low genetic diversity, high inbreeding estimates and a depletion of heterozygotes, which together indicate a predominantly clonal breeding system, but signs of sexual events are also present. Three populations were identified from the clustering analysis, and they were well supported by F statistics inferences and partially corroborated by distance-based. POP1 (111 strains was observed in all but one endemic area. POP2 (31 strains is also well-dispersed, but it was the predominant population in Mato Grosso (MT. POP3 (31 strains was less dispersed, and it was observed primarily in Mato Grosso do Sul (MS. Strains originated from an outbreak of canine VL in Southern Brazil were grouped in POP1 with those from Paraguay, which corroborates the hypothesis of dispersal from Northeastern Argentina and Paraguay. The distribution of VL in MS seems to follow the west-east construction of the Bolivia-Brazil pipeline from Corumbá municipality. This may have resulted in a strong association of POP3 and Lutzomyia cruzi, which is the main VL vector in Corumbá, and a dispersion of this population in this region that was shaped by human interference. This vector also occurs in MT and may influence the structure of POP2. This paper presents significant advances in the understanding of the population structure of L. infantum in Brazil and its association with eco-epidemiological aspects of VL.

  18. Clinical Forms of Canine Visceral Leishmaniasis in Naturally Leishmania infantum–Infected Dogs and Related Myelogram and Hemogram Changes

    Science.gov (United States)

    Roatt, Bruno Mendes; Aguiar-Soares, Rodrigo Dian de Oliveira; Reis, Levi Eduardo Soares; Carvalho, Maria das Graças; Carneiro, Cláudia Martins; Giunchetti, Rodolfo Cordeiro; Bouillet, Leoneide Erica Maduro; Lemos, Denise Silveira; Coura-Vital, Wendel; Reis, Alexandre Barbosa

    2013-01-01

    Hematological analysis has limited applications for disease diagnosis in Leishmania infantum–infected dogs, but it can be very important in evaluating the clinical forms of the disease and in understanding the evolution of canine visceral leishmaniasis (CVL) pathogenesis. Recently, we demonstrated that alterations in leucopoiesis and erythropoiesis are related to clinical status and bone marrow parasite density in dogs naturally infected by L. infantum. To further characterize these alterations, we evaluated the association between the hematological parameters in bone marrow and peripheral blood alterations in groups of L. infantum–infected dogs: asymptomatic I (AD-I: serum negative/PCR+), asymptomatic II (AD-II: serum positive), oligosymptomatic (OD), and symptomatic (SD). Results were compared with those from noninfected dogs (NID). The SD group was found to present a decrease in erythropoietic lineage with concomitant reductions in erythrocytes, hemoglobin, and hematocrit parameters, resulting in anemia. The SD group also had increased neutrophils and precursors and decreased band eosinophils and eosinophils, leading to peripheral blood leucopenia. In the AD-II group, lymphocytosis occurred in both the peripheral blood and the bone marrow compartments. The SD group exhibited lymphocytosis in the bone marrow, with lymphopenia in the peripheral blood. In contrast, the AD-I group, showed no significant changes suggestive of CVL, presenting normal counts in bone marrow and peripheral blood. Our results showed for the first time that important changes in hematopoiesis and hematological parameters occur during ongoing CVL in naturally infected dogs, mainly in symptomatic disease. Taken together, our results based on myelogram and hemogram parameters enable better understanding of the pathogenesis of the anemia, lymphocytosis, and lymphopenia, as well as the leucopenia (eosinopenia and monocytopenia), that contribute to CVL prognosis. PMID:24376612

  19. Occurrence of low density of Leishmania infantum in sandflies from a new focus of visceral leishmaniasis in northwest of Iran.

    Science.gov (United States)

    Parvizi, P; Alaeenovin, E; Mohammadi, S; Baghban, N

    2013-01-01

    Observations and case studies have shown that the number of Visceral Leishmaniasis (VL) cases have increased in the recent years in several areas of Iran including Sarab district, East Azerbaijan province. Sarab district has been considered as a new focus of VL in Iran. The density of the sandfly vector and the Leishmania parasites causing infection has been assessed in 2009. Sandfly species had been collected from Sarab district, East Azerbaijan province in 2009 using sticky papers and CDC traps. DNA of sandflies was extracted and nested PCR was amplified in a region of the ribosomal RNA amplicon of Leishmania (ITS1-5.8S rRNA gene), which was shown to be species-specific by DNA sequence. Altogether, 1317 male and female sandflies were trapped. At least 10 different sandfly species were identified morphologically. Leishmania infantum was the only Leishmania that was detected among the sandfly's population in Sarab district. All the infectious cases (4/223) found in the abundant sandfly region were Phlebotomus kandelakii. The diversity of sandflies was similar to those in the main VL focal points in Iran, but the diversity of parasite and density were significantly lower. The low prevalence of VL in Sarab district might be explained by the scarcity of infected domestic dogs Canis familiaris the primary reservoir host of VL in the region. By finding the L. infantum in P. kandelakii for the first time on this new focus, we are able to conclude that P. kandelakii might be the vector of L. infantum. In future, more works should be done to test status of P. kandelakii as a proven vector of L. infantum.

  20. The Genetic Structure of Leishmania infantum Populations in Brazil and Its Possible Association with the Transmission Cycle of Visceral Leishmaniasis

    Science.gov (United States)

    Ferreira, Gabriel Eduardo Melim; dos Santos, Barbara Neves; Dorval, Maria Elizabeth Cavalheiros; Ramos, Tereza Pompilio Bastos; Porrozzi, Renato; Peixoto, Alexandre Afranio; Cupolillo, Elisa

    2012-01-01

    Leishmania infantum is the etiologic agent of visceral leishmaniasis (VL) in the Americas, Mediterranean basin and West and Central Asia. Although the geographic structure of L. infantum populations from the Old World have been described, few studies have addressed the population structure of this parasite in the Neotropical region. We employed 14 microsatellites to analyze the population structure of the L. infantum strains isolated from humans and dogs from most of the Brazilian states endemic for VL and from Paraguay. The results indicate a low genetic diversity, high inbreeding estimates and a depletion of heterozygotes, which together indicate a predominantly clonal breeding system, but signs of sexual events are also present. Three populations were identified from the clustering analysis, and they were well supported by F statistics inferences and partially corroborated by distance-based. POP1 (111 strains) was observed in all but one endemic area. POP2 (31 strains) is also well-dispersed, but it was the predominant population in Mato Grosso (MT). POP3 (31 strains) was less dispersed, and it was observed primarily in Mato Grosso do Sul (MS). Strains originated from an outbreak of canine VL in Southern Brazil were grouped in POP1 with those from Paraguay, which corroborates the hypothesis of dispersal from Northeastern Argentina and Paraguay. The distribution of VL in MS seems to follow the west-east construction of the Bolivia-Brazil pipeline from Corumbá municipality. This may have resulted in a strong association of POP3 and Lutzomyia cruzi, which is the main VL vector in Corumbá, and a dispersion of this population in this region that was shaped by human interference. This vector also occurs in MT and may influence the structure of POP2. This paper presents significant advances in the understanding of the population structure of L. infantum in Brazil and its association with eco-epidemiological aspects of VL. PMID:22606248

  1. Leishmaniasis visceral en la Argentina: Notificación y situación vectorial (2006-2012

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    Ignacio T. Gould

    2013-04-01

    Full Text Available La leishmaniasis visceral (LV en la Argentina se notifica obligatoriamente a través del Sistema Nacional de Vigilancia de la Salud (SNVS. El análisis de la notificación muestra un total de 103 casos distribuidos en cuatro provincias, siendo Misiones la de mayor casuística con un total de 80 casos en 15 localidades, desde mayo 2006 hasta julio de 2012. Los niños de 0 a 15 años de edad son el grupo con mayor incidencia. En el año 2004 fue registrado por primera vez el riesgo de LV urbana endémica en la provincia de Formosa tras el hallazgo del vector Lutzomyia longipalpis. En el año 2006 la provincia de Misiones registra casos de LV humana, LV canina, y la provincia de Corrientes en el verano 2008-2009. En Santiago del Estero los casos de LV humana y LV canina en el año 2008 estuvieron asociados posiblemente a vectores secundarios. En el año 2010 Lu. longipalpis fue hallado en Chajarí, Entre Ríos, mostrando su dispersión hacia el sur. Por ello, para conocer la distribución del riesgo, entre enero y abril del 2011 se realizó búsqueda sistemática del vector de LV en 13 localidades de las provincias de Entre Ríos, Santa Fe y Santiago del Estero, totalizando 275 trampas/noche. Se comprobó la colonización de Lu. longipalpis, en la localidad de Chajarí. En Santiago del Estero no se encontró Lu. longipalpis por lo que Migonemyia migonei sigue incriminada como vector putativo de LV en esta región.

  2. Risk Factors associated with defaulting from visceral leishmaniasis treatment: analysis under routine programme conditions in Bihar, India.

    Science.gov (United States)

    Kansal, S; Chakravarty, J; Kumar, A; Malaviya, P; Boelaert, M; Hasker, E; Ostyn, B; Sundar, S

    2017-08-01

    To assess the rate of default from treatment in the visceral leishmaniasis (VL) elimination programme and to identify risk factors and its underlying causes. Case-control study conducted between December 2009 and June 2012 in three primary health centres (PHCs) of Muzaffarpur district, India. Patients who defaulted from treatment from the PHCs were considered as 'cases' and those who completed their treatment as 'controls'. Two controls were included in the study for each case. Respondents' opinion and satisfaction with the services provided at the PHCs were also elicited. Logistic regression was performed to assess the contribution of sociodemographic variables on patient status, and a discriminant analysis was used (after decomposing the original data) to identify factors that can predict the patient status as defaulter or not, based on factor scores of the components as predictor variables. During the study period, 16.3% (89/544) of patients defaulted; 87 cases and 188 controls were interviewed through a semistructured questionnaire. Women tended to be more at risk for default (OR, 1.6, 95% CI (0.9 -2.9). Treatment received was miltefosine in 55.6% and sodium stibogluconate (SSG) in 44.4%. Most (86%) defaulters completed their treatment at other healthcare facilities; 70% of them preferred non-governmental institutions. Most cited reasons for default were seeking a second opinion for VL treatment and preferring to be treated in specialised VL centres. Discriminant analysis showed only one significant predictor: dissatisfaction with the medical care received in PHCs. Efforts are needed to enhance the quality of VL care at PHC level, which will be beneficial in increasing treatment completion rates. © 2017 John Wiley & Sons Ltd.

  3. Incidence of visceral leishmaniasis in the Vaishali district of Bihar, India: spatial patterns and role of inland water bodies

    Directory of Open Access Journals (Sweden)

    Gouri Sankar Bhunia

    2011-05-01

    Full Text Available The role of the distribution of inland water bodies with respect to the transmission of visceral leishmaniasis (VL and its dominant vector, Phlebotomous argentipes, has been studied at the regional scale in Bihar, eastern India. The Landsat TM sensor multispectral scanning radiometer, with a spatial resolution of 30 m in the visible, reflective-infrared and shortwave- infrared (SWIR bands, was used to identify water bodies using the normalized differential pond index (NDPI calculated as follows: (Green – SWIR I/(Green + SWIR I. Nearest neighbour and grid square statistics were used to delineate spatial patterns and distribution of the sandfly vector and the disease it transmits. The female P. argentipes sandfly was found to be associated with the distance from open water and particularly abundant near non-perennial river banks (68.4%; P <0.001, while its association with rivers was focused further away from the water source (X2 = 26.3; P <0.001. The results also reveal that the distribution of VL is clustered around non-perennial riverbanks, while the pattern is slightly random around the perennial river banks. The grid square technique illustrate that the spatial distribution of the disease has a much stronger correlation with lower density of open waters surfaces as well as with sandfly densities (X2 = 26.0; P <0.001. The results of our study suggest that inland water presence poses a risk for VL by offering suitable breeding sites for P. argentipes, a fact that should be taken into account when attempting to control disease transmission.

  4. The Severity of Visceral Leishmaniasis Correlates with Elevated Levels of Serum IL-6, IL-27 and sCD14.

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    Priscila L Dos Santos

    2016-01-01

    Full Text Available Visceral leishmaniasis (VL is a severe disease caused by infection with protozoa of the genus Leishmania. Classic VL is characterized by a systemic infection of phagocytic cells and an intense activation of the inflammatory response. It is unclear why 90% of infected individuals do not develop the disease while a minority develop the classical form. Furthermore, among those that develop disease, a small group progresses to more severe form that is unresponsive to treatment. The presence of inflammatory mediators in serum could theoretically help to control the infection. However, there is also a release of anti-inflammatory mediators that could interfere with the control of parasite multiplication. In this study, we took advantage of the spectrum of outcomes to test the hypothesis that the immune profile of individuals infected with Leishmania (L. infantum is associated with the development and severity of disease.Sera from patients with confirmed diagnosis of VL were evaluated for the presence of numerous molecules, and levels compared with healthy control and asymptomatic infected individuals.Although differences were not observed in LPS levels, higher levels of sCD14 were detected in VL patients. Our data suggest that L. infantum may activate the inflammatory response via CD14, stimulating a generalized inflammatory response with production of several cytokines and soluble molecules, including IFN-γ, IL-27, IL-10, IL-6 and sCD14. These molecules were strongly associated with hepatosplenomegaly, neutropenia and thrombocytopenia. We also observed that IL-6 levels greater than 200 pg/ml were strongly associated with death. Together our data reinforce the close relationship of IFN-γ, IL-10, IL-6, TNF-α and IL-27 in the immune dynamics of VL and suggest the direct participation of sCD14 in the activation of the immune response against L. infantum.

  5. Time series of visceral leishmaniasis in Aracaju, state of Sergipe, Brazil (1999 to 2008): human and canine aspects.

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    Góes, Marco Aurélio de Oliveira; de Melo, Cláudia Moura; Jeraldo, Verônica de Lourdes Sierpe

    2012-06-01

    Considered as a neglected disease by the WHO, visceral leishmaniasis (VL) has expanded and urbanized. Its transmission and expansion have been linked to several factors. To evaluate the epidemiological aspects of VL in the city of Aracaju/SE, through retrospective studies of the historical series of human and canine VL in the 1999-2008 period. Secondary data from SINAN (Information System for Reportable Diseases) for human cases were used. Data from canine surveys and from the Zoonosis Control Center's (ZCC) passive demand were used for canine cases. 192 autochthonous cases of human VL were reported, and 63.5% were male. Children aged 1-4 years were the most affected (29.2%), followed by adults aged 20-29 years (15.6%) and children aged 5-9 years (15.1%). General mortality was 8.9%, and it was higher for the 60-69 year age group (60%); 32.3% of autochthonous cases performed serology for HIV, with a 6.9% positivity. Laboratory results were confirmed mostly by indirect isolated immunofluorescence (71.1%). 58,161 dogs were serologically tested for VL, with a positivity rate of 5.4%, while 87.0% of the surveys conducted annually by the ZCC, have a 4.4%positivity rate for VL. Of the 7,501 dogs that were brought to the ZCC for multiple complaints, the serological test was positive in 12.0%. Data show the endemicity of VL in the city, revealing the need for actions to reduce the risk of the population, mostly for the group with higher incidence and mortality, such as improvement in the diagnosis of VL and its HIV-associated infection, along with monitoring of the dog population, among others.

  6. Environmental factors associated with the distribution of visceral leishmaniasis in endemic areas of Bangladesh: modeling the ecological niche.

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    Abdullah, Abu Yousuf Md; Dewan, Ashraf; Shogib, Md Rakibul Islam; Rahman, Md Masudur; Hossain, Md Faruk

    2017-01-01

    Visceral leishmaniasis (VL) is a parasitic infection (also called kala-azar in South Asia) caused by Leishmania donovani that is a considerable threat to public health in the Indian subcontinent, including densely populated Bangladesh. The disease seriously affects the poorest subset of the population in the subcontinent. Despite the fact that the incidence of VL results in significant morbidity and mortality, its environmental determinants are relatively poorly understood, especially in Bangladesh. In this study, we have extracted a number of environmental variables obtained from a range of sources, along with human VL cases collected through several field visits, to model the distribution of disease which may then be used as a surrogate for determining the distribution of Phlebotomus argentipes vector, in hyperendemic and endemic areas of Mymensingh and Gazipur districts in Bangladesh. The analysis was carried out within an ecological niche model (ENM) framework using a maxent to explore the ecological requirements of the disease. The results suggest that VL in the study area can be predicted by precipitation during the warmest quarter of the year, land surface temperature (LST), and normalized difference water index (NDWI). As P. argentipes is the single proven vector of L. donovani in the study area, its distribution could reasonably be determined by the same environmental variables. The analysis further showed that the majority of VL cases were located in mauzas where the estimated probability of the disease occurrence was high. This may reflect the potential distribution of the disease and consequently P. argentipes in the study area. The results of this study are expected to have important implications, particularly in vector control strategies and management of risk associated with this disease. Public health officials can use the results to prioritize their visits in specific areas. Further, the findings can be used as a baseline to model how the

  7. Biomarkers of safety and immune protection for genetically modified live attenuated Leishmania vaccines against visceral leishmaniasis-Discovery and implications

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    Sreenivas eGannavaram

    2014-05-01

    Full Text Available Despite intense efforts there is no safe and efficacious vaccine against visceral leishmaniasis, which is fatal and endemic in many tropical countries. A major shortcoming in the vaccine development against blood borne parasitic agents such as Leishmania is the inadequate predictive power of the early immune responses mounted in the host against the experimental vaccines. Often immune correlates derived from in-bred animal models do not yield immune markers of protection that can be readily extrapolated to humans. The limited efficacy of vaccines based on DNA, sub-unit, heat killed parasites has led to the realization that acquisition of durable immunity against the protozoan parasites requires a controlled infection with a live attenuated organism. Recent success of irradiated malaria parasites as a vaccine candidate further strengthens this approach to vaccination. We developed several gene deletion mutants in L. donovani as potential live attenuated vaccines and reported extensively on the immunogenicity of LdCentrin1 deleted mutant in mice, hamsters and dogs. Additional limited studies using genetically modified live attenuated Leishmania parasites as vaccine candidates have been reported. However, for the live attenuated parasite vaccines, the primary barrier against widespread use remains the absence of clear biomarkers associated with protection and safety. Recent studies in evaluation of vaccines e.g., influenza and yellow fever vaccines, using systems biology tools demonstrated the power of such strategies in understanding the immunological mechanisms that underpin a protective phenotype. Applying similar tools in isolated human tissues such as PBMCs from healthy individuals infected with live attenuated parasites such as LdCen1-/- in vitro followed by human microarray hybridization experiments will enable us to understand how early vaccine-induced gene expression profiles and the associated immune responses are coordinately regulated

  8. Immunogenicity in dogs and protection against visceral leishmaniasis induced by a 14 kDa Leishmania infantum recombinant polypeptide

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    Claudia Abeijon

    2016-01-01

    Full Text Available In areas were human visceral leishmaniasis (VL is endemic, the domestic dog is the main parasite reservoir in the infectious cycle of Leishmania infantum. Development of prophylactic strategies to lower the parasite burden in dogs would reduce sand fly transmission thus lowering the incidence of zoonotic VL. Here we demonstrate that vaccination of dogs with a recombinant 14 kDa polypeptide of L. infantum nuclear transport factor 2 (Li-ntf2 mixed with adjuvant BpMPLA-SE resulted in the production of specific anti-Li-ntf2 IgG antibodies as well as IFN-γ release by the animals’ peripheral blood mononuclear cells stimulated with the antigen. In addition, immunization with this single and small 14 kDa polypeptide resulted in protracted progression of the infection of the animals after challenging with a high dose of virulent L. infantum. Five months after challenge the parasite load was lower in the bone marrow of immunized dogs compared to non-immunized animals. The antibody response to K39, a marker of active VL, at ten months after challenge was strong and significantly higher in the control dogs than in vaccinated animals. At the study termination vaccinated animals showed significantly more liver granulomas and lymphoid hyperplasia than non-vaccinated animals, which are both histological markers of resistance to infection. Together, these results indicate that the 14 kDa polypeptide is an attractive protective molecule that can be easily incorporated in a leishmanial polyprotein vaccine candidate to augment/complement the overall protective efficacy of the final product.

  9. Comparison of kDNA PCR-hybridization assay with three PCR methods for canines visceral Leishmaniasis diagnosis

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    Pilatti, Marcia M.; Andrade, Antero S.R. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)], e-mail: marciapilatti@yahoo.com.br, e-mail: antero@cdtn.br; Ferreira, Sidney A. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Parasitologia], e-mail: saninoalmeida@gmail.com

    2009-07-01

    The sensitivity of the kDNA PCR-Hybridization assay, which uses radioactive DNA probes (labeled with {sup 32}P), was compared with three conventional PCR methods used for canine visceral leishmaniasis diagnosis. All PCR methods had two steps: a first amplification followed by hybridization or by a new amplification (nested or semi nested). Two methods (kDNA PCR-Hybridization and kDNA snPCR) used primers addressed to kinetoplast minicircles and the other two methods to the coding (LnPCR) and intergenic noncoding regions (ITS-1 nPCR) of the ribosomal rRNA genes. The comparison was accomplished in two groups of 23 infected dogs using samples collected by the conjunctival swab procedure. In the Group 1 the DNA was extracted from cotton swabs by phenol-chloroform and in Group 2 by boiling. The most efficient PCR methods in the Group 1 were those based on kDNA targets. The kDNA PCR-Hybridization was able to detect parasites in 22/23 dogs (95.6%) and in 40/46 samples (86.9%). The kDNA snPCR was positive for 21/23 dogs (91.3%) and for 40/46 samples (86.9%). The positivities of the kDNA based methods were significantly higher than the positivities verified for the methods based on ribosomal rRNA genes (p<0.05). In the Group 2 the kDNA PCR- Hybridization showed a better performance detecting parasites in 18/23 dogs (78.3%) and in 31/46 samples (67.4%), significantly higher than the other three methods (p<0.05). The higher sensitivity of the minicircle kDNA based assays reported by others was confirmed in this study and kDNA PCR-Hybridization showed the best sensitivity among the assays evaluated. (author)

  10. Comparison of kDNA PCR-hybridization assay with three PCR methods for canines visceral Leishmaniasis diagnosis

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    Pilatti, Marcia M.; Andrade, Antero S.R.; Ferreira, Sidney A.

    2009-01-01

    The sensitivity of the kDNA PCR-Hybridization assay, which uses radioactive DNA probes (labeled with 32 P), was compared with three conventional PCR methods used for canine visceral leishmaniasis diagnosis. All PCR methods had two steps: a first amplification followed by hybridization or by a new amplification (nested or semi nested). Two methods (kDNA PCR-Hybridization and kDNA snPCR) used primers addressed to kinetoplast minicircles and the other two methods to the coding (LnPCR) and intergenic noncoding regions (ITS-1 nPCR) of the ribosomal rRNA genes. The comparison was accomplished in two groups of 23 infected dogs using samples collected by the conjunctival swab procedure. In the Group 1 the DNA was extracted from cotton swabs by phenol-chloroform and in Group 2 by boiling. The most efficient PCR methods in the Group 1 were those based on kDNA targets. The kDNA PCR-Hybridization was able to detect parasites in 22/23 dogs (95.6%) and in 40/46 samples (86.9%). The kDNA snPCR was positive for 21/23 dogs (91.3%) and for 40/46 samples (86.9%). The positivities of the kDNA based methods were significantly higher than the positivities verified for the methods based on ribosomal rRNA genes (p<0.05). In the Group 2 the kDNA PCR- Hybridization showed a better performance detecting parasites in 18/23 dogs (78.3%) and in 31/46 samples (67.4%), significantly higher than the other three methods (p<0.05). The higher sensitivity of the minicircle kDNA based assays reported by others was confirmed in this study and kDNA PCR-Hybridization showed the best sensitivity among the assays evaluated. (author)

  11. Knowledge, attitudes and practices related to visceral leishmaniasis in rural communities of Amhara State: a longitudinal study in northwest Ethiopia.

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    Noemí López-Perea

    2014-04-01

    Full Text Available BACKGROUND: In the northwest of Ethiopia, at the South Gondar region, there was a visceral leishmaniasis (VL outbreak in 2005, making the disease a public health concern for the regional health authorities ever since. The knowledge on how the population perceives the disease is essential in order to propose successful control strategies. METHODOLOGY/PRINCIPAL FINDINGS: Two surveys on VL knowledge, attitudes and practices were conducted at the beginning (May 2009 and at the end (February 2011 of a VL longitudinal study carried out in rural communities of Libo Kemkem and Fogera, two districts of the Amhara Regional State. Results showed that VL global knowledge was very low in the area, and that it improved substantially in the period studied. Specifically, from 2009 to 2011, the frequency of proper knowledge regarding VL signs and symptoms increased from 47% to 71% (p<0.0001, knowledge of VL causes increased from 8% to 25% (p<0.0001, and knowledge on VL protection measures from 16% to 55% (p<0.0001. Moreover, the improvement observed in VL knowledge was more marked among the families with no previous history of VL case. Finally, in 2011 more than 90% of the households owned at least an impregnated bed net and had been sprayed, and attitudes towards these and other protective measures were very positive (over 94% acceptance for all of them. CONCLUSIONS/SIGNIFICANCE: In 2009 the level of knowledge regarding VL was very low among the rural population of this area, although it improved substantially in the study period, probably due to the contribution of many actors in the area. VL patients and relatives should be appropriately informed and trained as they may act as successful health community agents. VL risk behavioural patterns are subject to change as attitudes towards protective measures were very positive overall.

  12. Immunoprotective responses of T helper type 1 stimulatory protein‐S‐adenosyl‐L‐homocysteine hydrolase against experimental visceral leishmaniasis

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    Khare, P.; Jaiswal, A. K.; Tripathi, C. D. P.; Sundar, S.

    2016-01-01

    Summary It is well known that a patient in clinical remission of visceral leishmaniasis (VL) remains immune to reinfection, which provides a rationale for the feasibility of a vaccine against this deadly disease. In earlier studies, observation of significant cellular responses in treated Leishmania patients as well as in hamsters against leishmanial antigens from different fractions led to its further proteomic characterization, wherein S‐adenosyl‐L‐homocysteine hydrolase (AdoHcy) was identified as a helper type 1 (Th1) stimulatory protein. The present study includes immunological characterization of this protein, its cellular responses [lymphoproliferation, nitric oxide (NO) production and cytokine responses] in treated Leishmania‐infected hamsters and patients as well as prophylactic efficacy against Leishmania challenge in hamsters and the immune responses generated thereof. Significantly higher cellular responses were noticed against recombinant L. donovani S‐adenosyl‐L‐homocysteine hydrolase (rLdAdoHcy) compared to soluble L. donovani antigen in treated samples. Moreover, stimulation of peripheral blood mononuclear cells with rLdAdoHcy up‐regulated the levels of interferon (IFN)‐γ, interleukin (IL)−12 and down‐regulated IL‐10. Furthermore, vaccination with rLdAdoHcy generated perceptible delayed‐type hypersensitivity response and exerted considerably good prophylactic efficacy (∼70% inhibition) against L. donovani challenge. The efficacy was confirmed by the increased expression levels of inducible NO synthase and Th1‐type cytokines, IFN‐γ and IL‐12 and down‐regulation of IL‐4, IL‐10 and transforming growth factor (TGF)‐β. The results indicate the potentiality of rLdAdoHcy protein as a suitable vaccine candidate against VL. PMID:26898994

  13. Evaluation of the immunoprophylactic potential of a killed vaccine candidate in combination with different adjuvants against murine visceral leishmaniasis.

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    Thakur, Ankita; Kaur, Harpreet; Kaur, Sukhbir

    2015-02-01

    Despite a large number of field trials, till date no prophylactic antileishmanial vaccine exists for human use. Killed antigen formulations offer the advantage of being safe but they have limited immunogenicity. Recent research has documented that efforts to develop effective Leishmania vaccine have been limited due to the lack of an appropriate adjuvant. Addition of adjuvants to vaccines boosts and directs the immunogenicity of antigens. So, the present study was done to evaluate the effectiveness of four adjuvants i.e. alum, saponin, cationic liposomes and monophosphoryl lipid-A in combination with Autoclaved Leishmania donovani (ALD) antigen against murine visceral leishmaniasis (VL). BALB/c mice were immunized thrice with respective vaccine formulation. Two weeks after last booster, challenge infection was given. Mice were sacrificed 15 days after last immunization and on 30, 60 and 90 post infection/challenge days. A considerable protective efficacy was shown by all vaccine formulations. It was evident from significant reduction in parasite load, profound delayed type hypersensitivity responses (DTH), increased IgG2a titres and high levels of Th1 cytokines (IFN-γ, IL-12) as compared to the infected controls. However, level of protection varied with the type of adjuvant used. Maximum protection was achieved with the use of liposome encapsulated ALD antigen and it was closely followed by group immunized with ALD+MPL-A. Significant results were also obtained with ALD+saponin, ALD+alum and ALD antigen (alone) but the protective efficacy was reduced as compared to other immunized groups. The present study reveals greater efficacy of two vaccine formulations i.e. ALD+liposome and ALD+MPL-A against murine VL. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Development of an Immunochromatographic Test for Diagnosis of Visceral Leishmaniasis Based on Detection of a Circulating Antigen.

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    Chun-hua Gao

    Full Text Available Visceral leishmaniasis (VL is a life-threatening disease caused by protozoan parasites of the Leishmania donovani complex. Early case detection followed by adequate treatment is essential to the control of VL. However, the available diagnostic tests are either invasive and require considerable expertise (parasitological demonstration of the parasite in tissue smears or unable to distinguish between past and active infection (serological methods. Therefore, we aimed to develop a lateral flow assay in the form of an immunochromatographic test (ICT device based on the detection of a circulating Leishmania antigen using monoclonal antibodies (mAbs.mAbs were produced by fusion of murine myeloma cells with splenocytes isolated from a mouse immunized with L. donovani soluble crude antigen. Out of 12 cloned hybridoma cell lines, two secreted mAbs recognizing the same leishmanial protein. These mAbs were used to produce an ICT as a sandwich assay for the detection of circulating antigen in serum and blood samples. The ICT was evaluated with 213 serum samples from VL patients living in VL endemic areas in China, and with 156 serum samples from patients with other diseases as well as 78 serum samples from healthy donors. Sensitivity, specificity and diagnostic efficiency of the new ICT was 95.8%, 98.7% and 97.3%, respectively. Compared with a commercially available antibody detecting ICT, our antigen-based ICT performed slightly better.The newly developed ICT is an easy to use and more accurate diagnostic tool which fulfils the performance and operational characteristics required for VL case detection under field and laboratory conditions. As our ICT detects a circulating antigen, it will also be useful in monitoring treatment success and diagnosing VL in immunocompromised patients.

  15. Epidemiological and entomological survey in a focus of visceral leishmaniasis in Pap district (Fergana Valley) of Namangan region, Uzbekistan.

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    Maroli, M; Krasnonos, L; Gafurov, I

    2001-12-21

    An active focus of human visceral leishmaniasis (VL) is present in Uzbekistan, Namangan region, Pap district, situated along the Fergana Valley at an altitude of 900-1300 m a.s.l. An overall total of 19 VL cases, all recorded in children less than 14 years of age, have been reported during the period of 1987-99 in three villages, namely Oltinkon (9 cases), Chodak (7 cases) and Guliston (3 cases). Clinical and epidemiological features suggest that the disease is zoonotic in nature and that it is possibly caused by Leishmania infantum, though no characterization of the causative agent was performed due to the failure in isolating the parasite. Currently, diagnosis is made exclusively on the basis of clinical manifestations followed by demonstration of parasites in bone marrow aspirates. Standardized monthly sandfly collections (July-September 1999) were made with sticky traps and hand captures from houses and peri-domestic areas. Twenty houses were monitored over two consecutive days every month in five villages scattered along the valley, three of which were the VL foci (Oltinkon, Chodak, Guliston) and the other two, Kandigan and Khonabad, were located at the top (>1300 m a.s.l.) and at the bottom of the valley (740 m a.s.l.), respectively. Among the sandfly species identified, Phlebotomus sergenti (46.0%) was the most prevalent species through the entire period, followed by P. papatasi (18.8%), P. longiductus (15.5%), P. alexandri (10.3%), P. angustus (6.6%), S. sumbarica (2.2%), P. keshishiani (0.6%) and S. grekovi (0.1%). The role of the suspected vector, P. longiductus in the transmission of VL cases in the Fergana focus is discussed in relation to its abundance and distribution in the valley.

  16. A comparison of the immune parameters of dogs infected with visceral leishmaniasis using Western blot and neutralization techniques.

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    Nogueira, Yeda L; Odorizzi, Rosa M F N; Nakamura, Paulo M

    2007-01-01

    The Western blot technique was used to demonstrate the presence of antibodies in the blood of dogs that presented canine visceral leishmaniasis. This technique was used against some specific molecules present in the lysate of the promastigote form of Leshmania chagasi. Through the association of the results of the Western blot technique with the morphological alterations seen as a result of the serum neutralization technique performed in McCoy cells (which mimetizes the macrophage) it was possible to observe the role of some molecules of great relevance in determining the disease in symptomatic dogs as well as that of some other molecules associated with asymptomatic infected dogs that may become transmitters as well as differentiating them as asymptomatic resistant dogs. In the sera analyses carried out during the immunobloting a variation of 9 to 27 immunoreacting bands was observed, which were then compared using Dice's similarity coefficient. In the dendrogram constructed on the basis of the coefficient, 50% similarity was observed among the total number of reagent bands with the promastigote lysate, thus creating five groups. The main difference observed related to the clinical condition of the dogs: symptomatic and asymptomatic dogs were found in separate groups. The asymptomatic group of dogs was distributed in two different places in the dendrogram because they presented two different behavior patterns regarding the cellular morphology in the serum neutralization reaction: the presence or absence of cellular lysis. According to this analysis it is possible to evaluate the immune status and associate it with specific markers observed in the reaction found in the Western blot strips.

  17. An outbreak investigation of visceral leishmaniasis among residents of Dharan town, eastern Nepal, evidence for urban transmission of Leishmania donovani

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    Uranw Surendra

    2013-01-01

    Full Text Available Abstract Background Visceral leishmaniasis (VL is a predominantly rural disease, common in the low lands of eastern Nepal. Since 1997 VL cases have also been reported among residents of the city of Dharan. Our main research objective was to find out whether there had been local transmission of VL inside the city. Methods We conducted an outbreak investigation including a case–control study; cases were all urban residents treated for VL between 2000 and 2008 at BP Koirala Institute of Health Sciences, a university hospital in the city. For each case, we selected four random controls, with no history of previous VL; frequency-matched for age. Cases and controls were subjected to a structured interview on the main exposures of interest and potential confounders; a binominal multilevel model was used to analyze the data. We also collected entomological data from all neighborhoods of the city. Results We enrolled 115 VL patients and 448 controls. Cases were strongly clustered, 70% residing in 3 out of 19 neighborhoods. We found a strong association with socio-economic status, the poorest being most at risk. Housing was a risk factor independent from socio-economic status, most at risk were those living in thatched houses without windows. ‘Sleeping upstairs’ and ‘sleeping on a bed’ were strongly protective, OR of 0.08 and 0.25 respectively; proximity to a case was a strong risk factor (OR 3.79. Sand flies were captured in all neighborhoods; in collections from several neighborhoods presence of L. donovani could be demonstrated by PCR. Conclusion The evidence found in this study is consistent with transmission of anthroponotic VL within the city. The vector P. argentipes and the parasite L. donovani have both been identified inside the town. These findings are highly relevant for policy makers; in VL endemic areas appropriate surveillance and disease control measures must be adopted not only in rural areas but in urban areas as well.

  18. Clinical forms of canine visceral Leishmaniasis in naturally Leishmania infantum-infected dogs and related myelogram and hemogram changes.

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    Roney de Carvalho Nicolato

    Full Text Available Hematological analysis has limited applications for disease diagnosis in Leishmania infantum-infected dogs, but it can be very important in evaluating the clinical forms of the disease and in understanding the evolution of canine visceral leishmaniasis (CVL pathogenesis. Recently, we demonstrated that alterations in leucopoiesis and erythropoiesis are related to clinical status and bone marrow parasite density in dogs naturally infected by L. infantum. To further characterize these alterations, we evaluated the association between the hematological parameters in bone marrow and peripheral blood alterations in groups of L. infantum-infected dogs: asymptomatic I (AD-I: serum negative/PCR+, asymptomatic II (AD-II: serum positive, oligosymptomatic (OD, and symptomatic (SD. Results were compared with those from noninfected dogs (NID. The SD group was found to present a decrease in erythropoietic lineage with concomitant reductions in erythrocytes, hemoglobin, and hematocrit parameters, resulting in anemia. The SD group also had increased neutrophils and precursors and decreased band eosinophils and eosinophils, leading to peripheral blood leucopenia. In the AD-II group, lymphocytosis occurred in both the peripheral blood and the bone marrow compartments. The SD group exhibited lymphocytosis in the bone marrow, with lymphopenia in the peripheral blood. In contrast, the AD-I group, showed no significant changes suggestive of CVL, presenting normal counts in bone marrow and peripheral blood. Our results showed for the first time that important changes in hematopoiesis and hematological parameters occur during ongoing CVL in naturally infected dogs, mainly in symptomatic disease. Taken together, our results based on myelogram and hemogram parameters enable better understanding of the pathogenesis of the anemia, lymphocytosis, and lymphopenia, as well as the leucopenia (eosinopenia and monocytopenia, that contribute to CVL prognosis.

  19. Development of a Scalable Process for the Synthesis of DNDI-VL-2098: A Potential Preclinical Drug Candidate for the Treatment of Visceral Leishmaniasis

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    Satam, Vijay S.; Pedada, Srinivasa Rao; Kamaraj, Pasumpon; Antao, Nakita; Singh, Apoorva; Hindupur, Rama Mohan; Pati, Hari N.; Thompson, Andrew M.; Launay, Delphine; Martin, Denis

    2016-01-01

    A process suitable for kilogram-scale synthesis of (2R)-2-methyl-6-nitro-2-{[4-(trifluoromethoxy)phenoxy]methyl}-2,3-dihydroimidazo[2,1-b][1,3]oxazole (DNDI-VL-2098, 2), a preclinical drug candidate for the treatment of visceral leishmaniasis, is described. The four-step synthesis of the target compound involves the Sharpless asymmetric epoxidation of 2-methyl-2-propen-1-ol, 8. Identification of a suitable synthetic route using retrosynthetic analysis and development of a scalable process to ...

  20. Caracterización parasitológica e inmunológica de la leishmaniasis visceral en el estado de Amhara, Etiopía

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    Gadisa Belachew, Endalamaw

    2012-01-01

    La leishmaniasis visceral (LV) o kala-azar es una enfermedad infecciosa que resulta fatal sin diagnóstico y tratamiento adecuado. Está causada por parásitos pertenecientes al complejo Leishmania donovani y es transmitida por dípteros hematófagos, concretamente hembras de diversas especies del género Phlebotomus en el Viejo Mundo y del género Lutzomyia en el Nuevo Mondo. Se estima que la incidencia mundial de LV es de 500 000 casos, de los cuales el 90% ocurre en diferentes países que se encue...

  1. The first report of the main vector of visceral leishmaniasis in America, Lutzomyia longipalpis (Lutz & Neiva) (Diptera: Psychodidae: Phlebotominae), in the state of Rio Grande do Sul, Brazil.

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    Souza, Getúlio Dornelles; Santos, Edmilson dos; Andrade Filho, José Dilermando

    2009-12-01

    Visceral leishmaniasis (VL) is a widespread zoonosis in Brazil and, up to now, there has been no record of the main vector of its agent, Lutzomyia longipalpis, in the Southern Region. Due to the diagnosis of VL in a dog in October 2008 in the city of São Borja, in the southernmost Brazilian state of Rio Grande do Sul, a collection of phlebotomines was undertaken to detect the presence of the vector Lu. longipalpis. The captures were carried out with CDC light traps on three consecutive nights in 2008. A total of 39 specimens of Lu. longipalpis were captured, thereby increasing the knowledge of the geographical distribution of this important vector.

  2. Avaliação do nível de conhecimento e de atitudes preventivas da população sobre a leishmaniose visceral em Belo Horizonte, Minas Gerais, Brasil Assessment of knowledge and preventive attitudes concerning visceral leishmaniasis in Belo Horizonte, Minas Gerais State, Brazil

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    Bárbara Kellen Antunes Borges

    2008-04-01

    Full Text Available Objetivou-se avaliar o nível de conhecimento e algumas atitudes preventivas em relação à leishmaniose visceral em Belo Horizonte, Minas Gerais, Brasil, em 2006. Foi feito um estudo de caso-controle, com visitas domiciliares e questionário semi-estrurado. Comparou-se dois grupos: (1 82 casos humanos de leishmaniose visceral ocorridos em 2004 e (2 164 controles, constituídos por vizinhos dos casos. A leishmaniose visceral acometeu mais em crianças, com aumento do risco de contrair leishmaniose visceral de 109,77 vezes para menores de dez anos. O homem demonstrou ter 2,57 vezes mais chances de adoecer que a mulher. A escolaridade da população mostrou-se baixa (68,3% não completaram o ensino médio. Cinqüenta por cento dos casos desconheciam-na quando foram infectados e apenas 1,2% conhecia o vetor. Conhecer algo sobre a leishmaniose visceral minimizou o risco de adoecer em 2,24 vezes. Quanto às atitudes de proteção, o risco de se contrair leishmaniose visceral diminui em 1,94 vez para pessoas que mantêm limpos os domicílios ou que levam o cão ao veterinário. Em Belo Horizonte, o conhecimento da população perante a leishmaniose visceral é superficial e as atitudes preventivas inespecíficas.The main objective of this study was to evaluate knowledge concerning visceral leishmaniasis and attitudes used to prevent the disease in Belo Horizonte, Minas Gerais State, Brazil, in 2006. A case-control study was conducted, with home visits and a questionnaire. The odds ratio was calculated, comparing 82 cases of human visceral leishmaniasis in 2004 and 164 controls (neighbors of cases. The disease was more frequent in children (OR = 109.77. Visceral leishmaniasis was 2.57 times more likely in males than in females. Overall schooling level was low (68.3% of subjects had not completed secondary school. Half of the cases did not know what visceral leishmaniasis was, and only 1.2% could identify the vector. Having basic knowledge of visceral

  3. Associação da carga parasitária renal com achados laboratoriais em cães com leishmaniose visceral Renal parasite load association with laboratory findings in dogs with visceral Leishmaniasis

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    Mariana de Medeiros Torres

    2013-05-01

    Full Text Available A leishmaniose visceral canina é uma doença grave e a morte ocorre por falência renal, considerando que os métodos diagnósticos convencionais não possibilitam a classificação clínica do animal. O objetivo deste estudo foi associar a carga parasitária renal aos achados clínicos e histopatológicos em cães com leishmaniose visceral. A análise microscópica revelou predomínio de nefrite intersticial mononuclear de graus variados em 59,3% dos cães avaliados. Entretanto, não houve diferença entre a carga parasitária renal de sintomáticos e oligossintomáticos (P= 0,35. As lesões renais foram de ordem inflamatória e a quantidade de parasitos não influenciaram na característica dessas lesões e nem nas alterações bioquímicas, mesmo em cães com diferentes classificações clínicas.Canine visceral leishmaniasis is a severe disease and the death occurs from renal failure, whereas conventional diagnostic methods do not allow the animal clinical staging. The aim of this study was to associate the renal parasite load to clinical and histopathological findings in dogs with visceral Leishmaniasis. Microscopic analysis revealed a predominance of mononuclear interstitial nephritis of varying degrees in 59, 3% of dogs evaluated. However, no difference was found between the renal parasite load of symptomatics and oligosymptomatics (P= 0,35. Renal lesions were inflammatory order and amount of parasites not influenced the characteristics of theses lesions nor biochemical changes, even in dogs with different clinical classifications.

  4. Spatial distribution of human and canine visceral leishmaniasis in Belo Horizonte, Minas Gerais State, Brasil, 1994-1997 Distribuição espacial da leishmaniose visceral humana e canina em Belo Horizonte, Minas Gerais, Brasil, 1994-1997

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    Cláudia Di Lorenzo Oliveira

    2001-10-01

    Full Text Available In this paper, we present spatial analysis of the association between all incidents cases of human Visceral Leishmaniasis and seropositive dogs, from 1994 to 1997 in Belo Horizonte, a large Brazilian city. We geocoded 158 human cases and 11,048 seropositive dogs and compared canine prevalence rates with Human Bayesian Incidence rates in the same areas. We also used Knox's test to evaluate the hypothesis of space-time clustering of human cases in the period. Additionally, we used Kernel's maps for seropositive dogs distribution and located the human cases in the resulting smooth maps. We concluded that human and dog rates are correlated. Also, the Visceral Leishmaniasis in Belo Horizonte spread quickly, but apart from the rates' magnitude, it has kept the same spatial pattern through time. We believe it is possible to use this technique to choose areas to implement control measures against Visceral Leishmaniasis in a more efficient way.Neste artigo, apresentamos uma análise espacial da associação entre todos os casos incidentes de leishmaniose visceral e em cães soropositivos ocorridos em Belo Horizonte no período de 1994 a 1997. Geocodificamos 158 casos humanos e 11.048 cães positivos, comparamos as taxas de prevalência canina por área e as taxas Bayesianas de incidência da doença humana nas mesmas áreas. Usamos o teste de Knox para testar a hipótese de cluster espaço temporal entre os casos humanos no período examinado. Adicionalmente, construímos Mapas de Kernel para cães soropositivos e sobrepusemos os casos humanos em quatro áreas. Os resultados apontam para correlação entre casos humanos e caninos. Além disso, a leishmaniose visceral espalhou-se rapidamente em Belo Horizonte, embora tenha mantido o mesmo padrão durante os anos analisados. Acreditamos ser possível o uso das técnicas empregadas para priorizar áreas onde as medidas de controle devem ser implementadas.

  5. 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.

  6. Interpretation of electrocardiographic, echocardiographic and biochemical findings during different stages of Canine Visceral Leishmaniasis

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    Ural K

    2017-09-01

    Full Text Available Objective. The purpose of the present study was to test the hypothesis that cardiac alterations participate within different stages of CVL. Materials and methods. Twenty-eight dogs were diagnosed with CVL, were classified [based on clinical signs, rapid ELISA/IFAT, hematological and serum biochemical tests, urinary protein/creatinine ratio, ECG and ECHO]. as follows; group I (mild disease, group II (moderate disease, group III (severe disease, group IV (very severe disease and group V included healthy controls. Results. Ig G antibodies against leishmaniasis as tested by IFAT, were deemed 1/64 to 1/16000 among infected groups. There were statistical significance regarding mean values for WBC [among healthy control group (V. and other groups (p=0.049], RBC [among stage III-stage IV and other groups (p=0.001], Hb [between stage I and stage III-stage IV (p=0.008, HCT [between stage I and other groups (p = 0.001] MCHC [between stage I and stage II- stage IV (p=0.046], serum creatinine [(p=0.008 stage IV and stage I-II within group V], serum protein [(p=0.002 among stage IV and stage I-III- healthy control groups] and serum albumine [(p=0.004 among stage IV and stage I-II]. There was no alteration in CTnI concentrations,among groups. UPC analysis revealed statistical difference among control group and stage II to IV dogs (p=0.000. Moderate or severe ECG abnormalities were detected in 6/28 of diseased dogs. Regarding ECHO examination LA/ Ao value presented significant difference (p=0.003 among stage IV and other groups. Conclusions. It may be suggested that establishing Leishvet Working Group to those of dogs classified into stage I to IV, ECG [left atrial/ventricular enlargement, myocardial hypoxia] and ECHO [left atrial dilation, decrased/increased LVIDs, decrased/increased LVIDd, shortened FS and EF (systolic dysfunction] alterations must be taken into account along with hematological and serum biochemical analysis.

  7. Leishmaniasis vector behaviour in Kenya

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    Mutinga, M.J.

    1980-01-01

    Leishmaniasis in Kenya exists in two forms: cutaneous and visceral. The vectors of visceral leishmaniasis have been the subject of investigation by various researchers since World War II, when the outbreak of the disease was first noticed. The vectors of cutaneous leishmaniasis were first worked on only a decade ago after the discovery of the disease focus in Mt. Elgon. The vector behaviour of these diseases, namely Phlebotomus pedifer, the vector of cutaneous leishmaniasis, and Phlebotomus martini, the vector of visceral leishmaniasis, are discussed in detail. P. pedifer has been found to breed and bite inside caves, whereas P. martini mainly bites inside houses. (author)

  8. Application of Flumethrin Pour-On on Reservoir Dogs and Its Efficacy against Sand Flies in Endemic Focus of Visceral Leishmaniasis, Meshkinshahr, Iran

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    Jalilnavaz, Mohammad Reza; Abai, Mohammad Reza; Vatandoost, Hassan; Mohebali, Mehdi; Akhavan, Amir Ahmad; Zarei, Zabihollah; Rafizadeh, Sayena; Bakhshi, Hassan; Rassi, Yaver

    2016-01-01

    Background: Visceral leishmaniasis (VL) is one of the most important parasitic zoonotic diseases in the world. Domestic dogs are the main domestic reservoirs of VL in endemic foci of Iran. Various methods, including vaccination, treatment of dogs, detection and removal of infected dogs have different results around the world. General policy on control of canine visceral leishmaniasis is protection of them from sand fly bites. The aim of this study was evaluation of pour-on application of flumethrin on dogs against blood-feeding and mortality of field-caught sand flies. Methods: Once every 20 days from May untill September 2013, the treated and control dogs were exposed with field caught sandflies for 2 hours under bed net traps. After the exposure time, both alive and dead sand flies were transferred in netted cups to the laboratory. The mortality rate of them was assessed after 24 hours. The blood-fed or unfed conditions were determined 2 hours after exposure to the dogs under stereomicroscope. Results: The blood feeding index was varied from 12.0 to 25.0 % and 53.0 to 58.0 % for treated and control dogs respectively (Psand flies. PMID:27047974

  9. Introducing Single Dose Liposomal Amphotericin B for the Treatment of Visceral Leishmaniasis in Rural Bangladesh: Feasibility and Acceptance to Patients and Health Staff

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    Eva-Maria Maintz

    2014-01-01

    Full Text Available Background. For the treatment of visceral leishmaniasis in Bangladesh, single dose liposomal amphotericin B (ambisome is supposed to be the safest and most effective treatment. Specific needs for application and storage raise questions about feasibility of its implementation and acceptance by patients and health staff. Methods. The study was carried out in the most endemic district of Bangladesh. Study population includes patients treated with ambisome or miltefosine, hospital staff, and a director of the national visceral leishmaniasis program. Study methods include direct observation (subdistrict hospitals, open interviews (heath staff and program personnel, structured questionnaires, and focus group discussions (patients. Results. Politicalcommitment for ambisome is strong; the general hospital infrastructure favours implementation but further strengthening is required, particularly for drug storage below 25°C (refrigerators, back-up energy (fuel for generators, and supplies for ambisome administration (like 5% dextrose solution. Ambisome created high satisfaction in patients and hospital staff, less adverse events, and less income loss for patients compared to miltefosine. Conclusions. High political commitment, general capacities of subdistrict hospitals, and high acceptability favour the implementation of ambisome treatment in Bangladesh. However, strengthening of the infrastructure and uninterrupted supplies of essential accessories is mandatory before introducing sLAB in Bangladesh.

  10. Application of Flumethrin Pour-On on Reservoir Dogs and Its Efficacy against Sand Flies in Endemic Focus of Visceral Leishmaniasis, Meshkinshahr, Iran.

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    Jalilnavaz, Mohammad Reza; Abai, Mohammad Reza; Vatandoost, Hassan; Mohebali, Mehdi; Akhavan, Amir Ahmad; Zarei, Zabihollah; Rafizadeh, Sayena; Bakhshi, Hassan; Rassi, Yaver

    2016-03-01

    Visceral leishmaniasis (VL) is one of the most important parasitic zoonotic diseases in the world. Domestic dogs are the main domestic reservoirs of VL in endemic foci of Iran. Various methods, including vaccination, treatment of dogs, detection and removal of infected dogs have different results around the world. General policy on control of canine visceral leishmaniasis is protection of them from sand fly bites. The aim of this study was evaluation of pour-on application of flumethrin on dogs against blood-feeding and mortality of field-caught sand flies. Once every 20 days from May untill September 2013, the treated and control dogs were exposed with field caught sandflies for 2 hours under bed net traps. After the exposure time, both alive and dead sand flies were transferred in netted cups to the laboratory. The mortality rate of them was assessed after 24 hours. The blood-fed or unfed conditions were determined 2 hours after exposure to the dogs under stereomicroscope. The blood feeding index was varied from 12.0 to 25.0 % and 53.0 to 58.0 % for treated and control dogs respectively (Pflies.

  11. Serological and molecular diagnostic tests for canine visceral leishmaniasis in Brazilian endemic area: one out of five seronegative dogs are infected.

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    Lopes, E G; Sevá, A P; Ferreira, F; Nunes, C M; Keid, L B; Hiramoto, R M; Ferreira, H L; Oliveira, T M F S; Bigotto, M F D; Galvis-Ovallos, F; Galati, E A B; Soares, R M

    2017-09-01

    Euthanasia of infected dogs is one of the measures adopted in Brazil to control visceral leishmaniasis (VL) in endemic areas. To detect infected dogs, animals are screened with the rapid test DPP® Visceral Canine Leishmaniasis for detection of antibodies against K26/K39 fusion antigens of amastigotes (DPP). DPP-positives are confirmed with an immunoenzymatic assay probing soluble antigens of promastigotes (ELISA), while DPP-negatives are considered free of infection. Here, 975 dogs from an endemic region were surveyed by using DPP, ELISA and real-time PCR (qPCR) for the diagnosis of VL. When DPP-negative dogs were tested by qPCR applied in blood and lymph node aspirates, 174/887 (19·6%) were positive in at least one sample. In a second sampling using 115 cases, the DPP-negative dogs were tested by qPCR in blood, lymph node and conjunctival swab samples, and 36/79 (45·6%) were positive in at least one sample. Low-to-moderate pairwise agreement was observed between all possible pair of tests. In conclusion, the official diagnosis of VL in dogs in Brazilian endemic areas failed to accuse an expressive number of infected animals and the impact of the low accuracy of serological tests in the success of euthanasia-based measure for VL control need to be assessed.

  12. Coinfection of Leishmania chagasi with Toxoplasma gondii, Feline Immunodeficiency Virus (FIV) and Feline Leukemia Virus (FeLV) in cats from an endemic area of zoonotic visceral leishmaniasis.

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    Sobrinho, Ludmila Silva Vicente; Rossi, Cláudio Nazaretian; Vides, Juliana Peloi; Braga, Eveline Tozzi; Gomes, Ana Amélia Domingues; de Lima, Valéria Marçal Félix; Perri, Sílvia Helena Venturoli; Generoso, Diego; Langoni, Hélio; Leutenegger, Christian; Biondo, Alexander Welker; Laurenti, Márcia Dalastra; Marcondes, Mary

    2012-06-08

    The aim of the present study was to determine the coinfection of Leishmania sp. with Toxoplasma gondii, Feline Immunodeficiency Virus (FIV) and Feline Leukemia Virus (FeLV) in a population of cats from an endemic area for zoonotic visceral leishmaniasis. An overall 66/302 (21.85%) cats were found positive for Leishmania sp., with infection determined by direct parasitological examination in 30/302 (9.93%), by serology in 46/302 (15.23%) and by both in 10/302 (3.31%) cats. Real time PCR followed by amplicon sequencing successfully confirmed Leishmania infantum (syn Leishmania chagasi) infection. Out of the Leishmania infected cats, coinfection with FIV was observed in 12/66 (18.18%), with T. gondii in 17/66 (25.75%) and with both agents in 5/66 (7.58%) cats. FeLV was found only in a single adult cat with no Leishmania infection. A positive association was observed in coinfection of Leishmania and FIV (p0.05). In conclusion, cats living in endemic areas of visceral leishmaniasis are significantly more likely to be coinfected with FIV, which may present confounding clinical signs and therefore cats in such areas should be always carefully screened for coinfections. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Cellular and humoral responses induced by Leishmania histone H2B and its divergent and conserved parts in cutaneous and visceral leishmaniasis patients, respectively.

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    Meddeb-Garnaoui, A; Toumi, A; Ghelis, H; Mahjoub, M; Louzir, H; Chenik, M

    2010-02-17

    Leishmania histone H2B has been reported to be a promising candidate for both vaccination and serodiagnosis. We evaluated the cellular immune responses induced by H2B and its divergent amino-terminal (H2B-N) and conserved carboxy-terminal (H2B-C) regions in individuals with a history of Localized Cutaneous Leishmaniasis (LCL) due to Leishmania (L.) major. H2B induced significantly high PBMC proliferation and IFNgamma levels in LCL individuals whereas significantly lower proliferation and IFNgamma levels were observed with the divergent part of the protein. All proteins induced IL10 in LCL and healthy individuals. We also evaluated the humoral responses induced by these proteins in patients with Mediterranean Visceral Leishmaniasis (MVL) due to L. infantum. H2B and H2B-N were highly recognized by MVL sera. Our results show that the entire H2B protein is more efficient than its amino- and carboxy-terminal regions in inducing a dominant Th1 profile in cured LCL subjects and suggest that this protein may constitute a potential vaccine against leishmaniasis. Furthermore, H2B and H2B-N are interesting antigens for serodiagnosis of MVL. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  14. High levels of CD4⁺ CTLA-4⁺ Treg cells and CCR5 density in HIV-1-infected patients with visceral leishmaniasis.

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    Vallejo, A; Abad-Fernández, M; Moreno, S; Moreno, A; Pérez-Elías, M J; Dronda, F; Casado, J L

    2015-02-01

    Visceral leishmaniasis (VL) in HIV-1-infected patients has been associated with poor immunological recovery and frequent disease relapses. The aim of this study was to analyse the role of T cell populations, Treg cells and CCR5 density in patients with VL compared to HIV-1-infected patients without leishmaniasis. A cross-sectional study of nine Leishmania-HIV-1-coinfected (LH) patients with VL receiving suppressive cART for at least 1 year were compared to 16 HIV-1-infected patients with non-immunological response (NIR, CD4 count below 250 cells/mm(3)) and 26 HIV-1-infected patients with immunological response (IR, CD4 count above 500 cells/mm(3)) without leishmaniasis. LH patients had a deep depletion of naïve T cells (p = 0.002), despite similar levels of effector T cells compared to NIR patients. CD4 Treg cells were similar compared to NIR patients, but higher compared to IR patients (p CCR5(+) T cell levels were higher compared to IR patients (p CCR5 density on T cells were higher compared to both NIR and IR patients (p CCR5 density on CD8(+) T cells are strongly associated with VL in HIV-1-infected patients. Also, these patients have a poor immunological profile that might explain the persistence and relapse of the pathogen.

  15. Comparative evaluation of immunochromatographic dipstick test (ICT) rk39, soluble antigen ELISA and IFAT for the sero-diagnosis of visceral leishmaniasis in Morocco.

    Science.gov (United States)

    Mniouil, Meryem; Fellah, Hajiba; Amarir, Fatima; Sadak, Abderrahim; Et-Touys, Abdeslam; Bakri, Youssef; Moustachi, Aziza; Tassou, Fatima Zahraa; Hida, Mostapha; Lyagoubi, Mohamed; Adlaoui, El Bachir; Rhajaoui, Mohamed; Sebti, Faiza

    2018-06-01

    A rapid, sensitive and specific tool for detection of Leishmania infantum infection in Humans would be highly desirable, because it would allow control interventions in endemic areas of visceral leishmaniasis. This study was carried out at the Reference National Laboratory of Leishmaniasis (RNLL) in National Institute of Hygiene (NIH) Morocco, in order to evaluate the diagnostic potential of immunochromatographic dipstick test (ICT) rk39 in Moroccan suspected VL patients. A total of 49 admitted patients with strong clinical suspicion of VL and 40 healthy controls were investigated for the performance of the ICT rk39. Bone marrow smears were examined for microscopic detection of Leishmania amastigotes obtained from the admitted patients. Only PCR and smear positive cases were considered as gold standard as well as confirmed cases of VL. Out of 49 suspected patients, twenty four (48.9%) were found PCR and smear-positive and twenty three (46.9%) were positive for ICT rk39. Voluntary healthy controls, which included twenty persons from the endemic zone and twenty from non-endemic zone of VL, were found all negative for the strip test. The sensitivity in sera was 75% by ELISA and 87.5% by IFAT, compared with 95.8% for ICT rk39. Specificity was 95.8%, with both tests ELISA and IFAT, and 100% by ICT rk39 respectively. Present study findings again reinforce that the ICT rk39 is a simple, reliable and easy-to-perform non-invasive diagnostic tool for visceral leishmaniasis in the endemic area of Morocco. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Mortality and case fatality due to visceral leishmaniasis in Brazil: a nationwide analysis of epidemiology, trends and spatial patterns.

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    Francisco Rogerlândio Martins-Melo

    Full Text Available BACKGROUND: Visceral leishmaniasis (VL is a significant public health problem in Brazil and several regions of the world. This study investigated the magnitude, temporal trends and spatial distribution of mortality related to VL in Brazil. METHODS: We performed a study based on secondary data obtained from the Brazilian Mortality Information System. We included all deaths in Brazil from 2000 to 2011, in which VL was recorded as cause of death. We present epidemiological characteristics, trend analysis of mortality and case fatality rates by joinpoint regression models, and spatial analysis using municipalities as geographical units of analysis. RESULTS: In the study period, 12,491,280 deaths were recorded in Brazil. VL was mentioned in 3,322 (0.03% deaths. Average annual age-adjusted mortality rate was 0.15 deaths per 100,000 inhabitants and case fatality rate 8.1%. Highest mortality rates were observed in males (0.19 deaths/100,000 inhabitants, <1 year-olds (1.03 deaths/100,000 inhabitants and residents in Northeast region (0.30 deaths/100,000 inhabitants. Highest case fatality rates were observed in males (8.8%, ≥ 70 year-olds (43.8% and residents in South region (17.7%. Mortality and case fatality rates showed a significant increase in Brazil over the period, with different patterns between regions: increasing mortality rates in the North (Annual Percent Change--APC: 9.4%; 95% confidence interval--CI: 5.3 to 13.6, and Southeast (APC: 8.1%; 95% CI: 2.6 to 13.9; and increasing case fatality rates in the Northeast (APC: 4.0%; 95% CI: 0.8 to 7.4. Spatial analysis identified a major cluster of high mortality encompassing a wide geographic range in North and Northeast Brazil. CONCLUSIONS: Despite ongoing control strategies, mortality related to VL in Brazil is increasing. Mortality and case fatality vary considerably between regions, and surveillance and control measures should be prioritized in high-risk clusters. Early diagnosis and treatment

  17. Classification and regression tree and spatial analyses reveal geographic heterogeneity in genome wide linkage study of Indian visceral leishmaniasis.

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    Michaela Fakiola

    2010-12-01

    Full Text Available Genome wide linkage studies (GWLS have provided evidence for loci controlling visceral leishmaniasis on Chromosomes 1p22, 6q27, 22q12 in Sudan and 6q27, 9p21, 17q11-q21 in Brazil. Genome wide studies from the major focus of disease in India have not previously been reported.We undertook a GWLS in India in which a primary ∼10 cM (515 microsatellites scan was carried out in 58 multicase pedigrees (74 nuclear families; 176 affected, 353 total individuals and replication sought in 79 pedigrees (102 nuclear families; 218 affected, 473 total individuals. The primary scan provided evidence (≥2 adjacent markers allele-sharing LOD≥0.59; nominal P≤0.05 for linkage on Chromosomes 2, 5, 6, 7, 8, 10, 11, 20 and X, with peaks at 6p25.3-p24.3 and 8p23.1-p21.3 contributed to largely by 31 Hindu families and at Xq21.1-q26.1 by 27 Muslim families. Refined mapping confirmed linkage across all primary scan families at 2q12.2-q14.1 and 11q13.2-q23.3, but only 11q13.2-q23.3 replicated (combined LOD = 1.59; P = 0.0034. Linkage at 6p25.3-p24.3 and 8p23.1-p21.3, and at Xq21.1-q26.1, was confirmed by refined mapping for primary Hindu and Muslim families, respectively, but only Xq21.1-q26.1 replicated across all Muslim families (combined LOD 1.49; P = 0.0045. STRUCTURE and SMARTPCA did not identify population genetic substructure related to religious group. Classification and regression tree, and spatial interpolation, analyses confirm geographical heterogeneity for linkages at 6p25.3-p24.3, 8p23.1-p21.3 and Xq21.1-q26.1, with specific clusters of families contributing LOD scores of 2.13 (P = 0.0009, 1.75 (P = 0.002 and 1.84 (P = 0.001, respectively.GWLS has identified novel loci that show geographical heterogeneity in their influence on susceptibility to VL in India.

  18. Efficacy and safety of available treatments for visceral leishmaniasis in Brazil: A multicenter, randomized, open label trial

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    Costa, Dorcas Lamounier; Costa, Carlos Henrique Nery; de Almeida, Roque Pacheco; de Melo, Enaldo Viera; de Carvalho, Sílvio Fernando Guimarães; Rabello, Ana; de Carvalho, Andréa Lucchesi; Sousa, Anastácio de Queiroz; Leite, Robério Dias; Lima, Simone Soares; Amaral, Thais Alves; Alves, Fabiana Piovesan; Rode, Joelle

    2017-01-01

    Background There is insufficient evidence to support visceral leishmaniasis (VL) treatment recommendations in Brazil and an urgent need to improve current treatments. Drug combinations may be an option. Methods A multicenter, randomized, open label, controlled trial was conducted in five sites in Brazil to evaluate efficacy and safety of (i) amphotericin B deoxycholate (AmphoB) (1 mg/kg/day for 14 days), (ii) liposomal amphotericin B (LAMB) (3 mg/kg/day for 7 days) and (iii) a combination of LAMB (10 mg/kg single dose) plus meglumine antimoniate (MA) (20 mg Sb+5/kg/day for 10 days), compared to (iv) standard treatment with MA (20 mg Sb+5/kg/day for 20 days). Patients, aged 6 months to 50 years, with confirmed VL and without HIV infection were enrolled in the study. Primary efficacy endpoint was clinical cure at 6 months. A planned efficacy and safety interim analysis led to trial interruption. Results 378 patients were randomized to the four treatment arms: MA (n = 112), AmphoB (n = 45), LAMB (n = 109), or LAMB plus MA (n = 112). A high toxicity of AmphoB prompted an unplanned interim safety analysis and this treatment arm was dropped. Per intention-to-treat protocol final analyses of the remaining 332 patients show cure rates at 6 months of 77.5% for MA, 87.2% for LAMB, and 83.9% for LAMB plus MA, without statistically significant differences between the experimental arms and comparator (LAMB: 9.7%; CI95% -0.28 to 19.68, p = 0.06; LAMB plus MA: 6.4%; CI95% -3.93 to 16.73; p = 0.222). LAMB monotherapy was safer than MA regarding frequency of treatment-related adverse events (AE) (p = 0.045), proportion of patients presenting at least one severe AE (p = 0.029), and the proportion of AEs resulting in definitive treatment discontinuation (p = 0.003). Conclusions Due to lower toxicity and acceptable efficacy, LAMB would be a more suitable first line treatment for VL than standard treatment. ClinicalTrials.gov identification number: NCT01310738. Trial registration

  19. The diagnostic accuracy of serologic and molecular methods for detecting visceral leishmaniasis in HIV infected patients: meta-analysis.

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    Gláucia Fernandes Cota

    Full Text Available BACKGROUND: Human visceral leishmaniasis (VL, a potentially fatal disease, has emerged as an important opportunistic condition in HIV infected patients. In immunocompromised patients, serological investigation is considered not an accurate diagnostic method for VL diagnosis and molecular techniques seem especially promising. OBJECTIVE: This work is a comprehensive systematic review and meta-analysis to evaluate the accuracy of serologic and molecular tests for VL diagnosis specifically in HIV-infected patients. METHODS: Two independent reviewers searched PubMed and LILACS databases. The quality of studies was assessed by QUADAS score. Sensitivity and specificity were pooled separately and compared with overall accuracy measures: diagnostic odds ratio (DOR and symmetric summary receiver operating characteristic (sROC. RESULTS: Thirty three studies recruiting 1,489 patients were included. The following tests were evaluated: Immunofluorescence Antibody Test (IFAT, Enzyme linked immunosorbent assay (ELISA, immunoblotting (Blot, direct agglutination test (DAT and polimerase chain reaction (PCR in whole blood and bone marrow. Most studies were carried out in Europe. Serological tests varied widely in performance, but with overall limited sensitivity. IFAT had poor sensitivity ranging from 11% to 82%. DOR (95% confidence interval was higher for DAT 36.01 (9.95-130.29 and Blot 27.51 (9.27-81.66 than for IFAT 7.43 (3.08-1791 and ELISA 3.06 (0.71-13.10. PCR in whole blood had the highest DOR: 400.35 (58.47-2741.42. The accuracy of PCR based on Q-point was 0.95; 95%CI 0.92-0.97, which means good overall performance. CONCLUSION: Based mainly on evidence gained by infection with Leishmania infantum chagasi, serological tests should not be used to rule out a diagnosis of VL among the HIV-infected, but a positive test at even low titers has diagnostic value when combined with the clinical case definition. Considering the available evidence, tests based on DNA

  20. Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison.

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    Gláucia F Cota

    Full Text Available We conducted a systematic literature review with indirect comparison of studies evaluating therapeutic efficacy and toxicity associated to visceral leishmaniasis (VL therapy among HIV infected individuals.The outcomes of interest were clinical and parasitological cure, mortality, and adverse events.PRISMA guidelines for systematic reviews and Cochrane manual were followed. Sources were MEDLINE, LILACS, EMBASE, Web of Knowledge databases and manual search of references from evaluated studies. We included all studies reporting outcomes after VL treatment, regardless of their design. Study quality was evaluated systematically by using the Newcastle-Ottawa Scale (NOS for assessing the quality of nonrandomized studies in meta-analyses. Comprehensive Meta-Analysis software v.2.2.048 was used to perform one-group meta-analysis of study arms with the same drug to estimate global rates of success and adverse events with each drug. These estimates were used, when possible, to indirectly compare treatment options, adjusted for CD4 count. Direct comparison was pooled when available.Seventeen studies reporting five treatment regimens and outcome of 920 VL episodes occurring in HIV infected individuals were included. The main outstanding difference in outcome among the treatment regimens was observed in mortality rate: it was around 3 times higher with high-dose antimony use (18.4%, CI 95% 13.3-25%, indirectly compared to lipid formulations of amphotericin B treatment (6.1%, CI 95% 3.9-9.4%. It was observed, also by indirect comparison, higher rates of clinical improvement in study arms using amphotericin B than in study arms using pentavalent antimonial therapy (Sb(v. The parasitological cure, an outcome that presented some degree of risk of selection and verification bias, had rates that varied widely within the same treatment arm, with high heterogeneity, hampering any formal comparison among drugs. One direct comparison of amphotericin and antimoniate was

  1. Health-related quality of life of HIV infected adults with and without Visceral Leishmaniasis in Northwest Ethiopia.

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    Alemayehu, Mekuriaw; Wubshet, Mamo; Mesfin, Nebiyu; Tamiru, Aschalew; Gebayehu, Abebaw

    2017-08-30

    Health-related quality of life (HRQoL) is an important outcome measure among HIV infected patients receiving antiretroviral therapy (ART). When HIV infected patients coinfected with Visceral Leishmaniasis (VL) the problem become severe because VL accelerates HIV replication and disease progression. The impact of VL on the quality of life of HIV infected patients has not been studied. In this study in Ethiopia, we compared the quality of life of HIV infected patients with and without VL. A cross-sectional study was conducted from October 2015 to September 2016 in selected health centers and hospitals, in Northwest Ethiopia. Data on quality of life was collected by trained nurses. The instrument used to collect the data was the short Amharic version of the World Health Organization Quality of Life for HIV clients (WHOQoL-HIV). Depression was assessed using the validated version of Kessler scale. Data was entered and analyzed using SPSS version 20. Descriptive statistics, bivariate and multivariate linear regression model was used to summarize the results. A total of 590 study participants were included in the study with response rate of 95%. Of the 590 patients included in our study 125 (21%) were HIV-VL coinfection. HIV-VL coinfected patients had a lower quality of life in all the domains as compared to HIV patients without VL. Depression was consistently and strongly associated with all the quality of life domains of both groups. Also, in HIV infected patients a longer duration in ART was associated with higher HRQoL domains except for the spiritual and level of independence domains. With regard to HIV-VL coinfected patients, a longer duration in ART was associated with psychological, spiritual and level of independence domains of HRQoL. Demographics, clinical, and treatment characteristics resulted few significant associations with HRQoL domains of both groups. HIV-VL coinfected patients had a poor quality of life in all the domains of the WHOQoL-HIV instrument

  2. Prevalence, features and risk factors for malaria co-infections amongst visceral leishmaniasis patients from Amudat Hospital, Uganda.

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    Erika van den Bogaart

    Full Text Available BACKGROUND AND METHODOLOGY: Due to geographic overlap of malaria and visceral leishmaniasis (VL, co-infections may exist but have been poorly investigated. To describe prevalence, features and risk factors for VL-malaria co-infections, a case-control analysis was conducted on data collected at Amudat Hospital, Uganda (2000-2006 by Médecins sans Frontières. Cases were identified as patients with laboratory-confirmed VL and malaria at hospital admission or during hospitalization; controls were VL patients with negative malaria smears. A logistic regression analysis was performed to study the association between patients' characteristics and the occurrence of the co-infection. RESULTS: Of 2414 patients with confirmed VL, 450 (19% were positively diagnosed with concomitant malaria. Most co-infected patients were males, residing in Kenya (69%. While young age was identified by multivariate analysis as a risk factor for concurrent VL and malaria, particularly the age groups 0-4 (odds ratio (OR: 2.44; 95% confidence interval (CI: 1.52-3.92 and 5-9 years (OR: 2.23, 95% CI: 1.45-3-45, mild (OR: 0.53; 95% CI: 0.32-0.88 and moderate (OR: 0.45; 95% CI: 0.27-0.77 anemia negatively correlated with the co-morbidity. VL patients harboring skin infections were nearly three times less likely to have the co-infection (OR: 0.35; 95% CI: 0.17-0.72, as highlighted by the multivariate model. Anorexia was slightly more frequent among co-infected patients (OR: 1.71; 95% CI: 0.96-3.03. The in-hospital case-fatality rate did not significantly differ between cases and controls, being 2.7% and 3.1% respectively (OR: 0.87; 95% CI: 0.46-1.63. CONCLUSIONS: Concurrent malaria represents a common condition among young VL patients living in the Pokot region of Kenya and Uganda. Although these co-morbidities did not result in a poorer prognosis, possibly due to early detection of malaria, a positive trend towards more severe symptoms was identified, indicating that routine

  3. Sensitive and less invasive confirmatory diagnosis of visceral leishmaniasis in Sudan using loop-mediated isothermal amplification (LAMP).

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    Mukhtar, Maowia; Ali, Sababil S; Boshara, Salah A; Albertini, Audrey; Monnerat, Séverine; Bessell, Paul; Mori, Yasuyoshi; Kubota, Yutaka; Ndung'u, Joseph M; Cruz, Israel

    2018-02-01

    Confirmatory diagnosis of visceral leishmaniasis (VL), as well as diagnosis of relapses and test of cure, usually requires examination by microscopy of samples collected by invasive means, such as splenic, bone marrow or lymph node aspirates. This causes discomfort to patients, with risks of bleeding and iatrogenic infections, and requires technical expertise. Molecular tests have great potential for diagnosis of VL using peripheral blood, but require well-equipped facilities and trained personnel. More user-friendly, and field-amenable options are therefore needed. One method that could meet these requirements is loop-mediated isothermal amplification (LAMP) using the Loopamp Leishmania Detection Kit, which comes as dried down reagents that can be stored at room temperature, and allows simple visualization of results. The Loopamp Leishmania Detection Kit (Eiken Chemical Co., Japan), was evaluated in the diagnosis of VL in Sudan. A total of 198 VL suspects were tested by microscopy of lymph node aspirates (the reference test), direct agglutination test-DAT (in house production) and rK28 antigen-based rapid diagnostic test (OnSite Leishmania rK39-Plus, CTK Biotech, USA). LAMP was performed on peripheral blood (whole blood and buffy coat) previously processed by: i) a direct boil and spin method, and ii) the QIAamp DNA Mini Kit (QIAgen). Ninety seven of the VL suspects were confirmed as cases by microscopy of lymph node aspirates. The sensitivity and specificity for each of the tests were: rK28 RDT 98.81% and 100%; DAT 88.10% and 78.22%; LAMP-boil and spin 97.65% and 99.01%; LAMP-QIAgen 100% and 99.01%. Due to its simplicity and high sensitivity, rK28 RDT can be used first in the diagnostic algorithm for primary VL diagnosis, the excellent performance of LAMP using peripheral blood indicates that it can be also included in the algorithm for diagnosis of VL as a simple test when parasitological confirmatory diagnosis is required in settings that are lower than the

  4. Studies on the protective and immunomodulatory efficacy of Withania somnifera along with cisplatin against experimental visceral leishmaniasis.

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    Sachdeva, Heena; Sehgal, Rakesh; Kaur, Sukhbir

    2013-06-01

    Visceral leishmaniasis (VL) or kala-azar continues to persist as one of the major public health problems in many tropical countries. However, no effective treatment for cure of the disease is yet available. The present study was designed to investigate the nephroprotective and immunomodulatory effect of Withania somnifera in cisplatin-treated Leishmania donovani-infected BALB/c mice. Administration of cisplatin (5 mg/kg body weight (b.wt.) daily for 5 days, i.p.) reduced the parasite load in L. donovani-infected BALB/c mice but produced damage in liver and kidney as manifested biochemically by an increase in SGOT, SGPT, serum creatinine, and blood urea nitrogen, respectively. The biochemical analysis was further substantiated by histopathological changes induced in the liver and kidney by cisplatin. However, W. somnifera (350 mg/kg b.wt. daily for 15 days, orally) when given along with cisplatin, significantly reversed these changes and enhanced the antileishmanial efficacy of the drug, cisplatin. But, when W. somnifera was given alone per se it showed less antileishmanial potential. The results also indicate that W. somnifera in combination with cisplatin resulted in significant selective upregulation of Th1 type of immunity because it guided expression of T helper cell (Th1)1 cytokines, IFN-gamma and IL-2; augmented levels of IgG2a over IgG1; and heightened DTH (delayed type hypersensitivity) responses while Th2 cytokines, IL-4, and IL-10 were downregulated. Flow cytometric analysis of W. somnifera and cisplatin-treated animals showed an increase in the percentage of T cells (CD4+, CD8+) and NK1.1 suggesting its effect on activation of T cells. These results confirm the protective and immunomodulatory activity of W. somnifera suggesting that it along with cisplatin may be a critical remedy for the amelioration of adverse effects of cisplatin. Thus, this combination appears to offer a fruitful strategy for treatment of VL.

  5. Feasibility of eliminating visceral leishmaniasis from the Indian subcontinent: Explorations with a set of deterministic age-structured transmission models Quantitative analysis of strategies to achieve the 2020 goals for neglected tropical diseases: Where are we now?

    NARCIS (Netherlands)

    E.A. le Rutte (Epke); L.E. Coffeng (Luc); D.M. Bontje (Daniel M.); E.C. Hasker (Epco C.); J.A. Ruiz Postigo (José A.); D. Argaw (Daniel); M. Boelaert (Marleen); S.J. de Vlas (Sake)

    2016-01-01

    textabstractBackground: Visceral leishmaniasis (VL) is a neglected tropical disease transmitted by sandflies. On the Indian subcontinent (ISC), VL is targeted for elimination as a public health problem by 2017. In the context of VL, the elimination target is defined as an annual VL incidence of <1

  6. Understanding the transmission dynamics of Leishmania donovani to provide robust evidence for interventions to eliminate visceral leishmaniasis in Bihar, India the LCNTDR Collection : Advances in scientific research for NTD control

    NARCIS (Netherlands)

    M.M. Cameron (Mary M.); A. Acosta-Serrano (Alvaro); C. Bern (Caryn); M. Boelaert (Marleen); M. Den Boer (Margriet); S. Burza (Sakib); L.A.C. Chapman (Lloyd A. C.); A. Chaskopoulou (Alexandra); M. Coleman (Michael); O. Courtenay (Orin); S. Croft (Simon); P.K. Das (P.); E. Dilger (Erin); G. Foster (Geraldine); R. Garlapati (Rajesh); L. Haines (Lee); A. Harris (Angela); J. Hemingway (Janet); T.D. Hollingsworth (T. Déirdre); S. Jervis (Sarah); G.F. Medley (Graham F.); M. Miles (Michael); M. Paine (Mark); A. Picado (Albert); R. Poché (Richard); P. Ready (Paul); M. Rogers (Matthew); M. Rowland (Mark); S. Sundar (Shyam); S.J. de Vlas (Sake); D. Weetman (David)

    2016-01-01

    textabstractVisceral Leishmaniasis (VL) is a neglected vector-borne disease. In India, it is transmitted to humans by Leishmania donovani-infected Phlebotomus argentipes sand flies. In 2005, VL was targeted for elimination by the governments of India, Nepal and Bangladesh by 2015. The elimination

  7. American cutaneous leishmaniasis: epidemiological profile of patients treated in Londrina from 1998 to 2009*

    Science.gov (United States)

    Junior, Rubens Pontello; Gon, Airton dos Santos; Ogama, Alessandra

    2013-01-01

    BACKGROUND American cutaneous leishmaniasis is a dermatozoonosis of compulsory notification with relevant morbidity. The disease is considered endemic in northern Paraná. OBJECTIVES To evaluate the clinical, laboratory and epidemiological aspects of patients with American cutaneous leishmaniasis treated at Clinics Hospital, State University of Londrina, Brazil (Paraná). METHODS This was an observational, cross-sectional, retrospective and descriptive study. The medical records of patients with American cutaneous leishmaniasis treated at the University Hospital of Londrina - Paraná, from 1998 to 2009 were evaluated. RESULTS A total of 470 patients, with prevalence of 8.72 cases / 100,000 inhabitants, participated in the study. Most patients were male, aged 21-40 years, with a single ulcerated lesion as the most common clinical presentation, located mainly in an exposed area of the body. With regard to immunological tests, the Montenegro intradermal reaction was positive in 84.4% of cases. Treatment with pentavalent antimony was well tolerated, and patient follow-up for a year occurred in 59% of cases. CONCLUSION American cutaneous leishmaniasis is still an endemic disease in the region, with a high potential for morbidity, but with a cure rate of around 95% after treatment. The use of immunological techniques facilitates the diagnosis of clinically suspicious cases. PMID:24173180

  8. Domestic and peridomestic transmission of American cutaneous leishmaniasis: changing epidemiological patterns present new control opportunities

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    Diarmid Campbell-Lendrum

    2001-02-01

    Full Text Available Predictions that deforestation would reduce American cutaneous leishmaniasis incidence have proved incorrect. Presentations at a recent international workshop, instead, demonstrated frequent domestication of transmission throughout Latin America. While posing new threats, this process also increases the effectiveness of vector control in and around houses. New approaches for sand fly control and effective targeting of resources are reviewed.

  9. Spontaneous cure of American cutaneous leishmaniasis due to Leishmania naiffi in two Dutch infantry soldiers

    NARCIS (Netherlands)

    van der Snoek, E. M.; Lammers, A. M.; Kortbeek, L. M.; Roelfsema, J. H.; Bart, A.; Jaspers, C. A. J. J.

    2009-01-01

    We report two Dutch infantry soldiers who acquired American cutaneous leishmaniasis (ACL) during military jungle training in Surinam. The lesions had existed for 3 and 5 months, respectively, before the soldiers presented for treatment. The lesions occurred on the head and right thigh, and were

  10. Occurrence of two autochthonous cases of American cutaneous leishmaniasis in the neighborhood of Caju, city of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Bernardes Filho, Fred; Bonatto, Danielle Cristine; Martins, Gustavo; Maier, Leonardo de Medeiros; Nery, José Augusto da Costa; Azulay-Abulafia, Luna

    2014-01-01

    American cutaneous leishmaniasis is in full geographic expansion in Brazil and it is considered among the infectious and parasitic diseases of utmost importance worldwide, not only by its frequency, but mainly by therapeutic difficulties, deformities and sequelae that may result. In the state of Rio de Janeiro, the first autochthonous case of American cutaneous leishmaniasis was registered by Rabello in 1913. The authors report two cases of the disease in the region around the Cemetery São Francisco Xavier, in the Caju neighborhood, Rio de Janeiro city, and emphasize the need for actions that aim to early diagnosis and treatment of American cutaneous leishmaniasis cases.

  11. Occurrence of two autochthonous cases of American cutaneous leishmaniasis in the neighborhood of Caju, city of Rio de Janeiro, Brazil*

    Science.gov (United States)

    Bernardes Filho, Fred; Bonatto, Danielle Cristine; Martins, Gustavo; Maier, Leonardo de Medeiros; Nery, José Augusto da Costa; Azulay-Abulafia, Luna

    2014-01-01

    American cutaneous leishmaniasis is in full geographic expansion in Brazil and it is considered among the infectious and parasitic diseases of utmost importance worldwide, not only by its frequency, but mainly by therapeutic difficulties, deformities and sequelae that may result. In the state of Rio de Janeiro, the first autochthonous case of American cutaneous leishmaniasis was registered by Rabello in 1913. The authors report two cases of the disease in the region around the Cemetery São Francisco Xavier, in the Caju neighborhood, Rio de Janeiro city, and emphasize the need for actions that aim to early diagnosis and treatment of American cutaneous leishmaniasis cases. PMID:25184938

  12. South American collaboration in scientific publications on leishmaniasis: bibliometric analysis in SCOPUS (2000-2011).

    Science.gov (United States)

    Huamaní, Charles; Romaní, Franco; González-Alcaide, Gregorio; Mejia, Miluska O; Ramos, José Manuel; Espinoza, Manuel; Cabezas, César

    2014-01-01

    Evaluate the production and the research collaborative network on Leishmaniasis in South America. 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. 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. 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.

  13. 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.

  14. Forum: geographic spread and urbanization of visceral leishmaniasis in Brazil. Introduction Fórum: expansão geográfica e urbanização da leishmaniose visceral no Brasil. Introdução

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    Guilherme L. Werneck

    2008-12-01

    Full Text Available The geographic spread and urbanization of visceral leishmaniasis in Brazil has been described since the early 1980s. However, the putative factors associated with this process, its full characterization, and the implications for disease control still challenge researchers and Public Health professionals. Although the available data show that the disease occurs mainly in urban areas, current knowledge is insufficient to claim specificity in urban transmission as compared to rural niches. Transmission scenarios in urban settings appear to be highly heterogeneous, each showing some degree of similarity to the rural epidemiological pattern. The understanding of a relatively recent and complex problem like the introduction, spread, and maintenance of visceral leishmaniasis in urban areas requires new analytical approaches that consider the network of relevant variables and more elaborate methods capable of capturing the dynamics of the environmental and demographic transformations taking place in transmission areas.A expansão geográfica e urbanização da leishmaniose visceral no Brasil é um fenômeno notável desde a década de 1980. Entretanto, o detalhamento dos motivos relacionados a este processo, assim como sua própria caracterização e as implicações em termos de ações de controle da doença vêm desafiando pesquisadores e profissionais da área de Saúde Coletiva. Ainda que os dados disponíveis demonstrem que a doença ocorre majoritariamente em áreas urbanas, o conhecimento acumulado não permite afirmar que há suficiente particularidade na transmissão urbana, em contraposição àquela que ocorre nos tradicionais nichos rurais. O que parece existir é uma heterogeneidade nos cenários de transmissão em meio urbano, cada um deles com nuanças mais ou menos distintas, mostrando maior ou menor similaridade em relação ao padrão epidemiológico rural. A compreensão de um problema relativamente recente e complexo, como é a

  15. 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.

  16. Travelers' Health: Leishmaniasis, Visceral

    Science.gov (United States)

    ... such as the United States reflects travel and immigration patterns. VL is uncommon in US travelers and ... changing pattern at the hospital for tropical diseases, London. PLoS One. 2015;10(4):e0121418. Murray HW. ...

  17. Maxadilan-simile expression in Nyssomyia neivai, a sandfly vector in an endemic region of Brazil, and its immunogenicity in patients with American tegumentary leishmaniasis

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    Juliana Aires

    Full Text Available BACKGROUND Maxadilan (Max is a salivary component in the sandfly Lutzomyia longipalpis (Lutz & Neiva 1912, a vector of visceral leishmaniasis. Max has a powerful vasodilatory effect and is a candidate vaccine that has been tested in experimental leishmaniasis. Nyssomyia neivai (Pinto 1926 is a vector of the pathogen responsible for American tegumentary leishmaniasis (ATL in Brazil. OBJECTIVE We searched for Max expression in Ny. neivai and for antibodies against Max in ATL patients. METHODS cDNA and protein were extracted from the cephalic segment, including salivary glands, of Ny. neivai and analysed by polymerase chain reaction, DNA sequencing, and blotting assays. The results were compared with data obtained from Lu. longipalpis samples. We quantified antibodies against Max in serum samples from 41 patients with ATL (31 and 10 with the cutaneous and mucocutaneous forms, respectively and 63 controls from the endemic northeastern region of São Paulo state, using enzyme-linked immunosorbent assay. FINDINGS Recognition of a Max-simile peptide by specific antibodies confirmed expression of a Max sequence in Ny. neivai (GenBank EF601123.1. Compared to controls, patients with ATL presented higher levels of antibodies against Max (p = 0.004; 24.4% of the patients with ATL and 3.2% of the controls presented anti-Max levels above the cutoff index (p = 0.014. The anti-Max levels were not associated with the specific clinical form of ATL, leishmanin skin test response, absence or presence of amastigotes in histopathologic exam, results of indirect immunofluorescence testing for leishmaniasis, or duration of cutaneous form disease. MAIN CONCLUSION High serum anti-Max levels did not protect patients against ATL, but confirmed previous natural exposure to Ny. neivai bites in this ATL endemic region.

  18. Leishmaniose visceral: características clínico-epidemiológicas em crianças de área endêmica Visceral leishmaniasis: clinical and epidemiological features of children in an endemic area

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    Márcia J. A. Queiroz

    2004-04-01

    Full Text Available OBJETIVO: Descrever as características clínico-epidemiológicas, o tratamento e a letalidade das crianças internadas com leishmaniose visceral em um hospital pediátrico de referência. MÉTODOS: Análise retrospectiva dos dados biológicos, demográficos, clínicos e laboratoriais das crianças internadas no Instituto Materno-Infantil de Pernambuco, em Recife, no período compreendido entre 1996 e 2001. RESULTADOS: Foram incluídas 431 crianças, de 4 meses a 13,7 anos de idade, sendo que 50,3% eram do sexo feminino, e 82,5% eram do interior do estado de Pernambuco. Cerca de 70% dos domicílios eram de alvenaria, 70% não dispunham de água encanada ou sistema de esgoto sanitário, e o tempo médio de permanência das mães na escola foi de 3 anos. Esplenomegalia e febre estavam presentes em 97% e 95,6% dos casos, respectivamente, e 44,5% dos pacientes eram subnutridos. Em 47 (10,9% dos pacientes foi detectada infecção na admissão. O nível médio de hemoglobina foi de 6 g/dl, de leucócitos 3.516/mm³ e de plaquetas 118.641/mm³. O tratamento de escolha foi o glucantime (98% dos casos, e em sete pacientes, a anfotericina B foi utilizada. A letalidade foi de 10,2%, sendo que as principais causas imediatas de óbito foram atribuídas a infecções associadas, hemorragias e insuficiência hepática. CONCLUSÕES: Os autores destacam as características clínicas, epidemiológicas e laboratoriais da leishmaniose visceral em área endêmica, além do diagnóstico tardio e alta letalidade, sugerindo a capacitação de profissionais de saúde para o reconhecimento precoce e tratamento adequado da doença e suas complicações.OBJECTIVE: To describe the clinical and epidemiological features of children with visceral leishmaniasis admitted to a pediatric referral hospital, and to describe treatment measures and the case fatality rate . METHODS: Retrospective analysis of biological, demographic, clinical and laboratory data from children with

  19. Expression of cysteine proteinase type I and II of Leishmania infantum and their recognition by sera during canine and human visceral leishmaniasis.

    Science.gov (United States)

    Rafati, Sima; Nakhaee, Alireza; Taheri, Tahere; Ghashghaii, Andishe; Salmanian, Ali Hatef; Jimenez, Maribel; Mohebali, Mehdi; Masina, Slavica; Fasel, Nicolas

    2003-01-01

    In this study, the mature domains of type I (CPB) and type II (CPA) cysteine proteinases (CPs) of Leishmania infantum were expressed and their immunogenic properties defined using sera from active and recovered cases of human visceral leishmaniasis and sera from infected dogs. Immunoblotting and ELISA analysis indicated that a freeze/thaw extract of parasite antigens showed similar and intensive recognition in both active cases of human and dog sera but lower recognition in recovered human individuals. The total IgG of actively infected human sera was higher than in recovered cases when rCPs were used as antigen. In contrast to dog sera, both active and recovered human cases have higher recognition toward rCPB than rCPA. Furthermore, the asymptomatic dogs in contrast to the symptomatic cases exhibited specific lymphocyte proliferation to both crude antigens and rCPs.

  20. Development of a Scalable Process for the Synthesis of DNDI-VL-2098: A Potential Preclinical Drug Candidate for the Treatment of Visceral Leishmaniasis.

    Science.gov (United States)

    Satam, Vijay S; Pedada, Srinivasa Rao; Kamaraj, Pasumpon; Antao, Nakita; Singh, Apoorva; Hindupur, Rama Mohan; Pati, Hari N; Thompson, Andrew M; Launay, Delphine; Martin, Denis

    2017-01-20

    A process suitable for kilogram-scale synthesis of (2 R )-2-methyl-6-nitro-2-{[4-(trifluoromethoxy)phenoxy]methyl}-2,3-dihydroimidazo[2,1- b ][1,3]oxazole (DNDI-VL-2098, 2 ), a preclinical drug candidate for the treatment of visceral leishmaniasis, is described. The four-step synthesis of the target compound involves the Sharpless asymmetric epoxidation of 2-methyl-2-propen-1-ol, 8 . Identification of a suitable synthetic route using retrosynthetic analysis and development of a scalable process to access several kilograms of 2 are illustrated. The process was simplified by employing in situ synthesis of some intermediates, reducing safety hazards, and eliminating the need for column chromatography. The improved reactions were carried out on the kilogram scale to produce 2 in good yield, high optical purity, and high quality.

  1. Cutaneous and visceral leishmaniasis co-infection in dogs from Rio de Janeiro, Brazil: evaluation by specific PCR and RFLP-PCR assays

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    Marize Quinhones Pires

    2014-04-01

    Full Text Available Introduction During a diagnostic evaluation of canine visceral leishmaniasis (VL, two of seventeen dogs were found to be co-infected by Leishmania (Viannia braziliensis and Leishmania (Leishmania chagasi. Methods Specific polymerase chain reaction (PCR and restriction fragment length polymorphism-PCR (RFLP-PCR assays were performed. Results PCR assays for Leishmania subgenus identification followed by RFLP-PCR analysis in biopsies from cutaneous lesions and the spleen confirmed the presence of Leishmania (Viannia braziliensis and Leishmania (Leishmania chagasi in those fragments. Conclusions This report reinforces the importance of using serological and molecular techniques in the epidemiological surveillance of canine populations in endemic areas in which both diseases are known to co-exist. In such cases, a reassessment of the control measures is required.

  2. Cutaneous and visceral leishmaniasis co-infection in dogs from Rio de Janeiro, Brazil: evaluation by specific PCR and RFLP-PCR assays.

    Science.gov (United States)

    Pires, Marize Quinhones; Madeira, Maria de Fátima; Bittencourt, Vânia Rita Elias Pinheiro; Pacheco, Raquel da Silva

    2014-01-01

    During a diagnostic evaluation of canine visceral leishmaniasis (VL), two of seventeen dogs were found to be co-infected by Leishmania (Viannia) braziliensis and Leishmania (Leishmania) chagasi. Specific polymerase chain reaction (PCR) and restriction fragment length polymorphism-PCR (RFLP-PCR) assays were performed. PCR assays for Leishmania subgenus identification followed by RFLP-PCR analysis in biopsies from cutaneous lesions and the spleen confirmed the presence of Leishmania (Viannia) braziliensis and Leishmania (Leishmania) chagasi in those fragments. This report reinforces the importance of using serological and molecular techniques in the epidemiological surveillance of canine populations in endemic areas in which both diseases are known to co-exist. In such cases, a reassessment of the control measures is required.

  3. A novel recombinant Leishmania donovani p45, a partial coding region of methionine aminopeptidase, generates protective immunity by inducing a Th1 stimulatory response against experimental visceral leishmaniasis.

    Science.gov (United States)

    Gupta, Reema; Kushawaha, Pramod K; Tripathi, Chandra Dev Pati; Sundar, Shyam; Dube, Anuradha

    2012-05-01

    The development of a vaccine against visceral leishmaniasis (VL) conferring long-lasting immunity remains a challenge. Identification and proteomic characterization of parasite proteins led to the detection of p45, a member of the methionine aminopeptidase family. To our knowledge the present study is the first known report that describes the molecular and immunological characterization of p45. Recombinant Leishmania donovani p45 (rLdp45) induced cellular responses in cured hamsters and generated Th1-type cytokines from peripheral blood mononuclear cells of cured/endemic VL patients. Immunization with rLdp45 exerted considerable prophylactic efficacy (∼85%) supported by an increase in mRNA expression of iNOS, IFN-γ, TNF-α and IL-12 and decrease in TGF-β and IL-4, indicating its potential as a vaccine candidate against VL. Copyright © 2012. Published by Elsevier Ltd.

  4. A field study of the survival and dispersal pattern of Lutzomyia longipalpis in an endemic area of visceral leishmaniasis in Brazil

    Science.gov (United States)

    Casanova, Claudio; Pimentel Bergamaschi, Denise

    2018-01-01

    Zoonotic Visceral leishmaniasis (ZVL) is a neglected tropical disease that in the Americas is caused by the infection of Leishmania infantum and the domestic dog (Canis familiaris) is the main parasite reservoir in urban areas. The parasite is mainly transmitted by populations of the sibling species Lutzomyia longipalpis that has been spreading in countries including Brazil, Argentina, Paraguay and more recently Uruguay. Although bionomic parameters such as population survival and the duration of the gonotrophic cycle are critical in evaluating vector capacity, field studies have rarely been applied to sand fly populations. The present study sought to evaluate basic bionomic parameters related to the vectorial capacity of the (S)-9-methylgermacrene-B population of the Lu. longipalpis complex in a visceral leishmaniasis area of Sao Paulo state. The daily survival rate, the duration of the gonotrophic cycle and the dispersal pattern were evaluated through the mark- release-recapture method. A total of 1,547 males and 401 females were marked and released in five experiments carried out between February 2013 and February 2014. The higher recapture rates occurred within 100 meters of the release point and the estimated daily survival rates varied between 0.69 and 0.89 for females and between 0.69 and 0.79 for males. The minimum duration of the gonotrophic cycle observed was five days. The absolute population size, calculated ranged from 900 to 4,857 females and from 2,882 to 9,543 males. Our results demonstrate a high survival rate of this vector population and low dispersal that could be associated with the presence of all necessary conditions for its establishment and maintenance in the peridomiciles of this area. Our findings contribute to the basic data necessary for the understanding of ZVL dynamics and the evaluation of the implementation of prevention and control measures. PMID:29608563

  5. Application of Flumethrin Pour-On on Reservoir Dogs and Its Efficacy against Sand Flies in Endemic Focus of Visceral Leishmaniasis, Meshkinshahr, Iran

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    MohammadReza Jalilnavaz

    2015-10-01

    Full Text Available Background: Visceral leishmaniasis (VL is one of the most important parasitic zoonotic diseases in the world. Do­mestic dogs are the main domestic reservoirs of VL in endemic foci of Iran. Various methods, including vaccination, treatment of dogs, detection and removal of infected dogs have different results around the world. General policy on control of canine visceral leishmaniasis is protection of them from sand fly bites. The aim of this study was evalua­tion of pour-on application of flumethrin on dogs against blood-feeding and mortality of field-caught sand flies.Methods: Once every 20 days from May untill September 2013, the treated and control dogs were exposed with field caught sandflies for 2 hours under bed net traps. After the exposure time, both alive and dead sand flies were trans­ferred in netted cups to the laboratory. The mortality rate of them was assessed after 24 hours. The blood-fed or un­fed conditions were determined 2 hours after exposure to the dogs under stereomicroscope.Results: The blood feeding index was varied from 12.0 to 25.0 % and 53.0 to 58.0 % for treated and control dogs respectively (P< 0.0001. The blood feeding inhibition was 75.0–87.0 % and 41.0–46.0 % for the control and treated dogs (P< 0.0001, respectively.The total mortality rate was 94.0–100 % and 19.0–58.0 % respectively for the treated and control groups (P< 0.001.Conclustion: Application of pour-on flumethrin on dogs caused 90–100 % mortality until 2.5 month and inhibited the blood-feeding of sand flies. 

  6. A field study of the survival and dispersal pattern of Lutzomyia longipalpis in an endemic area of visceral leishmaniasis in Brazil.

    Science.gov (United States)

    Galvis-Ovallos, Fredy; Casanova, Claudio; Pimentel Bergamaschi, Denise; Bianchi Galati, Eunice Aparecida

    2018-04-01

    Zoonotic Visceral leishmaniasis (ZVL) is a neglected tropical disease that in the Americas is caused by the infection of Leishmania infantum and the domestic dog (Canis familiaris) is the main parasite reservoir in urban areas. The parasite is mainly transmitted by populations of the sibling species Lutzomyia longipalpis that has been spreading in countries including Brazil, Argentina, Paraguay and more recently Uruguay. Although bionomic parameters such as population survival and the duration of the gonotrophic cycle are critical in evaluating vector capacity, field studies have rarely been applied to sand fly populations. The present study sought to evaluate basic bionomic parameters related to the vectorial capacity of the (S)-9-methylgermacrene-B population of the Lu. longipalpis complex in a visceral leishmaniasis area of Sao Paulo state. The daily survival rate, the duration of the gonotrophic cycle and the dispersal pattern were evaluated through the mark- release-recapture method. A total of 1,547 males and 401 females were marked and released in five experiments carried out between February 2013 and February 2014. The higher recapture rates occurred within 100 meters of the release point and the estimated daily survival rates varied between 0.69 and 0.89 for females and between 0.69 and 0.79 for males. The minimum duration of the gonotrophic cycle observed was five days. The absolute population size, calculated ranged from 900 to 4,857 females and from 2,882 to 9,543 males. Our results demonstrate a high survival rate of this vector population and low dispersal that could be associated with the presence of all necessary conditions for its establishment and maintenance in the peridomiciles of this area. Our findings contribute to the basic data necessary for the understanding of ZVL dynamics and the evaluation of the implementation of prevention and control measures.

  7. Live AttenuatedLeishmania donovaniCentrin Gene-Deleted Parasites Induce IL-23-Dependent IL-17-Protective Immune Response against Visceral Leishmaniasis in a Murine Model.

    Science.gov (United States)

    Banerjee, Antara; Bhattacharya, Parna; Dagur, Pradeep K; Karmakar, Subir; Ismail, Nevien; Joshi, Amritanshu B; Akue, Adovi D; KuKuruga, Mark; McCoy, John Philip; Dey, Ranadhir; Nakhasi, Hira L

    2018-01-01

    No vaccine exists against visceral leishmaniasis. To develop effective vaccines, we have previously reported protective role of live attenuated centrin gene-deleted Leishmania donovani ( LdCen -/- ) parasites through induction of Th1 type immune response in mice, hamsters, and dogs. In this study, we specifically explored the role of Th17 cells in LdCen -/- -induced host protection in mice. Our results showed that compared with wild-type L. donovani infection, LdCen -/- parasites induce significantly higher expression of Th17 differentiation cytokines in splenic dendritic cells. There was also induction of IL-17 and its promoting cytokines in total splenocytes and in both CD4 and CD8 T cells following immunization with LdCen -/- Upon challenge with wild-type parasites, IL-17 and its differentiating cytokines were significantly higher in LdCen -/- -immunized mice compared with nonimmunized mice that resulted in parasite control. Alongside IL-17 induction, we observed induction of IFN-γ-producing Th1 cells as reported earlier. However, Th17 cells are generated before Th1 cells. Neutralization of either IL-17 or IFN-γ abrogated LdCen -/- -induced host protection further confirming the essential role of Th17 along with Th1 cytokines in host protection. Treatment with recombinant IL-23, which is required for stabilization and maintenance of IL-17, heightened Th17, and Tc17 responses in immunized mice splenocytes. In contrast, Th17 response was absent in immunized IL-23R -/- mice that failed to induce protection upon virulent Leishmania challenge suggesting that IL-23 plays an essential role in IL-17-mediated protection by LdCen -/- parasites. This study unveiled the role of IL-23-dependent IL-17 induction in LdCen -/- parasite-induced immunity and subsequent protection against visceral leishmaniasis.

  8. Vaccination with liposomal leishmanial antigens adjuvanted with monophosphoryl lipid-trehalose dicorynomycolate (MPL-TDM) confers long-term protection against visceral leishmaniasis through a human administrable route.

    Science.gov (United States)

    Ravindran, Rajesh; Maji, Mithun; Ali, Nahid

    2012-01-01

    The development of a long-term protective subunit vaccine against visceral leishmaniasis depends on antigens and adjuvants that can induce an appropriate immune response. The immunization of leishmanial antigens alone shows limited efficacy in the absence of an appropriate adjuvant. Earlier we demonstrated sustained protection against Leishmania donovani with leishmanial antigens entrapped in cationic liposomes through an intraperitoneal route. However, this route is not applicable for human administration. Herein, we therefore evaluated the immune response and protection induced by liposomal soluble leishmanial antigen (SLA) formulated with monophosphoryl lipid-trehalose dicorynomycolate (MPL-TDM) through a subcutaneous route. Subcutaneous immunization of BALB/c mice with SLA entrapped in liposomes or with MPL-TDM elicited partial protection against experimental visceral leishmaniasis. In contrast, liposomal SLA adjuvanted with MPL-TDM induced significantly higher levels of protection in liver and spleen in BALB/c mice challenged 10 days post-vaccination. Protection conferred by this formulation was sustained up to 12 weeks of immunization, and infection was controlled for at least 4 months of the challenge, similar to liposomal SLA immunization administered intraperitoneally. An analysis of cellular immune responses of liposomal SLA + MPL-TDM immunized mice demonstrated the induction of IFN-γ and IgG2a antibody production not only 10 days or 12 weeks post-vaccination but also 4 months after the challenge infection and a down regulation of IL-4 production after infection. Moreover, long-term immunity elicited by this formulation was associated with IFN-γ production also by CD8⁺ T cells. Taken together, our results suggest that liposomal SLA + MPL-TDM represent a good vaccine formulation for the induction of durable protection against L. donovani through a human administrable route.

  9. rKLO8, a Novel Leishmania donovani – Derived Recombinant Immunodominant Protein for Sensitive Detection of Visceral Leishmaniasis in Sudan

    Science.gov (United States)

    Abass, Elfadil; Bollig, Nadine; Reinhard, Katharina; Camara, Bärbel; Mansour, Durria; Visekruna, Alexander; Lohoff, Michael; Steinhoff, Ulrich

    2013-01-01

    Background For effective control of visceral leishmaniasis (VL) in East Africa, new rapid diagnostic tests are required to replace current tests with low sensitivity. The aim of this study is to improve diagnosis of VL in East Africa by testing a new antigen from an autochthonous L. donovani strain in Sudan. Methodology and Principle Findings We cloned, expressed and purified a novel recombinant protein antigen of L. donovani from Sudan, designated rKLO8, that contains putative conserved domains with significant similarity to the immunodominant kinesin proteins of Leishmania. rKLO8 exhibited 93% and 88% amino acid identity with cloned kinesin proteins of L. infantum (synonymous L. chagasi) (K39) and L. donovani (KE16), respectively. We evaluated the diagnostic efficiency of the recombinant protein in ELISA for specific detection of VL patients from Sudan. Data were compared with a rK39 ELISA and two commercial kits, the rK39 strip test and the direct agglutination test (DAT). Of 106 parasitologically confirmed VL sera, 104 (98.1%) were tested positive by rKLO8 as compared to 102 (96.2%) by rK39. Importantly, the patients' sera showed increased reactivity with rKLO8 than rK39. Specificity was 96.1% and 94.8% for rKLO8- and rK39 ELISAs, respectively. DAT showed 100% specificity and 94.3% sensitivity while rK39 strip test performed with 81.1% sensitivity and 98.7% specificity. Conclusion The increased reactivity of Sudanese VL sera with the rKLO8 makes this antigen a potential candidate for diagnosis of visceral leishmaniasis in Sudan. However, the suitability at the field level will depend on its performance in a rapid test format. PMID:23875052

  10. Enzyme-Linked Immunosorbent Assay Based on Soluble Promastigote Antigen Detects Immunoglobulin M (IgM) and IgG Antibodies in Sera from Cases of Visceral and Cutaneous Leishmaniasis

    Science.gov (United States)

    Ryan, Jeffrey R.; Smithyman, Anthony M.; Rajasekariah, G-Halli; Hochberg, Lisa; Stiteler, John M.; Martin, Samuel K.

    2002-01-01

    Leishmaniasis causes significant morbidity and mortality in areas where it is endemic. In areas where it is nonendemic, global travel and increased incidence of the disease in human immunodeficiency virus and intravenous-drug user populations are also causes for concern. The unavailability of rapid and reliable tests for diagnosis of the various leishmaniases makes patient management difficult. We have developed an enzyme-linked immunosorbent assay (ELISA) that can detect immunoglobulin M (IgM) and IgG antibodies in patients with visceral and cutaneous leishmaniasis. These practical assays are based on soluble antigens from promastigotes cultivated in a protein-free medium. In preliminary studies, 129 visceral (Brazil, Italy, North Africa, and Nepal) and 143 cutaneous (Brazil) leishmaniasis patients with controls were tested. Overall, the tests showed a sensitivity of 95.1%. In addition, the ELISA correctly identified 42 sera from Brazilian dogs with canine leishmaniasis and 10 healthy controls. Serological tests for the various clinical manifestations of leishmaniasis could be useful epidemiological and patient management tools in populations of areas of endemicity and nonendemicity. PMID:11880434

  11. Polymerase chain reaction-based assay for the detection and identification of sand fly gregarines in Lutzomyia longipalpis, a vector of visceral leishmaniasis.

    Science.gov (United States)

    Caligiuri, Lorena G; Acardi, Soraya A; Santini, María Soledad; Salomón, Oscar D; McCarthy, Christina B

    2014-06-01

    Gregarines that parasitise phlebotomine sand flies belong to the genus Psychodiella and, even though they are highly host-specific, only five species have been described to date. Their most outstanding features include the unique localisation of the oocysts in the accessory glands of the female host, which ensures contamination of the egg surface during oviposition, and the fact that they naturally parasitise the vectors of Leishmania, causal agent of leishmaniasis. The type species, Ps. chagasi, was first described in Lutzomyia longipalpis, vector of visceral leishmaniasis (VL), from Brazil. We recently reported Ps. chagasi sequences in Lu. longipalpis from Posadas (Misiones, Argentina), an endemic VL location where this gregarine had not been previously recorded. In order to analyse the incidence of Ps. chagasi infections in Lu. longipalpis from this location, the aim of this study was to develop a diagnostic assay for sand fly gregarine parasites in Lu. longipalpis. For this, we designed primers using the Ps. chagasi sequences we previously identified and performed an in vitro validation by PCR amplification of the original sand fly samples. Their specificity and sensitivity as diagnostic primers were subsequently confirmed by PCR reactions using total DNA extracted from naturally infected Lu. longipalpis from the same location (Posadas, Argentina). © 2014 The Society for Vector Ecology.

  12. Especies de Lutzomyia en un foco urbano de leishmaniasis visceral y cutánea en El Carmen de Bolívar, Bolívar, Colombia

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    Luis Alberto Cortés

    2008-09-01

    Full Text Available Introducción. Se describen algunos aspectos de la ecología y de la importancia de las especies de Lutzomyia presentes en un foco de leishmaniasis en El Carmen de Bolívar, departamento de Bolívar. Objetivos. Establecer algunos de los patrones del comportamiento de las especies de Lutzomyia y asociar su posible papel en la transmisión de leishmaniasis en un foco de leishmaniasis visceral y cutánea. Materiales y métodos. Se utilizaron trampas CDC en diferentes hábitat, se hicieron capturas mensuales en cebo humano protegido en el intradomicilio y capturas en trampas Shannon en el extradomiclio. Estos datos se compararon con variables independientes, como precipitación, temperatura, humedad relativa y velocidad del viento mediante una correlación de Pearson para estimar el grado de asociación y determinar la influencia de las condiciones climáticas sobre la densidad de adultos de L. evansi y L. gomezi en diferentes hábitat. Resultados. Se capturaron cinco especies de Lutzomyia: L. evansi, L. cayennensis cayennensis, L. gomezi, L. dubitansi y L. walkeri. L. evansi y L. gomezi presentaron una relación significativa en la abundancia de adultos contra la velocidad del viento en el intradomicilio, las especies de Lutzomyia capturadas mostraron un comportamiento antropofílico con una actividad constante entre las 18:00 y las 20:00 horas. Conclusión. L. evansi y L. gomezi están en relación inversamente proporcional a la velocidad del viento, al disminuir, aumentan la actividad de las poblaciones de estas especies.

  13. The Potential Use of Forensic DNA Methods Applied to Sand Fly Blood Meal Analysis to Identify the Infection Reservoirs of Anthroponotic Visceral Leishmaniasis.

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    Ehud Inbar

    2016-05-01

    Full Text Available In the Indian sub-continent, visceral leishmaniasis (VL, also known as kala azar, is a fatal form of leishmaniasis caused by the kinetoplastid parasite Leishmania donovani and transmitted by the sand fly Phlebotomus argentipes. VL is prevalent in northeast India where it is believed to have an exclusive anthroponotic transmission cycle. There are four distinct cohorts of L. donovani exposed individuals who can potentially serve as infection reservoirs: patients with active disease, cured VL cases, patients with post kala azar dermal leishmaniasis (PKDL, and asymptomatic individuals. The relative contribution of each group to sustaining the transmission cycle of VL is not known.To answer this critical epidemiological question, we have addressed the feasibility of an approach that would use forensic DNA methods to recover human DNA profiles from the blood meals of infected sand flies that would then be matched to reference DNA sampled from individuals living or working in the vicinity of the sand fly collections. We found that the ability to obtain readable human DNA fingerprints from sand flies depended entirely on the size of the blood meal and the kinetics of its digestion. Useable profiles were obtained from most flies within the first 24 hours post blood meal (PBM, with a sharp decline at 48 hours and no readable profiles at 72 hours. This early time frame necessitated development of a sensitive, nested-PCR method compatible with detecting L. donovani within a fresh, 24 hours blood meal in flies fed on infected hamsters.Our findings establish the feasibility of the forensic DNA method to directly trace the human source of an infected blood meal, with constraints imposed by the requirement that the flies be recovered for analysis within 24 hours of their infective feed.

  14. The Potential Use of Forensic DNA Methods Applied to Sand Fly Blood Meal Analysis to Identify the Infection Reservoirs of Anthroponotic Visceral Leishmaniasis.

    Science.gov (United States)

    Inbar, Ehud; Lawyer, Philip; Sacks, David; Podini, Daniele

    2016-05-01

    In the Indian sub-continent, visceral leishmaniasis (VL), also known as kala azar, is a fatal form of leishmaniasis caused by the kinetoplastid parasite Leishmania donovani and transmitted by the sand fly Phlebotomus argentipes. VL is prevalent in northeast India where it is believed to have an exclusive anthroponotic transmission cycle. There are four distinct cohorts of L. donovani exposed individuals who can potentially serve as infection reservoirs: patients with active disease, cured VL cases, patients with post kala azar dermal leishmaniasis (PKDL), and asymptomatic individuals. The relative contribution of each group to sustaining the transmission cycle of VL is not known. To answer this critical epidemiological question, we have addressed the feasibility of an approach that would use forensic DNA methods to recover human DNA profiles from the blood meals of infected sand flies that would then be matched to reference DNA sampled from individuals living or working in the vicinity of the sand fly collections. We found that the ability to obtain readable human DNA fingerprints from sand flies depended entirely on the size of the blood meal and the kinetics of its digestion. Useable profiles were obtained from most flies within the first 24 hours post blood meal (PBM), with a sharp decline at 48 hours and no readable profiles at 72 hours. This early time frame necessitated development of a sensitive, nested-PCR method compatible with detecting L. donovani within a fresh, 24 hours blood meal in flies fed on infected hamsters. Our findings establish the feasibility of the forensic DNA method to directly trace the human source of an infected blood meal, with constraints imposed by the requirement that the flies be recovered for analysis within 24 hours of their infective feed.

  15. Investigação de áreas de risco como metodologia complementar ao controle da leishmaniose visceral canina Investigation of risk areas as complemental methodology for the control of canine visceral leishmaniasis

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    Fred S. Julião

    2007-08-01

    Full Text Available Foram investigadas áreas de risco de leishmaniose visceral canina no município de Camaçari, Bahia. Um total de 278 cães distribuídos em 141 residências, pertencentes a 20 áreas de risco investigadas, foi examinado sorologicamente (ELISA. A soroprevalência geral foi 21,7% (56/258 depois da exclusão dos 20 cães usados no início do estudo para delimitar a área. Os resultados respectivos das análises univariada e multivariada dos fatores relacionados à infecção do cão por Leishmania chagasi, a captura e distribuição do vetor na área e a metodologia usada para localizar os focos caninos são discutidos.Risk areas of canine visceral leishmaniasis in the city of Camaçari, Bahia, Brazil, were investigated. A total of 278 dogs from 141 homes pertaining to 20 investigated risk areas was serologically screened (ELISA. The general seroprevalence was 21.7% (56/258 after exclusion of 20 dogs used at the beginning of the survey to limit the study area. The respective results of the univariated and multivariated analysis of factors related to infection of dogs by Leishmania chagasi, to vector distribu-tion pattern in the area and to the methodology used to localize the canine focuses are discussed.

  16. Autochthonous canine visceral leishmaniasis in a non-endemic area: Bom Sucesso, Minas Gerais State, Brazil Ocorrência de leishmaniose visceral canina autóctone em uma área não-endêmica: Bom Sucesso, Minas Gerais, Brasil

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    Marcio Roberto Silva

    2008-02-01

    Full Text Available The article begins by describing a dog with characteristic symptoms of visceral leishmaniasis. A serum sample from this animal was positive by indirect immunofluorescence (IIF performed in anti-Leishmania total IgG in 1999. Tissues from the same dog were also positive by polymerase chain reaction (PCR in 2004, identifying Leishmania DNA in the cerebellum, liver, kidney, and intestine. This is the first report of a dog with autochthonous visceral leishmaniasis in the county of Bom Sucesso, Minas Gerais State, Brazil. The finding of this IIF-positive dog led to a canine visceral leishmaniasis epidemiological investigation in the county. The investigation was conducted from March 1999 to December 2005. IIF was positive for Leishmania in 22 (3% of 734 examined dogs. Among the 22 IIF-positive dogs, six presented characteristic symptoms of canine visceral leishmaniasis. The results of this epidemiological investigation were sent to local and State public health authorities, requesting visceral leishmaniasis control and preventive measures to interrupt transmission of the disease and avoid the occurrence of human cases.O presente trabalho descreve inicialmente um cão com sintomas característicos de leishmaniose visceral. Amostra de soro desse cão foi positiva por imunofluorescência indireta (IFI conduzida no IgG total anti-Leishmania em 1999. Além disso, tecidos desse cão foram positivos por reação em cadeia pela polimerase (PCR conduzida em 2004, identificando DNA de Leishmania no cerebelo, fígado, rim e intestino. Esta é a primeira vez que um cão com leishmaniose visceral autóctone foi descrito no Município de Bom Sucesso, Minas Gerais, Brasil. O achado desse cão reagente à IFI levou a uma investigação epidemiológica nesse município. Essa investigação foi conduzida de março de 1999 a dezembro de 2005. Vinte e dois de um total de 734 (3% cães examinados foram reagentes à IFI. Entre os 22 cães IFI reagentes, seis apresentaram

  17. 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.

  18. Efficiency of noninvasive sampling methods (swab) together with Polymerase Chain Reaction (PCR) for diagnosing American Tegumentary Leishmaniasis.

    Science.gov (United States)

    Boni, Sara Macente; Oyafuso, Luiza Keiko; Soler, Rita de Cassia; Lindoso, José Angelo Lauletta

    2017-06-01

    Traditional diagnostic methods used to detect American Tegumentary Leishmaniasis, such as histopathology using biopsy samples, culture techniques, and direct search for parasites, have low sensitivity and require invasive collection procedures. This study evaluates the efficiency of noninvasive sampling methods (swab) along with Polymerase Chain Reaction (PCR) for diagnosing American Tegumentary Leishmaniasis using skin and mucous samples from 25 patients who had tested positive for leishmaniasis. The outcome of the tests performance on swab samples was compatible with PCR results on biopsy samples. The findings have also shown that PCR-kDNA test is more efficient than PCR-HSP70 and qPCR tests (sensitivity of 92.3%, 40.7%, and 41%, respectively). Given the high sensitivity of the tests and the fact that the sampling method using swabs affords greater patient comfort and safety, it could be said that this method is a promising alternative to conventional biopsy-based methods for the molecular diagnosis of leishmaniasis.

  19. The distribution pattern of Lutzomyia longipalpis (Diptera: Psychodidae) in the peridomiciles of a sector with canine and human visceral leishmaniasis transmission in the municipality of Dracena, São Paulo, Brazil.

    Science.gov (United States)

    Rangel, Osias; Sampaio, Susy Mary Perpetuo; Ciaravolo, Ricardo Mario de Carvalho; Holcman, Marcia Moreira

    2012-03-01

    The specimen distribution pattern of a species can be used to characterise a population of interest and also provides area-specific guidance for pest management and control. In the municipality of Dracena, in the state of São Paulo, we analysed 5,889 Lutzomyia longipalpis specimens collected from the peridomiciles of 14 houses in a sector where American visceral leishmaniasis (AVL) is transmitted to humans and dogs. The goal was to analyse the dispersion and a theoretical fitting of the species occurrence probability. From January-December 2005, samples were collected once per week using CDC light traps that operated for 12-h periods. Each collection was considered a sub-sample and was evaluated monthly. The standardised Morisita index was used as a measure of dispersion. Adherence tests were performed for the log-series distribution. The number of traps was used to adjust the octave plots. The quantity of Lu. longipalpis in the sector was highly aggregated for each month of the year, adhering to a log-series distribution for 11 of the 12 months analysed. A sex-stratified analysis demonstrated a pattern of aggregated dispersion adjusted for each month of the year. The classes and frequencies of the traps in octaves can be employed as indicators for entomological surveillance and AVL control.

  20. Spontaneous cure of American cutaneous leishmaniasis due to Leishmania naiffi in two Dutch infantry soldiers.

    Science.gov (United States)

    van der Snoek, E M; Lammers, A M; Kortbeek, L M; Roelfsema, J H; Bart, A; Jaspers, C A J J

    2009-12-01

    We report two Dutch infantry soldiers who acquired American cutaneous leishmaniasis (ACL) during military jungle training in Surinam. The lesions had existed for 3 and 5 months, respectively, before the soldiers presented for treatment. The lesions occurred on the head and right thigh, and were small, uncomplicated and symptomless. PCR for Leishmania revealed Leishmania naiffi in both patients. No treatment was given, and the lesions in both men healed spontaneously within 4 and 6 weeks, respectively, after presentation to our clinic. CL is one of the important 'tropical' diseases in The Netherlands, primarily due to the increasing numbers of cases in travellers and in military personnel serving overseas. ACL due to L. naiffi is thought to be a mild expression of CL with a self-limiting nature. Lesions seem to be single, mostly small, ulcerating and usually appear on the hands, arms and legs. No case of mucocutaneous leishmaniasis has yet been attributed to this parasite.

  1. Evaluación de una prueba de aglutinación directa como método alternativo para el diagnóstico de leishmaniasis visceral canina y humana en Venezuela

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    Guillermo Terán-Angel

    2007-09-01

    Resultados. Todas las muestras de los pacientes con leishmaniasis visceral activa o curada fueron positivas. Mostraron títulos anti-L. donovani por encima de 1:1.600. Tres de cuatro casos con sospecha de leishmaniasis visceral también resultaron positivos a la prueba, mientras que los sueros controles y los de los pacientes con otras patologías dieron títulos por debajo de 1:800. Se obtuvo una sensibilidad de 100% a todos los puntos de corte considerados y una especificidad de 100% al punto de corte de 1:800 (intervalo de confianza de 95%, IC95%: 90,97%-100%. Las muestras de perros mostraron una sensibilidad de 92,59% (IC95%: 75,69%-99,09% y 100% de especificidad (IC95%: 79,42%-100% al punto de corte de 1:200. Conclusión. En general, nuestros resultados indican que el uso de la prueba de aglutinación directa es apropiado para la realización de estudios epidemiológicos y para el diagnóstico serológico de leishmaniasis visceral humana y canina en las áreas rurales de Venezuela.

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

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    Ludovic Reveiz

    Full Text Available 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.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.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.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.

  3. Visceral leishmaniasis in an environmentally protected area in southeastern Brazil: Epidemiological and laboratory cross-sectional investigation of phlebotomine fauna, wild hosts and canine cases.

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    Donalisio, Maria Rita; Paiz, Laís Moraes; da Silva, Vanessa Gusmon; Richini-Pereira, Virgínia Bodelão; von Zuben, Andrea Paula Bruno; Castagna, Claudio Luiz; Motoie, Gabriela; Hiramoto, Roberto Mitsuyoshi; Tolezano, José Eduardo

    2017-07-01

    Leishmaniasis is a rapidly expanding zoonosis that shows increasing urbanization. Concern exists regarding the role of wildlife in visceral leishmaniasis (VL) transmission, due to frequent natural or anthropogenic environmental changes that facilitate contact between wildlife, humans and their pets. The municipality of Campinas, in southeastern Brazil, initially recorded VL in 2009, when the first autochthonous case was confirmed in a dog living in an upscale residential condominium, located inside an environmentally protected area (EPA). Since then, disease transmission remains restricted to dogs inhabiting two geographically contiguous condominiums within the EPA. We conducted a cross-sectional study of the VL focus to investigate Leishmania spp. infection in domestic dogs, wild mammals and sand flies using molecular tools and recommended serological techniques. Canine seroprevalences of 1.5% and 1.2% were observed in 2013 and 2015, respectively. Six insect species, confirmed or suspected vectors or potential transmitters of Leishmania, were identified. Two specimens of the main L. (L.) infantum vector in Brazil, Lutzomyia longipalpis, were captured in the EPA. Natural infection by L. (L.) infantum was recorded in one Expapillata firmatoi specimen and two Pintomyia monticola. Natural infection by L. (L.) infantum and Leishmania subgenus Viannia was also detected in two white-eared opossums (Didelphis albiventris), a known reservoir of VL. Geographical coordinates of each sampling of infected animals were plotted on a map of the EPA, demonstrating proximity between these animals, human residences, including the dogs positive for VL, and forest areas. The EPA, which is inhabited by humans, has an active VL focus. The risk of establishing and maintaining disease transmission foci in similar scenarios, i.e. wild areas that undergo environmental modifications, is evident. Moreover, different epidemiological profiles of VL must be included to elaborate prevention and

  4. Use of Pentamidine As Secondary Prophylaxis to Prevent Visceral Leishmaniasis Relapse in HIV Infected Patients, the First Twelve Months of a Prospective Cohort Study.

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    Ermias Diro

    Full Text Available Visceral leishmaniasis (VL has become an important opportunistic infection in persons with HIV-infection in VL-endemic areas. The co-infection leads to profound immunosuppression and high rate of annual VL recurrence. This study assessed the effectiveness, safety and feasibility of monthly pentamidine infusions to prevent recurrence of VL in HIV co-infected patients.A single-arm, open-label trial was conducted at two leishmaniasis treatment centers in northwest Ethiopia. HIV-infected patients with a VL episode were included after parasitological cure. Monthly infusions of 4 mg/kg pentamidine-isethionate diluted in normal-saline were started for 12 months. All received antiretroviral therapy (ART. Time-to-relapse or death was the primary end point.Seventy-four patients were included. The probability of relapse-free survival at 6 months and at 12 months was 79% and 71% respectively. Renal failure, a possible drug-related serious adverse event, occurred in two patients with severe pneumonia. Forty-one patients completed the regimen taking at least 11 of the 12 doses. Main reasons to discontinue were: 15 relapsed, five died and seven became lost to follow-up. More patients failed among those with a CD4+cell count ≤ 50 cells/μl, 5/7 (71.4% than those with counts above 200 cells/μl, 2/12 (16.7%, (p = 0.005.Pentamidine secondary prophylaxis led to a 29% failure rate within one year, much lower than reported in historical controls (50%-100%. Patients with low CD4+cell counts are at increased risk of relapse despite effective initial VL treatment, ART and secondary prophylaxis. VL should be detected and treated early enough in patients with HIV infection before profound immune deficiency installs.

  5. Immucillins ImmA and ImmH Are Effective and Non-toxic in the Treatment of Experimental Visceral Leishmaniasis.

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    Elisangela Oliveira Freitas

    2015-12-01

    Full Text Available Immucillins ImmA (IA, ImmH (IH and SerMe-ImmH (SMIH are synthetic deazapurine nucleoside analogues that inhibit Leishmania (L. infantum chagasi and Leishmania (L. amazonensis multiplication in vitro without macrophage toxicity. Immucillins are compared to the Glucantime standard drug in the chemotherapy of Leishmania (L. infantum chagasi infection in mice and hamsters. These agents are tested for toxicity and immune system response.BALB/c mice were infected with 107 amastigotes, treated with IA, IH, SMIH or Glucantime (2.5mg/kg/day and monitored for clinical variables, parasite load, antibody levels and splenocyte IFN-γ, TNF-α, and IL-10 expression. Cytokines and CD4+, CD8+ and CD19+ lymphocyte frequencies were assessed in uninfected controls and in response to immucillins. Urea, creatinine, GOT and GPT levels were monitored in sera. Anti-Leishmania-specific IgG1 antibodies (anti-NH36 increased in untreated animals. IgG2a response, high levels of IFN-γ, TNF-α and lower levels of IL-10 were detected in mice treated with the immucillins and Glucantime. Immucillins permitted normal weight gain, prevented hepato-splenomegaly and cleared the parasite infection (85-89% without renal and hepatic toxicity. Immucillins promoted 35% lower secretion of IFN-γ in uninfected controls than in infected mice. IA and IH increased the CD4+ T and CD19+ B cell frequencies. SMIH increased only the proportion of CD-19 B cells. IA and IH also cured infected hamsters with lower toxicity than Glucantime.Immucillins IA, IH and SMIH were effective in treating leishmaniasis in mice. In hamsters, IA and IH were also effective. The highest therapeutic efficacy was obtained with IA, possibly due to its induction of a TH1 immune response. Low immucillin doses were required and showed no toxicity. Our results disclose the potential use of IA and IH in the therapy of visceral leishmaniasis.

  6. Assessment of the Effects of a Novel Herbal Immunomodulator Drug (IMOD on Cytokine Profiles in Experimental Canine Visceral Leishmaniasis: a Preliminary Survey.

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    Abdolali Malmasi

    2014-09-01

    Full Text Available Cytokines play a fundamental role in the regulation of immune responses in remission and/or relapsing of leishmaniasis. Therefore, immunotherapy for the treatment of canine visceral leishmaniasis (CVL has represented a principle approach in control of the infection. The present research aimed to evaluating the immunotherapeutic potential of a novel herbal immunomodulator drug (IMOD on CVL.Twelve mongrel dogs were intravenously infected with Iranian strain of L. infantum and randomly divided into three groups; 1: negative control (non-infected, 2: immunotherapy with IMOD and 3: positive control (non-treated. Cell proliferation and Th1-/Th2-type cytokines were measured in peripheral blood mononuclear cell (PBMC by cell proliferation kit I (MTT and enzyme-linked immunospot (ELISpot assays, respectively.At the 60 days follow-up assessment, no adverse effects were observed in treated interventional group. Cellular proliferation assay indicated that PBMCs of IMOD group had higher stimulation index (SI than positive control group (p < 0.05. Enhancement of CD4+T cells such as IL-2, IL-4 & IL-10 were detected in negative control group due to in vitro IMOD stimulation 30 days post-treatment. In accordance to decreasing trends of Th1 & Th2 cytokines in positive control group, the mean number of IFN-γ IL-2, IL-4 and IL-10 spot forming cells (SFCs down regulated for IMOD group during the study.These data indicate that IMOD had immunomodulatory potential but is not sufficient for total parasitic cure due to balance of Th1/Th2 cytokines. This is a preliminary study and we propose to undertake a series of experiments to evaluate the CVL due to in vitro modulatory effects of IMOD.

  7. Visceral leishmaniasis in an environmentally protected area in southeastern Brazil: Epidemiological and laboratory cross-sectional investigation of phlebotomine fauna, wild hosts and canine cases.

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    Maria Rita Donalisio

    2017-07-01

    Full Text Available Leishmaniasis is a rapidly expanding zoonosis that shows increasing urbanization. Concern exists regarding the role of wildlife in visceral leishmaniasis (VL transmission, due to frequent natural or anthropogenic environmental changes that facilitate contact between wildlife, humans and their pets. The municipality of Campinas, in southeastern Brazil, initially recorded VL in 2009, when the first autochthonous case was confirmed in a dog living in an upscale residential condominium, located inside an environmentally protected area (EPA. Since then, disease transmission remains restricted to dogs inhabiting two geographically contiguous condominiums within the EPA.We conducted a cross-sectional study of the VL focus to investigate Leishmania spp. infection in domestic dogs, wild mammals and sand flies using molecular tools and recommended serological techniques. Canine seroprevalences of 1.5% and 1.2% were observed in 2013 and 2015, respectively. Six insect species, confirmed or suspected vectors or potential transmitters of Leishmania, were identified. Two specimens of the main L. (L. infantum vector in Brazil, Lutzomyia longipalpis, were captured in the EPA. Natural infection by L. (L. infantum was recorded in one Expapillata firmatoi specimen and two Pintomyia monticola. Natural infection by L. (L. infantum and Leishmania subgenus Viannia was also detected in two white-eared opossums (Didelphis albiventris, a known reservoir of VL. Geographical coordinates of each sampling of infected animals were plotted on a map of the EPA, demonstrating proximity between these animals, human residences, including the dogs positive for VL, and forest areas.The EPA, which is inhabited by humans, has an active VL focus. The risk of establishing and maintaining disease transmission foci in similar scenarios, i.e. wild areas that undergo environmental modifications, is evident. Moreover, different epidemiological profiles of VL must be included to elaborate

  8. Of cattle, sand flies and men: a systematic review of risk factor analyses for South Asian visceral leishmaniasis and implications for elimination.

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    Caryn Bern

    2010-02-01

    Full Text Available Studies performed over the past decade have identified fairly consistent epidemiological patterns of risk factors for visceral leishmaniasis (VL in the Indian subcontinent.To inform the current regional VL elimination effort and identify key gaps in knowledge, we performed a systematic review of the literature, with a special emphasis on data regarding the role of cattle because primary risk factor studies have yielded apparently contradictory results. Because humans form the sole infection reservoir, clustering of kala-azar cases is a prominent epidemiological feature, both at the household level and on a larger scale. Subclinical infection also tends to show clustering around kala-azar cases. Within villages, areas become saturated over a period of several years; kala-azar incidence then decreases while neighboring areas see increases. More recently, post kala-azar dermal leishmaniasis (PKDL cases have followed kala-azar peaks. Mud walls, palpable dampness in houses, and peri-domestic vegetation may increase infection risk through enhanced density and prolonged survival of the sand fly vector. Bed net use, sleeping on a cot and indoor residual spraying are generally associated with decreased risk. Poor micronutrient status increases the risk of progression to kala-azar. The presence of cattle is associated with increased risk in some studies and decreased risk in others, reflecting the complexity of the effect of bovines on sand fly abundance, aggregation, feeding behavior and leishmanial infection rates. Poverty is an overarching theme, interacting with individual risk factors on multiple levels.Carefully designed demonstration projects, taking into account the complex web of interconnected risk factors, are needed to provide direct proof of principle for elimination and to identify the most effective maintenance activities to prevent a rapid resurgence when interventions are scaled back. More effective, short-course treatment regimens for

  9. Visceral leishmaniasis in an environmentally protected area in southeastern Brazil: Epidemiological and laboratory cross-sectional investigation of phlebotomine fauna, wild hosts and canine cases

    Science.gov (United States)

    von Zuben, Andrea Paula Bruno; Castagna, Claudio Luiz; Motoie, Gabriela; Hiramoto, Roberto Mitsuyoshi

    2017-01-01

    Background Leishmaniasis is a rapidly expanding zoonosis that shows increasing urbanization. Concern exists regarding the role of wildlife in visceral leishmaniasis (VL) transmission, due to frequent natural or anthropogenic environmental changes that facilitate contact between wildlife, humans and their pets. The municipality of Campinas, in southeastern Brazil, initially recorded VL in 2009, when the first autochthonous case was confirmed in a dog living in an upscale residential condominium, located inside an environmentally protected area (EPA). Since then, disease transmission remains restricted to dogs inhabiting two geographically contiguous condominiums within the EPA. Methodology/Principal findings We conducted a cross-sectional study of the VL focus to investigate Leishmania spp. infection in domestic dogs, wild mammals and sand flies using molecular tools and recommended serological techniques. Canine seroprevalences of 1.5% and 1.2% were observed in 2013 and 2015, respectively. Six insect species, confirmed or suspected vectors or potential transmitters of Leishmania, were identified. Two specimens of the main L. (L.) infantum vector in Brazil, Lutzomyia longipalpis, were captured in the EPA. Natural infection by L. (L.) infantum was recorded in one Expapillata firmatoi specimen and two Pintomyia monticola. Natural infection by L. (L.) infantum and Leishmania subgenus Viannia was also detected in two white-eared opossums (Didelphis albiventris), a known reservoir of VL. Geographical coordinates of each sampling of infected animals were plotted on a map of the EPA, demonstrating proximity between these animals, human residences, including the dogs positive for VL, and forest areas. Conclusions/Significance The EPA, which is inhabited by humans, has an active VL focus. The risk of establishing and maintaining disease transmission foci in similar scenarios, i.e. wild areas that undergo environmental modifications, is evident. Moreover, different

  10. Of cattle, sand flies and men: a systematic review of risk factor analyses for South Asian visceral leishmaniasis and implications for elimination.

    Science.gov (United States)

    Bern, Caryn; Courtenay, Orin; Alvar, Jorge

    2010-02-09

    Studies performed over the past decade have identified fairly consistent epidemiological patterns of risk factors for visceral leishmaniasis (VL) in the Indian subcontinent. To inform the current regional VL elimination effort and identify key gaps in knowledge, we performed a systematic review of the literature, with a special emphasis on data regarding the role of cattle because primary risk factor studies have yielded apparently contradictory results. Because humans form the sole infection reservoir, clustering of kala-azar cases is a prominent epidemiological feature, both at the household level and on a larger scale. Subclinical infection also tends to show clustering around kala-azar cases. Within villages, areas become saturated over a period of several years; kala-azar incidence then decreases while neighboring areas see increases. More recently, post kala-azar dermal leishmaniasis (PKDL) cases have followed kala-azar peaks. Mud walls, palpable dampness in houses, and peri-domestic vegetation may increase infection risk through enhanced density and prolonged survival of the sand fly vector. Bed net use, sleeping on a cot and indoor residual spraying are generally associated with decreased risk. Poor micronutrient status increases the risk of progression to kala-azar. The presence of cattle is associated with increased risk in some studies and decreased risk in others, reflecting the complexity of the effect of bovines on sand fly abundance, aggregation, feeding behavior and leishmanial infection rates. Poverty is an overarching theme, interacting with individual risk factors on multiple levels. Carefully designed demonstration p