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Sample records for anthroponotic cutaneous leishmaniasis

  1. Clinical Features of Anthroponotic Cutaneous Leishmaniasis in a Major Focus, Southeastern Iran, 1994-2014

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    Ahmad KHOSRAVI

    2017-12-01

    Full Text Available AbstractBackground: Cutaneous leishmaniasis (CL is associated with a broad and complex clinical spectrum of diseases. The objectives of this study were to assess the clinical features and identification of the causative agents of CL in a well-known focus of anthroponotic CL (ACL caused by Leishmania tropica, southeast Iran.Methods: This study was performed randomly as a descriptive cross-sectional survey to evaluate 2000 CL patients by active and passive case-detection approaches in Kerman Province from 1994 to 2014. The ACL patients were confirmed by direct smear and 600 cases by one or a combination of intrinsic methods.Results: Children aged <10 yr old were the most infected patients (P<0.001. The majority of the CL lesions were located in hands (46.3%, face (34.1%, legs (14.3%, and other parts of the body (5.3%. The mean number of lesions was 1.5 and most of the patients had single lesion (65%.Typical clinical lesions included papule (36.8%, followed by ulcerated nodule (20.7%, plaque (18.4%, and ulcerated plaque (18.5%. While among atypical clinical features, leishmaniasis recidivans (LR (4.7% and leishmanid (0.3% were the dominant forms, followed by diffuse, disseminated, sporotrichoid, and erysipeloid types, 0.1% each, and then lymphedematous, lymphadenic, hyperkeratotic, paronychial, and mutilating types, 0.05% each. Based on various intrinsic methods the parasites isolated from the lesions were characterized as L. tropica.Conclusion: ACL due to L. tropica presents numerous cases of localized form and diverse uncommon clinical presentations, which mimic other disease conditions. Therefore, physicians should be aware of such manifestations for selecting appropriate treatment modality.

  2. Distribution pattern of anthroponotic cutaneous leishmaniasis caused by Leishmania tropica in Western Afghanistan during 2013-2014.

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    Fakhar, Mahdi; Karamian, Mehdi; Ghatee, Mohammad Amin; Taylor, Walter Robert; Pazoki Ghohe, Hossein; Rasooli, Sayed Abobakar

    2017-12-01

    Anthroponotic cutaneous leishmaniasis (ACL), caused by Leishmania tropica, is the main cause of cutaneous leishmaniasis (CL) in the Herat province, Western Afghanistan. We investigated the role of environmental factors on ACL distribution in Herat. Epidemiological data from 2457 patients were retrieved from the local WHO sub-office. Shapefile layers of districts, cities, villages, land cover, soil type and digital elevation model (DEM) of the Herat province were used to assess, by logistic regression modelling, the effects of land cover, soil types, elevation, and proximity to the Harirud river on the distribution of ACL. The key determinants of distribution were: (i) close proximity to the Harirud river, (ii) elevation between 700 and 1200m, (iii) intensive and intermittent irrigated cultivated land, and (iv) Haplocalcids with Torriorthents and Torrifluvents soil types. No ACL cases were found below 700m, and a few cases were present at >1200m in irrigated areas around the Harirud river. These findings suggest that moist soil and the humidity from irrigated areas found between 700 and 1200m provide suitable breeding sites of Phlebotomus sergenti, the main sandfly vector of L. tropica in Afghanistan. The effect of elevation also explains the predominance of ACL over ZCL in this region. The present study showed that distribution of ACL is strongly associated with environmental factors in West Afghanistan where the political and socio-economic conditions may also affect the epidemiology of CL. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Evaluation of the ecological characteristics in the vector of anthroponotic cutaneous leishmaniasis in a new focus of Mohammad Abad, Kerman, southeast of Iran

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    Abbas Aghaei Afshar

    2017-02-01

    Full Text Available Objective: To evaluate the fauna, seasonal activity and the host preference of sand flies and to determine the main vectors of anthroponotic cutaneous leishmaniasis in Mohammad Abad, Kerman Province, southeast of Iran. Methods: Sand flies were collected indoors and outdoors by sticky paper traps from May to November, 2012. Regarding the importance of host preference and its impact on leishmaniasis control, blood meal was analyzed by the restriction fragment length polymorphism method. The cytochrome b mitochondrial genomic regions (mitochondrial DNA and enzymatic digestion of Xho I and Hae III were used for the diagnosis of human blood feeding. In the detection of leptomonad (promastigote infection in sand flies, a nested PCR method and high resolution melt analysis were exploited. Results: A total of 919 sand flies were identified as belonging to 14 species in two genera, namely, Phlebotomus spp. (5 species and Sergentomyia spp. (9 species. The most frequently occurring species was Phlebotomus sergenti (P. sergenti (67.46%, followed by Phlebotomus papatasi (19.37%. The highest indoor collection of P. sergenti was realized in late July, and the highest outdoor collection of P. sergenti ensued in early July. A total of 250 sand flies were collected for host preference analysis, and blood meals of 120 sand flies belonged to the species of P. sergenti were subjected to restriction fragment length polymorphism confirmation. A total of 39 P. sergenti sand flies (32.5% were identified to have fed on human. NestedPCR and high resolution melt analyses confirmed that these sand flies had been infected with Leishmania tropica. Conclusions: The present study has confirmed P. sergenti as the main Phlebotomine sand fly vector for anthroponotic cutaneous leishmaniasis caused by Leishmania tropica in Southeastern Iran.

  4. The topical treatment of anthroponotic cutaneous leishmaniasis with the tincture of thioxolone plus benzoxonium chloride (Thio-Ben) along with cryotherapy: a single-blind randomized clinical trial.

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    Daie Parizi, Mohammad Hossein; Karvar, Mehran; Sharifi, Iraj; Bahrampour, Abbas; Heshmat Khah, Amireh; Rahnama, Zahra; Baziar, Zahra; Amiri, Rezvan

    2015-01-01

    A simple efficacious topical treatment for cutaneous leishmaniasis (CL) is still an unresolved challenge. This study aimed to evaluate the efficacy of the topical use of thioxolone plus benzoxonium chloride (Thio-Ben) tincture in combination with cryotherapy in comparison with intralesional meglumine antimoniate (Glucantime) along with cryotherapy in treating anthroponotic CL (ACL). The study was conducted in Leishmaniasis Center in Dadbin Health Care Clinic, Kerman, Iran. Sixty-four CL lesions were randomly assigned to receive Thio-Ben plus cryotherapy (TC) (n = 32) or Glucantime plus cryotherapy (GC) (n = 32). Thio-Ben was used topically every other day and Glucantime was used intralesionally once a week for a maximum of 3 months. In both study groups, cryotherapy was administered using liquid nitrogen once every 2 weeks. Of 64 recruited lesions, 47 lesions completed the study protocol. Twenty lesions (91%) in TC group and 23 lesions (92%) in GC group showed complete cure. TC group showed faster clinical response. Pain, hypersensitivity reaction, dizziness, and nausea were only seen in GC group. This study showed that the topical use of Thio-Ben combined with cryotherapy has a good efficacy in treating ACL with the benefit that Thio-Ben has more patient compliance and less side effects than intralesional Glucantime. © 2015 Wiley Periodicals, Inc.

  5. The Emergence of Anthroponotic Cutaneous Leishmaniasis Following the Earthquake in Southern Villages of Bam District, Southeastern Iran, 2010

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    Mohammad Reza Aflatoonian

    2013-03-01

    Full Text Available Background: The objective of this study was to assess the epidemiological characteristics of a new emerging focus of cutaneous leishmaniasis (CL in southern villages of Bam District, southeastern Iran, 2010.Methods: A house-to- house census survey of 5544 individuals were interviewed and physically examined for the presence of active lesions or scars. Diagnosis was confirmed by direct smears, cultures and identification by PCR. The data were entered into a computer and SPSS ver. 15.Results: Overall, 1.2% of the inhabitants were infected, 0.5% active and 0.7% scars and females were more signifi­cantly infected (1.7% than males (0.8%, (P= 0.003. All age groups were equally affected. Most of the lesions were on the face and majority had single lesion. Most of the cases appeared from 2006 to 2008 during the CL epidemic in the city of Bam. PCR indicated L. tropica as the causative agent.Conclusion: The presence of non-immune individuals along with suitable ecological conditions could induce a new emerging focus of ACL in villages.

  6. Cutaneous Leishmaniasis

    Science.gov (United States)

    2011-06-01

    thosis, and intraepidermal abscesses (Figs 4.23 to 4.26). In the dermis, where the inflammatory infiltrate consists of histiocytes, lymphocytes...intraepidermal abscess . See also Figures 4.39, 4.51, 4.53, and 4.54. x24 Figure 4.26 Higher magnification of intraepidermal abscess in patient described in...patient. J Heart Lung Transplant. 1992;11:820-823. 41. Azadeh B, Samad A, Ardehali S. Histological spectrum of cutaneous leishmaniasis due to

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

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    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.

  8. Cutaneous leishmaniasis in Assam

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    Baishya B

    1996-01-01

    Full Text Available A case of cutaneous leishmaniasis is being reported from Assam, a North Eastern state of India. Clinical feature and direct smear examination of the case confirmed the diagnosis. Dramatic resolution of the lesions with sodium antimony gluconate during 10 days of therapy was achieved.

  9. Miltefosine in cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Rahman, S.B.; Mumtaz, N.; Bari, A.

    2007-01-01

    To determine the efficacy of oral Miltefosine in patients with cutaneous leishmaniasis and its comparison with the most effective standard treatment, pentavalent antimony compound. Thirty patients, 12 years of age or older clinically and histopathologically diagnosed as cutaneous leishmaniasis were selected. Fifteen patients received orally administered Miltefosine 2.5mg/kg/day for 28 days and remaining 15 received injectable pentavalent antimony 20mg/kg/day for 28 days. Pre-treatment complete physical examination was done along with necessary laboratory investigations in all cases. These were repeated again after 2 weeks and at the end of treatment to note any deviation from the normal limits. Groups were almost matched in terms of age, weight, parasitological score. The efficacy was evaluated by ulcer size, before therapy, at 2 weeks and 4 weeks. Patients were followed-up at 3 and 6 months. Efficacy of two groups was statistically compared by calculating p-value by z-test. All patients completed the study without any serious complication. Lesions improved significantly and only scarring and post-inflammatory pigmentation was left. At 3 months, cure rate was 93% in group A and it was 73.33% in group B while at the end of 6 months, it was 86% and 66.6% respectively. This difference between efficacies of two groups was not found to be statistically significant (p-value >0.5). Miltefosine appears to be a safe and effective alternative to currently used therapies. The striking advantage of Miltefosine is its oral administration and it may also be helpful in regions where parasites are resistant to current agents. (author)

  10. American cutaneous leishmaniasis triggered byelectrocoagulation

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    Sofia Sales Martins

    Full Text Available Abstract Cutaneous leishmaniasis is usually transmitted by infected phlebotomine sand fly bites that initiate local cutaneous lesions. Few reports in the literature describe other modes of transmission. We report a case of a previously healthy 59-year-old woman who underwent electrocoagulation to remove seborrheic keratosis confirmed by dermatoscopy. Three months later, a skin fragment tested positive for Leishmania culture; the parasite was identified as L. (V. braziliensis. Trauma may generate inflammatory cascades that favor Leishmania growth and lesion formation in previously infected patients. American cutaneous leishmaniasis is a dynamic disease with unclear pathophysiology because of continually changing environments, demographics, and human behaviors.

  11. Unusual Presentation of Cutaneous Leishmaniasis: Ocular Leishmaniasis

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    Masoud Doroodgar

    2017-01-01

    Full Text Available The leishmaniases are parasitic diseases that are transmitted to humans by infected female sandflies. Cutaneous leishmaniasis (CL is one of 3 main forms of the disease. CL is the most common form of the disease and is endemic in many urban and rural parts of Iran and usually caused by two species of Leishmania: L. major and L. tropica. We report a case of unusual leishmaniasis with 25 lesions on exposed parts of the body and right eyelid involvement (ocular leishmaniasis. The patient was a 75-year-old male farmer referred to health care center in Aran va Bidgol city. The disease was diagnosed by direct smear, culture, and PCR from the lesions. PCR was positive for Leishmania major.

  12. Cutaneous leishmaniasis in North Dakota.

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    Douvoyiannis, Miltiadis; Khromachou, Tamim; Byers, Norman; Hargreaves, James; Murray, Henry W

    2014-09-01

    In the United States, autochthonous cutaneous leishmaniasis caused by infection with Leishmania mexicana has been reported from Texas and Oklahoma. Here, we describe a child with 2 new features: cutaneous infection acquired outside of the south-central United States (in North Dakota) and infection caused by Leishmania donovani species complex. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Many faces of cutaneous leishmaniasis

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    Bari Arfan Ul

    2008-01-01

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

  14. Chronic zosteriform cutaneous leishmaniasis

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    Omidian M

    2006-01-01

    Full Text Available Cutaneous leishmanasis (CL may present with unusual clinical variants such as acute paronychial, annular, palmoplantar, zosteriform, erysipeloid, and sporotrichoid. The zosteriform variant has rarely been reported. Unusual lesions may be morphologically attributed to an altered host response or owing to an atypical strain of parasites in these lesions. We report a patient with CL in a multidermatomal pattern on the back and buttock of a man in Khozestan province in the south of Iran. To our knowledge, this is the first reported case of multidermatomal zosteriform CL. It was resistant to conventional treatment but responded well to a combination of meglumine antimoniate, allopurinol, and cryotherapy.

  15. Cutaneous Leishmaniasis with Unusual Presentation

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    N Bagherani

    2009-05-01

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

  16. Phlebotomus sergenti in a Cutaneous Leishmaniasis Focus in Azilal Province (High Atlas, Morocco): Molecular Detection and Genotyping of Leishmania tropica, and Feeding Behavior

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    Ajaoud , Malika; Es-Sette , Nargys; Charrel , Rémi N.; Laamrani-Idrissi , Abderahmane; Nhammi , Haddou; Riyad , Myriam; Lemrani , Meryem

    2015-01-01

    International audience; Background Phlebotomus (Paraphlebotomus) sergenti is at least one of the confirmed vectors for the transmission of cutaneous leishmaniasis caused by Leishmania tropica and distributed widely in Morocco. This form of leishmaniasis is considered largely as anthroponotic, although dogs were found infected with Leishmania tropica, suggestive of zoonosis in some rural areas. Methodology and Findings This survey aimed at (i) studying the presence of Leishmania in field caugh...

  17. Molecular Characterization of Leishmania Species Isolated from Cutaneous Leishmaniasis in Yemen

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    Mahdy, Mohammed A. K.; Al-Mekhlafi, Hesham M.; Al-Mekhlafi, Abdulsalam M.; Lim, Yvonne A. L.; Bin Shuaib, Naemah O. M.; Azazy, Ahmed A.; Mahmud, Rohela

    2010-01-01

    Background Cutaneous leishmaniasis (CL) is a neglected tropical disease endemic in the tropics and subtropics with a global yearly incidence of 1.5 million. Although CL is the most common form of leishmaniasis, which is responsible for 60% of DALYs lost due to tropical-cluster diseases prevalent in Yemen, available information is very limited. Methodology/Principal Findings This study was conducted to determine the molecular characterization of Leishmania species isolated from human cutaneous lesions in Yemen. Dermal scrapes were collected and examined for Leishmania amastigotes using the Giemsa staining technique. Amplification of the ribosomal internal transcribed spacer 1(ITS-1) gene was carried out using nested PCR and subsequent sequencing. The sequences from Leishmania isolates were subjected to phylogenetic analysis using the neighbor-joining and maximum parsimony methods. The trees identified Leishmania tropica from 16 isolates which were represented by two sequence types. Conclusions/Significance The predominance of the anthroponotic species (i.e. L. tropica) indicates the probability of anthroponotic transmission of cutaneous leishmaniasis in Yemen. These findings will help public health authorities to build an effective control strategy taking into consideration person–to-person transmission as the main dynamic of transmission of CL. PMID:20862227

  18. 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.

  19. American cutaneous leishmaniasis triggered by electrocoagulation.

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    Martins, Sofia Sales; Santos, Adriana de Oliveira; Lima, Beatriz Dolabela; Gomes, Ciro Martins; Sampaio, Raimunda Nonata Ribeiro

    2018-01-01

    Cutaneous leishmaniasis is usually transmitted by infected phlebotomine sand fly bites that initiate local cutaneous lesions. Few reports in the literature describe other modes of transmission. We report a case of a previously healthy 59-year-old woman who underwent electrocoagulation to remove seborrheic keratosis confirmed by dermatoscopy. Three months later, a skin fragment tested positive for Leishmania culture; the parasite was identified as L. (V.) braziliensis. Trauma may generate inflammatory cascades that favor Leishmania growth and lesion formation in previously infected patients. American cutaneous leishmaniasis is a dynamic disease with unclear pathophysiology because of continually changing environments, demographics, and human behaviors.

  20. Diagnosis of Cutaneous Leishmaniasis by Multiplex PCR

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    M Heiat

    2010-07-01

    Full Text Available Introduction: Annually, more than 14 million people are reported to be infected with Leishmaniasis all over the world. In Iran, this disease is seen in the form of cutaneous and visceral leishmaniasis, of which the cutaneous form is more wide spread. In recent years, cutaneous leishmaniaisis is diagnosed by PCR utilizing specific primers in order to amplify different parasite genes including ribosomal RNA genes, kinetoplast DNA or tandem repeating sequences. The aim of this research was to detect early stage cutaneous leishmaniasis using Multiplex-PCR technique. Methods: In this study, 67 samples were prepared from patients with cutaneous leishmaniasis. DNA was extracted with phenolchloroform. Each specimen was analyzed using two different pairs of PCR primers. The sensitivity of each PCR was optimized on pure Leishmania DNA prior to use for diagnosis. Two standard parasites L. major and L. tropica were used as positive control. Results: DNA amplification fragments were two 115 bp and 683 bp for AB and UL primers, respectively. The sensitivity of two primers was not equal for detection of L. major and L. tropica. The sensivity of PCR with AB primer was 35 cells, while that for UL primer was 40 cells. Conclusion: The results of this study indicate that PCR is a sensitive diagnostic assay for cutaneous leishmaniasis and could be employed as the new standard for routine diagnosis when species identification is not required. However, the ability to identify species is especially important in prognosis of the disease and in deciding appropriate therapy, especially in regions where more than one type of species and disease are seen by clinicians.

  1. Epidemiological studies on cutaneous leishmaniasis in Ad ...

    African Journals Online (AJOL)

    http://www.cioms.ch/publications/layout_guide2002.p df. 4. Uzun S, Durdu M, Çulha G, Allahverdiyev AM,. Memişoğlu HR. Clinical features, epidemiology, and efficacy and safety of intralesional antimony treatment of cutaneous leishmaniasis: recent experience in Turkey. J. Parasitol 2004; 90: 853-859. 5. Uzun S, Uslular C, ...

  2. Mefloquine in the treatment of cutaneous leishmaniasis

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    Correia Dalmo

    1999-01-01

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

  3. Cutaneous leishmaniasis with lymphadenopathy due to Leishmania donovani

    NARCIS (Netherlands)

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

    2009-01-01

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

  4. Cutaneous leishmaniasis in Dutch military

    NARCIS (Netherlands)

    van Thiel, P.P.A.M.

    2010-01-01

    Leishmaniasis is een tropische ziekte veroorzaakt door een parasiet die wordt overgebracht door de zandvlieg. Pieter-Paul van Thiel beschrijft de besmetting van militairen tijdens drie missies in Afghanistan, en jungletrainingen in Suriname en Belize. Bij een missie in Noord-Afghanistan in 2005

  5. American cutaneous leishmaniasis in infancy and childhood.

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    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.

  6. Cutaneous Manifestations of Human and Murine Leishmaniasis

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    Breanna M. Scorza

    2017-06-01

    Full Text Available The leishmaniases are diseases caused by pathogenic protozoan parasites of the genus Leishmania. Infections are initiated when a sand fly vector inoculates Leishmania parasites into the skin of a mammalian host. Leishmania causes a spectrum of inflammatory cutaneous disease manifestations. The type of cutaneous pathology is determined in part by the infecting Leishmania species, but also by a combination of inflammatory and anti-inflammatory host immune response factors resulting in different clinical outcomes. This review discusses the distinct cutaneous syndromes described in humans, and current knowledge of the inflammatory responses associated with divergent cutaneous pathologic responses to different Leishmania species. The contribution of key hematopoietic cells in experimental cutaneous leishmaniasis in mouse models are also reviewed and compared with those observed during human infection. We hypothesize that local skin events influence the ensuing adaptive immune response to Leishmania spp. infections, and that the balance between inflammatory and regulatory factors induced by infection are critical for determining cutaneous pathology and outcome of infection.

  7. Miltefosine for Old World cutaneous leishmaniasis: An experimental ...

    African Journals Online (AJOL)

    Background: Leishmaniasis is one of the neglected diseases included in the World Health Organization's list of the top guns of antimicrobial resistance. Miltefosine (MIL) was the first successful oral agent used against visceral leishmaniasis in India. As regards cutaneous leishmaniasis (CL), multiple experimental and ...

  8. Unusual presentation of cutaneous leishmaniasis

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    Lahiry Anup Kumar

    2002-01-01

    Full Text Available Cutaneous leis hmaniasis is endemic in some regions of Saudi Arabia. A case with uncommon hyperkeratotic type of lesion was seen. Being an endemic zone, a slit- skin smear was done and stained with Giemsa′s stain. Smears howed Leishman Donovan bodies within and outside the macrophages. Significant improvement, followed by complete resolution of the lesion was seen with ketoconazole treatment.

  9. Cutaneous Leishmaniasis – Dermoscopic Findings And Cryotherapy

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    Dobrev Hristo P.

    2015-03-01

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

  10. Isolated cutaneous leishmaniasis over face – A diagnostic dilemma ...

    African Journals Online (AJOL)

    Isolated cutaneous leishmaniasis over face – A diagnostic dilemma. Santosh K. Swain, Ishwar C. Behera, Mahesh C. Sahu, Maitreyee Panda. Abstract. Cutaneous Leishmaniasis (CL) is a disease caused by an intracellular protozoa belong to the genus Leishmania, transmitted by the bite of a sandfly. It has diverse clinical ...

  11. 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

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

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    Vazirianzadeh B.* PhD,

    2014-08-01

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

  13. Ongoing epidemic of cutaneous leishmaniasis among Syrian refugees, Lebanon.

    Science.gov (United States)

    Saroufim, Maya; Charafeddine, Khalil; Issa, Grace; Khalifeh, Haifaa; Habib, Robert H; Berry, Atika; Ghosn, Nada; Rady, Alissar; Khalifeh, Ibrahim

    2014-10-01

    In September 2012, a cutaneous leishmaniasis outbreak began among Syrian refugees in Lebanon. For 948 patients in whom leishmaniasis was not confirmed, we obtained samples for microscopic confirmation and molecular speciation. We identified Leishmania tropica in 85% and L. major in 15% of patients. After 3 months of megulamine antimonite therapy, patients initial cure rate was 82%.

  14. Ongoing Epidemic of Cutaneous Leishmaniasis among Syrian Refugees, Lebanon1

    Science.gov (United States)

    Saroufim, Maya; Charafeddine, Khalil; Issa, Grace; Khalifeh, Haifaa; Habib, Robert H.; Berry, Atika; Ghosn, Nada; Rady, Alissar

    2014-01-01

    In September 2012, a cutaneous leishmaniasis outbreak began among Syrian refugees in Lebanon. For 948 patients in whom leishmaniasis was not confirmed, we obtained samples for microscopic confirmation and molecular speciation. We identified Leishmania tropica in 85% and L. major in 15% of patients. After 3 months of megulamine antimonite therapy, patients initial cure rate was 82%. PMID:25279543

  15. Cutaneous Leishmaniasis in an American Adolescent Returning From Israel.

    Science.gov (United States)

    Ganjaei, Kimia G; Lawton, Kira; Gaur, Sunanda

    2018-06-06

    We present here the case of a healthy 16-year-old American girl who returned from an organized trip to Israel with cutaneous leishmaniasis caused by Leishmania major; the infection was treated successfully with paromomycin-gentamicin ointment. She was initially misdiagnosed with staphylococcal and pseudomonal cellulitis. Although cutaneous leishmaniasis is seen only rarely in the United States, it should be considered when diagnosing new skin lesions after travel to affected countries.

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

    OpenAIRE

    López, Liliana; Robayo, Martha; Vargas, Margarita; Vélez, Iván D

    2012-01-01

    Abstract Background Pentavalent antimonials (Sb5) and miltefosine are the first-line drugs for treating cutaneous leishmaniasis in Colombia; however, toxicity and treatment duration negatively impact compliance and cost, justifying an active search for better therapeutic options. We compared the efficacy and safety of thermotherapy and meglumine antimoniate for the treatment of cutaneous leishmaniasis in Colombia. Method An open randomized Phase III clinical trial was performed in five milita...

  17. Sensitive Molecular Diagnostics for Cutaneous Leishmaniasis.

    Science.gov (United States)

    Sagi, Orli; Berkowitz, Anat; Codish, Shlomi; Novack, Victor; Rashti, Aviv; Akad, Fouad; Shemer-Avni, Yonat

    2017-01-01

    Rapid diagnosis of cutaneous leishmaniasis (CL) and identification of Leishmania species is highly important for the disease management. In Israel, CL is caused mainly by Leishmania major and Leishmania tropica species. We established an easy to handle point of care lesion-swabbing, combined with a highly sensitive multiplex real time PCR (multiplex qPCR) for accurate and rapid diagnosis of Leishmania species. Using three probes: one general for: Leishmania species, and two specific for L major , and L tropica , we screened 1783 clinical samples collected during two years. Leishmania species was found in 1086 individuals, 1008 L major , and 70 L tropica . Eight samples positive for Leishmania species only, were further tested using a second set of multiplex qPCR developed, and were found positive for Leishmania braziliensis and Leishmania infantum/donovani (2 and 6 samples, concomitantly). Taken together, the test enabled diagnostics and better treatment of Leishmania infections from the Old World (1078 samples) and the New World (8 samples), and the subtyping of the dominant strains in the region, as well as in returning travelers'.

  18. Cutaneous leishmaniasis in children: A case series

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    Mrinal Gupta

    2018-01-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is a protozoal disease usually caused by Leishmania major and Leishmania tropica and transmitted by the bite of a sandfly. It is usually characterized by a single, polymorphous lesion located in an uncovered area. Aims: This study aimed to evaluate the clinico-epidemiological characteristics of CL among children. Materials and Methods: It was a retro-prospective study carried out over a period of 18 months in our center, in which the clinico-epidemiological features of children presenting with CL were assessed. Results: A total of 10 children (male:female - 7:3 were included in the study with the age range of 1–15 years, with a mean age of 8.8 years. Face was the most commonly affected site (n = 8, followed by neck and hands (1 each, and nodulo-ulcerative was the most common clinical type seen in nine patients. Skin smears for Leishman–Donovan (LD bodies were positive in five patients while the skin biopsy, which was done in four cases, showed the presence of LD bodies in only one patient. Conclusion: CL is a common presentation among children, especially in the endemic areas, and the clinical features are similar to the adult onset disease.

  19. Epidemiological profile of cutaneous leishmaniasis in Morocco, 2004-2013.

    Science.gov (United States)

    Laboudi, M

    2017-02-01

    The main objective of our study is to provide a comprehensive overview of the situation of cutaneous leishmaniasis in Morocco. We therefore conducted a retrospective descriptive study covering the decade 2004-2013. Data were collected from the Moroccan Ministry of Health's annual reports about the national program against leishmaniasis. These data show a regression in the cases due to Leishmania major and the persistence of L. tropica transmission. Mapping cutaneous leishmaniasis cases reported between 2004 and 2013 showed geographical changes ; the number of cases due to L. tropica were concentrated in the regions of Marrakech-Tensift-Elhaouz, Souss Massa-Draa Tadla-Azila, and Taza-Al Hoceima-Taounate. Cutaneous disease due to L. major was most common in the Souss-Massa-Draa region. Continuous monitoring of the epidemiological situation is important to assess the actions taken to reduce its incidence.

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

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    A Dehghan-Shadkam

    2007-07-01

    Full Text Available Interoduction: Cutaneous leishmaniasis is a major health problem in some parts of Iran,which exists as zoonotic and anthroponotic forms in different foci of the country.Following an epidemic of cutaneous leishmaniasis in Bafgh city,(Yazd province, centeral Iran,this study was carried out to determine the ecology of sandflies,reservoir hosts and human infection in 2005. Methods: This descriptive-crosss section study was done in the year 2005. Sandflies were collected biweekly from fixed sites of human dwellings and rodent burrows using 30 sticky (oiled paper traps from the beginning to the active season. Rodents were caught in 20 live traps baited with cucumber biweekly.500 households (2123 persons in the Bafgh city were randomly selected.All members of the selected households were examined clinically in the end of each season and forms were completed for each households during a house - to - house visit. Results: A total of 1784 sandflies (252from indoors and 1532 from outdoors were collected. Six species were identified including Phlebotomus papatasi, P.mongolensis, Sergentomyia sintoni, S.theodori, S.dentata, S. baghdadis. The predominant species were P. papatasi in indoors(87.3%and S.sintoni in rodent burrows (53% in the studied areas. 39 M. libycus and 3 R.opimus were collected and examined. Both M. libycus and R.opimus were found to be infected with leishmania major.In the population of 2123 individuals in the Bafgh city, prevalence of scars and ulcers was 1.8% and 0.9% respectively. Conclusion: Based on this survey, L.major is the principal agent, M. libycus ,R.opimus are the reservoir hosts and P.papatasi is the probable vector of ZCL in Bafgh city because about 87.3% of indoor sandflies were of these species. Leishmania major was isolated from the caught rodents

  1. Standardization of intralesional meglumine antimoniate treatment for cutaneous leishmaniasis.

    Science.gov (United States)

    Duque, Maria Cristina de Oliveira; Vasconcellos, Érica de Camargo Ferreira E; Pimentel, Maria Inês Fernandes; Lyra, Marcelo Rosandiski; Pacheco, Sandro Javier Bedoya; Marzochi, Mauro Celio de Almeida; Rosalino, Cláudia Maria Valete; Schubach, Armando de Oliveira

    2016-01-01

    Intralesional treatment for cutaneous leishmaniasis has been applied for over 30 years at the Oswaldo Cruz Foundation, Rio de Janeiro, with good therapeutic results and without relevant systemic toxicity. Meglumine antimoniate was injected subcutaneously, using a long medium-caliber needle (for example, 30mm × 0.8mm); patients received 1-3 injections, with 15-day intervals. The technique is described in detail sufficient to enable replication. The treatment of cutaneous leishmaniasis with intralesional meglumine antimoniate is a simple, effective, and safe technique, which may be used in basic healthcare settings.

  2. Cutaneous leishmaniasis: An emerging infection in a non-endemic area and a brief update

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    Rastogi V

    2007-01-01

    Full Text Available We report here the emergence of a new focus of cutaneous leishmaniasis (CL due to Leishmania tropica (L. tropica in the Ajmer city of Rajasthan, India, a previously non-endemic area. Between January-February 2006, 13 new indigenously acquired cases of CL were diagnosed among the patients attending the Skin and STD department, JLN Hospital, Ajmer. The diagnosis was based on clinical presentation, demonstration of amastigotes (LT bodies in Giemsa stained smear of the lesion and response to intralesional / local anti-leishmanial drug therapy. In addition, culture of the promastigote forms of L. tropica from the lesion was successfully attempted in four of the smear negatives cases. By retrospective analysis, 23 new indigenous cases of CL have been diagnosed in the same setting during the period January 2004 - December 2005, based on clinical and therapeutic response alone. There was no clear-cut history of sandfly bite and travel outside the district or state to endemic area in any of the cases. However, all of them came from a common residential area (famous dargah of Ajmer and the peak incidence was seen in January, four months after the famous Urs fair of Ajmer, the location was urban and the lesions were characteristic of L. tropica. Therefore, the disease is suspected to be anthroponotic. These features are suggestive of a common mode of transmission, source and/or vector signalling introduction of this infection into a non-endemic area.

  3. Epidemiological study on acute cutaneous leishmaniasis in Morocco

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    Kholoud Kahime

    2016-01-01

    Conclusions: ZCL and ACL are still major health problems in Morocco. We highlight the spatiotemporal change of cutaneous leishmaniasis incidence through the country during the last ten years and we underline the correlation between ZCL incidence and the percentage of rural population in Morocco.

  4. Changing pattern of imported cutaneous leishmaniasis in the Netherlands

    NARCIS (Netherlands)

    Zeegelaar, J. E.; Steketee, W. H.; van Thiel, P. P. A. M.; Wetsteyn, J. C. F. M.; Kager, P. A.; Faber, W. R.

    2005-01-01

    Cutaneous leishmaniasis (CL) in western countries seems to be appearing more frequently. Our aim was to determine if there has been a shift in countries where CL is acquired and whether the incidence has changed, and to assess current diagnostic procedures and treatment modalities. In a

  5. Cutaneous leishmaniasis: recent developments in diagnosis and management

    NARCIS (Netherlands)

    de Vries, Henry J. C.; Reedijk, Sophia H.; Schallig, Henk D. F. H.

    2015-01-01

    This review focuses on recent developments in the diagnosis, treatment, management, and strategies for the prevention and control of cutaneous leishmaniasis (CL) caused by both Old and New World Leishmania species. CL is caused by the vector-borne protozoan parasite Leishmania and is transmitted via

  6. The case of diagnosis of imported cutaneous leishmaniasis in Zaporozhye

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    V. G. Savelyev

    2014-08-01

    Full Text Available Aim. Article presents the current data on the clinical and epidemiological issue of leishmaniasis. Methods and results. Leishmaniasis is endemic disease in 88 countries, mainly in tropical and subtropical climates. Probability of importation of American cutaneous leishmaniasis in our country is practically zero, but, given the rarity of this disease, we present own clinical observation of imported cutaneous leishmaniasis in Zaporozhye. At the beginning of the third millennium has greatly increased the urgency of tropical parasitic diseases, including leishmaniasis. According to WHO, the world's 14 million people are infected each year there is about 2 million new cases and about 350 million live in areas at risk. Leishmaniasis - a group of vector-borne protozoal disease in humans and animals characterized by lesions of the internal organs (visceral leishmaniasis or the skin and mucous membranes (cutaneous leishmaniasis, which is the vector mosquitoes. We present their own clinical observations of American cutaneous leishmaniasis imported. Patient S., 41 years was hospitalized in Zaporozhye Regional Clinical Hospital infectious on 07.17.2013, with suspected cutaneous leishmaniasis. From the history of the disease is known that for the first time in February 2013 the patient have got relative to blade area redness and bump that appeared above the skin, and had a magnitude of 2,3 mm brownish-red. To the doctor the patient has not addressed. After 1,5-2 months bump grew and he began to stand out ichor, which dries and formed a crust on top of the hump. Further small ulcers that did not bring discomfort and pain to the patient appeared. However, every month ulcer increased. In July, after vacation at sea, rose weeping sores and perifocal inflammation appeared. Ulcer size reached 2 cm in diameter. The patient first applied to the dermatologist at the beginning of July 2013. Dermatologist excluded secondary syphilis and tuberculosis skin and sent to an

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

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    Hossein Mortazavi

    2014-01-01

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

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

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    A.F. Brilhante

    2016-08-01

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

  9. Cutaneous Leishmaniasis – A Case Series from Dresden

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    Uwe Wollina

    2018-01-01

    Full Text Available Leishmaniasis is world-wide one of the most common infectious disorders caused by protozoa. Due to the climate change, there is a risk of further spread of the disease to central and northern Europe. Another important issue is the high number of refugees from Syria since Syria is one of the hot spots of Old World leishmaniasis. We report on single-centre experience with leishmaniasis in the capital of Saxony, Dresden, during the years 2001 to 2017. We noted a substantial increase in the last five years. Once a very rare exotic disorder in Germany, cutaneous leishmaniasis has become a reality and physicians should be aware of it. A significant number of cases are from Syrian refugees; other cases had been acquired by tourists in the Mediterranean region!

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

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    López Liliana

    2012-05-01

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

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

    Science.gov (United States)

    López, Liliana; Robayo, Martha; Vargas, Margarita; Vélez, Iván D

    2012-05-17

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

  12. Disseminated Cutaneous Leishmaniasis in Colombia: Report of 27 Cases

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    Iván D. Vélez

    2015-10-01

    Full Text Available Disseminated leishmaniasis (DL is a poorly described disease that is frequently misdiagnosed as other clinical manifestations of cutaneous leishmaniasis (CL such as diffuse CL or post-kala-azar dermal leishmaniasis. Twenty-seven cases of DL diagnosed between 1997 and 2015 are described. A higher prevalence was observed in men (mean age 32 years. The number of lesions per patient ranged from 12 to 294, distributed mainly in the upper extremities, face and trunk. The lesions were mostly plaques or nodules. Seven patients had nasal mucous damage, 74% of the patients were of mixed race, 92% lived in northwestern Colombia, and Leishmania (Viannia panamensis was identified as the causative agent in 58% of cases. Eighteen patients recovered with pentavalent antimonial. The importance of distinguishing DL from those other clinical presentations is based on the fact that disseminated, diffuse and post-kala-azar CL are very different in etiology, clinical manifestations and response to treatment and prognosis.

  13. Arnica Tincture Cures Cutaneous Leishmaniasis in Golden Hamsters

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    Sara M. Robledo

    2018-01-01

    Full Text Available In search for potential therapeutic alternatives to existing treatments for cutaneous Leishmaniasis, we have investigated the effect of Arnica tincture Ph. Eur. (a 70% hydroethanolic tincture prepared from flowerheads of Arnica montana L. on the lesions caused by infection with Leishmania braziliensis in a model with golden hamsters. The animals were treated topically with a daily single dose of the preparation for 28 days. Subsequently, the healing process was monitored by recording the lesion size in intervals of 15 days up to day 90. As a result, Arnica tincture fully cured three out of five hamsters while one animal showed an improvement and another one suffered from a relapse. This result was slightly better than that obtained with the positive control, meglumine antimonate, which cured two of five hamsters while the other three showed a relapse after 90 days. This result encourages us to further investigate the potential of Arnica tincture in the treatment of cutaneous Leishmaniasis.

  14. Leishmania serology in the diagnosis of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Mashood, A.H.; Malik, N.; Abbasi, S.

    2013-01-01

    Background: The gold standard to diagnose cutaneous leishmaniasis is histopathology, but there has always been a need of a rapid, reliable, cheap and convenient laboratory investigation. Serological tests fulfill the above criteria. Objective: The objective of the study was to determine the sensitivity and specificity of enzyme linked immunosorbent assay (ELISA) in detection of leishmania antibodies, in comparison with the histopathology. Place and duration of study: The study was conducted in Military Hospital Rawalpindi from 1st November 2010 to 30th June 2011. Patients and methods: The study population included the patients who were clinically diagnosed with cutaneous leishmaniasis. All of them were biopsied and serum was sent for leishmania serology. Results: A total of 47 patients were included. They were all adult males. The histopathology was positive in 31/47 patients (65.95%), while the leishmania serology was positive in 36/47 cases (76.59%). The sensitiuites was 74.19%, specificity was 18.75%, positive predictive value has 63.88%, negative predicative value was 27% and accuracy was 55%. Conclusion: In the light of sensitivity analysis, it may be concluded that leishmania serology has moderate sensitivity and low specificity; hence it is not a reliable test for cutaneous leishmaniasis. (author)

  15. Leishmaniasis cutánea en España Cutaneous leishmaniasis in Spain

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    F Pulgar

    2011-09-01

    Full Text Available Comunicamos un caso de Leishmaniasis cutánea localizada en miembros inferiores, la respuesta terapéutica al antimonial fue buena, observándose solo una cicatriz residual. La entidad no es frecuente en España.An 84-years-old woman from Spain with papules-nodules, some ulcerated in the lower limbs is reported. The therapeutic response to the meglumine was satisfactory with a residual scar as only secuelae. The Cutaneous Leishmaniasis is infrequent in Spain.

  16. New epidemiological pattern of cutaneous leishmaniasis in two pre-Saharan arid provinces, southern Morocco.

    Science.gov (United States)

    Ait Kbaich, Mouad; Mhaidi, Idriss; Ezzahidi, Abdelkacem; Dersi, Nouredine; El Hamouchi, Adil; Riyad, Myriam; Akarid, Khadija; Lemrani, Meryem

    2017-09-01

    Three Leishmania species are responsible of cutaneous leishmaniasis (CL) in Morocco. Zoonotic CL due to Leishmania major and Leishmania infantum, the first is known as established in the eastern arid regions, whereas the latter evolves sporadically, especially in the North. While Leishmania tropica, classically considered anthroponotic, is endemic in the semi-arid regions and is largely distributed throughout the country. The aim of this study was to identify the Leishmania species causing CL in two Provinces in arid pre-Saharan region known as zoonotic CL foci, and to contribute an update to the national data concerning the distribution of Leishmania species in both regions. The recruitment of patients was done in six localities in Ouarzazate and Zagoura provinces in 2015 and 2016. Out of 81 samples collected, 66 were positive (81%) by ITS1-PCR amplification of Leishmania DNA extracted from stained smears. The highest rate of Leishmania infection was registered in children aged 9 years or less (71,2%). The ITS1-PCR- RFLP analysis revealed the predominance of L. major infecting 52 patients (79%), followed by L. tropica in 12 patients (18%) and L. infantum in 2 patients who had no history of travel outside the studied area (3%). The sequencing of the ITS1 of both L. infantum, showed 100% similarities with L. infantum strains isolated from dogs and visceral leishmaniasis patients from the south and north of Morocco. The coexistence of the 3 Leishmania species in the same focus, and the difficult distinction of infections associated to the different Leishmania species based only on clinical lesions' aspects complicate the diagnosis and then the national control strategy, as well as the therapeutic management. The epidemiological pattern of CL in the studied areas appears to have changed during the last decades, from a predominant zoonotic CL caused by L. major to a polymorphic disease that can be due to any of the 3 Leishmania species. The expansion of L. infantum and

  17. Epidemiological Study on Cutaneous Leishmaniasis in an Endemic Area, of Qom Province, Central Iran

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    Abedin Saghafipour

    2017-10-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is one of the most important health problems in many areas of Iran. There are two forms of the disease in Iran, anthroponotic and zoonotic CL. This study conducted to assess the epi­demiological situation of CL in an endemic area of Qom Province, central Iran from Apr to Nov 2015.Methods: The sticky paper traps and aspirating tubes were used for collecting adult sand flies. Sherman traps and small insect nets were used to capture rodents and small mammals. Giemsa staining was used for preparing the ex­panded smear and followed by PCR for identifying the causative agent in human, vectors, and reservoirs. In this study, relative frequency of CL was also calculated.Results: Fourteen species of Phlebotomine sand flies were collected. Phlebotomus papatasi (61.74% was the pre­dominant species through the period of activity. Overall, 62 Meriones libycus, 8 Nesokia indica, 4 Mus musculus, 16 Allactaga elater and 2 Hemiechinus auritis were caught. PCR technique showed 6 out of 150 P. papatasi (2%, two out of 62 M. libycus (3.23% and all of suspected human's skin tissue samples (100% were infected with Leishmania major. The relative frequency of CL was 0.30%. Conclusion: This is the first detection of L. major within P. papatasi, M. libycus and human in Kahak District in Qom Province of Iran. Zoonotic cycle of CL exists in this area, L. major is the causative agent, P. papatasi is the main vector and M. libycus is the main reservoir of the disease. 

  18. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis

    NARCIS (Netherlands)

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

    2012-01-01

    This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML

  19. A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

    Science.gov (United States)

    2017-10-01

    leishmaniasis (ML). LCL in the New World is most commonly caused by species of the Viannia subgenus (L. braziliensis, L. panamensis, L. guyanensis, L...significant impact on military operations. Thousands of cases of visceral and cutaneous leishmaniasis occurred in soldiers in World Wars I and II. Military... population . Unpublished information indicates that the number of military personnel with cutaneous leishmaniasis could exceed 3,000. Rationale. A major

  20. Pharmacokinetic of antimony in mice with cutaneous Leishmaniasis

    International Nuclear Information System (INIS)

    Borborema, Samanta E.T.; Nascimento, Nanci do; Osso Junior, Joao A.

    2007-01-01

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

  1. Pharmacokinetic of antimony in mice with cutaneous Leishmaniasis

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-01

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

  2. Cutaneous leishmaniasis responds to daylight-activated photodynamic therapy

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: Cutaneous leishmaniasis (CL) is endemic in Israel, with hundreds of new cases reported in recent years. Photodynamic therapy (PDT) is highly effective for treatment of CL, but requires equipment available only at specialized centres. Daylight-activated PDT (DA-PDT) abolishes the need...... application of a thick layer of 16% methyl aminolaevulinate and 30-min occlusion, the lesions were exposed to daylight for 2·5 h. Treatment sessions were repeated at weekly intervals until clinical and microbiological cure. Control lesions were either treated with cryotherapy or left untreated. RESULTS...

  3. Recurrent cutaneous leishmaniasis Leishmaniose recidiva cútis

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    Ciro Martins Gomes

    2013-06-01

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

  4. Murine cutaneous leishmaniasis investigated by MALDI mass spectrometry imaging.

    Science.gov (United States)

    Negrão, Fernanda; de O Rocha, Daniele F; Jaeeger, Caroline F; Rocha, Francisca J S; Eberlin, Marcos N; Giorgio, Selma

    2017-09-26

    Imaging mass spectrometry (IMS) is recognized as a powerful tool to investigate the spatial distribution of untargeted or targeted molecules of a wide variety of samples including tissue sections. Leishmania is a protozoan parasite that causes different clinical manifestations in mammalian hosts. Leishmaniasis is a major public health risk in different continents and represents one of the most important neglected diseases. Cutaneous lesions from mice experimentally infected with Leishmania spp. were investigated by matrix-assisted laser desorption ionization MS using the SCiLS Lab software for statistical analysis. Being applied to cutaneous leishmaniasis (CL) for the first time, MALDI-IMS was used to search for peptides and low molecular weight proteins (2-10 kDa) as candidates for potential biomarkers. Footpad sections of Balb/c mice infected with (i) Leishmania amazonensis or (ii) Leishmania major were imaged. The comparison between healthy and infected skin highlighted a set of twelve possible biomarker proteins for L. amazonenis and four proteins for L. major. Further characterization of these proteins could reveal how these proteins act in pathology progression and confirm their values as biomarkers.

  5. 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...

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

    NARCIS (Netherlands)

    van Thiel, Pieter-Paul A. M.; van Gool, Tom; Kager, Piet A.; Bart, Aldert

    2010-01-01

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

  7. A cluster of cutaneous leishmaniasis associated with human smuggling.

    Science.gov (United States)

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

    2011-06-01

    Cutaneous leishmaniasis (CL) is rarely seen in the United States, and the social and geographic context of the infection can be a key to its diagnosis and management. Four Somali and one Ethiopian, in U.S. Border Patrol custody, came to the United States by the same human trafficking route: Djibouti to Dubai to Moscow to Havana to Quito; and then by ground by Columbia/Panama to the United States-Mexico border where they were detained. Although traveling at different times, all five patients simultaneously presented to our institution with chronic ulcerative skin lesions at different sites and stages of evolution. Culture of biopsy specimens grew Leishmania panamensis. Soon thereafter, three individuals from East Africa traveling the identical route presented with L. panamensis CL to physicians in Tacoma, WA. We document here the association of a human trafficking route and new world CL. Clinicians and public health officials should be aware of this emerging infectious disease risk.

  8. Diabetes melutus associated with pentamidine isethionate in diffuse cutaneous leishmaniasis

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    Jackson Mauricio Lopes Costa

    1995-12-01

    Full Text Available The authors report a case of a male patient from Bacabal, MA with diffuse cutaneous leishmaniasis (DCL, for at least nine years, with 168 lesions on his body. These were tumour-like nodules with some ulceratmi. He usedpentavalent antimonial (glucantime® and an association of gamma interferon plus glucantime with improvement of the lesions but relapsed later. Recently, pentamidine isethionate (pentacarinat® was given a dosage of 4mg/kg/weight/day on alternate days for 20 applications. After 3 months a similar course of 10 application was given 2 times. Later he developed diabetic signs with weight loss of 10kg, polydypsia, polyuria and xerostomia. The lower limbs lesions showed signs of activity. Blood glucose levels normalised and remain like this at moment. Attention is drawn to the fact that pentamidine isethionate should be used as a therapy option with care, obeyng rigorous laboratory controls including a glucose tolerance test.

  9. Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras.

    Science.gov (United States)

    Soto, Lucrecia Acosta; Caballero, Nelson; Fuentes, Lesny Ruth; Muñoz, Pedro Torres; Gómez Echevarría, Jose Ramón; López, Montserrat Pérez; Bornay Llinares, Fernando Jorge; Stanford, John L; Stanford, Cynthia A; Donoghue, Helen D

    2017-10-01

    In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae , Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.

  10. A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

    Science.gov (United States)

    2016-10-01

    operations. Thousands of cases of visceral and cutaneous leishmaniasis occurred in soldiers in World Wars I and II. Military training and combat operations...Puplampu, NAMRU-3 o Dr. Diana Carolina Gallego, CIDEIM, Colombia o Blgist. Jose Luis Malaga, UPCH-UTMB  This 05-days workshop consisted of 02 days of...mechanism is used in this project to detect cutaneous leishmaniasis, a parasite that has plagued US soldiers during the war on terror, the technology can

  11. Histological grading patterns in patients of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Saleem, K.; Ayaz, B.; Shaikh, A.

    2007-01-01

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

  12. Local increase of arginase activity in lesions of patients with cutaneous leishmaniasis in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Tamrat Abebe

    Full Text Available Cutaneous leishmaniasis is a vector-borne disease that is in Ethiopia mainly caused by the parasite Leishmania aethiopica. This neglected tropical disease is common in rural areas and causes serious morbidity. Persistent nonhealing cutaneous leishmaniasis has been associated with poor T cell mediated responses; however, the underlying mechanisms are not well understood.We have recently shown in an experimental model of cutaneous leishmaniasis that arginase-induced L-arginine metabolism suppresses antigen-specific T cell responses at the site of pathology, but not in the periphery. To test whether these results translate to human disease, we recruited patients presenting with localized lesions of cutaneous leishmaniasis and assessed the levels of arginase activity in cells isolated from peripheral blood and from skin biopsies. Arginase activity was similar in peripheral blood mononuclear cells (PBMCs from patients and healthy controls. In sharp contrast, arginase activity was significantly increased in lesion biopsies of patients with localized cutaneous leishmaniasis as compared with controls. Furthermore, we found that the expression levels of CD3ζ, CD4 and CD8 molecules were considerably lower at the site of pathology as compared to those observed in paired PBMCs.Our results suggest that increased arginase in lesions of patients with cutaneous leishmaniasis might play a role in the pathogenesis of the disease by impairing T cell effector functions.

  13. Toxicological analysis and effectiveness of oral Kalanchoe pinnata on a human case of cutaneous leishmaniasis.

    Science.gov (United States)

    Torres-Santos, E C; Da Silva, S A G; Costa, S S; Santos, A P P T; Almeida, A P; Rossi-Bergmann, B

    2003-08-01

    Leishmaniasis is an extremely difficult disease to treat. Previously, it was shown that oral Kalanchoe pinnata (Kp) leaf extract is strongly effective against murine leishmaniasis. Here, it is shown that the serum levels of alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), urea and alkaline phosphatase were unchanged in mice orally treated with supraoptimal Kp doses for 30 days, indicating the absence of chronic toxicity to the liver, heart or kidney. Additionally, evidence is presented that human leishmaniasis may also be controlled with oral Kp. A 36-year-old man with an active cutaneous leishmaniasis was orally treated with 30 g wet weight of Kp leaves/day for 14 days. During the Kp treatment, the lesion stopped growing and slightly decreased. No adverse reactions or toxicity was observed. This study reports for the first time that Kalanchoe pinnata contains substances potentially active and safe for the oral treatment of human cutaneous leishmaniasis. Copyright 2003 John Wiley & Sons, Ltd.

  14. Forecasting Temporal Dynamics of Cutaneous Leishmaniasis in Northeast Brazil

    Science.gov (United States)

    Lewnard, Joseph A.; Jirmanus, Lara; Júnior, Nivison Nery; Machado, Paulo R.; Glesby, Marshall J.; Ko, Albert I.; Carvalho, Edgar M.; Schriefer, Albert; Weinberger, Daniel M.

    2014-01-01

    Introduction Cutaneous leishmaniasis (CL) is a vector-borne disease of increasing importance in northeastern Brazil. It is known that sandflies, which spread the causative parasites, have weather-dependent population dynamics. Routinely-gathered weather data may be useful for anticipating disease risk and planning interventions. Methodology/Principal Findings We fit time series models using meteorological covariates to predict CL cases in a rural region of Bahía, Brazil from 1994 to 2004. We used the models to forecast CL cases for the period 2005 to 2008. Models accounting for meteorological predictors reduced mean squared error in one, two, and three month-ahead forecasts by up to 16% relative to forecasts from a null model accounting only for temporal autocorrelation. Significance These outcomes suggest CL risk in northeastern Brazil might be partially dependent on weather. Responses to forecasted CL epidemics may include bolstering clinical capacity and disease surveillance in at-risk areas. Ecological mechanisms by which weather influences CL risk merit future research attention as public health intervention targets. PMID:25356734

  15. A sensitive new microculture method for diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Allahverdiyev, Adil M; Uzun, Soner; Bagirova, Malahat; Durdu, Murat; Memisoglu, Hamdi R

    2004-03-01

    A sensitive microcapillary culture method (MCM) was developed for rapid diagnosis of cutaneous leishmaniasis (CL). The MCM is superior to the traditional culture method (TCM) as determined by the smaller inoculum size, the higher sensitivity for detection of promastigotes, and the more rapid time for emergence of promastigotes. With lesion amastigote loads from grade III to 0, the positive rates and the periods for promastigote emergence were 3-4-fold higher and faster with the MCM than with the TCM, e.g., 83-97% positive in 4-7 days versus 20-40% positive in 15-30 days (P = 0.0001). The higher Pco(2) and lower Po(2) and pH presumably encourage a rapid amastigote-to-promastigote differentiation and/or the survival or growth of the latter. This MCM has the advantage of simplicity, and may be suitable for diagnostic use and for parasite retrieval in many other endemic sites where parasites are known to be difficult to grow.

  16. An improved microculture method for diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Pagheh, Abdolsattar; Fakhar, Mahdi; Mesgarian, Fatemeh; Gholami, Shirzad; Ahmadpour, Ehsan

    2014-12-01

    This study evaluated the performance of three diagnostic methods for cutaneous leishmaniasis (CL). Patients who came to the Health Center Laboratory of Gonbad-e-Qabus in Golestan Province, Iran, were enrolled in the study. Skin scraping smear, improved microculture (IMC) and polymerase chain reaction (PCR) were performed. A total of 303 subjects were recruited, among whom 273 subjects fulfilled the criteria for CL. Sensitivity and specificity were 88.8 % (95 % CI = 84.2-92.2 %) and 100.0 % for smears, 98.4 % (95 % CI = 96.1-99.1 %) and 100.0 % for IMC, both of them 100.0 % for PCR. Although, PCR was relatively more sensitive than the IMC, the high correlation (agreement = 96 %, Kappa = 0.82) between IMC and PCR along with the advantages of simplicity, rapidity, adequate sensitivity and as a needle free method, offers the IMC as a valuable alternative diagnostic method for PCR in diagnosis of CL.

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

    Directory of Open Access Journals (Sweden)

    Oscar D Salomón

    2008-05-01

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

  18. Arginase activity of Leishmania isolated from patients with cutaneous leishmaniasis.

    Science.gov (United States)

    Badirzadeh, A; Taheri, T; Abedi-Astaneh, F; Taslimi, Y; Abdossamadi, Z; Montakhab-Yeganeh, H; Aghashahi, M; Niyyati, M; Rafati, S

    2017-09-01

    Cutaneous leishmaniasis (CL) is one of the most important vector-borne parasitic diseases, highly endemic in Iran, and its prevalence is increasing all over the country. Arginase (ARG) activity in isolated Leishmania parasites from CL patients is yet to be explored. This study aimed to compare the ARG activity of isolated Leishmania promastigotes from CL patients with a standard strain of Leishmania major and its influences on the disease pathogenesis. We recruited 16 confirmed CL patients from Qom Province, in central Iran; after detection of Leishmania species using PCR-RFLP, we assessed the levels of ARG in the isolated promastigotes and determined the parasites' growth rate. Only L. major was identified from CL patients. The level of ARG activity in the isolated Leishmania promastigotes from CL patients was significantly higher than that obtained from the standard strain of L. major. No significant correlations between ARG activity and lesion size, number or duration were observed; in contrast, a significant negative correlation was seen between ARG level and Leishmania' growth rate. The obtained results suggest that increased ARG expression and activity in the isolated Leishmania promastigotes might contribute to the higher parasite infectivity and play a major role in the pathogenicity of the CL. © 2017 John Wiley & Sons Ltd.

  19. Detection of Cutaneous Leishmaniasis by PCR in Fasa district in 2012

    Directory of Open Access Journals (Sweden)

    Mehdi Sharafi

    2013-09-01

    Material & Methods: Slit biopsies were collected from 138 suspected cases of cutaneous leishmaniasis who were presented, consecutively, in Fasa district from April 2011 to February 2012. After the microscopy, the entire smear was then scraped off the slide surface for DNA extraction and PCR assay. Results: All 138 investigated smears were reported positive by microscopy and nested PCR assay. In PCR, One of the smears had the 750-bp band, indicative of L. tropica and the rest had the 560-bp band indicative of L. major. Conclusion: In conclusion, the cutaneous leishmaniasis found in Fasa district is predominantly Rural Cutaneous Leishmaniasis. The PCR-based assay used in the present study appears to be a suitable and powerful tool for the characterization of Leishmanial species.

  20. Molecular Epidemiological Survey of Cutaneous Leishmaniasis in Two Highly Endemic Metropolises of Iran, Application of FTA Cards for DNA Extraction From Giemsa-Stained Slides.

    Science.gov (United States)

    Izadi, Shahrokh; Mirhendi, Hossein; Jalalizand, Niloufar; Khodadadi, Hossein; Mohebali, Mehdi; Nekoeian, Shahram; Jamshidi, Ali; Ghatee, Mohammad Amin

    2016-02-01

    PCR has been used for confirmation of leishmaniasis in epidemiological studies, but complexity of DNA extraction and PCR approach has confined its routine use in developing countries. In this study, recent epidemiological situation of cutaneous leishmaniasis (CL) in two hyper-endemic metropolises of Shiraz and Isfahan in Iran was studied using DNA extraction by commercial FTA cards and kinetoplastid DNA (kDNA)-PCR amplification for detection/identification of Leishmania directly from stained skin scraping imprints. Fifty four and 30 samples were collected from clinically diagnosed CL patients referred to clinical laboratories of leishmaniasis control centers in Isfahan and Shiraz cities, respectively. The samples were examined by direct microscopy and then scrapings of the stained smears were applied to FTA cards and used directly as DNA source in a nested-PCR to amplify kDNA to detect and identify Leishmania species. Fifty four of 84 (64.2%) slides obtained from patients had positive results microscopically, while 79/84 (94%) of slides had positive results by FTA card-nested-PCR. PCR and microscopy showed a sensitivity of 96.4% and 64.2% and specificity of 100% and 100%, respectively. Interestingly, Leishmania major as causative agent of zoonotic CL was identified in 100% and 90.7% of CL cases from Isfahan and Shiraz cities, respectively, but L. tropica was detected from only 9.3% of cases from Shiraz city. All cases from central regions of Shiraz were L. tropica and no CL case was found in Isfahan central areas. Filter paper-based DNA extraction can facilitate routine use of PCR for diagnosis of CL in research and diagnostic laboratories in Iran and countries with similar conditions. Epidemiologic changes including dominancy of L. major in suburbs of Shiraz and Isfahan metropolises where anthroponotic CL caused by L. tropica had been established, showed necessity of precise studies on CL epidemiology in old urban and newly added districts in the suburbs.

  1. Detection of Leishmania parasites in the blood of patients with isolated cutaneous leishmaniasis.

    Science.gov (United States)

    Nakkash-Chmaisse, Hania; Makki, Raja; Nahhas, Georges; Knio, Khouzama; Nuwayri-Salti, Nuha

    2011-07-01

    The consequences of the spread of Leishmania parasites to the blood from lesions in patients with cutaneous leishmaniasis are numerous. To assess the magnitude of this invasion we conducted the present study on patients referred to the American University of Beirut Medical Center for cutaneous leishmaniasis. Patients referred for the management of cutaneous leishmaniasis were included in the study. Skin and blood cultures for Leishmania were taken from these patients. One hundred sixty-two patients were proven to have cutaneous leishmaniasis by pathology; 52% were males and 44% females (gender information was missing for 4%). Patient age ranged from 5 months to 70 years. None of the patients had received treatment for Leishmania. We obtained parasite isolates from 85 patients (52.5%), proven by cultures from skin and blood/blood components. Interestingly, the parasite was isolated in the blood and blood components of 50 patients (30.9%). Isoenzyme analysis confirmed the fact that the organisms in blood and skin were the same; from the 28 isolates that were positive in both skin and blood, eight isolates were Leishmania major and two were Leishmania tropica. The remaining isolates, whether positive in both blood and skin or in either of these tissues, skin or blood and its products, were Leishmania infantum sensu lato. In the current study, the detection rate of parasites in the blood of patients with cutaneous leishmaniasis was high. This illustrates the invasive characteristic of the parasite that has escaped the skin. Testing should be considered in areas other than Lebanon, especially around the Mediterranean basin. Whether these findings support the administration of systemic treatment for cutaneous leishmaniasis or not needs to be confirmed in larger prospective studies. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  2. Epidemiology, pathology and treatment of cutaneous leishmaniasis in taif region of saudi arabia.

    Directory of Open Access Journals (Sweden)

    Wajihullah Khan

    2014-09-01

    Full Text Available Cutaneous leishmaniasis is an annoying and disfiguring disease affecting around 1,500,000 individuals globally. There are endemic pockets of this disease in Taif region. In some patients, lesion often weeps and leads to scar formation. The study was conducted to see the efficacy of fluconazole and itraconazole in the patients of cutaneous leishmaniasis and the effect of these drugs on liver enzymes and kidney markers.Positivity of Leishmania was recorded by microscopic examinations of smears. Specific diagnosis for Leishmania major and L. tropica was made with the help of nested polymerase chain reaction. Fluconazole was given at the rate of 200mg/day while itraconazole was given at 150mg/day for six weeks. AST, ALT, creatinine and urea were estimated during medication.Leishmania major and L. tropica were the species responsible for cutaneous leishmaniasis in Taif region. 81% patients had single lesions, mostly on face followed by hands and legs. 15% of the lesions had bacterial contamination. In terms of efficacy, fluconazole gave slightly better results compared to itraconazole. After 6 weeks of medications, slightly elevated values were recorded for liver enzymes and creatinine.Transmission of leishmaniasis in Taif region is probably because of poor coverage of residual insecticides spraying at hiding places in pile-ups of rocks and abandoned houses from where sand flies visit nearby houses and cattle sheds during night. Fluconazole and itraconazole may be used for the treatment of cutaneous leishmaniasis with good recovery rate and fewer side effects.

  3. 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.

  4. Identification of Leishmania tropica from micro-foci of cutaneous leishmaniasis in the Kenyan Rift Valley.

    Science.gov (United States)

    Odiwuor, Samwel; Muia, Alfred; Magiri, Charles; Maes, Ilse; Kirigi, George; Dujardin, Jean-Claude; Wasunna, Monique; Mbuchi, Margaret; Auwera, Gert Van der

    2012-07-01

    We performed diagnosis and species identification of parasites in lesion samples from suspected cutaneous leishmaniasis patients in four villages, three of which are in a known Leishmania tropica endemic region in Kenya. Samples were analyzed both by microscopy and PCR for Leishmania, and typed by an assay using four ribosomal DNA-based species-identification PCRs. The lesions were demonstrated to be caused by L. tropica, which confirms the re-emergence of cutaneous leishmaniasis from this species after a period of reduced incidence in the endemic zone. Our report highlights the importance of an intervention and sustained Leishmania control program.

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

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    Jeffrey D. Chulay

    1988-12-01

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

  6. Molecular detection and identification of Leishmania infection in naturally infected sand flies in a focus of cutaneous leishmaniasis in northern Morocco

    OpenAIRE

    Es-Sette, Nargys; Ajaoud, Malika; Laamrani-Idrissi, Abderrahman; Mellouki, Fouad; Lemrani, Meryem

    2014-01-01

    Background Cutaneous leishmaniasis is an infectious disease caused by various species of the flagellate protozoan Leishmania. During the past 20 years, cutaneous leishmaniasis has emerged as a major public health threat in Morocco. The main objective of this study was to study the occurrence of Leishmania infection in vectors and to identify sand fly blood meal sources in an endemic locality of cutaneous leishmaniasis within Sefrou province, where the vectors of leishmaniasis were still unkno...

  7. Interferon-¿- and tumour necrosis factor-a-producing cells in humans who are immune to cutaneous leishmaniasis

    DEFF Research Database (Denmark)

    Kemp, K; Theander, T G; Hviid, L

    1999-01-01

    Individuals infected with Leishmania major usually acquire immunity to cutaneous leishmaniasis. In this study we have investigated peripheral blood mononuclear cells (PBMC) stimulated by Leishmania antigens in two groups of Sudanese individuals, one with a history of cutaneous leishmaniasis and one...... leishmaniasis produced significantly higher levels of IFN-gamma and TNF-alpha than cells from individuals without a history of the disease. Similar levels of IL-10 were found in the two groups. Flow cytometric analysis revealed high numbers of CD3+ cells producing IFN-gamma and TNF-alpha, and only a few CD3......+ cells containing IL-10, in the PBMC cultures from the individuals with a history of cutaneous leishmaniasis. Interferon-gamma and TNF-alpha were predominantly produced by CD4+ T cells rather than CD8+ T cells. The results suggest that cellular immunity against cutaneous leishmaniasis is mediated...

  8. Is the dog a possible reservoir for cutaneous leishmaniasis in suriname?

    NARCIS (Netherlands)

    Kent, Alida; Ramkalup, Prakash; Mans, Dennis; Schallig, Henk

    2013-01-01

    Cutaneous leishmaniasis (CL) is an emerging disease in Suriname, with at least 200 cases per year. Little is known about the biology of CL in the country. The most important parasite species is Leishmania Viannia guyanensis, but possible vectors and reservoirs are hardly incriminated. In the present

  9. The pathology of cutaneous leishmaniasis due to Leishmania major in Sudan

    DEFF Research Database (Denmark)

    Gaafar, A; el Kadaro, A Y; Theander, T G

    1995-01-01

    The pathology of cutaneous leishmaniasis in Sudan, where the disease is caused by Leishmania major, was studied by light and electron microscopy. Lesions were classified into four distinct groups based on the ratio of different cell types, especially lymphocytes, macrophages, and plasma cells...

  10. 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

  11. 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.

  12. Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya.

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    Ahmad Amro

    2017-09-01

    Full Text Available Cutaneous leishmaniasis (CL is a major public health problem in Libya. In this paper, we describe the eco-epidemiological parameters of CL during the armed conflict period from January 2011 till December 2012. Current spatiotemporal distributions of CL cases were explored and projected to the future using a correlative modelling approach. In addition the present results were compared with our previous data obtained for the time period 1995-2008.We investigated 312 CL patients who presented to the Dermatology Department at the Tripoli Central Hospital and came from 81 endemic areas distributed in 10 districts. The patients presented with typical localized lesions which appeared commonly on the face, arms and legs. Molecular identification of parasites by a PCR-RFLP approach targeting the ITS1 region of the rDNA was successful for 81 patients with two causative species identified: L. major and L. tropica comprised 59 (72.8% and 22 (27.2% cases, respectively. Around 77.3% of L. tropica CL and 57.7% of L. major CL caused single lesions. Five CL patients among our data set were seropositive for HIV. L. tropica was found mainly in three districts, Murqub (27.3%, Jabal al Gharbi (27.3% and Misrata (13.7% while L. major was found in two districts, in Jabal al Gharbi (61% and Jafara (20.3%. Seasonal occurrence of CL cases showed that most cases (74.2% admitted to the hospital between November and March, L. major cases from November till January (69.4%, and L. tropica cases mainly in January and February (41%. Two risk factors were identified for the two species; the presence of previously infected household members, and the presence of rodents and sandflies in patient's neighborhoods. Spatiotemporal projections using correlative distribution models based on current case data and climatic conditions showed that coastal regions have a higher level of risk due to more favourable conditions for the transmitting vectors.Future projection of CL until 2060

  13. Epidemiological role of a rodent in Morocco: Case of cutaneous leishmaniasis

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    Mohamed Echchakery

    2015-08-01

    Full Text Available Commensal rodents as well as wild ones may present a potential risk to public health. They are reservoirs or vectors of many pathogens. This review provides an update on their epidemiological role in the spread of leishmaniasis in Morocco. In Morocco, the order Rodentia is represented by 7 families and 32 species of which Rattus norvegicus, Psammomys obesus, Mastomys erythrolecus, Meriones shawi, Meriones crassus and Meriones libycus are considered reservoirs of leishmaniasis in Asia, Midle East and Africa. With the aim to define the extent of zoonotic leishmaniasis risk in Morocco, we represent and discuss the geographical distribution of these potential reservoirs in relation to that of Phlebotomus papatasi, proven vector of cutaneous leishmaniasis by Leishmania major in Morocco.

  14. Efficacy of glucantime for treatment of cutaneous leishmaniasis in Central Iran

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    Mahmoud Mohammadzadeh

    2013-04-01

    Full Text Available Summary: Glucantime remains the first-line treatment for cutaneous leishmaniasis. In a prospective study, we evaluated its efficacy and side effects in patients treated in Yazd from 2010 to 2011. Methods: Patients with lesions compatible with cutaneous leishmaniasis were considered eligible for inclusion in this study if the disease was confirmed parasitologically. The exclusion criteria were as follows: the patient preferred a treatment modality other than Glucantime; there was no indication for treatment; the patient had underlying kidney, liver, or cardiac disease; or was pregnant and lactating.Patients with ≤3 lesions and/or lesions <3 cm in diameter were treated with Glucantime intralesionally if the lesions were not located on the face, neck or joints; sporotrichoid; or superinfected with bacteria. All other patients were prescribed intramuscular Glucantime at 10–20 mg/kg/day for 20 days. Results: The failure rate for patients treated with one course of Glucantime was 22.6% overall. There were no associations between age, sex, weight, the route of administration, the number and size of lesions, the adequacy of the dose of the drug injected intramuscularly, the number of intralesional injections (<6 or ≥6 and the duration of therapy. The only factor associated with failure was reported previous exposure to antimony (p value 0.047. Adverse effects occurred in 14.2% of patients (22/155. Conclusion: Glucantime is an effective drug for the treatment of cutaneous leishmaniasis in central Iran. However, because cutaneous leishmaniasis heals spontaneously and to prevent the acquisition of resistance, the indications for treatment in each region should be defined carefully. Keywords: Cutaneous leishmaniasis, Efficacy, Glucantime, Iran

  15. A new focus of cutaneous leishmaniasis in Jammu division of Jammu and Kashmir State, India

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    Neenu Kaul

    2016-01-01

    Full Text Available Background: Cutaneous leishmaniasis in India is mainly confined to the deserts of Rajasthan; some cases have been reported from the dry north-western half of the Indo-Gangetic plain, including Punjab, Himachal Pradesh, Delhi and Varanasi. Aims: To highlight a new focus of cutaneous leishmaniasis in the Jammu division of Jammu and Kashmir State, previously a non-endemic area. This report presents the clinico-epidemiological and investigative results of 120 new cases of cutaneous leishmaniasis detected between November 2012 and October 2013. Methods: The clinical diagnosis of cutaneous leishmaniasis was made using criteria proposed by Bari and Rahman. It was further confirmed by the demonstration of Leishman-Donovan bodies in Leishman stained slit skin smears and skin biopsy specimens, and/or by a satisfactory response to intra-lesional sodium stibogluconate given weekly for 4 weeks. Serial clinical photographs were taken before giving injections and at the end of the 6 th week. Results: There were 67 females and 53 males with an age range of 8 months to 80 years. The most frequently affected site was the face. Lesions were most commonly of the nodulo-ulcerative type. The number of lesions ranged from 1 to 4. Farmers (28.1%, homemakers (27.2% and students (27.2% were significantly over-represented among the occupations (P < 0.001. Skin smears and biopsies were positive for Leishman-Donovan bodies in 50.8% and 44.2% cases, respectively. Conclusions: There is a new focus of cutaneous leishmaniasis in Jammu division which deserves urgent attention from the public health angle. Further epidemiological studies are warranted to establish the identity of the vector and the strain of Leishmania involved.

  16. Phlebotomus sergenti in a Cutaneous Leishmaniasis Focus in Azilal Province (High Atlas, Morocco): Molecular Detection and Genotyping of Leishmania tropica, and Feeding Behavior

    Science.gov (United States)

    Ajaoud, Malika; Es-Sette, Nargys; Charrel, Rémi N; Laamrani-Idrissi, Abderahmane; Nhammi, Haddou; Riyad, Myriam; Lemrani, Meryem

    2015-01-01

    Background Phlebotomus (Paraphlebotomus) sergenti is at least one of the confirmed vectors for the transmission of cutaneous leishmaniasis caused by Leishmania tropica and distributed widely in Morocco. This form of leishmaniasis is considered largely as anthroponotic, although dogs were found infected with Leishmania tropica, suggestive of zoonosis in some rural areas. Methodology and Findings This survey aimed at (i) studying the presence of Leishmania in field caught Phlebotomus sergenti, (ii) investigating genetic diversity within Leishmania tropica and (iii) identifying the host-blood feeding preferences of Phlebotomus sergenti. A total of 4,407 sand flies were collected in three rural areas of Azilal province, using CDC miniature light traps. Samples collected were found to consist of 13 species: Phlebotomus spp. and 3 Sergentomyia spp. The most abundant species was Phlebotomus sergenti, accounting for 45.75 % of the total. 965 female Phlebotomus sergenti were screened for the presence of Leishmania by ITS1-PCR-RFLP, giving a positive rate of 5.7% (55/965), all being identified as Leishmania tropica. Nucleotide heterogeneity of PCR-amplified ITS1-5.8S rRNA gene-ITS2 was noted. Analyses of 31 sequences obtained segregated them into 16 haplotypes, of which 7 contain superimposed peaks at certain nucleotide positions, suggestive of heterozygosity. Phlebotomus sergenti collected were found to feed on a large variety of vertebrate hosts, as determined by Cytochrome b sequencing of the DNA from the blood meals of 64 engorged females. Conclusion Our findings supported the notion that Phlebotomus sergenti is the primary vector of Leishmania tropica in this focus, and that the latter is genetically very heterogeneous. Furthermore, our results might be suggestive of a certain level of heterozygosity in Leishmania tropica population. This finding, as well as the feeding of the vectors on different animals are of interest for further investigation. PMID:25826399

  17. Phlebotomus sergenti in a cutaneous leishmaniasis focus in Azilal province (High Atlas, Morocco: molecular detection and genotyping of Leishmania tropica, and feeding behavior.

    Directory of Open Access Journals (Sweden)

    Malika Ajaoud

    2015-03-01

    Full Text Available Phlebotomus (Paraphlebotomus sergenti is at least one of the confirmed vectors for the transmission of cutaneous leishmaniasis caused by Leishmania tropica and distributed widely in Morocco. This form of leishmaniasis is considered largely as anthroponotic, although dogs were found infected with Leishmania tropica, suggestive of zoonosis in some rural areas.This survey aimed at (i studying the presence of Leishmania in field caught Phlebotomus sergenti, (ii investigating genetic diversity within Leishmania tropica and (iii identifying the host-blood feeding preferences of Phlebotomus sergenti. A total of 4,407 sand flies were collected in three rural areas of Azilal province, using CDC miniature light traps. Samples collected were found to consist of 13 species: Phlebotomus spp. and 3 Sergentomyia spp. The most abundant species was Phlebotomus sergenti, accounting for 45.75 % of the total. 965 female Phlebotomus sergenti were screened for the presence of Leishmania by ITS1-PCR-RFLP, giving a positive rate of 5.7% (55/965, all being identified as Leishmania tropica. Nucleotide heterogeneity of PCR-amplified ITS1-5.8S rRNA gene-ITS2 was noted. Analyses of 31 sequences obtained segregated them into 16 haplotypes, of which 7 contain superimposed peaks at certain nucleotide positions, suggestive of heterozygosity. Phlebotomus sergenti collected were found to feed on a large variety of vertebrate hosts, as determined by Cytochrome b sequencing of the DNA from the blood meals of 64 engorged females.Our findings supported the notion that Phlebotomus sergenti is the primary vector of Leishmania tropica in this focus, and that the latter is genetically very heterogeneous. Furthermore, our results might be suggestive of a certain level of heterozygosity in Leishmania tropica population. This finding, as well as the feeding of the vectors on different animals are of interest for further investigation.

  18. Emergence of cutaneous leishmaniasis in Polonnaruwa, Sri Lanka 2008-2011.

    Science.gov (United States)

    Sandanayaka, Rohana; Kahawita, Indra; Gamage, Ajith; Siribaddana, Sisira; Agampodi, Suneth

    2014-02-01

    To report cutaneous leishmaniasis (CL) in Polonnaruwa, Sri Lanka. The study population included all patients with CL reported from Polonnaruwa district from January 2008 through April 2012. Data were collected in the dermatology unit of Polonnaruwa General Hospital and the regional epidemiology unit of Polonnaruwa. Four hundred and forty six patients with leishmaniasis were detected; clinical details were available for 362. Mean annual incidence of leishmaniasis between 2008 and 2012 in Polonnaruwa district was 26.2 per 100,000. The case incidence steadily increased during the study period. Case distribution by month peaked between August and November. Cases were geographically clustered in three administrative divisions with a mean annual incidence ranging from 94.7 to 54.1 per 100,000 population. Significantly more (n = 294, 65.9%) males than females were affected (χ(2) for goodness of fit = 48.4, P < 0.001). The commonest type of lesion was nodules (n = 157, 43.4%) followed by crust (n = 116, 32.0%). The majority of patients had lesions on upper limbs (n = 144, 39.8%) or the face (n = 117, 32.3%). Cutaneous leishmaniasis is increasing in Polonnaruwa, with clear spatial and temporal clustering. Sri Lanka needs more vigilant leishmaniasis surveillance. © 2013 John Wiley & Sons Ltd.

  19. Epidemiological Pattern of Cutaneous Leishmaniasis in the Province of Fars, Iran (Since 2010-2014

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    Ali Fattahi Bafghi

    2016-10-01

    Full Text Available Abstract Introduction: Cutaneous Leishmaniasis is considered as an important health problem in Iran. This disease begins as small papules and then they gradually grow and turn into wounds. Since the epidemiological study of this problem is effective in preventing and controlling it, the current research was conducted on epidemiological pattern of Cutaneous Leishmaniasis in the province of Fars, Iran (2010-2014 Materials and Methods: This cross-sectional study was conducted on the registered information (20601 patients and documents of the patients having problem in Fars province remedial and health care centers over the last 5 years. First, the registered demographic and epidemiological data of patients were extracted and then analyzed through by using SPSS software. Results: A total of 20601 patients including 10607 males (51% and 9994 females (49% participated this study. Patients were in the age range of 20-29 years old and minority of them was 5-9 years old. Most lesions were on the hand and leg of the patients. It was also found that there was a significant relationship between age groups and types of Leishmaniasis (P<0.05 as well as gender and type of Cutaneous Leishmaniasis (P<0.05. Conclusion: According to this is investigation, there was an ascending trend in disease frequency which was based on the descending process. This indicates promotion of educational- hygiene status as well as observance of personal hygiene principals.

  20. The distribution of radiolabelled drug in animals infected with cutaneous leishmaniasis: comparison of free and liposome-bound sodium stibogluconate

    International Nuclear Information System (INIS)

    New, R.R.C.; Chance, M.L.; Critchley, M.

    1982-01-01

    Sodium stibogluconate, labelled with antimony 125, was used to study the altered distribution of drugs, entrapped by positively and negatively charged liposomes, used to treat cutaneous leishmaniasis. (U.K.)

  1. Sporothrix schenckii Sensu Lato identification in fragments of skin lesion cultured in NNN medium for differential diagnosis of cutaneous leishmaniasis.

    Science.gov (United States)

    Antonio, Liliane de Fátima; Pimentel, Maria Inês Fernandes; Lyra, Marcelo Rosandiski; Madeira, Maria de Fátima; Miranda, Luciana de Freitas Campos; Paes, Rodrigo Almeida; Brito-Santos, Fábio; Carvalho, Maria Helena Galdino Figueredo; Schubach, Armando de Oliveira

    2017-02-01

    Eighty-nine patients with clinical suspicion of leishmaniasis were referred for differential diagnosis. Sporothrix schenckii sensu lato was isolated in Novy-MacNeal-Nicolle + Schneider media in 98% of 64 patients with final diagnosis of sporotrichosis. This medium may be suitable for diagnosis of sporotrichosis in areas where cutaneous leishmaniasis is also endemic. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    A. L. Bittencourt

    1991-03-01

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

  3. Interferon-Gamma and Interlukin-4 Patterns in BALB/c Mice Suffering From Cutaneous Leishmaniasis Treated With Cantharidin

    OpenAIRE

    Maroufi, Yahya; Ghaffarifar, Fatemeh; Dalimi, Abdolhosein; Sharifi, Zohreh

    2014-01-01

    Background: Cutaneous leishmaniasis is a health problem in the world. Lesions should be treated on cosmetically or functionally important sites, such as the face and hands. Cantharidin is a terpenoid compound produced naturally by beetles of Meloidae and Oedemeridae families. Objectives: The current study aimed to investigate the effect of cantharidin on Cutaneous Leishmaniasis (CL) lesions and IFN-γ and IL-4 patterns in infected BALB/c mice. Materials and Methods: Infected BALB/c mice were d...

  4. First case report of atypical disseminated cutaneous leishmaniasis in an opium abuser in Iran

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    Seyed Ahmad Hashemi

    2018-02-01

    Full Text Available ABSTRACT Leishmaniasis is a worldwide tropical infectious disease caused by different species of intracellular protozoa parasites of the genus Leishmania . Herein, we report a 78-year-old man with unusual diffuse cutaneous leishmaniasis (DCL who had a history of opium abuse and chronic obstructive pulmonary disease (COPD. He had multiple papular, crusted and severely ulcerated lesions extended to his arm and chest. Direct smears and skin punch biopsy of the lesions were suggestive of leishmaniasis. Parasite DNA was amplified from ulcers, and identified as Leishmania major by PCR-RFLP, confirmed by sequencing analyses. The aim of the current study was to bring to attention this atypical form of disease in CL endemic countries. Thus, this is the first case of DCL in an opium abuser with COPD due to L. major in Northeastern Iran indicating that atypical and extensive forms of CL (DCL owing to L. major are increasing in Iran.

  5. Evaluation of Knowledge, Attitude and Performance of the Mothers of Children Affected by Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    S.H. Hejazi

    2010-01-01

    Full Text Available Background Cutaneous leishmaniasis (CL is one of the health problems of many tropical and subtropical regions and is endemic in many parts of Iran especially. Cutaneous leishmaniasis not only is a health problem but also is a social and cultural problem in Iran. Education about health for high risk population seems to have a critical role in prevention of leishmaniasis and therefore evaluation of knowledge, attitude and performance are of importance. For the success of prevention and control programs of any disease, the most important prerequisite is community participation. Program implementers need to understand the disease-related knowledge, attitude, and practices (KAP of the community, because these are the important determinants of community participation. There are no data from Iran focusing on these aspects, and thus this study presents the information on KAP related to cutaneous leishmaniasis (C.L in Iran. Methods In this study 166 mothers that had at least one child with CL were studied. Data collection was performed using questionnaires that were designed by epidemiologist and were analyzed using SPSS software. Results The mean of KAP score was 15.7 ± 1.6 (range of 11.5–19. 48 mothers (28.9% had weak KAP, 79 mothers (47.6% had average KAP and 39 mothers (23.5% had excellent KAP. Conclusion According to our results, about 28.9% the mothers had inappropriate KAP score about leishmaniasis highlighting the fact that at least one third of the Isfahan population needs practical education about combating with leishamaniasis. To close the gap between the knowledge and practice of the mothers, face to face education and use of instructional aides are recommended.

  6. Urban Transmission of American Cutaneous Leishmaniasis in Argentina: Spatial Analysis Study

    Science.gov (United States)

    Gil, José F.; Nasser, Julio R.; Cajal, Silvana P.; Juarez, Marisa; Acosta, Norma; Cimino, Rubén O.; Diosque, Patricio; Krolewiecki, Alejandro J.

    2010-01-01

    We used kernel density and scan statistics to examine the spatial distribution of cases of pediatric and adult American cutaneous leishmaniasis in an urban disease-endemic area in Salta Province, Argentina. Spatial analysis was used for the whole population and stratified by women > 14 years of age (n = 159), men > 14 years of age (n = 667), and children < 15 years of age (n = 213). Although kernel density for adults encompassed nearly the entire city, distribution in children was most prevalent in the peripheral areas of the city. Scan statistic analysis for adult males, adult females, and children found 11, 2, and 8 clusters, respectively. Clusters for children had the highest odds ratios (P < 0.05) and were located in proximity of plantations and secondary vegetation. The data from this study provide further evidence of the potential urban transmission of American cutaneous leishmaniasis in northern Argentina. PMID:20207869

  7. Chemotherapeutic potential of 17-AAG against cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis.

    Science.gov (United States)

    Santos, Diego M; Petersen, Antonio L O A; Celes, Fabiana S; Borges, Valeria M; Veras, Patricia S T; de Oliveira, Camila I

    2014-10-01

    Leishmaniasis remains a worldwide public health problem. The limited therapeutic options, drug toxicity and reports of resistance, reinforce the need for the development of new treatment options. Previously, we showed that 17-(allylamino)-17-demethoxygeldanamycin (17-AAG), a Heat Shock Protein 90 (HSP90)-specific inhibitor, reduces L. (L.) amazonensis infection in vitro. Herein, we expand the current knowledge on the leishmanicidal activity of 17-AAG against cutaneous leishmaniasis, employing an experimental model of infection with L. (V.) braziliensis. Exposure of axenic L. (V.) braziliensis promastigotes to 17-AAG resulted in direct dose-dependent parasite killing. These results were extended to L. (V.) braziliensis-infected macrophages, an effect that was dissociated from the production of nitric oxide (NO), superoxide (O(-2)) or inflammatory mediators such as TNF-α, IL-6 and MCP-1. The leishmanicidal effect was then demonstrated in vivo, employing BALB/c mice infected with L. braziliensis. In this model, 17-AAG treatment resulted in smaller skin lesions and parasite counts were also significantly reduced. Lastly, 17-AAG showed a similar effect to amphotericin B regarding the ability to reduce parasite viability. 17-AAG effectively inhibited the growth of L. braziliensis, both in vitro and in vivo. Given the chronicity of L. (V.) braziliensis infection and its association with mucocutaneous leishmaniasis, 17-AAG can be envisaged as a new chemotherapeutic alternative for cutaneous Leishmaniasis.

  8. Obtaining membranes for alternative treatment hydrogels of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Oliveira, Maria Jose Alves de

    2013-01-01

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

  9. Sporotrichoid cutaneous leishmaniasis due to Leishmania major of different zymodemes in the Sudan and Saudi Arabia: a comparative study

    DEFF Research Database (Denmark)

    Gaafar, A; Fadl, A; el Kadaro, A Y

    1994-01-01

    Sporotrichoid cutaneous leishmaniasis is due to dissemination of amastigotes via the lymphatics to the subcutaneous tissues. A comparison was made between the potential to disseminate by this route of 2 parasites of different zymodemes in Sudan and Saudi Arabia. In Sudan cutaneous leishmaniasis...... is caused by Leishmania major zymodeme LON-1, and in Saudi Arabia by L. major LON-4. Sporotrichoid leishmaniasis was significantly more common in Sudan, occurring in 23% of patients compared with 10% in Saudi Arabia. Lymph node involvement was slightly more prevalent in the Sudan. Clinical and pathological...... differences between subcutaneous nodules, particularly when they ulcerate, and multiple primary cutaneous lesions are described and treatment of localized and sporotrichoid leishmaniasis is discussed. The pathological features of the primary lesions in the Sudan and Saudi Arabia were similar....

  10. Use of hematological parameters in evaluation of treatment efficacy in cutaneous leishmaniasis

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    Bilal Sula

    2015-12-01

    Full Text Available Objective: In the present study we investigated the role of hematological parameters, including neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, mean platelet volume and platelet distribution width in the evaluation of treatment efficacy in adult patients diagnosed with cutaneous leishmaniasis. Methods: The study group included 45 adult patients diagnosed with cutaneous leishmaniasis and treated as inpatients in the dermatology clinic between 2011 and 2014. A group of 45 healthy adults served as a control group. Results: Pre- and post-treatment white blood cell count, neutrophils, and lymphocytes were significantly reduced among the patient group relative to the control group. Platelet distribution width, red cell distribution width, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were significantly elevated among the patients compared to the healthy subjects. Pre-treatment white blood cell, lymphocyte and platelet counts were significantly elevated compared to post-treatment counts among the patient cohort. Treatment was associated with reduced eosinophil count, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio relative to pre-treatment status. Conclusion: Routine hematological testing results such as platelet/lymphocyte ratio, white blood cell count, neutrophil count, red cell distribution width, platelet distribution width, and mean platelet volume may be clinically significant markers of the inflammatory state useful in the evaluation of early treatment efficacy among patients with cutaneous leishmaniasis. J Microbiol Infect Dis 2015;5(4: 167-172

  11. Alterations of serum antioxidant trace elements (Se, Zn and Cu status in patients with cutaneous leishmaniasis

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    Leila Farzin

    2014-02-01

    Full Text Available Objective: To assess the serum antioxidant trace elements selenium (Se, zinc (Zn and copper (Cu in cutaneous leishmaniasis patients. Methods: In this study, serum Se, Zn and Cu was determined by using atomic absorption spectrometry in patients with cutaneous leishmaniasis (n=95. The values were statistically compared between patients and control group (n=100 using One-way analysis of variance (ANOVA. Results: Our results showed that there was a significant difference in the values of Se and Zn between two groups (P0.05. Se and Zn levels were found to be (4.33依1.06 and (70.23依19.12 µg/dL in cutaneous leishmaniasis cases, and these values were found statistically lower compared to the controls (11.10依2.37 and (119.61依26.18 µg/dL, respectively. Conclusions: The observations that host products are released from stimulated leukocytes and could induce metabolic changes similar to an acute-phase response revealed an endocrine role for the immune system. Characteristic changes in trace-mineral metabolism are an integral part of the acute-phase response. The changes are usually reflected in decreased serum Se and Zn concentrations.

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

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    Nilka Luisa Diaz

    2013-06-01

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

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

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    Liliana López

    2013-06-01

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

  14. Sandfly Surveillance within an Emerging Epidemic Focus ofCutaneous Leishmaniasis in Southeastern Iran

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    MR Yaghoobi-Ershadi

    2010-06-01

    Full Text Available "n "nBackground: Cutaneous leishmaniasis due to Leishmania major has become a hot topic in Iran. The objective of this study was to determine some ecological aspects of sand flies in the study area. "n "nMethods: Sand flies were collected biweekly from indoors and outdoors fixed places in the selected villages, using 30 sticky paper traps from the beginning to the end of the active season of 2006 in Kerman Province, south of Iran. The flies were mounted and identified. Some blood fed and gravid female sand flies of rodent burrows and indoors were dissected and examined microscopically for natural promastigote infection of Leishmania parasite during August to September. "n "nResults: In total, 2439 specimens comprising 8 species (3 Phlebotomus and 5 Sergentomyia were identified. The most common sand fly was P. papatasi and represented 87.1% of sand flies from indoors and 57.2% from outdoors. The activity of the species extended from April to end October. There are two peaks in the density curve of this species, one in June and the second in August. Natural promastigote infection was found in P. papatasi (12.7%. "n "nConclusion: Phlebotomus papatasi is considered as a probable vector among gerbils and to humans with a high percentage of promastigote infection in this new focus of cutaneous leishmaniasis. The Bahraman area which until recently was unknown as an endemic area seems now to represent a focus of zoonotic cutaneous leishmaniasis transmission in Iran.

  15. Comparison of oral itraconazole and intramuscular meglumine antimoniate in the treatment of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Saleem, K.; Rahman, A.

    2007-01-01

    To compare the efficacy and tolerability of oral itraconazole against intramuscular meglumine antimoniate in the treatment of Cutaneous Leishmaniasis (CL). Two hundred eligible and consenting patients of Cutaneous Leishmaniasis (CL) were divided in two groups with 100 patients in each. The number and location of the lesions were documented and clinical types of cutaneous leishmaniasis were noted. The diagnosis was confirmed by skin slit smear and histopathology of the lesional skin. Culture on Nicolle Novy MacNeal (NNN) medium and Leishmanin test was done in all patients. All the patients in both groups were subjected to complete blood picture, urine examination, serum urea and creatinine levels and ECG examination. One group was given itraconazole 100 mg twice daily orally for a duration of 6-8 weeks. The other group was given meglumine antimoniate 10 cc in the form of deep intramuscular injections for 15-30 days. The efficacy of the treatment was judged by clinical and parasitological response. Side effects of the agents were also noted during treatment. Out of 200 patients studied, 185 were males and 15 were females. The mean age of presentation was 30 + 6.6 years. Single lesion was seen in 132 (66%) subjects whereas 68 (34%) subjects had multiple lesions. Slit skin smears were positive in 50 (25%) of the patients. Skin biopsy yielded the presence of LT bodies in 150 (75%) subjects. The culture was positive in 102 (51%) cases. Leishmanin test was positive in 94% subjects. Seventy-five (75%) patients on itraconazole therapy showed complete clinical and parasitological cure in 4-8 weeks duration. A rise in ALT was seen in 12% subjects. Five (5%) subjects did not show any improvement till the end of therapy. Sixty-five (65%) subjects on meglumine antimoniate showed complete healing in 15-30 days. In 35 (35%) of the patients, the treatment had to be stopped due to intolerable side-effects. Four cases of lupoid leishmaniasis and 4 cases of sporotrichoid leishmaniasis

  16. Effect of topical honey application along with intralesional injection of glucantime in the treatment of cutaneous leishmaniasis

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    Moradi Shahram

    2007-04-01

    Full Text Available Abstract Background Leishmaniasis is an endemic disease in Iran. Although many treatments have been suggested for this disease, there hasn't been an effective and safe treatment yet. Regarding the healing effect of honey in the chronic ulcers and its reported therapeutic effect in cutaneous leishmaniasis, we performed a study to better evaluate the efficacy of honey in cutaneous leishmaniasis and its final scar. Methods In a prospective clinical trial, 100 patients with confirmed cutaneous leishmaniasis were selected and randomized into 2 groups. Group A were treated with topical honey twice daily along with intralesional injection of glucantime once weekly until complete healing of the ulcer or for maximum of 6 weeks. Group B were treated with intralesional injection of glucantime alone until complete healing of the ulcer or for a maximum of 6 weeks, too. The patients were followed for 4 months. The collected data were analyzed statistically using statistical tests including Chi-square, Mann Whitney and Kaplan – Mayer tests. Results In this study, 45 patients that had cutaneous leishmaniasis were treated with intralesional glucantime alone and 45 patients were treated with topical honey and glucantime . Ten patients left out the study. In the glucantime alone treated group, 32 patients (71.1% had complete cure whereas in the group treated with both glucantime & topical honey, 23 patients (51.1% achieved complete cure. This difference was significant statistically (p = 0.04. Conclusion Further studies to better clarify the efficacy of honey in cutaneous leishmaniasis is needed. We suggest that in another study, the efficacy of honey with standardized level of antibacterial activity is evaluated against cutaneous leishmaniasis.

  17. Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application: A treatment option for pediatric cutaneous leishmaniasis.

    Science.gov (United States)

    Hilerowicz, Yuval; Koren, Amir; Mashiah, Jacob; Katz, Oren; Sprecher, Eli; Artzi, Ofir

    2018-05-01

    Leishmaniasis is a protozoan zoonotic parasitic infection with cutaneous, mucocutaneous, and visceral manifestations. Israel is endemic for cutaneous leishmaniasis, which is a self-limited disease but is associated with scarring, which is often a source of psychological and social burden for patients. Scars can be especially devastating for children and teenagers. A wide range of physical and medical approaches is used to treat cutaneous leishmaniasis, among which intralesional injections of sodium stibogluconate rank among the most frequently used. Unfortunately, despite being effective, this therapeutic modality can be very painful. Fractional ablative laser creates a controlled mesh-like pattern of tissue ablation in the skin that promotes dermal remodeling and collagen production while at the same time facilitating enhanced delivery of topically applied medications. Patients were treated with fractional ablative carbon dioxide laser followed by immediate topical application of sodium stibogluconate. All children were diagnosed with cutaneous leishmaniasis prior to treatment initiation.. Ten children were treated. One leishmania tropica-positive girl failed to respond. The other nine patients achieved clinical cure and demonstrated good to excellent final cosmesis. Self-rated patient satisfaction and tolerance were high No adverse effects were observed or reported during treatment. Fractional ablative carbon dioxide laser followed by topical sodium stibogluconate application appears to be a safe and promising treatment for cutaneous leishmaniasis infection in children. Future controlled studies are required to validate these findings and compare this technique with traditional approaches. © 2018 Wiley Periodicals, Inc.

  18. Reactivation of cutaneous and mucocutaneous tegumentary leishmaniasis in rheumatoid arthritis patients: an emerging problem?

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    Regina Maia de Souza

    Full Text Available ABSTRACT Rheumatoid arthritis (RA is a chronic condition that is frequent in patients living in tropical areas exposed to leishmaniasis. RA therapy involves immunosuppressant drugs such as methotrexate (MTX, monoclonal antibodies (mAbs and prednisone. We report an unusual presentation of cutaneous (CL or mucocutaneous leishmaniasis (ML in RA patients from an endemic area of leishmaniasis. A 51-year-old woman noted a cutaneous ulcer on her left ankle during MTX and prednisone RA therapy. Initially diagnosed as a venous stasis ulcer, the aspirate of the injury revealed the presence of Leishmania DNA. A 73-year-old woman presenting non-ulcerated, infiltrated and painful erythematous nodules inside her nostrils while receiving MTX, anti-TNF mAb, and prednisone for RA, had also the aspirate of injuries showing the presence of Leishmania DNA. Both patients healed after the therapy with liposomal amphotericin. The RA therapy has changed to low-dose prednisone, without further reactivation episodes. Both cases suggest that CL or ML can reactivate after administration of an immunosuppressant for RA treatment. Therefore, immunosuppressive treatments for RA should be carefully prescribed in patients from endemic areas or with a history of CL and ML.

  19. Oral metabolism and efficacy of Kalanchoe pinnata flavonoids in a murine model of cutaneous leishmaniasis.

    Science.gov (United States)

    Muzitano, Michelle F; Falcão, Camila A B; Cruz, Elaine A; Bergonzi, Maria C; Bilia, Anna R; Vincieri, Franco F; Rossi-Bergmann, Bartira; Costa, Sônia S

    2009-03-01

    Leishmaniasis is a parasitic disease that threatens 350 million people worldwide. In a search for new antileishmanial drugs, the in vitro activity of flavonoids from Kalanchoe pinnata (Crassulaceae) was previously demonstrated in infected cells. In order to demonstrate the safety and oral activity of K. pinnata, flavonoids were evaluated in vivo in a murine model of cutaneous leishmaniasis. Daily oral doses of quercetin 3-O-alpha-L-arabinopyranosyl (1-->2)-alpha-L-rhamnopyranoside, quercetin 3-O-alpha-L-rhamnopyranoside, and free quercetin (16 mg/kg body weight) all were able to control the lesion growth caused by Leishmania amazonensis and to significantly reduce parasite load. These flavonoids were as effective as the crude K. pinnata aqueous extract given at 320 mg/kg body weight. HPLC-DAD-MS analysis of the plasma of extract-treated mice suggested that quercetin and quercetin glucuronides are the main metabolites of K. pinnata quercetin glycosides. Our results indicate that K. pinnata quercetin glycosides are important active components of the aqueous extract and that they possess potent oral efficacy against cutaneous leishmaniasis.

  20. Leishmaniasis cutánea difusa en un paciente con sida Diffuse cutaneous leishmaniasis in a patient with AIDS

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    Carlos Pérez

    2006-12-01

    .Objective: A patient with a leishmaniasis-Aids co-infection was presented and discussed.
    Methods and results: A 29-year -old soldiier, coming from the Province of San José del Guaviare, Colombia, complained of a weight loss of 18 kgs in the previous ten months as well as a two-month-old cutaneous leision. Elisa and Western blot tests were positive for HIV infection. LT CD4 were 92/mm3. He had a generalized erythematous, psoriasiform dermal lesion,which, upon biopsy, revealed an abundance of phagocytosed microorganisms that stained black with Gomory's technique. Disseminated histoplasmosis was diagnosed. The patient received anti-retroviral therapy and itraconazole, without regression of the lesions. Amphotericin B was beneficial but the lesions recurred several months later, more numerous, nodular and with occurrence in the oral mucosa. Nine months after the initial diagnosis additional skin biopsies and review of the previous biopsies established that the patient had diffuse cutaneous leishmaniasis. The leishmania parasite did not grow in culture. Miltefosine produced marked improvement, but the lesions recurred and were cured finally with 52 Glucantime® injections administered for two months. Presently, the patient remains in good condition 21 months after diagnosis of leishmaniasis.
    Conclusions: Diffuse cutaneous leishmaniasis may be a common clinical manifestation when leishmaniasis and AIDS co-occur. Its treatment is difficult and must include an antiparasitic drug as well as prophylactic,and anti-retroviral therapy. Leishmania amastigotes typically are not Gomory-positive and can be differentiated from Histoplasma by morphology, immunohistochemistry, culture, antibody-specific response and PCR. The leishmaniasis-AIDS co-infection enhances invasive capacity for both causal microorganisms. Increasing case numbers can be expected in Colombia, due to the high frequency of both diseases.

  1. Canine cutaneous leishmaniasis caused by neotropical Leishmania infantum despite of systemic disease: A case report.

    Science.gov (United States)

    Cavalcanti, Amanda; Lobo, Rogério; Cupolillo, Elisa; Bustamante, Fábio; Porrozzi, Renato

    2012-12-01

    Visceral leishmaniasis is an anthropozoonosis caused by a protozoan Leishmania infantum (syn. Leishmania chagasi). Here, we report a typical case of canine cutaneous leishmaniasis due to L. infantum infection without any other systemic symptom in one dog in the city of Rio de Janeiro, Brazil. A mongrel female dog was admitted in a veterinary clinic with reports of chronic wounds in the body. Physical examination revealed erosive lesions in the limbs, nasal ulcers, presence of ectoparasites and seborrheic dermatitis. Blood samples and fragments of healthy and injured skin were collected. The complete hemogram revealed aregenerative normocytic normochromic anemia and erythrocyte rouleaux, and biochemical analysis revealed normal renal and hepatic functions. Cytology of the muzzle and skin lesions suggested pyogranulomatous inflammatory process. The histopathology of a skin fragment was performed and revealed suspicion of protozoa accompanied by necrotizing dermatitis. The diagnosis of leishmaniasis was accomplished by positive serology, isolation of Leishmania from the skin lesion, and also by molecular test (PCR targeting the conserved region of Leishmania kDNA). Culture was positive for damaged skin samples. PCR targeting a fragment of Leishmania hsp70 gene was performed employing DNA extracted from damaged skin. RFLP of the amplified hsp70 fragment identified the parasite as L. infantum, instead of Leishmania braziliensis, the main agent of cutaneous leishmaniasis in Rio de Janeiro. Characterization of isolated promastigotes by five different enzymatic systems confirmed the species identification of the etiological agent. Serology was positive by ELISA and rapid test. This case warns to the suspicion of viscerotropic Leishmania in cases of chronic skin lesions and brings the discussion of the mechanisms involved in the parasite tissue tropism. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. INFLUENCE OF MICROBIOTA IN EXPERIMENTAL CUTANEOUS LEISHMANIASIS IN SWISS MICE

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    OLIVEIRA Marcia Rosa de

    1999-01-01

    Full Text Available Infection of Swiss/NIH mice with Leishmania major was compared with infection in isogenic resistant C57BL/6 and susceptible BALB/c mice. Swiss/NIH mice showed self-controlled lesions in the injected foot pad. The production of high levels of interferon-g (IFN-g and low levels of interleukin-4 (IL-4 by cells from these animals suggests that they mount a Th1-type immune response. The importance of the indigenous microbiota on the development of murine leishmaniasis was investigated by infecting germfree Swiss/NIH in the hind footpad with L. major and conventionalizing after 3 weeks of infection. Lesions from conventionalized Swiss/NIH mice were significantly larger than conventional mice. Histopathological analysis of lesions from conventionalized animals showed abscesses of variable shapes and sizes and high numbers of parasitized macrophages. In the lesions from conventional mice, besides the absence of abscess formation, parasites were rarely observed. On the other hand, cells from conventional and conventionalized mice produced similar Th1-type response characterized by high levels of IFN-g and low levels of IL-4. In this study, we demonstrated that Swiss/NIH mice are resistant to L. major infection and that the absence of the normal microbiota at the beginning of infection significantly influenced the lesion size and the inflammatory response at the site of infection.

  3. Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc supplementation together with antimony treatment

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    Miguel Guzman-Rivero

    2014-11-01

    Full Text Available Background: The role of micronutrient status for the incidence and clinical course of cutaneous leishmaniasis is not much studied. Still zinc supplementation in leishmaniasis has shown some effect on the clinical recovery, but the evidence in humans is limited. Objective: To compare biochemical nutritional status in cutaneous leishmaniasis patients with that in controls and to study the effects of zinc supplementation for 60 days. Design: Twenty-nine patients with cutaneous leishmaniasis were treated with antimony for 20 days. Fourteen of them got 45 mg zinc daily and 15 of them got placebo. Biomarkers of nutritional and inflammatory status and changes in size and characteristics of skin lesions were measured. Results: The level of transferrin receptor was higher in patients than in controls but otherwise no differences in nutritional status were found between patients and controls. No significant effects of zinc supplementation on the clinical recovery were observed as assessed by lesion area reduction and characteristics or on biochemical parameters. Conclusions: It is concluded that nutritional status was essentially unaffected in cutaneous leishmaniasis and that oral zinc supplementation administered together with intramuscular injection of antimony had no additional clinical benefit.

  4. Efficacy of thermotherapy to treat cutaneous leishmaniasis: a meta-analysis of controlled clinical trials.

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    Jaiberth Antonio Cardona-Arias

    Full Text Available The efficacy of thermotherapy for the treatment of cutaneous leishmaniasis presents diverse results with low statistical power.To evaluate the efficacy of thermotherapy to treat cutaneous leishmaniasis.A meta-analysis of controlled clinical trials in 12 databases based on the implementation of a research protocol with inclusion and exclusion criteria and an assessment of methodological quality. The reproducibility and completeness were guaranteed in the information search and extraction. Heterogeneity, sensitivity and publication bias were assessed by graphical methods (Galbraith, L'Abblé, funnel plot, Egger plot, and influence plot and analytical methods (DerSimonian-Laird, Begg and Egger. Random-effects forest plots were constructed, and a cumulative meta-analysis was performed.Eight studies were included with 622 patients who underwent thermotherapy, with an efficacy of 73.2% (95% confidence interval (CI = 69.6-76.7%, and with 667 patients who underwent systemic treatment, with an efficacy of 70.6% (95% CI=67.1-74.1%. Heterogeneity between studies, good sensitivity for the combined measure, and no publication bias were observed. The relative risk for comparison of the efficacy of treatment was 1.02 (95%CI=0.91, 1.15, showing that the effectiveness of thermotherapy is equal to that of pentavalent antimonial drugs.Due to its efficacy, greater safety and lower cost, thermotherapy should be the first treatment option for cutaneous leishmaniasis in areas where the prevalence of the mucocutaneous form is low and in patients with contraindications to systemic treatment, such as kidney, liver and heart diseases, as well as in pregnant women, infants, and patients with human immunodeficiency virus infection/acquired immune deficiency syndrome.

  5. Comprehensive economic evaluation of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia.

    Science.gov (United States)

    Cardona-Arias, Jaiberth Antonio; López-Carvajal, Liliana; Tamayo-Plata, Mery Patricia; Vélez, Iván Darío

    2018-01-29

    Cutaneous leishmaniasis causes a high disease burden in Colombia, and available treatments present systemic toxicity, low patient compliance, contraindications, and high costs. The purpose of this study was to estimate the cost-effectiveness of thermotherapy versus Glucantime in patients with cutaneous leishmaniasis in Colombia. Cost-effectiveness study from an institutional perspective in 8133 incident cases. Data on therapeutic efficacy and safety were included, calculating standard costs; the outcomes were disability adjusted life years (DALYs) and the number of patients cured. The information sources were the Colombian Public Health Surveillance System, disease burden studies, and one meta-analysis of controlled clinical trials. Incremental cost-effectiveness was determined, and uncertainty was evaluated with tornado diagrams and Monte Carlo simulations. Thermotherapy would generate costs of US$ 501,621; the handling of adverse effects, US$ 29,224; and therapeutic failures, US$ 300,053. For Glucantime, these costs would be US$ 2,731,276, US$ 58,254, and US$ 406,298, respectively. With thermotherapy, the cost would be US$ 2062 per DALY averted and US$ 69 per patient cured; with Glucantime, the cost would be US$ 4241 per DALY averted and US$ 85 per patient cured. In Monte Carlo simulations, thermotherapy was the dominant strategy for DALYs averted in 67.9% of cases and highly cost-effective for patients cured in 72%. In Colombia, thermotherapy can be included as a cost-effective strategy for the management of cutaneous leishmaniasis. Its incorporation into clinical practice guidelines could represent savings of approximately US$ 10,488 per DALY averted and costs of US$ 116 per additional patient cured, compared to the use of Glucantime. These findings show the relevance of the incorporation of this treatment in our country and others with similar parasitological, clinical, and epidemiological patterns.

  6. Report of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in a cutaneous-leishmaniasis-endemic area of Panama.

    Science.gov (United States)

    Valderrama, Anayansi; Tavares, Mara Garcia; Andrade Filho, José Dilermando

    2011-12-01

    Lutzomyia longipalpis is the primary vector of the parasite responsible for visceral leishmaniasis in the Americas. In the present study, Lu. longipalpis was found in a domiciliary area in Limón, a district in Capira, a region in which cutaneous leishmaniasis is endemic in Panama. Previously, this species has been found in a humid forest in this same region. Finding Lu. longipalpis in domiciliary areas indicates that this species may be adapting to new habitats and that it may play a role in the transmission of leishmaniasis in Panama.

  7. Plasma levels of interlukin-4 and Interferon- in patients with chronic or healed cutaneous leishmaniasis

    OpenAIRE

    Ahmad Reza Taheri; Vahid Mashayekhi Goyonlo; Yalda Nahidi; Nasrin Moheghi; Jalil Tavakkol Afshari

    2014-01-01

    Objective(s): In this study, the serum level of interferon-γ (IFN- γ) and interlukin-4 (IL-4) was evaluated as a marker of Th1 and Th2 immune response that influence the clinical course of cutaneous leishmaniasis . Materials and Methods: This cross-sectional study was conducted on 44 cases of cutaneous leishmaniasis (21 cases with healed lesions and 23 cases with chronic non-healing lesions. Thirty-two non-infected persons living in the area were considered as controls. Serum levels of IFN- γ...

  8. Imaging of the host/parasite interplay in cutaneous leishmaniasis.

    Science.gov (United States)

    Millington, Owain R; Myburgh, Elmarie; Mottram, Jeremy C; Alexander, James

    2010-11-01

    An understanding of host-parasite interplay is essential for the development of therapeutics and vaccines. Immunoparasitologists have learned a great deal from 'conventional'in vitro and in vivo approaches, but recent developments in imaging technologies have provided us (immunologists and parasitologists) with the ability to ask new and exciting questions about the dynamic nature of the parasite-immune system interface. These studies are providing us with new insights into the mechanisms involved in the initiation of a Leishmania infection and the consequent induction and regulation of the immune response. Here, we review some of the recent developments and discuss how these observations can be further developed to understand the immunology of cutaneous Leishmania infection in vivo. (c) 2010 Elsevier Inc. All rights reserved.

  9. Distinct ultrastructural aspects in different biopsies of a single patient with diffuse cutaneous leishmaniasis

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    Achilea Lisboa Bittencourt

    1990-03-01

    Full Text Available The authors investigated the relation between parasites and host-cells in active and regressed lesions of a patient with diffuse cutaneous leishmaniasis, evaluating the frequency of different cell types, and the location and integrity of amastigotes. No correlation was found between parasite integrity and size of parasitophorous vacuoles. They observed ultrastructural findings characterizing a cell mediated immune response: macrophages lysis, parasitic destruction inside macrophages, close contact between parasitized macrophages and lymphocytes and between parasites and lymphocytes, lymphocytic infiltration and fibrosis. They suggest that in DCL there is a limited cellular immune response, although insufficient to control infection.

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

    DEFF Research Database (Denmark)

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

    2000-01-01

    The skin lesions of five patient volunteers with dry-type cutaneous leishmaniasis were treated by intralesional injection of auto-leukocytes prepared from buffy coat of the patient's own blood. Giemsa stained, air-dried cytological smear preparations were prepared from scrapings taken from...... the margins of the lesions. The cellular interaction between the organism and the inflammatory response of the host was studied. All lesions showed clinical evidence of regression. The cytological findings suggested progressive degradation of the Leishman donovan (LD) bodies within the parasitophorous...

  11. Sandfly Lutzomyia longipalpis in a Cutaneous leishmaniasis focus in central Colombia.

    Science.gov (United States)

    López, Y; Osorio, L; Alvarez, G; Rojas, J; Jiménez, F; Gómez, C; Ferro, C

    1996-01-01

    Lutzomyia longipalpis, 15 other species of the genus Lutzomyia, and one species of Brumptomyia were collected in an endemic focus of cutaneous leishmaniasis in a river canyon 450 m above sea-level, in Rio Claro, Antioquia, Colombia. The presence of Lu. longipalpis is associated with the destruction of the primary forest and the development of new farmland and rural settlement in this region. The composition of species identified a different habitat for Lu. longipalpis in Colombia. Lu. yuilli and Lu. longipalpis were predominant (68.26%) followed by Lu. trapidoi, Lu. hartmani, Lu. triramula, Lu. panamensis, Lu. gomezi.

  12. Sporotrichosis in Iran: A mini review of reported cases in patients suspected to cutaneous leishmaniasis

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    shahram mahmoudi

    2015-03-01

    Full Text Available Sporotrichosis is a chronic subcutaneous fungal infection with global distribution. It is a rare fungal infection with nine reported cases in Iran, including eight humans and one animal, within the past 30 years. Among the human cases, seven were of the fixed cutaneous type of sporotrichosis and one had sporotrichoid lymphocutaneous. The reported patients were within the age range of 23-60 years, and six of them were female. The most frequent sites of infection were forearms and hands, as well as the face and legs. In addition, the majority of the cases had previously been suspected of leishmaniasis and received treatment. Sporotrichosis is not a well-known condition in Iran and is often misdiagnosed and erroneously treated for other cutaneous parasitic or bacterial infections with similar clinical manifestations. Therefore, sporotrichosis should be taken into account in the differential diagnosis of nodular-ulcerative skin lesions.

  13. Sporotrichosis in Iran: A mini review of reported cases in patients suspected to cutaneous leishmaniasis

    Science.gov (United States)

    Mahmoudi, S; Zaini, F

    2015-01-01

    Sporotrichosis is a chronic subcutaneous fungal infection with global distribution. It is a rare fungal infection with nine reported cases in Iran, including eight humans and one animal, within the past 30 years. Among the human cases, seven were of the fixed cutaneous type of sporotrichosis and one had sporotrichoid lymphocutaneous. The reported patients were within the age range of 23-60 years, and six of them were female. The most frequent sites of infection were forearms and hands, as well as the face and legs. In addition, the majority of the cases had previously been suspected of leishmaniasis and received treatment. Sporotrichosis is not a well-known condition in Iran and is often misdiagnosed and erroneously treated for other cutaneous parasitic or bacterial infections with similar clinical manifestations. Therefore, sporotrichosis should be taken into account in the differential diagnosis of nodular-ulcerative skin lesions. PMID:28680987

  14. Control of zoonotic cutaneous leishmaniasis vector, Phlebotomus papatasi, using attractive toxic sugar baits (ATSB.

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    Abedin Saghafipour

    Full Text Available Attractive Toxic Sugar Baits (ATSB is a new vector control method that meets Integrated Vector Management (IVM goals. In an experimental design, this study aimed to determine effects of ATSB on control of Phlebotomus papatasi, as a main vector of Zoonotic Cutaneous Leishmaniasis (ZCL, in Qom Province, center of Iran.In a cross-sectional design, boric acid was mixed with brown sugar solution and tested as toxic baits for P. papatasi. Two methods were utilized to use the baits: (a spraying ATSB on vegetation, bushes, and shrubs; and (b setting ATSB-treated barrier fences in front of colonies at 500 m distance from the houses in outskirts of villages. In order to examine the residual efficacy rate of ATSB-treated barrier fences, the bioassay test was used. Density of P. papatasi sandflies was measured using sticky and light traps biweekly. For data analysis, Mann-Whitney U Test and Kruskal-Wallis were used. Results ATSB-treated barrier fences led to 3 times reduction in P. papatasi population. Besides that, ATSB spraying on plants led to more than 5 times reduction in P. papatasi population.Comparing the incidence of leishmaniasis in treated villages before and after the study showed that the incidence was statistically reduced. Therefore, ATSB is an effective method to control vectors and prevent leishmaniasis.

  15. A novel non-invasive diagnostic sampling technique for cutaneous leishmaniasis.

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    Yasaman Taslimi

    2017-07-01

    Full Text Available Accurate diagnosis of cutaneous leishmaniasis (CL is important for chemotherapy and epidemiological studies. Common approaches for Leishmania detection involve the invasive collection of specimens for direct identification of amastigotes by microscopy and the culturing of promastigotes from infected tissues. Although these techniques are highly specific, they require highly skilled health workers and have the inherent risks of all invasive procedures, such as pain and risk of bacterial and fungal super-infection. Therefore, it is essential to reduce discomfort, potential infection and scarring caused by invasive diagnostic approaches especially for children. In this report, we present a novel non-invasive method, that is painless, rapid and user-friendly, using sequential tape strips for sampling and isolation of DNA from the surface of active and healed skin lesions of CL patients. A total of 119 patients suspected of suffering from cutaneous leishmaniasis with different clinical manifestations were recruited and samples were collected both from their lesions and from uninfected areas. In addition, 15 fungal-infected lesions and 54 areas of healthy skin were examined. The duration of sampling is short (less than one minute and species identification by PCR is highly specific and sensitive. The sequential tape stripping sampling method is a sensitive, non-invasive and cost-effective alternative to traditional diagnostic assays and it is suitable for field studies as well as for use in health care centers.

  16. Early Cutaneous Leishmaniasis Patients Infected With Leishmania braziliensis Express Increased Inflammatory Responses After Antimony Therapy.

    Science.gov (United States)

    Costa, Rúbia S; Carvalho, Lucas P; Campos, Taís M; Magalhães, Andréa S; Passos, Sara T; Schriefer, Albert; Silva, Juliana A; Lago, Ednaldo; Paixão, Camilla S; Machado, Paulo; Scott, Phillip; Carvalho, Edgar M

    2018-02-14

    Early cutaneous leishmaniasis (ECL) is characterized by a nonulcerated papular lesion and illness duration less than 30 days. Approximately 4 weeks later, the cutaneous leishmaniasis (CL) ulcers appear. We were surprised to find that failure after antimony therapy (Sb5) is higher in ECL than CL. We hypothesize that the inflammatory response in ECL patients may increase during Sb5 therapy, which leads to treatment failure. A cohort of 44 ECL patients infected by Leishmania braziliensis was established to evaluate the response to Sb5 and to compare immunologic responses in ECL patients with CL and healthy subjects. A hierarchical clustering based on cytokine levels showed a weak positive correlation between proinflammatory cytokine levels and those patients that failed Sb5 treatment. Although Sb5 therapy decreased interferon-γ and tumor necrosis factor levels in CL patients, we were surprised to find that an increase in these cytokines was observed in ECL patients. Moreover, interleukin (IL)-10 was less able to down-modulate immune responses in ECL. The enhanced production of proinflammatory cytokines, due in part to the decreased ability of IL-10 to down-modulate immune response during therapy in ECL, promotes the development and persistence of leishmania ulcer despite antimony therapy. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  17. Is the Dog a Possible Reservoir for Cutaneous Leishmaniasis in Suriname?

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    Alida Kent

    2013-01-01

    Full Text Available Cutaneous leishmaniasis (CL is an emerging disease in Suriname, with at least 200 cases per year. Little is known about the biology of CL in the country. The most important parasite species is Leishmania Viannia guyanensis, but possible vectors and reservoirs are hardly incriminated. In the present study, it was investigated whether the dog could possibly be a zoonotic reservoir for the disease in Suriname. Forty-seven dogs were examined for overt clinical signs of leishmaniasis, and blood samples were collected on filter paper for serology (direct agglutination test and molecular biology (by polymerase chain reaction. Three dogs had clinical signs that could be compatible with canine cutaneous leishmaniosis: dermatitis (two or nasal lesion (one. Two dogs were seropositive with DAT (titre > 1 : 1600, and three animals had a borderline titre (1 : 800. All other animals (n=42 were DAT negative. PCR analysis found Leishmania DNA equivalent to 1 parasite per mL in only one dog at a first round of analysis, but this animal was negative after retesting. The clinical, serological, and molecular data show some preliminary lines of evidence that canine leishmaniosis is present in Suriname, but further studies are needed to incriminate the reservoir, including a possible sylvatic cycle.

  18. Utility of Western Blot Analysis for the Diagnosis of Cutaneous Leishmaniasis

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    Marzieh ASHRAFMANSOURI

    2015-12-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is a parasitic disease with a relatively wide distribution in different areas of the world, including Iran. The parasite is mainly diagnosed microscopically, but serological approaches might be useful for diagnosis as well.  This study aimed to assess the efficacy of an immunoblotting system for serodiagnosis of cutaneous leishmaniasis in Iran.Methods: Sixty-one sera samples from parasitologically confirmed CL patients and 50 sera samples from healthy controls along with 50 sera sample from non-CL patients were collected. Native strain of Leishmania major was cultured in Schnei­der medium and soluble Leishmania antigens were prepared from amastigotes-like parasites. All of sera samples were evaluated by an immunoblot­ting system.Results: Components of 14 to 135 kDa were detectable by the sera of CL pa­tients. From 61 sera of CL patients, 59 cases (96.7% detected a 63 kDa subunit and 51 cases (83.6% recognized a 32-35 kDa component. Among all subunits, the 63 kDa band showed the highest sensitivity (96.7% and a 75 kDa band had the highest (98% specificity.Conclusion: Immunoblotting has a satisfactory performance in diagnosis of CL and this test can be used, as an aid, for proper diagnosis of CL.

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

    Directory of Open Access Journals (Sweden)

    Wilson Mayrink

    2010-02-01

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

  20. Cost-effectiveness analysis of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis.

    Science.gov (United States)

    Cardona-Arias, Jaiberth Antonio; López-Carvajal, Liliana; Tamayo Plata, Mery Patricia; Vélez, Iván Darío

    2017-05-01

    The treatment of cutaneous leishmaniasis is toxic, has contraindications, and a high cost. The objective of this study was to estimate the cost-effectiveness of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis. Effectiveness was the proportion of healing and safety with the adverse effects; these parameters were estimated from a controlled clinical trial and a meta-analysis. A standard costing was conducted. Average and incremental cost-effectiveness ratios were estimated. The uncertainty regarding effectiveness, safety, and costs was determined through sensitivity analyses. The total costs were $66,807 with Glucantime and $14,079 with thermotherapy. The therapeutic effectiveness rates were 64.2% for thermotherapy and 85.1% for Glucantime. The average cost-effectiveness ratios ranged between $721 and $1275 for Glucantime and between $187 and $390 for thermotherapy. Based on the meta-analysis, thermotherapy may be a dominant strategy. The excellent cost-effectiveness ratio of thermotherapy shows the relevance of its inclusion in guidelines for the treatment. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  1. Wound healing genes and susceptibility to cutaneous leishmaniasis in Brazil: Role of COL1A1

    Science.gov (United States)

    Almeida, Lucas; Oliveira, Joyce; Guimarães, Luiz Henrique; Carvalho, Edgar M; Blackwell, Jenefer M

    2015-01-01

    Previous studies have demonstrated a role for wound healing genes in resolution of cutaneous lesions caused by Leishmania spp. in both mice and humans, including the gene FLI1 encoding Friend leukaemia virus integration 1. Reduction of Fli1 expression in mice has been shown to result in up-regulation of collagen type I alpha 1 (Col1a1) and alpha 2 (Col1a2) genes and, conversely, in down-regulation of the matrix metalloproteinase 1 (Mmp1) gene, suggesting that Fli1 suppression is involved in activation of the profibrotic gene program. Here we examined single nucleotide polymorphisms (SNPs) in these genes as risk factors for cutaneous (CL) and mucosal leishmaniasis (ML), and leishmaniasis per se, caused by L. braziliensis in humans. SNPs were genotyped in 168 nuclear families (250 CL; 87 ML cases) and replicated in 157 families (402 CL; 39 ML cases). Family-based association tests (FBAT) showed the strongest association between SNPs rs1061237 (combined P=0.002) and rs2586488 (combined P=0.027) at COL1A1 and CL disease. This contributes to our further understanding of the role of wound healing in the resolution of CL disease, providing potential for therapies modulating COL1A1 via drugs acting on FLI1. PMID:25562121

  2. Linking Climate to Incidence of Zoonotic Cutaneous Leishmaniasis (L. major) in Pre-Saharan North Africa

    Science.gov (United States)

    Bounoua, Lahouari; Kahime, Kholoud; Houti, Leila; Blakey, Tara; Ebi, Kristie L.; Zhang, Ping; Imhoff, Marc L.; Thome, Kurtis J.; Dudek, Claire; Sahabi, Salah A.; hide

    2013-01-01

    Shifts in surface climate may have changed the dynamic of zoonotic cutaneous leishmaniasis (ZCL) in the pre-Saharan zones of North Africa. Caused by Leishmania major, this form multiplies in the body of rodents serving as reservoirs of the disease. The parasite is then transmitted to human hosts by the bite of a Phlebotomine sand fly (Diptera: Psychodidae) that was previously fed by biting an infected reservoir. We examine the seasonal and interannual dynamics of the incidence of this ZCL as a function of surface climate indicators in two regions covering a large area of the semi-arid Pre-Saharan North Africa. Results suggest that in this area, changes in climate may have initiated a trophic cascade that resulted in an increase in ZCL incidence. We find the correlation between the rainy season precipitation and the same year Normalized Difference Vegetation Index (NDVI) to be strong for both regions while the number of cases of ZCL incidence lags the precipitation and NDVI by 2 years. The zoonotic cutaneous leishmaniasis seasonal dynamic appears to be controlled by minimum temperatures and presents a 2-month lag between the reported infection date and the presumed date when the infection actually occurred. The decadal increase in the number of ZCL occurrence in the region suggests that changes in climate increased minimum temperatures sufficiently and created conditions suitable for endemicity that did not previously exist. We also find that temperatures above a critical range suppress ZCL incidence by limiting the vector's reproductive activity.

  3. [Lutzomyia antunesi as suspected vector of cutaneous leishmaniasis in the Orinoquian region of Colombia].

    Science.gov (United States)

    Vásquez-Trujillo, Adolfo; Santamaría-Herreño, Erika; González-Reina, Angélica E; Buitrago-Alvarez, Luz S; Góngora-Orjuela, Agustín; Cabrera-Quintero, Olga L

    2008-01-01

    Identifying probable cutaneous leishmaniasis vectors in a rural area a few kilometres from the city of Villavicencio, taking the relative abundance of sand-flies and their natural infection with Leishmania spphaving into account. A CDC trap was used for sampling sand-flies in and around 15 dwellings. Pools of three females from the most abundant Lutzomyia species were used for identifying Leishmania spp. by PCR, with OL1 and OL2 primers. 1 304 sand-flies from nine species were captured, of which L. antunesi (75,6 %) and L. walkeri (19,2 %) were the most abundant. These was a low abundance of L. panamensis and L. gomezi anthropophilic species (<2,4 %). PCR detected Leishmania spp. infection in two L. antunesi groups (total=123 processed females). Due to the fact that L. antunesi was the most abundant species and was found to have Leishmania infection, it may be considered to be the main suspected cutaneous leishmaniasis vector in the rural area being studied. It is recommended that detailed studies of this species' biology (including biting and resting behaviour) should be carried out, aimed at furthering vector control measures.

  4. Topical terbinafine in the treatment of cutaneous leishmaniasis: triple blind randomized clinical trial.

    Science.gov (United States)

    Farajzadeh, Saeedeh; Heshmatkhah, Amireh; Vares, Behrooz; Mohebbi, Elham; Mohebbi, Azadeh; Aflatoonian, Mahin; Eybpoosh, Sana; Sharifi, Iraj; Aflatoonian, Mohammad Reza; Shamsi Meymandi, Simin; Fekri, Ali Reza; Mostafavi, Mahshid

    2016-12-01

    Leishmaniasis is a spectrum of disease condition with considerable health impacts, caused by different species of Leishmania . This disease is currently endemic in 98 countries and territories in the world. There are many treatment modalities for cutaneous leishmaniasis. The use of topical terbinafine in the treatment of cutaneous leishmaniasis has recently been considered. Eighty-eight participants more than two years old with proven acute CL by a positive direct smear were randomly allocated to one of the two study arms: first group received meglumine antimoniate (Glucantime) 20 mg/kg/day intramuscular injection (IM) plus a placebo ointment (Mahan Vaseline) for 20 days. The second group received meglumine antimoniate (Glucantime) 20 mg/kg/day IM plus topical terbinafine, for 20 days and were monitored closely by dermatologist during the course of the study. Crude regression analysis showed that there was no significant difference between placebo and intervention group regarding partial or complete treatment (partial treatment: HR crude  = 1.1, CI 95 % = 0.7-1.7; complete treatment: HR crude  = 1.1, CI 95 % = 0.8-1.7). Although, there was no statistically significant different between the two treatment groups, but clinically it seems that the treatment rate in those who receive glucantime plus terbinafine was more effective than the other group. However this rate depended on the type of lesions. As data indicated ulcerated nodules, papules and plaque in experimental group have been completely improved two times faster than placebo group. Ulcerated nodules, nodules and plaque were partially improved faster in those used tebinafine than placebo ointment.

  5. Prevalence of cutaneous leishmaniasis along the Nile River north of Khartoum (Sudan) in the aftermath of an epidemic in 1985

    DEFF Research Database (Denmark)

    Kadaro, A Y; Ghalib, H W; Ali, M S

    1993-01-01

    Based on a pilot clinical study of the prevalence of cutaneous leishmaniasis (CL) among school children in villages on both banks of the Nile River north of Khartoum, Sudan in the aftermath of a 1985 epidemic, we studied a random sample (303 individuals) from one of these villages to determine...

  6. Leishmania chagasi/infantum : further investigations on Leishmania tropisms in atypical cutaneous and visceral leishmaniasis foci in Central America

    NARCIS (Netherlands)

    Campos Ponce, M.; Ponce, C.; Ponce, E; Maingon, R.D.

    2005-01-01

    In Central America, apparently genetically identical Leishmania chagasi/infantum parasites cause cutaneous (CL) and visceral leishmaniasis (VL), the latter being more frequent in young children. The present study investigated if there were pathology-related differences in virulence between Honduran

  7. Leishmania chagasi/infantum: further investigations on Leishmania tropisms in atypical cutaneous and visceral leishmaniasis foci in Central America.

    NARCIS (Netherlands)

    Campos Ponce, M.; Ponce, C.; Ponce, E.; Maingon, R.D.

    2005-01-01

    In Central America, apparently genetically identical Leishmania chagasi/infantum parasites cause cutaneous (CL) and visceral leishmaniasis (VL), the latter being more frequent in young children. The present study investigated if there were pathology-related differences in virulence between Honduran

  8. Cutaneous Leishmaniasis: Knowledge, Attitude and Practices of the Inhabitants of the Kani Forest Tribal Settlements of Tiruvananthapuram District, Kerala, India

    Science.gov (United States)

    Nandha, B.; Srinivasan, R.; Jambulingam, P.

    2014-01-01

    Cutaneous leishmaniasis (CL) is reported among Kani tribes in forest settlements of Tiruvananthapuram district, Kerala, India. Epidemiological investigations are ongoing and 27 histopathologically confirmed cases of CL have been reported from five settlements indicating transmission of disease within settlements. One of the priorities for…

  9. Characterization of the local and systemic immune responses in patients with cutaneous leishmaniasis due to Leishmania major

    DEFF Research Database (Denmark)

    Gaafar, A; Veress, B; Permin, H

    1999-01-01

    In this study skin biopsies and peripheral blood samples were obtained from patients with cutaneous leishmaniasis caused by Leishmania major. Samples were obtained at diagnosis and during healing when the lesions had regressed to half the original size. At diagnosis most of the cells expressed HLA...

  10. Sand fly population dynamics and cutaneous leishmaniasis among soldiers in an Atlantic forest remnant in northeastern Brazil.

    Science.gov (United States)

    Dantas-Torres, Filipe; Sales, Kamila Gaudêncio da Silva; Miranda, Débora Elienai de Oliveira; da Silva, Fernando José; Figueredo, Luciana Aguiar; de Melo, Fábio Lopes; de Brito, Maria Edileuza Felinto; Andrade, Maria Sandra; Brandão-Filho, Sinval Pinto

    2017-02-01

    Outbreaks of cutaneous leishmaniasis are relatively common among soldiers involved in nocturnal activities in tropical forests. We investigated the population dynamics of sand flies in a military training camp located in a remnant of Atlantic rainforest in northeastern Brazil, where outbreaks of cutaneous leishmaniasis have sporadically been described. From July 2012 to July 2014, light traps were monthly placed in 10 collection sites, being nine sites located near the forest edge and one near a sheep and goat stable. Light traps operated from 5:00 pm to 6:00 am, during four consecutive nights. Leishmania infection in sand flies was assessed using a fast real-time PCR assay. Cases of cutaneous leishmaniasis among soldiers were also investigated. In total, 24,606 sand flies belonging to 25 species were identified. Males (n = 12,683) predominated over females (n = 11,923). Sand flies were present during all months, being more numerous in March (n = 1,691) and April 2013 (n = 3,324). Lutzomyia choti (72.9%) was the most abundant species, followed by Lutzomyia longispina (13.8%), Lutzomyia complexa (5.3%), representing together >90% of the sand flies collected. Forty cases of cutaneous leishmaniasis were recorded among soldiers from January 2012 to December 2014. Leishmania isolates were obtained from eight patients and were all characterized as Leishmania braziliensis. Soldiers and anyone overnighting in Atlantic rainforest remnants should adopt preventative measures such as the use of repellents on bare skin or clothes and insecticide-treated tents.

  11. Parasitological and biochemical studies on cutaneous leishmaniasis in Shara'b District, Taiz, Yemen.

    Science.gov (United States)

    Asmaa, Qhtan; Al-Shamerii, Salwa; Al-Tag, Mohammed; Al-Shamerii, Adam; Li, Yiping; Osman, Bashir H

    2017-07-04

    The leishmaniasis is a group of diseases caused by intracellular haemoflagellate protozoan parasites of the genus Leishmania. Leishmaniasis has diverse clinical manifestations; cutaneous leishmaniasis (CL) is the most common form of leishmaniasis which is responsible for 60% of disability-adjusted life years. CL is endemic in Yemen. In Shara'b there is no reference study available to identify the prevalence of endemic diseases and no investigation has been conducted for diagnosing the diseases. This study was conducted in villages for CL which collected randomly. The study aimed at investigating the epidemiological factors of CL in Shara'b by using questioner. Symptoms of lesions in patients suffering from CL, confirmed by laboratory tests, gave a new evidence of biochemical diagnosis in 525 villagers aged between 1 and 60 years old. Venous bloods were collected from 99 patients as well as from 51 control after an overnight fast. The percentage prevalence of CL was found 18.8%. The prevalence rate of infection among males (19.3%) was higher than females (18.40%). Younger age group (1-15) had a higher prevalence rate (20.3%) than the other age groups. Furthermore, the population with no formal education had the higher rate of infection (61% of the total). A significant increase of serum malondialdehyde (P < 0.001) in CL patients was obtained. The highest level of MDA may be due to over production of ROS and RNS results in oxidative stress and the acceleration of lipid peroxidation in CL patients. There were high prevalence rates of CL in Shara'b. The patient who had CL has been found with many changes in some biochemical levels. This study provides a clear indication on the role of MDA as an early biochemical marker of peroxidation damage occurring during CL. Increased uric acid, and catalase activity was provided of free radical.

  12. [THE EPIDEMIOLOGICAL SITUATION OF LEISHMANIASIS IN THE RUSSIAN FEDERATION: THE FIRST VALID CASES OF LOCAL TRANSMISSION].

    Science.gov (United States)

    Ponrovsky, E N; Strelkova, M V; Zavoikin, V D; Tumolskaya, N I; Mazmanyan, M V; Baranets, M S; Zhirenkina, E N

    2015-01-01

    The authors have analyzed the data available in the literature and statistical offices and the results of their observations of the epidemiological situation of leishmaniasis in the Russian Federation (RF). In October 1991 to December 2014, the RF registered 89, leishmaniasis cases, including 83 imported cases from 24 countries and 6 local cases. Out of the 83 imported cases, there were those diagnosed with anthroponotic cutaneous leishmaniasis (n=31), zoonotic cutaneous leishmaniasis (n=20), visceral leishmaniasis (n=31), and mucocutaneous leishmaniasis (n=1). The Republic of Dagestan and Eastern Crimea are visceral Ieishmaniasis-enderpic, areas. The obtained data on the local cases of visceral leisimaniasis in Dagestan and on its sporadic cases in Crimea suggest that it is necessary to conduct epidemiological, epizootological, and entomological surveys in the above areas and to develop a system for visceral leishmaniasis epidemiological surveillance encompassing the whole package of antiepidemic measures. The effective treatment of leishmaniases requires that the RF Ministry of Health should register some current antileishmanial drugs (such as Glucantime) as soon as possible.

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

    Directory of Open Access Journals (Sweden)

    Marcelo Rosandiski LYRA

    2015-10-01

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

  14. New foci of cutaneous leishmaniasis in central Kenya and the Rift Valley.

    Science.gov (United States)

    Sang, D K; Okelo, G B; Ndegwa, C W; Ashford, R W

    1993-01-01

    Active case detection and investigations of sandfly resting places in suspected transmission sites of cutaneous leishmaniasis in central Kenya and the Rift Valley resulted in the identification of several foci of the disease in Samburu, Isiolo, Laikipia, Nakuru and Nyandarua districts. The foci occurred in areas ranging from semi-arid lowlands at 400 m altitude to highland plateaux at 2500 m, including the floor of the Rift Valley, and were mostly inhabited by recently settled communities, nomads and migrant charcoal burners. Four species of Phlebotomus, 3 of the subgenus Larroussius (P. pedifer, P. aculeatus and P. guggisbergi) and one Paraphlebotomus (P. saevus) were collected from caves, rock crevices and tree hollows found in river valleys and in lava flows.

  15. Survey of wild mammal hosts of cutaneous leishmaniasis parasites in panamá and costa rica.

    Science.gov (United States)

    González, Kadir; Calzada, José E; Saldaña, Azael; Rigg, Chystrie A; Alvarado, Gilbert; Rodríguez-Herrera, Bernal; Kitron, Uriel D; Adler, Gregory H; Gottdenker, Nicole L; Chaves, Luis Fernando; Baldi, Mario

    2015-03-01

    The eco-epidemiology of American cutaneous leishmaniasis (ACL) is driven by animal reservoir species that are a source of infection for sand flies that serve as vectors infecting humans with Leishmania spp parasites. The emergence and re-emergence of this disease across Latin America calls for further studies to identify reservoir species associated with enzootic transmission. Here, we present results from a survey of 52 individuals from 13 wild mammal species at endemic sites in Costa Rica and Panama where ACL mammal hosts have not been previously studied. For Leishmania spp. diagnostics we employed a novel PCR technique using blood samples collected on filter paper. We only found Leishmania spp parasites in one host, the two-toed sloth, Choloepus hoffmanni. Our findings add further support to the role of two-toed sloths as an important ACL reservoir in Central America.

  16. Linking Climate to Incidence of Zoonotic Cutaneous Leishmaniasis (L. major) in Pre-Saharan North Africa

    Energy Technology Data Exchange (ETDEWEB)

    Bounoua, Lahouari; Kahime, Kholoud; Houti, Leila; Blakey, Tara; Ebi, Kristie L.; Zhang, Ping; Imhoff, Marc L.; Thome, Kurtis; Dudek, Claire; Sahabi, Salah A.; Messouli, Mohammed; Makhlouf, Baghdad; EI Laamrani, Abderahmane; Boumezzough, Ali

    2013-08-20

    Shifts in surface climate may have changed the dynamic of zoonotic cutaneous leishmaniasis (ZCL) in the pre-Saharan zones of North Africa. Caused by Leishmania major, this form multiplies in the body of rodents serving as reservoirs of the disease. The parasite is then transmitted to human hosts by the bite of a Phlebotomine sand fly (Diptera: Psychodidae) that was previously fed by biting an infected reservoir. We examine the seasonal and interannual dynamics of the incidence of this ZCL as a function of surface climate indicators in two regions covering a large area of the semi-arid Pre-Saharan North Africa. Results suggest that in this area, changes in climate may have initiated a trophic cascade that resulted in an increase in ZCL incidence.

  17. [American cutaneous leishmaniasis: phlebotomine transmission area in the Municipality of Uberlândia, MG].

    Science.gov (United States)

    Lemos, Jureth Couto; Lima, Samuel do Carmo

    2005-01-01

    From May 2000 to January 2001 four, 15 hour-long collections of phlebotomine were done to the insect monitoring. The collection was done in an area of infection of American cutaneous leishmaniasis in the basin of the Araguari River in the municipality of Uberlandia (MG). The first collection was made in May (a cold, damp month), the second in June 2000 (a cold, dry month) the third in October 2000 (a hot, dry month) and the fourth in January 2001 (a hot, rainy month). CDC and Shannon light traps were used 6551 phlebotomne were captured and identified, 1990 male and 4562 female, comprised of two lines (Lutzomyia and Brumptomyia) and 8 species. Lutzomyia intermedia predominated with the largest number of specimens (6531), which accounted for 99.7% of the collected insects. In the four collections, it was observed that Lutzomyia intermedia manifested a preference for the month preceding the rainy season, with its high temperatures and humidity.

  18. Cutaneous leishmaniasis in frequent in equines from an endemic area in Rio de Janeiro, Brazil

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    Cruz Manuel Aguilar

    1986-12-01

    Full Text Available In an endemic area of cutaneous leishmaniasis in Rio de Janeiro State where a mule had been found infected, a systematic search among equines was performed, resulting in the detection of Leishmania parasites in skin lesions of 30.8% of the animals, which included horses and mules. The eventual role of equines in the epidemiology of the human disease is being investigated.O achado de uma mula infectada num foco endêmico de leishmaniose tegumentar no Rio de Janeiro, levou-nos a procurar sistematicamente infecções por Leishmania em equinos, resultando no encontro de 30,8% de parasitados, incluindo cavalos e mulas. A possibilidade de esses animais participarem da cadeia epidemiológica da leishmaniose humana está sendo investigada.

  19. Studies on the sand fly fauna (Diptera: Psychodidae) in high-transmission areas of cutaneous leishmaniasis in the Republic of Suriname

    NARCIS (Netherlands)

    Kent, Alida D.; Dos Santos, Thiago V.; Gangadin, Anielkoemar; Samjhawan, Ashok; Mans, Dennis R. A.; Schallig, Henk D. F. H.

    2013-01-01

    Sand flies (Diptera: Psychodidae) are the vectors of Leishmania parasites, the causative agents of leishmaniasis. Cutaneous leishmaniasis is an increasing public health problem in the Republic of Suriname and is mainly caused by Leishmania (Vianna) guyanensis, but L. (V.) braziliensis, L. (L.)

  20. Serodiagnosis of cutaneous leishmaniasis: assessment of an enzyme-linked immunosorbent assay using a peptide sequence from gene B protein

    DEFF Research Database (Denmark)

    Jensen, A T; Gaafar, A; Ismail, A

    1996-01-01

    An enzyme-linked immunosorbent assay (ELISA) using a 28 amino acid sequence of the repetitive element of gene B protein (GBP) from Leishmania major was developed for serodiagnosis of cutaneous leishmaniasis (CL). The assay was compared to ELISAs using crude amastigote and promastigote antigens from...... samples from healthy Sudanese individuals living in an area endemic for malaria but free of leish-maniasis were negative in all the assays. Significantly higher levels of antibodies were found in the patients who had suffered from the disease for more than eight weeks than in patients with a shorter...

  1. The potential economic value of a cutaneous leishmaniasis vaccine in seven endemic countries in the Americas.

    Science.gov (United States)

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

    2013-01-07

    Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relatively short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrate important economic benefits. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Evidence for Seroprevalence in Human Localized Cutaneous Leishmaniasis Caused by Leishmania donovani in Sri Lanka

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    Yamuna Deepani Siriwardana

    2018-01-01

    Full Text Available Visceral leishmaniasis (VL is considered as a major health threat in the Indian subcontinent. Leishmania donovani, a usually visceralizing species, causes cutaneous leishmaniasis (CL in Sri Lanka. However, visceralizing potential of the local L. donovani is not yet fully understood. This project studied the seroprevalence of local CL by using an in-house ELISA. An IgG-based ELISA using crude Leishmania antigen (Ag was developed and validated. A total of 50 laboratory confirmed cases of locally acquired CL were examined using the newly developed ELISA. According to the optimized ELISA, seroprevalence of anti-Leishmania IgG antibodies in the study group was 34.0% (n=17/50. Majority of seropositive individuals were males (n=13/17, representing 76%. Nearly half of the seropositive individuals were young adults (20–40 years, n=9/17, 53%. Higher proportions of single lesions, large lesions, and nodular lesions were associated with a seroconversion. A proportion of local L. donovani infections leading to CL have the ability to raise an antibody response in the host. This may indicate early systemic involvement as one possibility. Study of a large number of patients with adequate follow-up would be useful.

  3. [Species of Lutzomyia involved in an urban focus of visceral and cutaneous leishmaniasis].

    Science.gov (United States)

    Cortés, Luis Alberto; Fernández, Jhon James

    2008-09-01

    A focus of leishmanias transmission was reported in the municipality of El Carmen de Bolívar in the province of Bolívar, Colombia, where both cutaneous and visceral leishmaniasis cases have occured. Vector identification, ecology and behavior of potential vector species have not been characterized in this region, however. Sand fly species of the genus Lutzomyia were identified, patterns of behavior were established, and their possible roles in leishmaniasis transmission were evaluated. CDC light traps were used in several different habitats; in addition, monthly collections were made with human bait as attraction inside houses as well as outdoor Shannon trap collections. The collection data were compared with independent variables including precipitation, temperature, relative humidity and wind velocity by means of a Pearson correlation matrix to estimate levels of association and to determine the influence of the climatic conditions on the density of adults of Lutzomyia evansi and L. gomezi in each of the habitats. Five species of Lutzomyia were captured: L. evansi, L. cayennensis cayennensis, L. gomezi, L. dubitansi, and L. walkeri. Lutzomyia evansi and L. gomezi presented a significant relationship in the abundance of adults indoors with respect to outdoor wind velocity. The Lutzomyia species captured showed an anthropophagic behavior with a constant activity between the 18:00 and 20:00 hrs. Lutzomyia evansi and L. gomezi are inversely proportional in relationship to wind velocity-when the wind diminishes, the activity of these species increases.

  4. The frequency of old world cutaneous leishmaniasis in skin ulcers in Peshawar

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, S; Abdullah, F H [Khyber Girls Medical College, Peshawar (Pakistan). Department of Pathology; Khan, J A [University of Peshawar (Pakistan). Dept. of Pharmacy

    2009-07-15

    Old World Cutaneous Leishmaniasis (OWCL) is a preventable skin infection that leads to morbidity and social isolation. It is spreading rapidly. The sore of OWCL may be a non-ulcerative red papule, nodule or a large mutilating ulcer. The ulcer is typically painless and can leave a disfiguring scar. Methods: This was a descriptive study. The diagnosis of OWCL was established by finding LD bodies in skin smear preparation. Results: This study identified 1680 cutaneous leishmaniasis in 1767 skin ulcers. Children (n=924) were infected more than other age groups (n=756). There were typical skin sore of OWCL in 1512 cases while 168 patients had atypical presentation. The ulcers were painless in 1603 patients. History of insect bite was present in 1366 cases, thorn prick in 156 patients, religious visit to endemic areas in 256 patients, and 4 patients had post surgical non healing wound. Lesions with 4 to 6 months of age had a maximum yield of LD bodies. There were 498 patients from different areas of Peshawar; 688 cases from leishmania endemic belt of FATA while 89 patients came from other urban and rural areas of NWFP. Conclusions: There is a tremendous increase in cases of OWCL and the disease became endemic in many regions of Pakistan. The bordering areas along Afghanistan have constituted an endemic belt that had invaded the neighboring urban and rural areas. Several chronic non healing ulcers had been diagnosed as OWCL. Many cases have been detected in Peshawar. People need education about the nature of the diseases and the efficacy of personal protective measures. Spray with suitable insecticides is required in all residential areas. (author)

  5. Emergence of Cutaneous Leishmaniasis due to Leishmania major in a New Focus of Southern Iran

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    AA Akhavan

    2007-06-01

    Full Text Available Reports from the health center of Kerman Province, southern Iran showed an increasing of cutaneous leishmaniasis cases in Orzuieh Rural District, southwest of the province in 2003. The report encouraged the team to carry out an epidemi¬ological survey in the district during 2003-2004. The objectives were to determine the ecology of sand flies, potential reser¬voir hosts and human infection. A total of 1075 sand flies were collected by sticky traps and 7 species of sand flies were identified. They comprised 3 species of the genus Phlebotomus (P. papatasi, P. mongolensis and P. bergeroti and 4 species of the genus Sergentomyia (S. sintoni, S. clydei, S. tiberiadis and S. baghdadis. P. papatasi was the predominant species of the genus Phlebotomus in indoors (90.3% and outdoors (50.2%. Susceptibility tests on P. papatasi with DDT 4%. Showed that the species was susceptible to this insecticide. A total of 13 rodents consist of Tatera indica (76.9% and Nesokia indica (23.1% were collected. A study of prevalence among 2441 inhabitants in four villages showed a rate of 1.1% for active lesions and 10.4% for scars during November- December 2003. In a separate study examination of 1662 school children aged 6-12 years old showed 1.14% for ulcers and 14.7% for scars at the same time. The Leishmania parasites were isolated from man and characterized as Leishmania major using RAPD-PCR method. It seems that cutaneous leishmaniasis due to L. major (CLM has been prevailed in the district.

  6. Cruel disease, cruel medicine: self-treatment of cutaneous leishmaniasis with harmful chemical substances in Suriname.

    Science.gov (United States)

    Ramdas, Sahienshadebie

    2012-09-01

    Why are potentially harmful, non-biomedical chemical substances, such as battery acid, chlorine, herbicides, and insecticides, used in the treatment of cutaneous leishmaniasis (CL)? What drives people to use these products as medicine? This article is about perceptions of CL, and the quest for a cure, in Suriname, South America. It highlights the associative style of reasoning behind health seeking and discusses the use of harmful chemical substances as medicines. Cutaneous leishmaniasis, a parasitic disease, affects 1 to 1.5 million people globally. It has a spectrum of clinical manifestations, but the most prominent and disfiguring elements are extensive dermatological ulceration and scar formation from lesions. The data upon which this article is based are derived from anthropological research carried out in different parts of Suriname between September 2009 and December 2010. Data was collected through mainly qualitative methods, including interviewing 205 CL patients using structured questionnaires at the Dermatological Service in the capital Paramaribo. Almost all people with CL said they tried self-treatment, varying from the use of ethno-botanical products to non-biomedical chemical solutions. This article presents and interprets the views and practices of CL patients who sought treatment using harsh chemicals. It argues that a confluence of contextual factors - environmental, occupational, infrastructural, geographical, socio-cultural, economic, socio-psychological - leads to the use of harmful chemical substances to treat CL sores. This study is the first in Suriname - and one of the few done globally - focusing on social and cultural aspects related to CL health seeking. It aims to encourage health policy makers and health professionals to carefully initiate, provide, and evaluate CL treatment and prevention programs. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. The frequency of old world cutaneous leishmaniasis in skin ulcers in Peshawar

    International Nuclear Information System (INIS)

    Rahman, S.; Abdullah, F.H.; Khan, J.A.

    2009-01-01

    Old World Cutaneous Leishmaniasis (OWCL) is a preventable skin infection that leads to morbidity and social isolation. It is spreading rapidly. The sore of OWCL may be a non-ulcerative red papule, nodule or a large mutilating ulcer. The ulcer is typically painless and can leave a disfiguring scar. Methods: This was a descriptive study. The diagnosis of OWCL was established by finding LD bodies in skin smear preparation. Results: This study identified 1680 cutaneous leishmaniasis in 1767 skin ulcers. Children (n=924) were infected more than other age groups (n=756). There were typical skin sore of OWCL in 1512 cases while 168 patients had atypical presentation. The ulcers were painless in 1603 patients. History of insect bite was present in 1366 cases, thorn prick in 156 patients, religious visit to endemic areas in 256 patients, and 4 patients had post surgical non healing wound. Lesions with 4 to 6 months of age had a maximum yield of LD bodies. There were 498 patients from different areas of Peshawar; 688 cases from leishmania endemic belt of FATA while 89 patients came from other urban and rural areas of NWFP. Conclusions: There is a tremendous increase in cases of OWCL and the disease became endemic in many regions of Pakistan. The bordering areas along Afghanistan have constituted an endemic belt that had invaded the neighboring urban and rural areas. Several chronic non healing ulcers had been diagnosed as OWCL. Many cases have been detected in Peshawar. People need education about the nature of the diseases and the efficacy of personal protective measures. Spray with suitable insecticides is required in all residential areas. (author)

  8. Efficacy of cryotherapy for the treatment of cutaneous leishmaniasis: meta-analyses of clinical trials.

    Science.gov (United States)

    López-Carvajal, Liliana; Cardona-Arias, Jaiberth Antonio; Zapata-Cardona, María Isabel; Sánchez-Giraldo, Vanesa; Vélez, Iván Darío

    2016-07-26

    Cryotherapy is a local treatment for cutaneous leishmaniasis with variable efficacy and greater safety than conventional treatment. The objective of this study is to evaluate the efficacy and safety of cryotherapy for the treatment of cutaneous leishmaniasis and to compare it with pentavalent antimonials. A meta-analysis based on a search of nine databases with eight strategies was conducted. Inclusion and exclusion criteria were applied, the methodological quality of each article was evaluated, and the reproducibility of the study selection and information extraction from each clinical trial was assured. The per lesion and per patient efficacy was calculated, and a meta-analysis of relative risks with the random effects model and the Dersimonian and Laird's, Begg, and Egger tests, along with a sensitivity analysis, were performed. A meta-regression based on the methodological quality of the trials included was also performed. Eight studies were included in which respective per lesion efficacies of 67.3 % and 67.7 % were reported for cryotherapy and pentavalent antimonials. In 271 patients treated with cryotherapy and in 199 with pentavalent antimonials, respective per protocol and intent to treat efficacies of 63.6 % and 54.2 % were found in the first group, and per protocol and intent to treat efficacies of 74.7 % and 68.3 % were found in the second group. The relative risk for the comparison of efficacy in the two groups was 0.73 (0.42-1.29). The results of the sensitivity analysis and the meta-regression analysis of relative risks were statistically equal to the overall results. This investigation provides evidence in favor of the use of cryotherapy given that its efficacy is similar to that of pentavalent antimonials.

  9. Effect of the Syrian Civil War on Prevalence of Cutaneous Leishmaniasis in Southeastern Anatolia, Turkey.

    Science.gov (United States)

    Inci, Rahime; Ozturk, Perihan; Mulayim, Mehmet Kamil; Ozyurt, Kemal; Alatas, Emine Tugba; Inci, Mehmet Fatih

    2015-07-20

    Cutaneous leishmaniasis (CL) is a vector-mediated skin disease, characterized by chronic wounds on the skin and caused by macrophages in protozoan parasites. It is an endemic disease in the southern and southeastern Anatolia region and is still an important public health problem in Turkey. Because of the civil war in Syria, immigrants to this region in the last 3 years have begun to more frequently present with this disease. The aim of this study was to draw attention to the dramatic increase in new cases with CL after the beginning of the civil war in Syria. In this retrospective study, we evaluated demographic, epidemiological, and clinical features of 110 patients diagnosed with cutaneous leishmaniasis who were admitted to the Department of Dermatology at Kahramanmaras Sutcu Imam University Faculty of Medicine between January 2011 and June 2014. A total of 110 patients included in the study; 50 (45%) were males, and 60 (55%) were females. The age range of the study group was 1-78 years, and the infection was more prevalent in the 0-20 year age group. Of these patients, 76 (69%) were Syrian refugees living in tent camps and 34 (31%) were Turkish citizens. The majority of the cases were diagnosed between October and December. Immigrations to endemic regions of Turkey from neighbouring countries where CL incidence is higher may lead to large increases in case numbers. In order to decrease the risk of exposure, housing conditions of the refugees must be improved, routine health controls must be performed, effective measures must be set in place for vector control, and infected individuals must be diagnosed and treated to prevent spread of the infection.

  10. New endemic focus of cutaneous leishmaniasis in Pakistan and future epidemics threats

    Directory of Open Access Journals (Sweden)

    Abid Ali

    2016-02-01

    Full Text Available Objective: To get a clear epidemiological picture of cutaneous leishmaniasis in a new endemic focus, in order to address the most probable epidemic threats and its spread to the neighboring regions. Methods: A total of 870 clinically diagnosed patients were included in the study after taking consent and filling questionnaires from each individual. The field Giemsa-stained slides and cultures were examined microscopically. The data was organized in tables and graphs and analyzed using statistical package SPSS V 21. Results: The ratio of male was higher than females (499:371, cutaneous and mucocutaneous cases were 96.00% and 4.00%, and only 25.20% patient’s used bed nets. A total of 57.10% had dirty places near their homes. Similar cases in the neighborhood and in families were 48.50% and 67.10% respectively. Only 87.35 % of Patients in the age range of 1–20 years received treatment. Up to five lesions per individual were noticed and 72.20% of them had symptomatic secondary infections. The lesions were observed on different sites of the body. Conclusions: Leishmaniasis is neglected in Landi Kotal Khyber Agency, the reasons being prevailing security situations and political sensitivity. North Atlantic Treaty Organization forces in Afghanistan are in contact with Afghanis and with local people of Landi Kotal for logistic purposes. They may act as carriers in co-spreading of the species. There are potential risks of cross border transmission, with the probability of future epidemics in the surrounding regions.

  11. Rapid healing of cutaneous leishmaniasis by high-frequency electrocauterization and hydrogel wound care with or without DAC N-055: a randomized controlled phase IIa trial in Kabul.

    Directory of Open Access Journals (Sweden)

    Ahmad Fawad Jebran

    2014-02-01

    Full Text Available Anthroponotic cutaneous leishmaniasis (CL due to Leishmania (L. tropica infection is a chronic, frequently disfiguring skin disease with limited therapeutic options. In endemic countries healing of ulcerative lesions is often delayed by bacterial and/or fungal infections. Here, we studied a novel therapeutic concept to prevent superinfections, accelerate wound closure, and improve the cosmetic outcome of ACL.From 2004 to 2008 we performed a two-armed, randomized, double-blinded, phase IIa trial in Kabul, Afghanistan, with patients suffering from L. tropica CL. The skin lesions were treated with bipolar high-frequency electrocauterization (EC followed by daily moist-wound-treatment (MWT with polyacrylate hydrogel with (group I or without (group II pharmaceutical sodium chlorite (DAC N-055. Patients below age 5, with facial lesions, pregnancy, or serious comorbidities were excluded. The primary, photodocumented outcome was the time needed for complete lesion epithelialization. Biopsies for parasitological and (immunohistopathological analyses were taken prior to EC (1(st, after wound closure (2(nd and after 6 months (3(rd. The mean duration for complete wound closure was short and indifferent in group I (59 patients, 43.1 d and II (54 patients, 42 d; p = 0.83. In patients with Leishmania-positive 2(nd biopsies DAC N-055 caused a more rapid wound epithelialization (37.2 d vs. 58.3 d; p = 0.08. Superinfections occurred in both groups at the same rate (8.8%. Except for one patient, reulcerations (10.2% in group I, 18.5% in group II; p = 0.158 were confined to cases with persistent high parasite loads after healing. In vitro, DAC N-055 showed a leishmanicidal effect on pro- and amastigotes.Compared to previous results with intralesional antimony injections, the EC plus MWT protocol led to more rapid wound closure. The tentatively lower rate of relapses and the acceleration of wound closure in a subgroup of patients with parasite persistence warrant

  12. Cutaneous Leishmaniasis Induces a Transmissible Dysbiotic Skin Microbiota that Promotes Skin Inflammation.

    Science.gov (United States)

    Gimblet, Ciara; Meisel, Jacquelyn S; Loesche, Michael A; Cole, Stephen D; Horwinski, Joseph; Novais, Fernanda O; Misic, Ana M; Bradley, Charles W; Beiting, Daniel P; Rankin, Shelley C; Carvalho, Lucas P; Carvalho, Edgar M; Scott, Phillip; Grice, Elizabeth A

    2017-07-12

    Skin microbiota can impact allergic and autoimmune responses, wound healing, and anti-microbial defense. We investigated the role of skin microbiota in cutaneous leishmaniasis and found that human patients infected with Leishmania braziliensis develop dysbiotic skin microbiota, characterized by increases in the abundance of Staphylococcus and/or Streptococcus. Mice infected with L. major exhibit similar changes depending upon disease severity. Importantly, this dysbiosis is not limited to the lesion site, but is transmissible to normal skin distant from the infection site and to skin from co-housed naive mice. This observation allowed us to test whether a pre-existing dysbiotic skin microbiota influences disease, and we found that challenging dysbiotic naive mice with L. major or testing for contact hypersensitivity results in exacerbated skin inflammatory responses. These findings demonstrate that a dysbiotic skin microbiota is not only a consequence of tissue stress, but also enhances inflammation, which has implications for many inflammatory cutaneous diseases. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Interleukin-4 Receptor Alpha: From Innate to Adaptive Immunity in Murine Models of Cutaneous Leishmaniasis

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    Ramona Hurdayal

    2017-11-01

    Full Text Available The interleukin (IL-4 receptor alpha (IL-4Rα, ubiquitously expressed on both innate and adaptive immune cells, controls the signaling of archetypal type 2 immune regulators; IL-4 and IL-13, which elicit their signaling action by the type 1 IL-4Rα/gamma common and/or the type 2 IL-4Rα/IL-13Rα complexes. Global gene-deficient mouse models targeting IL-4, IL-13, or the IL-4Rα chain, followed by the development of conditional mice and generation of important cell-type-specific IL-4Rα-deficient mouse models, were indeed critical to gaining in-depth understanding of detrimental T helper (Th 2 mechanisms in type 1-controlled diseases. A primary example being cutaneous leishmaniasis, which is caused by the protozoan parasite Leishmania major, among others. The disease is characterized by localized self-healing cutaneous lesions and necrosis for which, currently, not a single vaccine has made it to a stage that can be considered effective. The spectrum of human leishmaniasis belongs to the top 10 infectious diseases according to the World Health Organization. As such, 350 million humans are at risk of infection and disease, with an incidence of 1.5–2 million new cases being reported annually. A major aim of our research is to identify correlates of host protection and evasion, which may aid in vaccine design and therapeutic interventions. In this review, we focus on the immune-regulatory role of the IL-4Rα chain from innate immune responses to the development of beneficial type 1 and detrimental type 2 adaptive immune responses during cutaneous Leishmania infection. We discuss the cell-specific requirements of the IL-4Rα chain on crucial innate immune cells during L. major infection, including, IL-4Rα-responsive skin keratinocytes, macrophages, and neutrophils, as well as dendritic cells (DCs. The latter, contributing to one of the paradigm shifts with respect to the role of IL-4 instructing DCs in vivo, to promote Th1 responses against L

  14. A Cross-Sectional Survey of Knowledge, Attitude and Practices Related to Cutaneous Leishmaniasis and Sand Flies in Punjab, Pakistan.

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    Ayesha Akram

    Full Text Available Recent outbreaks of cutaneous leishmaniasis make the disease a public health concern in Punjab, Pakistan. The knowledge of how the population perceives the disease and its vector is essential in order to design an effective management strategy, but such studies are rare in Pakistan.The present study was based on a cross-sectional self-administered survey comprising 250 household samples collected from five localities including Bhawalpur, Multan, Jhang, Faisalabad and Lahore. The results revealed that the respondents had a poor knowledge of the vector and disease. Few of the respondents were aware about the identification of sand flies, their breeding place, biting time, transmission of leishmaniasis and control measures. Skin infection and sandflies as the main disease symptom and vector of the disease, respectively, were known to some of the respondents. Some believed that summer was the main peak incidence of the disease and it could be transmitted from man to man via contact. However, most of the respondents believed that the disease could be cured. Admission to hospitals, cleanliness and use of bed nets were the treatment measures for the disease in suspected patients, whereas some thought that the use of bed nets could be helpful in preventing leishmaniasis infection.Poor knowledge of the disease and its vector in the study population emphasize the need to initiate health education and awareness campaigns to minimize the risks of cutaneous leishmaniasis outbreaks in the future.

  15. Sand fly population dynamics and cutaneous leishmaniasis among soldiers in an Atlantic forest remnant in northeastern Brazil.

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    Filipe Dantas-Torres

    2017-02-01

    Full Text Available Outbreaks of cutaneous leishmaniasis are relatively common among soldiers involved in nocturnal activities in tropical forests. We investigated the population dynamics of sand flies in a military training camp located in a remnant of Atlantic rainforest in northeastern Brazil, where outbreaks of cutaneous leishmaniasis have sporadically been described. From July 2012 to July 2014, light traps were monthly placed in 10 collection sites, being nine sites located near the forest edge and one near a sheep and goat stable. Light traps operated from 5:00 pm to 6:00 am, during four consecutive nights. Leishmania infection in sand flies was assessed using a fast real-time PCR assay. Cases of cutaneous leishmaniasis among soldiers were also investigated. In total, 24,606 sand flies belonging to 25 species were identified. Males (n = 12,683 predominated over females (n = 11,923. Sand flies were present during all months, being more numerous in March (n = 1,691 and April 2013 (n = 3,324. Lutzomyia choti (72.9% was the most abundant species, followed by Lutzomyia longispina (13.8%, Lutzomyia complexa (5.3%, representing together >90% of the sand flies collected. Forty cases of cutaneous leishmaniasis were recorded among soldiers from January 2012 to December 2014. Leishmania isolates were obtained from eight patients and were all characterized as Leishmania braziliensis. Soldiers and anyone overnighting in Atlantic rainforest remnants should adopt preventative measures such as the use of repellents on bare skin or clothes and insecticide-treated tents.

  16. First report of Warileya rotundipennis (Psychodidae: Phlebotominae) naturally infected with Leishmania (Viannia) in a focus of cutaneous leishmaniasis in Colombia.

    Science.gov (United States)

    Moreno, Mabel; Ferro, Cristina; Rosales-Chilama, Mariana; Rubiano, Luisa; Delgado, Marcela; Cossio, Alexandra; Gómez, Maria Adelaida; Ocampo, Clara; Saravia, Nancy Gore

    2015-08-01

    The expansion of transmission of cutaneous leishmaniasis from sylvatic ecosystems into peri-urban and domestic settings has occurred as sand flies have adapted to anthropogenic environmental modifications. Assessment of the intradomiciliary presence of sand flies in households of the settlement "La Cabaña", in the Department of Risaralda, Colombia, revealed an abundance of Warileya rotundipennis. This unexpected observation motivated further analyses to evaluate the participation of this species in the transmission of cutaneous leishmaniasis. Collections using CDC light traps were conducted during two consecutive nights in May and August 2011.The total of 667 sand flies collected were classified into five species: W. rotundipennis (n=654; 98.05%), Nyssomyia trapidoi (n=7; 1.04%); Lutzomyia (Helcocyrtomyia) hartmanni (n=3; 0.44%); Lutzomyia lichyi (n=2; 0.29%) and Psychodopygus panamensis (n=1; 0.14%). The striking predominance of W. rotundipennis within households during both wet (May) and dry (August) seasons, anthropophilic behavior demonstrated by human blood in 95.23% (60/63) evaluable blood-engorged specimens, and natural infection (5/168-3%) with genetically similar parasites of the Leishmania (Viannia) subgenus observed in a patient in this community, support the involvement of W. rotundipennis in the domestic transmission of cutaneous leishmaniasis in "La Cabaña". Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Polarity-sensitive nanocarrier for oral delivery of Sb(V and treatment of cutaneous leishmaniasis

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    Lanza JS

    2016-05-01

    Full Text Available Juliane S Lanza,1 Flaviana R Fernandes,1 José D Corrêa-Júnior,2 José MC Vilela,3 Rogério Magalhães-Paniago,4 Lucas AM Ferreira,5 Margareth S Andrade,3 Cynthia Demicheli,6 Maria N Melo,7 Frédéric Frézard1 1Department of Physiology and Biophysics, 2Department of Morphology, Instituto de Ciências Biológicas (ICB, Universidade Federal de Minas Gerais (UFMG, 3Innovation and Technology Center SENAI FIEMG – Campus CETEC, 4Department of Physics, Instituto de Ciências Exatas (ICEX, 5Department of Pharmaceutical Products, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG, 6Department of Chemistry, Instituto de Ciências Exatas (ICEX, 7Department of Parasitology, Instituto de Ciências Biológicas (ICB, Universidade Federal de Minas Gerais (UFMG, Belo Horizonte, Brazil Abstract: There is a great need for orally active drugs for the treatment of the neglected tropical disease leishmaniasis. Amphiphilic Sb(V complexes, such as 1:3 Sb–N-octanoyl-N-methylglucamide complex (SbL8, are promising drug candidates. It has been previously reported that SbL8 forms kinetically stabilized nanoassemblies in water and that this simple dispersion exhibits antileishmanial activity when given by oral route to a murine model of visceral leishmaniasis. The main objective of the present work was to interfere in the structural organization of these nanoassemblies so as to investigate their influence on the oral bioavailability of Sb, and ultimately, optimize an oral formulation of SbL8 for the treatment of cutaneous leishmaniasis. The structural organization of SbL8 nanoassemblies was manipulated through addition of propylene glycol (PG to the aqueous dispersion of SbL8. The presence of 50% (v/v PG resulted in the loss of hydrophobic microenvironment, as evidenced by fluorescence probing. However, nanostructures were still present, as demonstrated by dynamic light scattering, small-angle X-ray scattering, and atomic force microscopy (AFM. A

  18. Treatment of Cutaneous Leishmaniasis in Murine Model by Hydro Alcoholic Essence of Artemisia sieberi

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    A Doroodgar

    2008-12-01

    Full Text Available Background: Considering the prevalence of leishmaniasis in Iran and many side effects associated with pentavalent antimony compounds use in its treatment, this study was designed to evaluate the effect of Artemisia sieberi essence on the experimental ulcers of cutaneous leishmaniasis on BALB/c mice."nMethods: This experimental research was performed to determine the effect of various concentrations of  Artemisia essence in BALB/c mice previously infected with active Leishmania major promastigote. A total of 50 infected BALB/c mice were randomly divided into 5 groups. Three groups (30 mice were used in the experimental condi­tions and the others were assigned as the control groups. The experimental groups received 1%, 3% and 5% of Ar­temisia, respectively. One of the control groups received ethanol 80% and the other received no treatment. The drug was administered by dropping the liquid on the top lesions, three times daily for maximum of 30 d. Every 10 days the ulcers diameter were measured and sampled for amastigote in all groups. Ulcers diameter changes were deter­mined by statistical tests."nResults: After 30 days, diameter of CL lesions increased in 1%, 3% and 5% Artemisia concentrations and the control groups. Ulcers got bigger with the more concentration. Treatments could not reduce the diameter or caused small lesions. In addition, the mice direct smears in microscopic studies were positive."nConclusion: To find the effective concentration and the mechanism of the effectiveness of the drug, further investi­gations with less concentrates of A. sieberi essence are recommended.

  19. Treatment of Cutaneous Leishmaniasis in Murine Model by Hydro Alcoholic Essence of Artemisia sieberi

    Directory of Open Access Journals (Sweden)

    A Doroodgar

    2008-12-01

    Full Text Available Background: Considering the prevalence of leishmaniasis in Iran and many side effects associated with pentavalent antimony compounds use in its treatment, this study was designed to evaluate the effect of Artemisia sieberi essence on the experimental ulcers of cutaneous leishmaniasis on BALB/c mice.Methods: This experimental research was performed to determine the effect of various concentrations of  Artemisia essence in BALB/c mice previously infected with active Leishmania major promastigote. A total of 50 infected BALB/c mice were randomly divided into 5 groups. Three groups (30 mice were used in the experimental condi­tions and the others were assigned as the control groups. The experimental groups received 1%, 3% and 5% of Ar­temisia, respectively. One of the control groups received ethanol 80% and the other received no treatment. The drug was administered by dropping the liquid on the top lesions, three times daily for maximum of 30 d. Every 10 days the ulcers diameter were measured and sampled for amastigote in all groups. Ulcers diameter changes were deter­mined by statistical tests.Results: After 30 days, diameter of CL lesions increased in 1%, 3% and 5% Artemisia concentrations and the control groups. Ulcers got bigger with the more concentration. Treatments could not reduce the diameter or caused small lesions. In addition, the mice direct smears in microscopic studies were positive.Conclusion: To find the effective concentration and the mechanism of the effectiveness of the drug, further investi­gations with less concentrates of A. sieberi essence are recommended.

  20. Courtship behaviour of Phlebotomus papatasi the sand fly vector of cutaneous leishmaniasis

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    Chelbi Ifhem

    2012-08-01

    Full Text Available Abstract Background The sand fly Phlebotomus papatasi is an Old World vector of Leishmania major, the etiologic agent of zoonotic cutaneous leishmaniasis. This study describes the courtship behaviour of P. papatasi and compares it with that of Lutzomyia longipalpis, the New World vector of visceral leishmaniasis. Understanding the details of courtship behaviour in P. papatasi may help us to understand the role of sex pheromones in this important vector. Results P. papatasi courtship was found to start with the female touching the male, leading him to begin abdomen bending and wing flapping. Following a period of leg rubbing and facing, the male flaps his wings while approaching the female. The female then briefly flaps her wings in response, to indicate that she is willing to mate, thereby signaling the male to begin copulation. Male P. papatasi did not engage in parading behaviour, which is performed by male L. longipalpis to mark out individual territories during lekking (the establishment and maintenance of mating aggregations, or wing-flap during copulation, believed to function in the production of audio signals important to mate recognition. In P. papatasi the only predictor of mating success for males was previous copulation attempts and for females stationary wing-flapping. By contrast, male L. longipalpis mating success is predicted by male approach-flapping and semi-circling behaviour and for females stationary wing-flapping. Conclusions The results show that there are important differences between the mating behaviours of P. papatasi and L. longipalpis. Abdomen bending, which does not occur in L. longipalpis, may act in the release of sex pheromone from an as yet unidentified site in the male abdomen. In male L. longipalpis wing-flapping is believed to be associated with distribution of male pheromone. These different behaviours are likely to signify significant differences in how pheromone is used, an observation that is consistent

  1. Cutaneous leishmaniasis in Syria: clinical features, current status and the effects of war.

    Science.gov (United States)

    Hayani, Kinan; Dandashli, Anwar; Weisshaar, Elke

    2015-01-01

    Cutaneous leishmaniasis (CL) is a worldwide disease caused by an infection with the protozoan parasite Leishmania transmitted via sand flies. It is endemic in many of the poorest countries of all continents. "Aleppo boil" is one of the recognised names given to this disease in the medical literature. Although CL used to be well-controlled and well-documented in Syria, its incidence has dramatically increased since the beginning of the war; however, there is lack of documentation. Here, we present the past and current epidemiological situation of the disease in Syria. We also draw attention to gross and highly unusual clinical variants of CL presented to the Department of Dermatology in Aleppo covering the important differential clinical diagnoses, since this disease is already known to mimic other conditions. Diagnostic procedures and treatment as well as prevention are summarised. Due to the increased ability to travel, and especially the flight of Syrians to neighbouring countries, as well as to Europe, CL may become a new threat in formerly unaffected regions. Through this account, we hope to give weight to the aspiration that CL does not remain a neglected and often clinically overlooked tropical dermatosis.

  2. Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment

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    Rosiana Estéfane da Silva

    Full Text Available BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL treatment. Intralesional administration of meglumine antimoniate (MA represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation. For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience on outcome conformity (saturation status achievement, tolerability (pain referred and safety (bleeding were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.

  3. Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment.

    Science.gov (United States)

    Silva, Rosiana Estéfane da; Carvalho, Janaína de Pina; Ramalho, Dario Brock; Senna, Maria Camilo Ribeiro De; Moreira, Hugo Silva Assis; Rabello, Ana; Cota, Erika; Cota, Gláucia

    2018-02-01

    BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL) treatment. Intralesional administration of meglumine antimoniate (MA) represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP) for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation). For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience) on outcome conformity (saturation status achievement), tolerability (pain referred) and safety (bleeding) were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness) without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.

  4. Outbreak of Cutaneous Leishmaniasis in Peruvian Military Personnel Undertaking Training Activities in the Amazon Basin, 2010.

    Science.gov (United States)

    Oré, Marianela; Sáenz, Eliana; Cabrera, Rufino; Sanchez, Juan F; De Los Santos, Maxy B; Lucas, Carmen M; Núñez, Jorge H; Edgel, Kimberly A; Sopan, Justino; Fernández, Jorge; Carnero, Andres M; Baldeviano, G Christian; Arrasco, Juan C; Graf, Paul C F; Lescano, Andres G

    2015-08-01

    Military personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2-36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (~70%; P education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries. © The American Society of Tropical Medicine and Hygiene.

  5. Role for Lyt-2+ T cells in resistance to cutaneous leishmaniasis in immunized mice

    International Nuclear Information System (INIS)

    Farrell, J.P.; Muller, I.; Louis, J.A.

    1989-01-01

    The role of Lyt-2+ T cells in immunologic resistance to cutaneous leishmaniasis was analyzed by comparing infection patterns in resistant C57BL/6 mice and susceptible BALB/c mice induced to heal their infections after sub-lethal irradiation or i.v. immunization, with similar mice treated in vivo with anti-Lyt-2 antibodies. Administration of anti-Lyt-2 mAb resulted in a dramatic reduction in the number of lymphoid cells expressing the Lyt-2+ phenotype. Such treatment led to enhanced disease in both resistant C57BL/6 and irradiated BALB/c mice, as assessed by lesion size, but did not affect the capacity of these mice to ultimately resolve their infections. In contrast, anti-Lyt-2 treatment totally blocked the induction of resistance in i.v. immunized mice. These results suggest, that Lyt-2+ T cells may play a role in immunity to a Leishmania major infection and that their relative importance to resistance may depend on how resistance is induced

  6. Spatial distribution, Leishmania species and clinical traits of Cutaneous Leishmaniasis cases in the Colombian army.

    Science.gov (United States)

    Patino, Luz H; Mendez, Claudia; Rodriguez, Omaira; Romero, Yanira; Velandia, Daniel; Alvarado, Maria; Pérez, Julie; Duque, Maria Clara; Ramírez, Juan David

    2017-08-01

    In Colombia, the cutaneous leishmaniasis (CL) is the most common manifestation across the army personnel. Hence, it is mandatory to determine the species associated with the disease as well as the association with the clinical traits. A total of 273 samples of male patients with CL were included in the study and clinical data of the patients was studied. PCR and sequencing analyses (Cytb and HSP70 genes) were performed to identify the species and the intra-specific genetic variability. A georeferenced database was constructed to identify the spatial distribution of Leishmania species isolated. The identification of five species of Leishmania that circulate in the areas where army personnel are deployed is described. Predominant infecting Leishmania species corresponds to L. braziliensis (61.1%), followed by Leishmania panamensis (33.5%), with a high distribution of both species at geographical and municipal level. The species L. guyanensis, L. mexicana and L. lainsoni were also detected at lower frequency. We also showed the identification of different genotypes within L. braziliensis and L. panamensis. In conclusion, we identified the Leishmania species circulating in the areas where Colombian army personnel are deployed, as well as the high intra-specific genetic variability of L. braziliensis and L. panamensis and how these genotypes are distributed at the geographic level.

  7. Clinical and histopathological characteristics of cutaneous Leishmaniasis in Sanliurfa City of Turkey including Syrian refugees

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    Sezen Koçarslan

    2013-01-01

    Full Text Available Background: The aim of our study was to investigate the clinical and histopathological characteristics of cutaneous leishmaniasis (CL in the city of Sanliurfa in Turkey, where Syrian refugees also reside. Materials and Methods: At the Harran University Hospital outpatient clinics between 2012 and 2013, 54 CL cases, including 24 Syrian patients, underwent punch biopsy of the skin and/or a touch imprint. Patients in whom leishmania parasites were detected were included in the study. The clinical and histopathological data of the patients were obtained by a review of the patients′ medical records. All the slides of each patient were re-evaluated histopathologically. Results: Fifty-four cases (mean age; 17 ± 12 years, consisting of 32 males (59.3% and 22 females (40.7%, were examined. The most common site of involvement was the face (63%. The most common presentation was noduloulcerative lesions (57.4%. Histopathologically, the majority of the cases exhibited hyperkeratosis, follicular plugging of the epidermis, chronic inflammatory infiltration, leishmania amastigotes and non-caseating granulomatous inflammation in the dermis. Conclusion: CL presents with a wide spectrum of expression, both clinically and histologically, and may mimic other inflammatory and neoplastic diseases. The diagnosis of CL relies on the identification of leishmania amastigotes in either a direct smear of the lesion or in a tissue section.

  8. Clinical and histopathological characteristics of cutaneous Leishmaniasis in Sanliurfa City of Turkey including Syrian refugees.

    Science.gov (United States)

    Koçarslan, Sezen; Turan, Enver; Ekinci, Turan; Yesilova, Yavuz; Apari, Rabia

    2013-01-01

    The aim of our study was to investigate the clinical and histopathological characteristics of cutaneous leishmaniasis (CL) in the city of Sanliurfa in Turkey, where Syrian refugees also reside. At the Harran University Hospital outpatient clinics between 2012 and 2013, 54 CL cases, including 24 Syrian patients, underwent punch biopsy of the skin and/or a touch imprint. Patients in whom leishmania parasites were detected were included in the study. The clinical and histopathological data of the patients were obtained by a review of the patients' medical records. All the slides of each patient were re-evaluated histopathologically. Fifty-four cases (mean age; 17 ± 12 years), consisting of 32 males (59.3%) and 22 females (40.7%), were examined. The most common site of involvement was the face (63%). The most common presentation was noduloulcerative lesions (57.4%). Histopathologically, the majority of the cases exhibited hyperkeratosis, follicular plugging of the epidermis, chronic inflammatory infiltration, leishmania amastigotes and non-caseating granulomatous inflammation in the dermis. CL presents with a wide spectrum of expression, both clinically and histologically, and may mimic other inflammatory and neoplastic diseases. The diagnosis of CL relies on the identification of leishmania amastigotes in either a direct smear of the lesion or in a tissue section.

  9. Control of cutaneous leishmaniasis caused by Leishmania major in south-eastern Morocco.

    Science.gov (United States)

    Bennis, Issam; De Brouwere, Vincent; Ameur, Btissam; El Idrissi Laamrani, Abderrahmane; Chichaoui, Smaine; Hamid, Sahibi; Boelaert, Marleen

    2015-10-01

    The incidence of cutaneous leishmaniasis (CL) caused by Leishmania major has increased in Morocco over the last decade, prompting the Ministry of Health to take intersectoral response measures including vector and reservoir control. The aim of this article was to describe the CL outbreak response measures taken in the province of Errachidia, where the reservoir of L. major, a sand rat (Meriones shawi), was targeted using strychnine-poisoned wheat baits from 2010 to 2012. We analysed routine surveillance data and other information using the data of the CL control programme. We present data on the evolution and the extension of CL in this province as well as the epidemiological profile of the disease. Between 2004 and 2013, 7099 cases of CL were recorded in Errachidia Province, gradually affecting all districts. Our results demonstrate that more women were affected than men and that all age groups were represented. Errachidia Province was the epicentre of the recent CL outbreak in Morocco. A notable decline in incidence rates was observed after 2011. The outbreak control measures may have contributed to this decline, as well as climatic trends or progressing herd immunity. © 2015 John Wiley & Sons Ltd.

  10. Spatial distribution of cutaneous leishmaniasis in the state of Paraná, Brazil.

    Science.gov (United States)

    Melo, Helen Aline; Rossoni, Diogo Francisco; Teodoro, Ueslei

    2017-01-01

    The geographic distribution of cutaneous leishmaniasis (CL) makes it a disease of major clinical importance in Brazil, where it is endemic in the state of Paraná. The objective of this study was to analyze the spatial distribution of CL in Paraná between 2001 and 2015, based on data from the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) regarding autochthonous CL cases. Spatial autocorrelation was performed using Moran's Global Index and the Local Indicator of Spatial Association (LISA). The construction of maps was based on categories of association (high-high, low-low, high-low, and low-high). A total of 4,557 autochthonous cases of CL were registered in the state of Paraná, with an annual average of 303.8 (± 135.2) and a detection coefficient of 2.91. No correlation was found between global indices and their respective significance in 2001 (I = -0.456, p = 0.676), but evidence of spatial autocorrelation was found in other years (pCinzas-Laranjinha, and Ribeira areas. The state of Paraná should keep a constant surveillance over CL due to the prominent presence of socioeconomic and environmental factors such as the favorable circumstances for the vectors present in peri-urban and agriculture áreas.

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

    Science.gov (United States)

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

    2015-10-01

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

  12. Dispersal and memory of sand flies in an endemic area of cutaneous leishmaniasis, southern Brazil.

    Science.gov (United States)

    Silva, Natália Maria Maciel Guerra; De Melo, Simone Cristina Castanho Sabaini; Massafera, Rubens; Rossi, Robson Marcelo; Silveira, Thaís Gomes Verzignassi; Teodoro, Ueslei

    2013-09-01

    The dispersal of and the existence of memory in sand flies were measured in a transmission area of cutaneous leishmaniasis, in the municipality of Bandeirantes, Paraná, Brazil. Sand flies were caught in a rural area, with Shannon trap installed in the forest and three Falcão traps installed in a human-inhabited environment (HIE) and three others in an impacted environment presently uninhabited by humans (EUH), from 1800 to 0600 hours. The captured sand flies were marked with yellow, blue, or red fluorescent powder, according to the environments where they were captured. All marked sand flies were released at 0700 hours at a point between the three environments. The recaptures were made with 28 Falcão traps, distributed in the environments from for 10 consecutive days. The sand flies recaptured were examined under a stereomicroscope and later identified. It was concluded that sand flies are able to disperse over an average distance of 73 m, reaching 130 m in 24 h, showing that: 1) the sand flies were attracted with different intensities to each environment, and the ability to move among different environments allows the existence of enzootic cycle of Leishmania; 2) the sand flies possess a spatial memory, olfactory memory, or both, that enable them to return to the environment where they were captured initially, although the distances were different.

  13. Entomological and epidemiological study of a new focus of cutaneous leishmaniasis in Morocco.

    Science.gov (United States)

    Ramaoui, K; Guernaoui, S; Boumezzough, A

    2008-09-01

    Cutaneous leishmaniasis (CL) due to Leishmania tropica Wright has become an increasingly important problem in Al-Haouz province, Morocco. The objective of this paper was to undertake a retrospective analysis of CL between 2000 and 2006 and to study the sandfly fauna for the first time in this focus. The consultation of bulletins, registers and monthly and annual reports published by local and national medical services permitted a global synthesis of CL in Al-Haouz between 2000 and 2006. Sandflies were collected using sticky-paper traps in five selected stations in two communes, Ourika and Sti Fadma, the most affected by CL in Al-Haouz. Overall, 2,648 sandflies, belonging to five species of Phlebotomus and three of Sergentomyia, were collected. Phlebotomus sergenti Parrot (14.5%) was found in all studied stations where it was associated with domestic and peridomestic habitats. Based on this first report on ecology of sandflies and epidemiology of CL, Al-Haouz seems to be a typical focus of L. tropica and P. sergenti like the other Moroccan foci. Two communes, Sti Fadma and Ourika, constituted an important CL micro-focus in this region. Considering their economical importance (trade and tourism), they contribute probably to the dissemination of Leishmania parasite in bordering regions.

  14. An ecosystem approach to human health and the prevention of cutaneous leishmaniasis in Tumaco, Colombia

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    Rojas Carlos A.

    2001-01-01

    Full Text Available A study was conducted during 1996-1997 in 20 villages of Tumaco, Colombia, to evaluate the effectiveness of personal protective measures against cutaneous leishmaniasis (CL. The intervention was effective, but the high costs of the preventive measures and the lack of a more holistic approach hampered the intervention's sustainability. This paper analyzes the results using an ecosystem approach to human health. Using this approach, we found that CL has been present in the study area for a long time and affects farmers and those living closest to the forest. The forest constitutes the habitat for insect vectors (sandflies and parasite reservoirs (wild mammals. Four spatial scales were identified in this ecosystem: residential, village, regional, and global. From the ecosystem perspective, three interventions are proposed to prevent CL in the 20 villages: improve housing construction, organize village housing in clusters, and make diagnosis and treatment of CL more accessible. The design and implementation of these interventions require active involvement by people with the disease (village inhabitants and decision-makers (local authorities.

  15. Phlebotomine Vector Ecology in the Domestic Transmission of American Cutaneous Leishmaniasis in Chaparral, Colombia

    Science.gov (United States)

    Ferro, Cristina; Marín, Dairo; Góngora, Rafael; Carrasquilla, María C.; Trujillo, Jorge E.; Rueda, Norma K.; Marín, Jaime; Valderrama-Ardila, Carlos; Alexander, Neal; Pérez, Mauricio; Munstermann, Leonard E.; Ocampo, Clara B.

    2011-01-01

    Phlebotomine vector ecology was studied in the largest recorded outbreak of American cutaneous leishmaniasis in Colombia in 2004. In two rural townships that had experienced contrasting patterns of case incidence, this study evaluated phlebotomine species composition, seasonal abundance, nocturnal activity, blood source, prevalence of Leishmania infection, and species identification. CDC miniature light traps were used to trap the phlebotomines. Traps were set indoors, peridomestically, and in woodlands. Natural infection was determined in pools by polymerase chain reaction–Southern blot, and blood sources and species identification were determined by sequencing. Large differences were observed in population abundance between the two townships evaluated. Lutzomyia longiflocosa was the most abundant species (83.1%). Abundance was higher during months with lower precipitation. Nocturnal activity was associated with human domestic activity. Blood sources identified were mainly human (85%). A high prevalence of infection was found in L. longiflocosa indoors (2.7%) and the peridomestic setting (2.5%). L. longiflocosa was responsible for domestic transmission in Chaparral. PMID:22049038

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

    Science.gov (United States)

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

    2012-10-01

    To evaluate the environmental and ecological factors associated with Leishmania transmission and vector abundance in Chaparral, Tolima-Colombia. First, we compared the ecological characteristics, abundance of phlebotomies and potential reservoir hosts in the peridomestic environment (100 m radius) of randomly selected houses, between two townships with high and low cutaneous leishmaniasis incidence. Second, we examined peridomestic correlates of phlebotomine abundance in all 43 houses in the higher risk township. The high transmission township had higher coverage of forest (23%vs. 8.4%) and shade coffee (30.7%vs. 11%), and less coffee monoculture (16.8%vs. 26.2%) and pasture (6.3%vs. 12.3%), compared to the low transmission township. Lutzomyia were more abundant in the high transmission township 2.5 vs. 0.2/trap/night. Lutzomyia longiflocosa was the most common species in both townships: 1021/1450 (70%) and 39/80 (49%). Numbers of potential wild mammal reservoirs were small, although four species were found to be infected with Leishmania (Viannia) spp. In the high transmission township, the overall peridomiciliary capture rate of L. longiflocosa was 1.5/trap/night, and the abundance was higher in houses located nearer to forest (ρ = -0.30, P = 0.05). The findings are consistent with a domestic transmission cycle with the phlebotomies dependent on dense vegetation near the house. © 2012 Blackwell Publishing Ltd.

  17. Phlebotomine vector ecology in the domestic transmission of American cutaneous leishmaniasis in Chaparral, Colombia.

    Science.gov (United States)

    Ferro, Cristina; Marín, Dairo; Góngora, Rafael; Carrasquilla, María C; Trujillo, Jorge E; Rueda, Norma K; Marín, Jaime; Valderrama-Ardila, Carlos; Alexander, Neal; Pérez, Mauricio; Munstermann, Leonard E; Ocampo, Clara B

    2011-11-01

    Phlebotomine vector ecology was studied in the largest recorded outbreak of American cutaneous leishmaniasis in Colombia in 2004. In two rural townships that had experienced contrasting patterns of case incidence, this study evaluated phlebotomine species composition, seasonal abundance, nocturnal activity, blood source, prevalence of Leishmania infection, and species identification. CDC miniature light traps were used to trap the phlebotomines. Traps were set indoors, peridomestically, and in woodlands. Natural infection was determined in pools by polymerase chain reaction-Southern blot, and blood sources and species identification were determined by sequencing. Large differences were observed in population abundance between the two townships evaluated. Lutzomyia longiflocosa was the most abundant species (83.1%). Abundance was higher during months with lower precipitation. Nocturnal activity was associated with human domestic activity. Blood sources identified were mainly human (85%). A high prevalence of infection was found in L. longiflocosa indoors (2.7%) and the peridomestic setting (2.5%). L. longiflocosa was responsible for domestic transmission in Chaparral.

  18. Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method.

    Science.gov (United States)

    Sharafi, Mehdi; Ghaem, Haleh; Tabatabaee, Hamid Reza; Faramarzi, Hossein

    2017-01-01

    To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average (SARIMA) model. The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model. Besides, information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016. Moreover, various SARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on normality of the residuals' distribution, correspondence between the fitted and real amounts, and calculation of Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC). The study results indicated that SARIMA model (4,1,4)(0,1,0) (12) in general and SARIMA model (4,1,4)(0,1,1) (12) in below and above 15 years age groups could appropriately predict the disease trend in the study area. Moreover, temperature with a three-month delay (lag3) increased the disease trend, rainfall with a four-month delay (lag4) decreased the disease trend, and rainfall with a nine-month delay (lag9) increased the disease trend. Based on the results, leishmaniasis follows a descending trend in the study area in case drought condition continues, SARIMA models can suitably measure the disease trend, and the disease follows a seasonal trend. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  19. Performance of an ELISA and Indirect Immunofluorescence Assay in Serological Diagnosis of Zoonotic Cutaneous Leishmaniasis in Iran

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    Bahador Sarkari

    2014-01-01

    Full Text Available Serological assays have been extensively evaluated for diagnosis of visceral leishmaniasis (VL and considered as a routine method for diagnosis of VL while these methods are not properly evaluated for diagnosis of cutaneous leishmaniasis (CL. This study aimed to assess the performance of indirect immunofluorescent-antibody test (IFA and enzyme-linked immunosorbent assay (ELISA for serodiagnosis of cutaneous leishmaniasis in Iran. Sixty-one sera samples from parasitologically confirmed CL patients and 50 sera from healthy controls along with 50 sera from non-CL patients were collected. Antigen was prepared from promastigotes and amastigotes of Leishmania major. IFA was used to detect anti-Leishmania IgG while ELISA was used to detect anti-Leishmania IgM, total IgG, or IgG subclasses (IgG1 and 4. ELISA, for detection of total IgG and IgM, showed sensitivity of 83.6% and 84.7% and specificity of 62.7% and 54.6%, respectively. Sensitivity and specificity of ELISA for detecting IgG1 and IgG4 were 64%, 75% and 85%, 49%, respectively. Sensitivity and specificity of IFA were 91.6% and 81%. Conclusion. Findings of this study demonstrated that serological test, especially IFA, can be used for proper diagnosis of CL.

  20. Linfocitos T citotóxicos CD8+ en la leishmaniasis cutánea CD8+ cytotoxic lymphocytes in cutaneous leishmaniasis

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    Joselín Hernández-Ruiz

    2006-10-01

    Full Text Available OBJETIVO: Examinar la bibliografía relacionada con la participación de los linfocitos T CD8+ en la reacción inmunitaria a especies de Leishmania causantes de leishmaniasis cutánea. En esta enfermedad se ha resaltado la intervención de macrófagos, células dendríticas, NK y células T CD4+; sin embargo, es poco lo que se conoce de las células T CD8+. Los trabajos en modelos murinos señalan que la participación de las células CD8+ sucede a través de la producción de IFN-gamma, aunque su capacidad citotóxica puede desempeñar una función importante, como lo demuestran los hallazgos en seres humanos. La forma como se activan las células citotóxicas CD8+ es un enigma. Es posible que las células dendríticas realicen esa labor a través de mecanismos que incluyen transpresentación de antígenos. Comprender la contribución de este subtipo celular en la respuesta inmunitaria a Leishmania aportará novedosos conocimientos sobre la fisiopatogenia de la leishmaniasis, lo cual hará posible desarrollar nuevos enfoques terapéuticos para esta parasitosis.OBJECTIVE: Review of the literature on the role of CD8+ T cell in the immune response against Leishmania species that cause cutaneous leishmaniasis. The role of macrophages, dendritic cells, CD4 T cells and NK cells has been extensively analyzed in leishmaniasis, yet very little knowledge has been gained on CD8+ T cells in this disease. Murine models of leishmaniasis suggest that CD8+ T cells participate through IFNg production, yet their cytotoxic capacity may also play a crucial role, as has been found in human disease. It is an enigma what mechanisms underlie the CD8+ T cell activation. It is possible that dendritic cells activate CD8+ T cells through mechanisms that include antigen traspresentation. A better understanding of CD8+ T cells in the immune response against Leishmania will undoubtedly provide new insights into the physiopathogenesis of the disease that could lead to new

  1. Treatment of acute cutaneous leishmaniasis with intralesional injection of meglumine antimoniate: comparison of conventional technique with mesotherapy gun.

    Science.gov (United States)

    Kashani, Mansour Nassiri; Sadr, Bardia; Nilforoushzadeh, Mohammad Ali; Arasteh, Mahfar; Babakoohi, Shahab; Firooz, Alireza

    2010-09-01

    The gold standard treatment of Old World leishmaniasis, a common tropical parasitic infestation, is intralesional meglumine antimoniate injection. Mesotherapy is a new minimally invasive method of administration of variable substances to the skin. Comparison of the efficacy and adverse effects of treatment of leishmaniasis with intralesional injection of meglumine antimoniate using conventional method and mesotherapy method. Eighty-five patients with proven leishmaniasis were recruited and randomly treated by one of the two methods, either by conventional injection or by mesotherapy administration weekly. Lesion characteristics were evaluated at every treatment session as well as 1 week, 1 month and 3 months after cessation of treatment. The improvement in lesions was similar in both groups, while it was noted sooner in mesotherapy group with less amount of drug usage (P = 0.005 and 0.016 respectively). Also, patients treated with mesotherapy experienced less pain severity (P = 0.005). Mesotherapy is a safe and effective method of meglumine antimoniate injection for the treatment of cutaneous leishmaniasis and is less painful. © 2010 The International Society of Dermatology.

  2. Molecular characterization of leishmania infection from naturally infected sand flies caught in a focus of cutaneous leishmaniasis (eastern iran.

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    Mohammad Akhoundi

    2013-12-01

    Full Text Available Cutaneous leishmaniasis due to Leishmania major is a serious and increasing problem affecting many rural areas of 17 out of 31 provinces in Iran. Little is known about sand fly fauna and leishmaniases in Eastern Iran and no study has been carried out in Sarbisheh County. The aim of this study was to determine sand flies composition and probable Leishmania infection to find the probable vectors of leishmaniasis in Sarbisheh district.Sand flies were caught using both sticky papers and CDC light traps in August 2010. They were identified morphologically and analyzed for Leishmania infection by amplification of ITS-rDNA.Totally, 842 specimens were caught and 8 species recorded. They belonged to the genera Phlebotomus and Sergentomyia: P. (Phlebotomus papatasi, P. (Paraphlebotomus sergenti, P. (Pa. caucasicus, P. (Pa. mongolensis, P. (Pa. jacusieli, S. (Sergentomyia dentata, S. (Se. sintoni and S. (Sintonius clydei. All collected females were processed for Leishmania DNA detection by PCR amplifying of Internal Transcribed Spacer1 (partial sequence, 5.8S (complete sequence and ITS2 (partial sequence fragments. Thirteen females were positive for Leishmania DNA. The sequencing of the 430 bp amplicons indicated that 9 P. papatasi and 3 females belonging to the Caucasicus group carried L. major DNA whereas one P. sergenti carried L. tropica DNA.Phlebotomus papatasi and P. sergenti are, like in several places, the probable vectors of cutaneous leishmaniases in this emerging or unknown focus of cutaneous leishmaniases.

  3. Evaluation of the polymerase chain reaction in the diagnosis of cutaneous leishmaniasis due to Leishmania major: a comparison with direct microscopy of smears and sections from lesions

    DEFF Research Database (Denmark)

    Andresen, K; Gaafar, A; El-Hassan, A M

    1996-01-01

    We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed by microscopi......We have compared the sensitivity of the polymerase chain reaction (PCR) as a diagnostic tool against conventional microscopical diagnostic techniques in patients with cutaneous leishmaniasis from the Sudan. Twenty-eight patients were diagnosed according to clinical criteria followed......%, respectively. The PCR should be considered as a valuable and sensitive diagnostic tool in the diagnosis of cutaneous leishmaniasis; it has the added advantage of identification of the species of Leishmania causing the lesion....

  4. Intralesional Versus Oral Chloroquine in Cutaneous Leishmaniasis: Comparison of Outcome, Duration of Treatment and Total Dose of Drug

    International Nuclear Information System (INIS)

    Hanif, M. M.; Akram, K.; Mustafa, G.

    2016-01-01

    Objective: To compare intralesional versus oral chloroquine in cutaneous leishmaniasis and determine the cure rate, duration of treatment, and total dose of drug. Study Design: Randomized controlled study. Place and Duration of Study: Department of Dermatology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, from November 2013 to June 2014. Methodology: Consecutive 86 patients of cutaneous leishmaniasis, with single to multiple lesions of various sizes were enrolled and divided randomly into group A and B for the purpose of intralesional and oral chloroquine administration, respectively to compare the effect of the two routes on duration of treatment and total dose of the drug. SPSS version 16 was used for data analysis after data entry into it. Quantitative variables like, duration, cost and total dose of treatment were calculated as mean and standard deviation and compared by using T-test. P-value of less than 0.05 was taken as significant. Results: Cure rate was 100% in both groups towards the end of treatment. Mean duration of treatment was 9.17 ± 3 weeks in intralesional (A) group as against 11.37 ± 3 weeks in oral (B) group (p = 0.0028). Mean total dose of the drug given to each patient in group A was 5.8 ± 0.5 gm and in group B, it was 19.2 ± 1.5 gm, which is significantly higher (p=0.001). The total cost of treatment in group A was Rs. 90 ± 8 and in group B it was Rs. 91 ± 1 (p=0.446). Conclusion: Duration of treatment is significantly shorter and total dose is lesser with intralesional compared to oral chloroquine in treatment of cutaneous leishmaniasis. (author)

  5. Identification of species of leishmania isolated from patients with cutaneous leishmaniasis in Kermanshah; using RAPD-PCR technique

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    Yazdan Hamzavi

    2010-09-01

    Full Text Available Annually many numbers of pationts with Cutaneous Leishmaniasis (CL have been reported in Kermanshah province- IRAN. The study aimed to identify species of Leishmania isolated from patients with CT in Kermanshah. Seven isolates of Leishmania obtained from patients with CL, without any travelling to other provinces, were cultured in NNN medium. After mass production of leptomonads in RPMI 1640 medium DNA was purified and the species were diagnosed using RAPD-PCR technique. The study of electrophoretic fingerprints of the product of RAPD-PCR in seven isolates showed that Leshmania major was the causative agent of CL patients in Kermanshah province. More studies in this field recommended.

  6. Photodynamic Vaccination of BALB/c Mice for Prophylaxis of Cutaneous Leishmaniasis Caused by Leishmania amazonensis

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    Sayonara M. Viana

    2018-02-01

    Full Text Available Background: Photosensitizers (PS, like porphyrins and phthalocyanines (PC are excitable by light to generate cytotoxic singlet oxygen and other reactive oxygen species in the presence of atmospheric O2. Photodynamic inactivation of Leishmania by this means renders them non-viable, but preserves their effective use as vaccines. Leishmania can be photo-inactivated after PS-sensitization by loading via their endocytic uptake of PC or endogenous induction of transgenic mutants with delta-aminolevulinate (ALA to accumulate cytosolic uroporphyrin I (URO. Here, PS-sensitization and photo-inactivation of Leishmaniaamazonensis was further examined in vitro and in vivo for vaccination against cutaneous leishmaniasis (CL.Methods and Results:Leishmania amazonensis promastigotes were photodynamically inactivated in vitro by PC-loading followed by exposure to red light (1–2 J/cm2 or ALA-induction of uroporphyrinogenic transfectants to accumulate cytosolic URO followed by longwave UV exposure. When applied individually, both strategies of photodynamic inactivation were found to significantly, albeit incompletely abolish the MTT reduction activities of the promastigotes, their uptake by mouse bone marrow-derived macrophages in vitro and their infectivity to mouse ear dermis in vivo. Inactivation of Leishmania to completion by using a combination of both strategies was thus used for the sake of safety as whole-cell vaccines for immunization of BALB/c mice. Different cutaneous sites were assessed for the efficacy of such photodynamic vaccination in vivo. Each site was inoculated first with in vitro doubly PS-sensitized promastigotes and then spot-illuminated with white light (50 J/cm2 for their photo-inactivation in situ. Only in ear dermis parasites were photo-inactivated beyond detection. Mice were thus immunized once in the ear and challenged 3 weeks later at the tail base with virulent L. amazonensis. Prophylaxis was noted in mice photodynamically

  7. Prevalence of Cutaneous Leishmaniasis in Districts of High and Low Endemicity in Mali.

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    Bourama Traoré

    2016-11-01

    Full Text Available Historically the western sahelian dry regions of Mali are known to be highly endemic for cutaneous leishmaniasis (CL caused by Leishmania major, while cases are rarely reported from the Southern savanna forest of the country. Here, we report baseline prevalence of CL infection in 3 ecologically distinct districts of Mali (dry sahelian, north savanna and southern savanna forest areas. We screened 195 to 250 subjects from 50 to 60 randomly selected households in each of the 6 villages (four from the western sahelian district of Diema in Kayes region, one from the central district of Kolokani and one from the southern savanna district of Kolodieba, region of Sikasso. The screening consisted of: 1] A Leishmanin Skin Test (LST for detection of exposure to Leishmania parasites; 2] clinical examination of suspected lesions, followed by validation with PCR and 3] finger prick blood sample to determine antibody levels to sand fly saliva. LST positivity was higher in the western district of Diema (49.9% than in Kolokani (24.9% and was much lower in Kolondieba (2.6%. LST positivity increased with age rising from 13.8% to 88% in Diema for age groups 2-5 years and 41-65 years, respectively. All eight PCR-confirmed L. major CL cases were diagnosed in subjects below 18 years of age and all were residents of the district of Diema. Exposure to sand fly bites, measured by anti-saliva antibody titers, was comparable in individuals living in all three districts. However, antibody titers were significantly higher in LST positive individuals (P<0.0001. In conclusion, CL transmission remains active in the western region of Mali where lesions were mainly prevalent among children under 18 years old. LST positivity correlated to higher levels of antibodies to sand fly salivary proteins, suggesting their potential as a risk marker for CL acquisition in Mali.

  8. Divergent profile of emerging cutaneous leishmaniasis in subtropical Brazil: new endemic areas in the southern frontier.

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    Mariel Asbury Marlow

    Full Text Available BACKGROUND: Although known to be highly endemic in the Amazon regions of Brazil, the presence of cutaneous leishmaniasis (CL in the subtropical southern part of the country has largely been ignored. This study was conducted to demonstrate CL is emerging in the Brazilian state of Santa Catarina, as well as to characterize the epidemiological profile and Leishmania species involved. METHODOLOGY/PRINCIPAL FINDINGS: For this cross-sectional study, data from all CL cases from Santa Catarina, Brazil, reported to the Brazilian National Notifiable Diseases Information System from 2001 to 2009 were investigated. Amplification of the kDNA minicircle conserved region followed by restriction fragment length polymorphism (PCR-RFLP was conducted to screen for Leishmania species present in patient biopsy. Overall, 542 CL cases were reported, with majority resulting from autochthonous transmission (n = 401, 73.99% and occurring in urban zones (n = 422, 77.86%. Age, gender, zone of residence, origin of case, clinical form and case outcome were found to differ significantly by region. Imported cases were over seven times more likely to relapse (95% CI 2.56-21.09. Mapping of cases revealed new endemic areas in northeastern Santa Catarina with two species present. With the exception of three L. (Leishmania amazonensis cases (1.20%, majority of PCR positive samples were found to be L. (Viannia braziliensis (n = 248, 98.80%. CONCLUSIONS/SIGNIFICANCE: CL is now endemic in the state of Santa Catarina, Brazil, with case profiles varying significantly by region. L. (V. braziliensis has been identified as the predominant species in the region.

  9. Trend of cutaneous leishmaniasis in kermanshah province, west of iran from 1990 to 2012.

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    Yazdan Hamzavi

    2015-03-01

    Full Text Available This study was conducted to explain the trend of Cutaneous Leishmaniasis (CL in Kermanshah Province, western Iran from 1991-2012.In this analytical-descriptive study, all of the patients suspected to CL in Kermanshah Province were studied. Smears were prepared from most of them, stained with Giemsa, and examined microscopically for Leishman bodies. A few of the patients were diagnosed according to physician diagnosis and response to glucantime. Questionnaires were completed for all of them. Collected data were analyzed using SPSS-21 and Spearman and Kendall tests.From 1991 to 2012, 1684 cases of CL were recorded. In the years 2011-12 the frequency of CL in the province reached to 7.4/100,000, which showed a remarkable increase in the frequency of new cases CL in the province. In the years 2011-12 about 47% of total cases of CL in the province, was seen in Ghasr-e-Shirin district,which the frequency of CL in this district reached to 264.5/100,000. Frequency of CL in males and females was 57% and 43% respectively. The most cases of CL were seen in housewives (32.1% and age groups of 20 to 29 years old (19.9%. In addition, the most cases of disease were seen in winter (41.8% and fall (28.9%.CL is increasing remarkably in warm climates of the province, and Ghasr-e-Shirin must be of particular interest, as the most infected district in the province.

  10. Epidemiological study of cutaneous leishmaniasis in southwest of Iran during 2001–2011

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    Mohammad Hossien Feiz Haddad

    2016-06-01

    Full Text Available Objective: To examine the prevalence process and epidemiological characteristics of cutaneous leishmaniasis (CL during 2001–2011. Methods: This was a cross-sectional epidemiologic study examining 2 637 patients with CL in Susangerd county during 2001–2011. The data of all patients who referred to the Prevention Unit of Susangerd Health Center were registered in CL epidemiologic data summary forms. The data and parameters included age, gender, occupation, season, residence (urban, rural, and lesion location. Results: Out of 2 637 patients, 1 174 cases (44.5% were females and 1463 patients (55.5% were males. The maximum rate of infection was recorded in under 10-year-old age group (45.32% and its minimum rate was seen among those aged over 60 years (0.87%. Among them, 1 557 patients (59.0% were living in urban and 1 080 (41.0% were in rural areas. The maximum and minimum occupational frequency distributions were seen in students (49.9% and farmers (0.6%, respectively. The study showed that the maximum and minimum frequencies were observed in winter (52.33% and summer (7.62% correspondingly. The most lesion frequencies from lesion location point of view were related to hands (37.5%, faces (30.0%, feet (26.3% and other organs (6.2% and the number of lesions ranged from 1–5 and sized varied from 0.5–5.5 cm Conclusions: Epidemiological parameters such as age, gender, occupation, season, residence (urban, rural and lesion location in endemic regions have had significant effects on the prevalence of CL in Susangerd county and the findings can be effective for assessing disease prevention programs. In addition, CL might become a serious dermatological health problem in the near future due to a great population movement to the neighboring country Iraq with a high incidence to an endemic area.

  11. Spatial distribution of cutaneous leishmaniasis in the state of Paraná, Brazil.

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    Helen Aline Melo

    Full Text Available The geographic distribution of cutaneous leishmaniasis (CL makes it a disease of major clinical importance in Brazil, where it is endemic in the state of Paraná. The objective of this study was to analyze the spatial distribution of CL in Paraná between 2001 and 2015, based on data from the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases regarding autochthonous CL cases. Spatial autocorrelation was performed using Moran's Global Index and the Local Indicator of Spatial Association (LISA. The construction of maps was based on categories of association (high-high, low-low, high-low, and low-high. A total of 4,557 autochthonous cases of CL were registered in the state of Paraná, with an annual average of 303.8 (± 135.2 and a detection coefficient of 2.91. No correlation was found between global indices and their respective significance in 2001 (I = -0.456, p = 0.676, but evidence of spatial autocorrelation was found in other years (p< 0.05. In the construction and analysis of the cluster maps, areas with a high-high positive association were found in the Ivaí-Pirapó, Tibagi, Cinzas-Laranjinha, and Ribeira areas. The state of Paraná should keep a constant surveillance over CL due to the prominent presence of socioeconomic and environmental factors such as the favorable circumstances for the vectors present in peri-urban and agriculture áreas.

  12. Spatial Distribution of Sand Fly Vectors and Eco-Epidemiology of Cutaneous Leishmaniasis Transmission in Colombia.

    Science.gov (United States)

    Ferro, Cristina; López, Marla; Fuya, Patricia; Lugo, Ligia; Cordovez, Juan Manuel; González, Camila

    2015-01-01

    Leishmania is transmitted by Phlebotominae insects that maintain the enzootic cycle by circulating between sylvatic and domestic mammals; humans enter the cycles as accidental hosts due to the vector's search for blood source. In Colombia, leishmaniasis is an endemic disease and 95% of all cases are cutaneous (CL), these cases have been reported in several regions of the country where the intervention of sylvatic areas by the introduction of agriculture seem to have an impact on the rearrangement of new transmission cycles. Our study aimed to update vector species distribution in the country and to analyze the relationship between vectors' distribution, climate, land use and CL prevalence. A database with geographic information was assembled, and ecological niche modeling was performed to explore the potential distribution of each of the 21 species of medical importance in Colombia, using thirteen bioclimatic variables, three topographic and three principal components derived from NDVI. Binary models for each species were obtained and related to both land use coverage, and a CL prevalence map with available epidemiological data. Finally, maps of species potential distribution were summed to define potential species richness in the country. In total, 673 single records were obtained with Lutzomyia gomezi, Lutzomyia longipalpis, Psychodopygus panamensis, Psathyromyia shannoni and Pintomyia evansi the species with the highest number of records. Eighteen species had significant models, considering the area under the curve and the jackknife results: L. gomezi and P. panamensis had the widest potential distribution. All sand fly species except for Nyssomyia antunesi are mainly distributed in regions with rates of prevalence between 0.33 to 101.35 cases per 100,000 inhabitants and 76% of collection data points fall into transformed ecosystems. Distribution ranges of sand flies with medical importance in Colombia correspond predominantly to disturbed areas, where the

  13. Molecular detection and identification of Leishmania infection in naturally infected sand flies in a focus of cutaneous leishmaniasis in northern Morocco.

    Science.gov (United States)

    Es-Sette, Nargys; Ajaoud, Malika; Laamrani-Idrissi, Abderrahman; Mellouki, Fouad; Lemrani, Meryem

    2014-07-02

    Cutaneous leishmaniasis is an infectious disease caused by various species of the flagellate protozoan Leishmania. During the past 20 years, cutaneous leishmaniasis has emerged as a major public health threat in Morocco. The main objective of this study was to study the occurrence of Leishmania infection in vectors and to identify sand fly blood meal sources in an endemic locality of cutaneous leishmaniasis within Sefrou province, where the vectors of leishmaniasis were still unknown. 2650 sand flies were collected using CDC miniature light traps and identified morphologically. The identified sand flies were tested for Leishmania infection by nested PCR. The source of blood meal of 10 freshly engorged females: 6 Phlebotomus longicuspis and 4 Phlebotomus sergenti, was determined using the Cyt b sequence. The collected sand flies consisted of 10 species, seven of which belonged to the genus Phlebotomus and three to the genus Sergentomyia. The most abundant species was P. longicuspis, accounting for 72% of the total sand flies collected. In females of three P. longicuspis and four P. sergenti, Leishmania infantum and Leishmania tropica DNA was detected, respectively.The source of blood meal of engorged females showed that all sand flies tested fed on humans. We report for the first time the natural infection of P. longicuspis with L. infantum in Morocco. The high frequency of this species in this region, in addition to its anthropophilic character make P. longicuspis the putative vector of L. infantum in this cutaneous leishmaniasis focus where L. tropica is confirmed as the causative agent of the disease and P. sergenti as its vector. The presence of L. infantum, and its presumed vector in this area, makes this a site of high risk of visceral leishmaniasis, mostly because of the proximity of a focus of human and canine visceral leishmaniasis.

  14. Presence of American cutaneous leishmaniasis vectors surrounding the city of Medellín, Colombia

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    Agudelo Luz A

    2002-01-01

    Full Text Available The presence of Lutzomyia (Helcocyrtomyia hartmanni, as a vector of Leishmania colombiensis and L. columbiana (Verrucarum group, recently incriminated in the transmission of leishmaniasis, and L. pia (Verrucarum group are reported for the first time in a periurban area of Medellín city. There is thus a risk of leishmaniasis transmission in this town.

  15. A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

    Science.gov (United States)

    2016-10-01

    14. ABSTRACT Leishmaniasis is caused by the protozoan Leishmania and is generally transmitted by the bite of sand flies of the genus Lutzomyia or...INTRODUCTION: Leishmaniasis is caused by the protozoan Leishmania and is generally transmitted by the bite of sand flies of the genus Lutzomyia or

  16. Presence of American cutaneous Leishmaniasis vectors surrounding the city of Medellín, Colombia.

    Science.gov (United States)

    Agudelo, Luz A; Uribe, Jaime; Sierra, Diana; Ruiz, Fredy; Velez, Iván D

    2002-07-01

    The presence of Lutzomyia (Helcocyrtomyia) hartmanni, as a vector of Leishmania colombiensis and L. columbiana (Verrucarum group), recently incriminated in the transmission of leishmaniasis, and L. pia (Verrucarum group) are reported for the first time in a periurban area of Medellín city. There is thus a risk of leishmaniasis transmission in this town.

  17. Immunogenicity and efficacy of a bivalent DNA vaccine containing LeIF and TSA genes against murine cutaneous leishmaniasis.

    Science.gov (United States)

    Maspi, Nahid; Ghaffarifar, Fatemeh; Sharifi, Zohreh; Dalimi, Abdolhossein; Dayer, Mohammad Saaid

    2017-03-01

    There is no effective vaccine for the prevention and elimination of leishmaniasis. For this reason, we assessed the protective effects of DNA vaccines containing LeIF, TSA genes alone, or LeIF-TSA fusion against cutaneous leishmaniasis pEGFP-N1 plasmid (empty vector) and phosphate buffer saline (PBS) were used as control groups. Therefore, cellular and humoral immune responses were evaluated before and after the challenge with Leishmania major. Lesion diameter was also measured 3-12 weeks after challenge. All immunized mice with plasmid DNA encoding Leishmania antigens induced the partial immunity characterized by increased IFN-γ and IgG2a levels compared with control groups (p TSA, and LeIF-TSA, respectively, than in PBS group at 12th week post infection. IFN/IL-4 and IgG2a/IgG1 ratios indicated that group receiving LeIF-TSA fusion had the highest IFN-γ and IgG2a levels. In this study, DNA immunization promoted Th1 immune response characterized by higher IFN-γ and IgG2a levels and also reduction in lesion size. These results showed that a bivalent vaccine containing two distinct antigens may induce more potent immune responses against leishmaniasis. © 2017 APMIS. Published by John Wiley & Sons Ltd.

  18. Mast cells have no impact on cutaneous leishmaniasis severity and related Th2 differentiation in resistant and susceptible mice.

    Science.gov (United States)

    Paul, Christoph; Wolff, Svenja; Zapf, Thea; Raifer, Hartmann; Feyerabend, Thorsten B; Bollig, Nadine; Camara, Bärbel; Trier, Claudia; Schleicher, Ulrike; Rodewald, Hans-Reimer; Lohoff, Michael

    2016-01-01

    The genus leishmania comprises different protozoan parasites which are causative agents of muco-cutaneous and systemic, potentially lethal diseases. After infection with the species Leishmania major, resistant mice expand Th1 cells which stimulate macrophages for Leishmania destruction. In contrast, susceptible mice generate Th2 cells which deactivate macrophages, leading to systemic spread of the pathogens. Th-cell differentiation is determined within the first days, and Th2 cell differentiation requires IL-4, whereby the initial IL-4 source is often unknown. Mast cells are potential sources of IL-4, and hence their role in murine leishmaniasis has previously been studied in mast cell-deficient Kit mutant mice, although these mice display immunological phenotypes beyond mast cell deficiency. We therefore readdressed this question by infecting Kit-independent mast cell-deficient mice that are Th1 (C57BL/6 Cpa(Cre) ) or Th2 (BALB/c Cpa(Cre) ) prone with L. major. Using different parasite doses and intra- or subcutaneous infection routes, the results demonstrate no role of mast cells on lesion size development, parasite load, immune cell phenotypes expanding in draining lymph nodes, and cytokine production during murine cutaneous leishmaniasis. Thus, other cell types such as ILCs or T cells have to be considered as primary source of Th2-driving IL-4. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Clinical and Demographic Stratification of Test Performance: A Pooled Analysis of Five Laboratory Diagnostic Methods for American Cutaneous Leishmaniasis

    Science.gov (United States)

    Boggild, Andrea K.; Ramos, Ana P.; Espinosa, Diego; Valencia, Braulio M.; Veland, Nicolas; Miranda-Verastegui, Cesar; Arevalo, Jorge; Low, Donald E.; Llanos-Cuentas, Alejandro

    2010-01-01

    We evaluated performance characteristics of five diagnostic methods for cutaneous leishmaniasis. Patients who came to the Leishmania Clinic of Hospital Nacional Cayetano Heredia in Lima, Peru, were enrolled in the study. Lesion smears, culture, microculture, polymerase chain reaction (PCR), and leishmanin skin test (LST) were performed. A total of 145 patients with 202 lesions were enrolled: 114 patients with 161 lesions fulfilled criteria for cutaneous leishmaniasis. Sensitivity and specificity were 57.8% (95% confidence interval [CI] = 50.2–65.4%) and 100.0% for culture, 78.3% (95% CI = 71.9–84.7%) and 100.0% for microculture, 71.4% (95% CI = 64.4–78.4%) and 100.0% for smears, 78.2% (95% CI = 70.6–85.8%) and 77.4% (95% CI = 62.7–92.1%) for LST, and 96.9% (95% CI = 94.2–99.6%) and 65.9% (95% CI = 51.4–80.4%) for PCR. PCR was more sensitive than the other assays (P < 0.001). Sensitivities of culture, smears, and LST varied by lesion duration and appearance. PCR offers performance advantages over other assays, irrespective of patient age, sex, lesion duration, or appearance. That clinical factors influence performance of non-molecular assays offers clinicians a patient-focused approach to diagnostic test selection. PMID:20682880

  20. Development of an acquisition protocol and a segmentation algortihm for wounds of cutaneous Leishmaniasis in digital images

    Science.gov (United States)

    Diaz, Kristians; Castañeda, Benjamín; Miranda, César; Lavarello, Roberto; Llanos, Alejandro

    2010-03-01

    We developed a protocol for the acquisition of digital images and an algorithm for a color-based automatic segmentation of cutaneous lesions of Leishmaniasis. The protocol for image acquisition provides control over the working environment to manipulate brightness, lighting and undesirable shadows on the injury using indirect lighting. Also, this protocol was used to accurately calculate the area of the lesion expressed in mm2 even in curved surfaces by combining the information from two consecutive images. Different color spaces were analyzed and compared using ROC curves in order to determine the color layer with the highest contrast between the background and the wound. The proposed algorithm is composed of three stages: (1) Location of the wound determined by threshold and mathematical morphology techniques to the H layer of the HSV color space, (2) Determination of the boundaries of the wound by analyzing the color characteristics in the YIQ space based on masks (for the wound and the background) estimated from the first stage, and (3) Refinement of the calculations obtained on the previous stages by using the discrete dynamic contours algorithm. The segmented regions obtained with the algorithm were compared with manual segmentations made by a medical specialist. Broadly speaking, our results support that color provides useful information during segmentation and measurement of wounds of cutaneous Leishmaniasis. Results from ten images showed 99% specificity, 89% sensitivity, and 98% accuracy.

  1. Clinicoepidemiologic pattern of cutaneous leishmaniasis and molecular characterization of its causative agent in Hajjah governorate, northwest of Yemen.

    Science.gov (United States)

    Mogalli, Nabil M; El Hossary, Shabaan S; Khatri, Mishri Lal; Mukred, Abdualdaim M; Kassem, Hala A; El Sawaf, Bahira M; Ramadan, Nadia F

    2016-11-01

    The clinicoepidemiologic profile of 143 cases (93 males and 50 females) with cutaneous leishmaniasis from 18 villages of Hajjah governorate, Yemen was studied. Dry-type lesions were seen in 98.6% and wet-type lesions in 1.4% of patients. Lesions were localized in all cases with different morphological patterns. Microscopic examination of Giemsa-stained slit smears revealed amastigotes in 74.1% of patients with dry-type lesions and 0% in patients with wet-type lesions. The burden of the parasites in the lesions was high indicating active transmission of the disease. Most cases were from villages with moderate altitude range (8001-1600m). All age groups were affected, but most cases were seen in ages from 5 to 15 years. Leishmania species identification was done for all cases by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The biopsic material was scraped from both Giemsa-stained and methanol-fixed smears. The molecular characterization of Leishmania species revealed Leishmania tropica as the causative agent of cutaneous leishmaniasis in Hajjah, Yemen. The risk factors associated with the transmission of the disease and recommendations for improving case detection were discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Analysis of salivary gland transcripts of the sand fly Lutzomyia ayacuchensis, a vector of Andean-type cutaneous leishmaniasis

    Science.gov (United States)

    Kato, Hirotomo; Jochim, Ryan C.; Gomez, Eduardo A.; Uezato, Hiroshi; Mimori, Tatsuyuki; Korenaga, Masataka; Sakurai, Tatsuya; Katakura, Ken; Valenzuela, Jesus G.; Hashiguchi, Yoshihisa

    2013-01-01

    The saliva of blood sucking insects contains potent pharmacologically active components that assist them in counteracting the host hemostatic and inflammatory systems during blood feeding. In addition, sand fly salivary proteins affect host immunity and have the potential to be a vaccine against Leishmania infection. In the present study, the salivary gland transcripts of Lutzomyia ayacuchensis, a vector of cutaneous leishmaniasis in Ecuadorian and Peruvian Andes, were analyzed by sequencing randomly selected clones of the salivary gland cDNA library of this sand fly. This resulted in the identification of the most abundant transcripts coding for secreted proteins. These proteins were homologous to the salivary molecules present in other sand flies including the RGD-containing peptide, PpSP15/SL1 family protein, yellow-related protein, putative apyrase, antigen 5-related protein, D7 family protein, and 27 kDa salivary protein. Of note, homologues of maxadilan, an active vasodilator abundantly present in saliva of Lutzomyia longipalpis, were not identified. This analysis is the first description of salivary proteins from a sand fly of the subgenus Helcocyrtomyia and from vector of cutaneous leishmaniasis in the New World. The present analysis will provide further insights into the evolution of salivary components in blood sucking arthropods. PMID:23000112

  3. Efficacy of pentavalent antimoniate intralesional infiltration therapy for cutaneous leishmaniasis: A systematic review.

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    Nayara Castelano Brito

    Full Text Available The mainstays of cutaneous leishmaniasis (CL treatment, in several world regions, are pentavalent antimony (Sbv compounds administered parenterally, despite their recognized toxicity, which requires frequent laboratory monitoring and complicates their use in areas with scarce infrastructure. As result of these drawbacks, the WHO Expert Committee on leishmaniasis has expanded the recommendations for the use of local therapies, including Sbv intralesional infiltration (IL-Sbv, as CL therapy alternatives even in the New World. However, the efficacy of these approaches has never been compiled. The aim of this study was to critically and systematically assess the efficacy of IL-Sbv for CL treatment.The PRISMA guidelines for systematic reviews and the Cochrane manual were followed. The sources used were the MEDLINE and LILACS databases and the International Clinical Trials Registry Platform of the World Health Organization. The outcome of interest was a clinical cure, defined as complete re-epithelialization of all lesions. The IL-Sbv pooled cure rate was estimated for several subgroups and direct comparisons were performed when possible.Thirty nine articles (40 studies involving 5679 patients treated with IL-Sbv infiltration were included. In direct comparison, only three studies involving 229 patients compared IL-Sbv infiltration versus placebo and no difference was observed (OR: 1,9; 95%IC 0,93 to 3,82 based on cure rate 69.6% (95%CI 17.6-96.1% and 83,2% (95%CI 66-92.7% for placebo and IL-Sbv, respectively. In an alternative and non-comparative analysis, gathering all study arms using the intervention, the pooled IL-Sbv efficacy rate was 75% (95%CI 68-81%. In the Old World, the observed overall IL-Sbv efficacy rate was 75% (95%CI 66-82%, and the cure rates were significantly higher with sodium stibogluconate (SSG than with meglumine antimoniate (MA: 83% (95%CI 75-90% versus 68% (95%CI 54-79%, p = 0.03. Studies directly comparing IL-Sbv with topical

  4. Comparison of the immune profile of nonhealing cutaneous Leishmaniasis patients with those with active lesions and those who have recovered from infection

    DEFF Research Database (Denmark)

    Ajdary, S; Alimohammadian, M H; Eslami, M B

    2000-01-01

    Th1-type cellular immune responses play a critical role in protection against infection with Leishmania parasites, whereas activation of Th2-type cells results in progressive disease. Cutaneous leishmaniasis caused by Leishmania major is often a self-healing disease; however, persistent nonhealing...

  5. A Comparison between the Effects of Glucantime, Topical Trichloroacetic Acid 50% plus Glucantime, and Fractional Carbon Dioxide Laser plus Glucantime on Cutaneous Leishmaniasis Lesions

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    Fariba Jaffary

    2016-01-01

    Full Text Available Background. Cutaneous leishmaniasis is an endemic disease in Iran. Pentavalent antimonial drugs have been the first line of therapy in cutaneous leishmaniasis for many years. However, the cure rate of these agents is still not favorable. This study was carried out to compare the efficacies of intralesional glucantime with topical trichloroacetic acid 50% (TCA 50% + glucantime and fractional carbon dioxide laser + glucantime in the treatment of cutaneous leishmaniasis. Methods. A total of 90 patients were randomly divided into three groups of 30 to be treated with intralesional injection of glucantime, a combination of topical TCA 50% and glucantime, or a combination of fractional laser and glucantime. The overall clinical improvement and changes in sizes of lesions and scars were assessed and compared among three groups. Results. The mean duration of treatment was 6.1±2.1 weeks in all patients (range: 2–12 weeks and 6.8±1.7, 5.2±1.0, and 6.3±3.0 weeks in glucantime, topical TCA plus glucantime, and fractional laser plus glucantime groups, respectively (P=0.011. Complete improvement was observed in 10 (38.5%, 27 (90%, and 20 (87% patients of glucantime, glucantime + TCA, and glucantime + laser groups, respectively (P<0.001. Conclusion. Compared to glucantime alone, the combination of intralesional glucantime and TCA 50% or fractional CO2 laser had significantly higher and faster cure rate in patients with cutaneous leishmaniasis.

  6. Zoonotic cutaneous leishmaniasis in Shiraz, Southern Iran: A molecular, isoenzyme and morphologic approach

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    Qasem Asgari

    2007-05-01

    Full Text Available

    BACKGROUND: Cutaneous leishmaniasis (CL with diverse clinical manifestations is prevalent and remains a major public health problem in Iran and its incidence has been doubled over the last decade. The present study is about the potential role of rodents in the epidemiology of CL in Kharameh district in Shiraz, Southern Iran.

    METHODS: From April 2004 to April 2005, a total of sixteen rodents were collected in live traps from the endemic area of CL in Kharameh district in Shiraz. Evans medium was used for culture. Specific polymerase chain reaction and isoenzyme electrophoresis methods were performed to characterize the parasite.

    RESULTS: The rodent species were Tatera indica. Three samples from Tatera indica were found positive (2 males and 1 female in Kafdehak and Sejel-Abad villages for L. major. Macrophages in the bone marrow of femoral bone were infected with the amastigote form of the parasite.

    CONCLUSIONS: It seems that T. indica is the reservoir host for CL in Kharameh (a district in Shiraz, Southern Iran. It was shown that the bone marrow of the rodents is the tissue of choice for light and ultrastructural studies of

  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. [Transmission of cutaneous leishmaniasis associated with cacao (Theobroma cacao) plantations in Tabasco].

    Science.gov (United States)

    Carrada Figueroa, Georgina Del Carmen; Leal Ascencio, Víctor Javier; Jiménez Sastré, Alejandro; López Álvarez, Jorge

    2014-01-01

    Tabasco is the Mexican state that reported the highest number (37.4%) of patients with leishmaniasis during 1990-2011. Close to 90% of these patients lived in Chontalpa, where the municipality of Cunduacán accounted for the majority of the cases. One of the characteristics of this region is that houses are located within cacao plantations. To determine if cacao plantations are a risk factor for leishmaniasis transmission in locations of Cunduacán, Tabasco. We performed an analytical and retrospective study of 115 locations in Cunduacán, analyzing the number of localities with or without patients with leishmaniasis registered between 2000-2011 and, additionally, if they had cacao plantations, using a map where different crops were georeferenced. We measured the magnitude of the association (odds ratio, 95% CI). During the period 2000-2011, cases of leishmaniasis were reported in 77 (67.0%) Cunduacán locations, of these, 55 (71.4%) had cocoa plantations, five (6.5%) of banana, five (6.5%) of cane, and 12 (15.6%) had no crops georeferenced. We found that cocoa crops are a risk factor for the transmission of leishmaniasis (OR: 3.438; 95% CI: 1,526-7,742). The probability of transmission of leishmaniasis in areas with cocoa crops is greater than in communities without this crop.

  9. A current perspective on leishmaniasis

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    Angela Clem

    2010-01-01

    Full Text Available There are many challenges facing the successful control and eradication of cutaneous and visceral leishmaniasis. Leishmaniasis is still endemic in many poverty stricken and war torn areas. Through the use of an extensive literature review, this article examined the global disease burden of cutaneous and visceral leishmaniasis. Surveillance and control measures for leishmaniasis being used by the World Health Organization were also discussed in this article. Finally, potential new treatments and possible vaccines for leishmaniasis were reviewed in this article.

  10. Respuesta inmune celular en enfermos con Leishmaniasis cutánea atípica Celular immune response in patients with atypical cutaneous leishmaniasis

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    Consuelo Macías Abraham

    1999-04-01

    Full Text Available Se estudió la respuesta inmune celular en 14 enfermos con leishmaniasis cutánea atípica (LCA, variante clínica reportada en Centroamérica, en particular en Honduras y Costa Rica en este año, en 16 enfermos con leishmaniasis cutánea localizada (LCL y en 32 donantes de sangre en el Laboratorio de Inmunología del Centro Nacional de Diagnóstico y Referencia (CNDR del MINSA, Managua, Nicaragua. Se estudió la cuantificación de los linfocitos T totales (CD3 y las subpoblaciones linfocitarias (CD4 y CD8 con anticuerpos monoclonales específicos por inmunofluorescencia indirecta. No se observaron diferencias significativas entre los valores de CD3 y CD4 entre los enfermos con LCA y los controles normales; sin embargo, sí un incremento significativo de las células CD8. Por otra parte, se observó una disminución significativa de los niveles de linfocitos CD3 y CD4 en los enfermos con LCL, no así de los niveles de CD8, en relación con los controles normales. Se observaron diferencias significativas de los niveles de las células CD3, CD4 y CD8 entre ambas formas clínicas de la enfermedad LCL y LCA. Se discute la importancia de la inmunodepresión de las células CD4 en la LCL y el posible comportamiento diferente de las células T en la LCA, con niveles normales de las células CD4 e incremento de la subpoblación citotóxica en una nueva variante clínica menos agresiva de la enfermedadThe cellular immune response was studied in 14 patients with atypic cutaneous leishmaniasis (ACL, a clinical variant reported in Central America, and particularly in Honduras and Costa Rica, during this year, in 16 patients suffering from localized cutaneous leishmaniasis (LCL; and in 32 blood donors at the Immunology Laboratory of the National Diagnosis and Reference Laboratory (NDRL of the Ministry of Health, in Managua, Nicaragua. The quantitation of total T lymphocytes (CD3 and the lymphocyte subsets (CD4 and CD8 with specific monoclonal antibodies were

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

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    Wilson Mayrink

    2006-02-01

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

  12. Cutaneous leishmaniasis in the central provinces of Hama and Edlib in Syria: Vector identification and parasite typing.

    Science.gov (United States)

    Haddad, Nabil; Saliba, Hanadi; Altawil, Atef; Villinsky, Jeffrey; Al-Nahhas, Samar

    2015-10-12

    Cutaneous leishmaniasis is a disease transmitted by sand fly bites. This disease is highly prevalent in Syria where Leishmania major and Leishmania tropica are the known aetiological agents. In 2011, more than 58,000 cases were reported in the country by the Ministry of Health. The central region of the country harbors 20 % of the reported cases. However, the epidemiology of the disease in this area is not well understood. An epidemiological survey was conducted in 2010 to identity the circulating parasite and the sand fly vector in the central provinces of Edlib and Hama. Sand fly specimens were collected using CDC light traps and identified morphologically. Total DNA was extracted from the abdomens of female specimens and from Giemsa-stained skin lesion smears of 80 patients. Leishmania parasites were first identified by sequencing the ITS1 gene amplicons. Then polymorphism analysis was performed using the RFLP technique. A total of 2142 sand flies were collected. They belonged to eight species, among which Phlebotomus sergenti and Phlebotomus papatasi were the most predominant. L. tropica ITS1 gene was amplified from two pools of P. sergenti specimens and from skin smears of cutaneous leishmaniasis patients. This suggests that P. sergenti is the potential vector species in the study area. The digestion profiles of the obtained amplicons by TaqI restriction enzyme were identical for all analysed L. tropica parasites. Moreover, L. infantum ITS1 gene was amplified from two pools of Phlebotomus tobbi in the relatively humid zone of Edlib. L. tropica is confirmed to be the aetiological agent of cutaneous leishmaniasis cases in the central provinces. RFLP technique failed to show any genetic heterogeneity in the ITS1 gene among the tested parasites. The molecular detection of this parasite in human skin smears and in P. sergenti supports the vector status of this species in the study area. The detection of L. infantum in P. tobbi specimens indicates a potential

  13. Hourly activity of Lutzomyia neivai in the endemic zone of cutaneous leishmaniasis in Tucumán, Argentina: preliminary results

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    Ana Denise Fuenzalida

    2011-08-01

    Full Text Available In the present work, the hourly activity of Lutzomyia neivai was studied in the southern part of the province of Tucumán, Argentina, in an area of transmission of cutaneous leishmaniasis during two months of higher activity. In addition, the variables that influenced the abundance of Lu. neivai were evaluated. A total of 1,146 individuals belonging to Lu. neivai (97% and Lutzomyia migonei (3% were captured. The hourly activity of Lu. neivai was mainly nocturnal, with a bimodal pattern in both months. In January, the variable that most influenced the abundance of Lu. neivai was the temperature, whereas in April, that variable was humidity. These results may contribute to the design of anti-vectorial control measures at a micro-focal scale.

  14. [Spatial and/or olfactory memory in sandflies in an endemic area for American cutaneous leishmaniasis, southern Brazil].

    Science.gov (United States)

    Freitas, Janaína Sales de; Reinhold-Castro, Kárin Rosi; Casanova, Cláudio; Silva, Joseane Padilha da; Previdelli, Isolde; Teodoro, Ueslei

    2009-01-01

    The results from an investigation on the possibility that sandflies in an endemic area for American cutaneous leishmaniasis, in the state of Paraná, may have memory are reported. Sandflies were caught in Recanto Marista, Doutor Camargo, State of Paraná, Brazil, using Falcão traps in two chicken sheds (G1 and G2), between November 15 and 26, 2007. A total of 2,080 sandflies were caught (1,000 in G1 and 1,080 in G2) and these were marked and released. Nyssomyia neivai was the most (90.5%) frequent species. Out of the total released, 168 sandflies (8%) were recaptured and the recapture rate in G2 was significant. The results show that it is possible that spatial or olfactory memory and/or host loyalty exists, and that this will guide the sandflies in recognizing the places where sources of blood are available.

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

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    DA Cerino

    2010-01-01

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

  16. In Vitro and In Vivo Evaluation of Essential Oil from Artemisia absinthium L. Formulated in Nanocochleates against Cutaneous Leishmaniasis

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    Beatriz Tamargo

    2017-06-01

    Full Text Available Background: Leishmaniasis is a zoonotic disease caused by protozoan parasites from Leishmania genus. Currently, there are no effective vaccines available and the available therapies are far from ideal. In particular, the development of new therapeutic strategies to reduce the infection caused by Leishmania amazonensis could be considered desirable. Different plant-derived products have demonstrated antileishmanial activity, including the essential oil (EO from Artemisia absinthium L. (EO-Aa, Asteraceae. Methods: In the present study, the EO-Aa formulated in nanocochleates (EO-Aa-NC was investigated in vitro against intracellular amastigotes of L. amazonensis and non-infected macrophages from BALB/c mice. In addition, the EO-Aa-NC was also evaluated in vivo against on experimental cutaneous leishmaniasis, which body weight, lesion progression, and parasite load were determined. Results: EO-Aa-NC displayed IC50 values of 21.5 ± 2.5 μg/mL and 27.7 ± 5.6 μg/mL against intracellular amastigotes of L. amazonensis and non-infected peritoneal macrophage, respectively. In the animal model, the EO-Aa-NC (30 mg/kg/intralesional route/every 4 days 4 times showed no deaths or weight loss greater than 10%. In parallel, the EO-Aa-NC suppressed the infection in the murine model by approximately 50%, which was statistically superior (p < 0.05 than controls and mice treated with EO-Aa. In comparison with Glucantime®, EO-Aa-NC inhibited the progression of infection as efficiently (p > 0.05 as administration of the reference drug. Conclusions: Encochleation of EO-Aa resulted in a stable, tolerable, and efficacious antileishmanial formulation, facilitating systemic delivery of EO, with increased activity compared to administration of the free EO-Aa. This new formulation shows promising potential to future studies aimed at a new therapeutic strategy to treat leishmaniasis.

  17. T-Cell-Mediated Immune Responses in Patients with Cutaneous or Mucosal Leishmaniasis: Long-Term Evaluation after Therapy

    Science.gov (United States)

    Da-Cruz, Alda Maria; Bittar, Rita; Mattos, Marise; Oliveira-Neto, Manuel P.; Nogueira, Ricardo; Pinho-Ribeiro, Vanessa; Azeredo-Coutinho, Rilza Beatriz; Coutinho, Sergio G.

    2002-01-01

    T-cell immune responses in patients with cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) were studied during the active disease, at the end of therapy, and 1 to 17 years posttherapy (long-term follow-up). Lymphocyte proliferative responses, phenotypic characterization of CD4+ and CD8+ Leishmania-reactive T cells, and cytokine production were assayed. Patients with active ML and CL showed higher proportions of CD4+ than CD8+ T cells. In CL, the healing process was associated with a decrease of CD4+ and an increase of CD8+, leading to similar CD4+ and CD8+ proportions. This pattern was only seen in ML after long-term therapy. Long-term follow-up of patients with CL showed a positive CD4+/CD8+ ratio as observed during the active disease, although the percentages of these T cell subsets were significantly lower. Patients with CL did not show significant differences between gamma interferon (IFN-γ) and interleukin-5 (IL-5) production during the period of study. Patients with active ML presented higher IFN-γ and IL-5 levels compared to patients with active CL. IL-4 was only detected during active disease. Patients long term after cure from ML showed increasing production of IFN-γ, significant decrease of IL-5, and no IL-4 production. Two apparently beneficial immunological parameters were detected in tegumentary leishmaniasis: (i) decreasing proportions of CD4+ Leishmania-reactive T cells in the absence of IL-4 production associated with cure of CL and ML and (ii) decreasing levels of IL-5 long after cure, better detected in patients with ML. The observed T-cell responses maintained for a long period in healed patients could be relevant for immunoprotection against reinfection and used as a parameter for determining the prognosis of patients and selecting future vaccine preparations. PMID:11874860

  18. [Cutaneous leishmaniasis cases in Nizip, Turkey after the Syrian civil war].

    Science.gov (United States)

    Salman, Ismail Serkan; Vural, Ahmet; Unver, Ahmet; Saçar, Suzan

    2014-01-01

    Cutaneous leishmaniasis (CL), seen endemically in many countries, is a widespread protozoon disease all around the world. The neighboring countries of Turkey namely Iran, Iraq and Syria are highly endemic regions for CL, and more than 98% of the cases in Turkey are reported from South and Southeastern Anatolian regions. The aim of this study was to detect the prevalence of CL in Nizip, a district of Gaziantep province of southeastern Turkey, for three and half year period and to call attention to the dramatic increase of CL cases observed after the Syrian civil war. A total of 416 samples obtained from clinically suspected CL patients (of them 341 were Syrian refugees) who were admitted to Nizip State Hospital between January 1st 2010 and March 19th 2013 were included in the study. Lesion samples were collected according to the notice issued by Turkish Ministry of Health and Giemsa-stained smears were examined under the microscope (x1000). Samples from 77 patients (18.5%) yielded positive results with the observation of Leishmania amastigote forms. Fourty-seven (61%) of patients were female and 30 (39%) were male. Of the positive patients 52 (67.5%) belonged to 0-19 age group, 13 (16.9%) 20-39 and 12 (15.6%) 40-60 age groups. In the evaluation of the lesion characteristics, 33 (43%) patients had single and 44 (57%) had multiple lesions with a distribution mainly on face, arm and lower extremities, in a decreasing order. The period of time for the development of the lesions varied from 1.5 month to one year with the mean value of 3.4 months. There was no statistically significant relationship between the age and gender of patients, and the characteristics (quantity, distribution and time of occurence) of lesions (p> 0.05). The number of domestic and Syrian CL cases detected in Nizip in the years of 2010, 2011, 2012 and 2013 (the first three months) were as follows; 1 and 0, 2 and 0, 7 and 0, 5 and 62, respectively. So a total of 62 (80.5%) and 15 (19.5%) of CL

  19. The role of CD4 and CD8 T cells in human cutaneous leishmaniasis.

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    Claudia Ida Brodskyn

    2014-09-01

    Full Text Available Leishmaniasis, caused by infection with parasites of the Leishmania genus, affects millions of individuals worldwide. This disease displays distinct clinical manifestations ranging from self-healing skin lesions to severe tissue damage. The control of Leishmania infection is dependent on cellular immune mechanisms, and evidence has shown that CD4 and CD8 T lymphocytes play different roles in the outcome of leishmaniasis. Although the presence of CD4 T cells is important for controlling parasite growth, the results in the literature suggest that the inflammatory response elicited by these cells could contribute to the pathogenesis of lesions. However, recent studies on CD8 T lymphocytes show that these cells are mainly involved in tissue damage through cytotoxic mechanisms. In this review, we focus on the recent advances in the study of the human adaptive immunological response in the pathogenesis of tegumentary leishmaniasis.

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

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    Cláudio Casanova

    2005-11-01

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

  1. Epidemiological aspects of American cutaneous leishmaniasis (ACL in an endemic area of forest extractivist culture in western Brazilian Amazonia

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    Andreia Fernandes Brilhante

    Full Text Available ABSTRACT The study sought to analyze clinical and epidemiological aspects of cutaneous leishmaniasis (CL in Xapuri, Acre, Brazil. Data from 2008 to 2014 registered in the notification records of the disease of the Information System of the Complaints of Notification (SINAN, and the data of the Information Department of the Unified Health System (DATASUS available from 2007 to 2013 were used and analyzed in the light of the statistics of the temporal series by the Prais-Winsten method and chi-squared test. A total of 906 cases were registered with 60.2% occurring in men and 39.7% in women. The groups from 0 to 4 years of age (48.0% and from 5 to 19 years of age (23.3% were the most affected. Regarding the clinical forms, 77.7% presented CL and 22.3% mucocutaneous leishmaniasis (MCL. Among the 896 cases with information on the diagnostic methods used, Montenegro’s skin test predominated (66.4%, with a positive result of 95.8% for CL and 99.3% for MCL. Treatment with N-methylglucamine antimony was performed in 99.4% of the cases, but discontinuously used in the majority of patients. This study presents information which may be used as a tool for the epidemiological surveillance and control of the disease in Xapuri, a region which depends essentially on forest resources and ecological tourism.

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

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    Anayansi Valderrama

    2011-12-01

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

  3. A two years study on vectors of cutaneous Leishmaniasis. Evidence for sylvatic transmission cycle in the state of Campeche, Mexico.

    Science.gov (United States)

    Rebollar-Téllez, E A; Ramírez-Fraire, A; Andrade-Narvaez, F J

    1996-01-01

    Vectors of cutaneous leishmaniasis in the State of Campeche were studied in relation to the transmission cycle of Leishmania (Le.) mexicana. To determine how transmission of leishmaniasis occurs, we collected phlebotomine sand flies for two years. In the first year (October 1990 to November 1991) the collections were made with CDC light traps, Shannon traps and direct captures at natural shelters around the village (La Libertad. In the second year (February 1993 to January 1994) the catches were performed at 8 km southeast of La Libertad in the forest. Female sand flies were examined for Leishmania. During the first year, 347 sand flies of nine species were collected, most of which were Lutzomyia deleoni (61.3%). When all nine species were considered, more females than males were captured. Low densities of anthropophillic species of sand flies around the village indicated that sylvatic transmission was taking place. For the second year. 1484 sand flies of 16 species were caught. The most common were L. olmeca olmeca (21.7%), L. cruciata (19.2%) and L. ovallesi (14.1%). Similarly, more females were caught than males. Thirty-five females of five species were found infected with flagellates believed to be Leishmania sp. The highest infection rate was found in L. olmeca olmeca (7.1%) followed by L. cruciata (4.5%) and L. ovallesi (1.1%). These data plus other evidence on the epidemiology of human cases and results from reservoir studies are discussed in relation to the sylvatic transmission cycle.

  4. Pomegranate (Punica granatum Juice Shows Antioxidant Activity against Cutaneous Leishmaniasis-Induced Oxidative Stress in Female BALB/c Mice

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    Badriah Alkathiri

    2017-12-01

    Full Text Available Leishmania species are parasites that multiply within phagocytes and cause several clinical diseases characterized by single or multiple ulcerations. One of the complications that can induce tissue damage and the resulting scars is caused by secondary bacterial infections. Studies to find new, effective, and safe oral drugs for treating leishmaniasis are being conducted since several decades, owing to the problems associated with the use of antimonials available. Previously, the antiparasitic and antioxidant properties of Punica granatum (pomegranate, P. granatum have been reported. Therefore, in the present study, we aimed to investigate the antileishmanial activity of pomegranate aqueous juice in vitro and in female BALB/c mice. A 3-(4.5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT assay in Leishmania major promastigotes and alterations in the antioxidant status, liver function, and skin histological changes in L. major-infected mice orally treated with pomegranate juice alone and in combination with the antibiotic ciprofloxacin, were used to investigate the in vitro and in vivo antileishmanial activity of pomegranate juice, respectively. Oral P. granatum juice treatment significantly reduced the average size of cutaneous leishmaniasis lesions compared with that of the untreated mice. This antileishmanial activity of P. granatum was associated with enhanced antioxidant enzyme activities. Histopathological evaluation proved the antileishmanial activity of P. granatum, but did not reveal changes in the treated animals, compared to the positive control. In conclusion, P. granatum shows high and fast antileishmanial activity probably by boosting the endogenous antioxidant activity.

  5. Pomegranate (Punica granatum) Juice Shows Antioxidant Activity against Cutaneous Leishmaniasis-Induced Oxidative Stress in Female BALB/c Mice.

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    Alkathiri, Badriah; El-Khadragy, Manal F; Metwally, Dina M; Al-Olayan, Ebtesam M; Bakhrebah, Muhammed A; Abdel Moneim, Ahmed E

    2017-12-18

    Leishmania species are parasites that multiply within phagocytes and cause several clinical diseases characterized by single or multiple ulcerations. One of the complications that can induce tissue damage and the resulting scars is caused by secondary bacterial infections. Studies to find new, effective, and safe oral drugs for treating leishmaniasis are being conducted since several decades, owing to the problems associated with the use of antimonials available. Previously, the antiparasitic and antioxidant properties of Punica granatum (pomegranate, P. granatum ) have been reported. Therefore, in the present study, we aimed to investigate the antileishmanial activity of pomegranate aqueous juice in vitro and in female BALB/c mice. A 3-(4.5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay in Leishmania major promastigotes and alterations in the antioxidant status, liver function, and skin histological changes in L. major -infected mice orally treated with pomegranate juice alone and in combination with the antibiotic ciprofloxacin, were used to investigate the in vitro and in vivo antileishmanial activity of pomegranate juice, respectively. Oral P. granatum juice treatment significantly reduced the average size of cutaneous leishmaniasis lesions compared with that of the untreated mice. This antileishmanial activity of P. granatum was associated with enhanced antioxidant enzyme activities. Histopathological evaluation proved the antileishmanial activity of P. granatum , but did not reveal changes in the treated animals, compared to the positive control. In conclusion, P. granatum shows high and fast antileishmanial activity probably by boosting the endogenous antioxidant activity.

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

    Science.gov (United States)

    2014-01-01

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

  7. Environmental suitability for Lutzomyia (Nyssomyia) whitmani (Diptera: Psychodidae: Phlebotominae) and the occurrence of American cutaneous leishmaniasis in Brazil.

    Science.gov (United States)

    da Costa, Simone Miranda; Cordeiro, José Luís Passos; Rangel, Elizabeth Ferreira

    2018-03-07

    Leishmaniasis represents an important public health problem in Brazil. The continuous process of urbanization and expansion of human activities in forest areas impacts natural habitats, modifying the ecology of some species of Leishmania, as well as its vectors and reservoirs and, consequently, changes the epidemiological pattern that contributes to the expansion of American cutaneous leishmaniasis in Brazil. Here, we discuss Lutzomyia (Nyssomyia) whitmani, the main vector of ACL, transmitting two dermotropic Leishmania species including Leishmania (Viannia) braziliensis and Leishmania (V.) shawi. We used the maximum entropy niche modelling approach (MaxEnt) to evaluate the environmental suitability of L. (N.) whitmani and the transmission of ACL in Brazil, in addition to designing models for a future scenario of climate change. MaxEnt was used under the "auto-features" mode and the default settings, with 100-fold repetition (bootstrap). The logistic output was used with higher values in the habitat suitability map, representing more favourable conditions for the occurrence of L. (N.) whitmani and human cases of ACL. Two models were developed: the Lutzomyia (N.) whitmani model (LWM) and the American cutaneous leishmaniasis model (ACLM). LWM identified the species "preferential habitat" included regions with moderate annual precipitation (AP) between 1000-1600 mm, intermediate vegetation density (NDVI) values, mean temperature of the coldest quarter (MTCQ), between 15-21 °C, and annual mean temperature (AMT), between 19-24 °C. ACLM indicates that ACL is strongly associated with areas of intermediate density vegetation, areas with AP between 800-1200 mm, MTCQ above 16 °C and AMT below 23 °C. The models generated for L. (N.) whitmani and ACL indicated a satisfactory predictive capacity. Future projections of LWM indicate an expansion of climatic suitability for L. (N.) whitmani for the northern and southern regions of Brazil. Future projections of ACL indicate the

  8. Molecular epidemiological study of cutaneous leishmaniasis in the east north of Iran

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    Kazem Hassanpour

    2014-09-01

    Full Text Available Objective: To identify and study the epidemiology of Leishmania species isolated from patients with leishmaniasis by PCR method in Sabzevar, Khorasan Razavi Province, Iran. Methods: Aspirated samples from the lesions of 86 patients with confirmed leishmaniasis used for direct smear preparation. The samples are prepared and cultured in the Novy-MacNealNicolle and Roswell Park Memorial Institute-1640 culture mediums. After extraction of DNA by using phenol-chloroform, parasite kintoplast DNA gene amplification was done by using PCR. The electrophoresis pattern of each species was compared with standard species of Leishmania tropica (L. tropica and Leishmania major (L. major. Results: Results of PCR patterns of kintoplast DNA gene suggested that two types of L. tropica and L. major isolated from leishmaniasis patients in Sabzevar and their findings indicated that both species of parasites, L. tropica and L. major are prevalent in Sabzevar. Conclusions: According to this information, Sabzevar can be divided in two focal points of dry and dry-wet in terms of leishmaniasis, while it was previously known as the dry focal point. Likewise a significant relationship observed between Leishmania species to time distribution, type of lesion, amount of parasites and infection districts.

  9. Cutaneous leishmaniasis in the dorsal skin of hamsters: a useful model for the screening of antileishmanial drugs.

    Science.gov (United States)

    Robledo, Sara M; Carrillo, Lina M; Daza, Alejandro; Restrepo, Adriana M; Muñoz, Diana L; Tobón, Jairo; Murillo, Javier D; López, Anderson; Ríos, Carolina; Mesa, Carol V; Upegui, Yulieth A; Valencia-Tobón, Alejandro; Mondragón-Shem, Karina; Rodríguez, Berardo; Vélez, Iván D

    2012-04-21

    Traditionally, hamsters are experimentally inoculated in the snout or the footpad. However in these sites an ulcer not always occurs, measurement of lesion size is a hard procedure and animals show difficulty to eat, breathe and move because of the lesion. In order to optimize the hamster model for cutaneous leishmaniasis, young adult male and female golden hamsters (Mesocricetus auratus) were injected intradermally at the dorsal skin with 1 to 1.5 x l0(7) promastigotes of Leishmania species and progression of subsequent lesions were evaluated for up to 16 weeks post infection. The golden hamster was selected because it is considered the adequate bio-model to evaluate drugs against Leishmania as they are susceptible to infection by different species. Cutaneous infection of hamsters results in chronic but controlled lesions, and a clinical evolution with signs similar to those observed in humans. Therefore, the establishment of the extent of infection by measuring the size of the lesion according to the area of indurations and ulcers is feasible. This approach has proven its versatility and easy management during inoculation, follow up and characterization of typical lesions (ulcers), application of treatments through different ways and obtaining of clinical samples after different treatments. By using this method the quality of animal life regarding locomotion, search for food and water, play and social activities is also preserved.

  10. Evaluation of a direct immunofluorescent antibody (difma test using Leishmania genus - specific monoclonal antibody in the routine diagnosis of cutaneous leishmaniasis

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    Martha E. Chico

    1995-06-01

    Full Text Available A direct immunofluorescent antibody (DIFMA test using a Leishmania genus- specific monoclonal antibody was evaluated in the routine diagnosis of cutaneous leishmaniasis (CL in Ecuador. This test was compared with the standard diagnostic techniques of scrapings, culture and histology. Diagnostic samples were taken from a total of 90 active dermal ulcers from patients from areas of Ecuador known to be endemic for cutaneous leishmaniasis. DIFMA was positive in all lesions. It was shown to be significantly superior to standard diagnostic methods either alone or in combination. The sensitivity of DIFMA did not diminish with chronicity of lesions. This test proved to be extremely useful in the routine diagnosis of CL because it is highly sensitive, is easy to use and produces rapid results.

  11. High and low doses of antimony (Sb v in American cutaneous leishmaniasis: a five years follow-up study of 15 patients

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    MP Oliveira-Neto

    1996-04-01

    Full Text Available Seventeen patients proceeding from the municipality of Rio de Janeiro, Brazil presenting with the cutaneous ulcerative form of American leishmaniasis were treated with one ampoule of pentavalent antimony daily for 30 days. With this regimen the individuals doses varies greatly: from 3.8 mg/kg of body weight to 22.3 mg/kg. After five years, patients receiving either a smaller dose or a bigger one, showed the same therapeutic result: cutaneous scars and no mucosal lesions.

  12. Blood-meal identification in phlebotomine sand flies (Diptera: Psychodidae) from Valle Hermoso, a high prevalence zone for cutaneous leishmaniasis in Ecuador.

    Science.gov (United States)

    Anaguano, David F; Ponce, Patricio; Baldeón, Manuel E; Santander, Stephanie; Cevallos, Varsovia

    2015-12-01

    Cutaneous leishmaniasis is a neglected tropical disease transmitted by phlebotomine sand flies of the genus Lutzomyia. In South America, cutaneous leishmaniasis is endemic in the majority of countries. There are no previous reports of phlebotomine sand fly host feeding sources in Ecuador. We identified blood meal sources for phlebotomine sand fly species in Valle Hermoso, a hyper endemic area for leishmaniasis in Ecuador. Phlebotomine sand fly collections were carried out during the dry and rainy seasons. PCR and multiplex PCR were performed from DNA extracted from the abdomens of blood-fed females to specifically identify the avian and mammalian blood meal sources. Avian-blood (77%), mammalian-blood (16%) and mixed avian-mammalian blood (7%) were found in the samples. At the species level, blood from chickens (35.5%), humans (2.8%), cows (2.8%) and dogs (1.9%) was specifically detected. Nyssomyia trapidoi was the most common species of Lutzomyia found that fed on birds. The present results may aid the development of effective strategies to control leishmaniasis in Ecuador. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Isolation and isoenzyme characterization of Leishmania (Viannia braziliensis from a case of human cutaneous leishmaniasis in northeast centre of the state of São Paulo

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    MC Pinto

    2005-11-01

    Full Text Available The diagnosis of human cutaneous leishmaniasis in small towns is sometimes made without the species identification of the Leishmania, even in areas without previous epidemiological surveys. Here we report the isolation of a Leishmania strain from a patient of Rincão, state of São Paulo, that was identified by isoenzyme characterization as L. (Viannia braziliensis. Sand fly collections were made in the area where the patient live in order to investigate the likely vector species.

  14. [Lutzomyia longiflocosa as suspected vector of cutaneous leishmaniasis in a focus of cutaneous leishmaniasis on the sub-andean region of Tolima department, Colombia, and the knowledge on sandflies by the inhabitants].

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    Pardo, Raúl H; Cabrera, Olga Lucía; Becerra, Jorge; Fuya, Patricia; Ferro, Cristina

    2006-10-01

    Between 2003 and 2004 the largest epidemic of cutaneous leishmaniasis in Colombia (2,810 cases, with the highest incidence of 6,202 x 100,000 in 2004) occurred in the sub-Andean rural area of the municipalities of Chaparral and San Antonio in the department of Tolima. The present study was carried out to identify suspected vectors and to establish the knowledge that the inhabitants have about sand flies in order to use this information for vector control. 46 houses were sampled with CDC light traps set up indoors to establish the sand fly species composition, abundance and the percentage of infestation. Houses were examined during daylight to identify endophagy. A questionnaire was applied in order to estimate the knowledge about sand flies, their role in transmission and the sites and seasons of highest abundance. Three anthropophilic sand fly species of possible epidemiological importance were found. L. longiflocosa was the dominant sand fly species accounting for 81.7% (192 / 235) of all catches and infested the highest number of houses (41.7%). The other two species were L. columbiana and L. nuneztovari, with relative abundances of 3.4% and 2.1%, respectively, and house infestations of 13.0% and 6.5%, respectively. There was no evidence of endophilic behavior. Inhabitants recognized sand flies and their role in transmission. They identified the houses and the dry season as the site and time period of highest sand fly abundance. Based on its high anthropophily, predominance and apparent endophagic behavior, L. longiflocosa is the most probable vector of leishmaniasis indoors. L. columbiana and L. nuneztovari could be involved as secondary vectors outdoors. The importance of these findings on sand fly control is discussed.

  15. A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis

    Science.gov (United States)

    2017-10-01

    Leishmaniasis is caused by the protozoan Leishmania and is generally transmitted by the bite of sand flies of the genus Lutzomyia or Phlebotomus, The...generally transmitted by the bite of sand flies of the genus Lutzomyia or Phlebotomus, The disease has significant global impact, producing 10-20 million...will improve the quality of life of populations living in endemic areas. The availability of RPA-LF in economically depressed regions will improve the

  16. [Blood feeding preference of Lutzomyia whitmani (Diptera, Psychodidae) in a transmission area for American cutaneous leishmaniasis in the State of Maranhão, Brazil].

    Science.gov (United States)

    Fonteles, Raquel Silva; Vasconcelos, Gabriel Costa E; Azevêdo, Patrícia Castelo Branco; Lopes, Gildevan Nolasco; Moraes, Jorge Luiz Pinto; Lorosa, Elias Seixas; Kuppinger, Oliver; Rebêlo, José Manuel Macário

    2009-01-01

    The aim of this study was to determine the sources of blood meals for females of Lutzomyia whitmani, a phlebotomine species incriminated as the main vector for American cutaneous leishmaniasis in Maranhão. For this, 70 Lutzomyia whitmani females were collected in the municipality of Axixá, an area with one of the greatest numbers of cases of American cutaneous leishmaniasis in humans in Maranhão. They were analyzed using the precipitin technique. Ninety percent of the specimens showed a reaction to some type of antiserum positive immune reaction, among which 73% presented single reactions, with predominance for chicken blood (22%), rodent blood (14.3%) and human blood (12.7%). Among the double reactions, the predominant combinations were chicken/human (6.3%), chicken/opossum (4.8%), ox/human (3.2%) and opossum/human (3.2%). Thus, we conclude that humans and domestic and synanthropic animals are blood meal sources for Lutzomyia whitmani and may play an important role in the transmission cycle for American cutaneous leishmaniasis, thus explaining the cases of this disease in Axixá.

  17. [Socio-epidemiological and cultural aspects of cutaneous leishmaniasis: conceptions, attitudes and practices in the populations of Tierralta and Valencia (Cordoba, Colombia)].

    Science.gov (United States)

    Patiño-Londoño, Sandra Yaneth; Salazar, Lina Marcela; Acero, Catalina Tovar; Bernal, Iván Darío Vélez

    2017-01-01

    This article focuses on the conceptions, attitudes and practices of the inhabitants from four villages (veredas) in Tierralta and Valencia (Cordoba, Colombia), who have suffered from or are aware of the existence of cutaneous leishmaniasis. A mixed methodology was implemented based in a qualitative design using interviews and focus groups (n=45) and an epidemiological design which included applying the Montenegro test (n=251), uncovering suspected cases of cutaneous leishmaniasis in humans, (n=5) and applying epidemiological surveys (n=409). Among the results, a lack of knowledge regarding the vector was found; although respondents could identify the Lutzomyia (known as "alú"), they did not correlate it with cutaneous leishmaniasis. In addition, traditional home treatments were more frequently used, increasing the underrecording of cases. With respect to healthcare personnel, flaws in diagnosis and treatment were found, which reinforces adherence to home treatments. This scenario calls for a reflection upon the challenges of the health care system in relation to the interventions of health personnel in communities situated in endemic areas.

  18. Molecular Characterization of Leishmania Parasites in Giemsa-Stained Slides from Cases of Human Cutaneous and Visceral Leishmaniasis, Eastern Algeria.

    Science.gov (United States)

    Beldi, Nadia; Mansouri, Roukaya; Bettaieb, Jihene; Yaacoub, Alia; Souguir Omrani, Hejer; Saadi Ben Aoun, Yusr; Saadni, Farida; Guizani, Ikram; Guerbouj, Souheila

    2017-06-01

    In Algeria, visceral leishmaniasis (VL) is due to Leishmania (L.) infantum, while three cutaneous forms (CL) are caused by Leishmania major, Leishmania tropica and Leishmania infantum. In this study, the use of Giemsa-stained slides was evaluated with two PCR techniques, in Eastern Algeria. A total of 136 samples corresponding to 100 CL smears (skin scrapings) and 36 VL slides (bone marrow aspirates) collected from 2008 to 2014 were tested. Upon DNA extraction, two PCRs were used to amplify the ribosomal Internal Transcribed Spacer 1 (ITS1) and mini-exon genes. Amplified products were digested (PCR-RFLP) and profiles analyzed for Leishmania species identification. A statistical analysis was also performed. ITS1-PCR was found significantly more sensitive than mini-exon-PCR (77.95% positives vs. 67.65%; p = 0.001). Comparison of PCR positivity showed statistically significant differences between old and recently prepared slides suggesting a better use of recent slides in PCR analyses. For species identification, PCR-restriction fragment length polymorphism (RFLP) results of ITS1 and mini-exon were concordant. L. infantum was identified from VL cases and L. infantum, L. major, and L. tropica from CL ones. According to geographical origin, L. infantum was found in North-Eastern provinces, while L. major was distributed from the North to the Center-East of Algeria. Interestingly, two L. tropica samples were identified in Annaba, located far North-East Algeria. Distribution of leishmaniasis in Eastern parts of Algeria, besides finding of L. tropica in the far North, is in this study described for the first time using molecular tools, thus confirming the usefulness of slides for PCR identification of Leishmania parasites in retrospective epidemiological investigations.

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

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    Rodrigo Augusto Ferreira de Souza

    2015-05-01

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

  20. A two years study on vectors of cutaneous leishmaniasis: Evidence for sylvatic transmission cycle in the State of Campeche, Mexico

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    Eduardo A Rebollar-Téllez

    1996-10-01

    Full Text Available Vectors of cutaneous leishmaniasis in the State of Campeche were studied in relation to the transmission cycle of Leishmania (Le. mexicana. To determine how transmission of leishmaniasis occurs, we collected phlebotomine sand flies for two years. In the first year (October 1990 to November 1991 the collections were made with CDC light traps, Shannon traps and direct captures at natural shelters around the village (<200 m of La Libertad. In the second year (February 1993 to January 1994 the catches were performed at 8 km southeast of La Libertad in the forest. Female sand flies were examined for Leishmania. During the first year, 347 sand flies of nine species were collected, most of which were Lutzomyia deleoni (61.3%. When all nine species were considered, more females than males were captured. Low densities of anthropophillic species of sand flies around the village indicated that sylvatic transmission was taking place. For the second year, 1484 sand flies of 16 species were caught. The most common were L. olmeca olmeca (21.7%, L. cruciata (19.2% and L. ovallesi (14.1%. Similarly, more females were caught than males. Thirty-five females of five species were found infected with flagellates believed to be Leishmania sp. The highest infection rate was found in L. olmeca olmeca (7.1% followed by L. cruciata (4.5% and L. ovallesi (1.1%. These data plus other evidence on the epidemiology of human cases and results from reservoir studies are discussed in relation to the sylvatic transmission cycle.

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

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    Grazielle Cardoso da Graça

    2012-08-01

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

  2. Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis.

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    Brandon A Berger

    2017-04-01

    Full Text Available Oral miltefosine has been shown to be non-inferior to first-line, injectable meglumine antimoniate (MA for the treatment of cutaneous leishmaniasis (CL in children. Miltefosine may be administered via in-home caregiver Directly Observed Therapy (cDOT, while patients must travel to clinics to receive MA. We performed a cost-effectiveness analysis comparing miltefosine by cDOT versus MA for pediatric CL in southwest Colombia.We developed a Monte Carlo model comparing the cost-per-cure of miltefosine by cDOT compared to MA from patient, government payer, and societal perspectives (societal = sum of patient and government payer perspective costs. Drug effectiveness and adverse events were estimated from clinical trials. Healthcare utilization and costs of travel were obtained from surveys of providers and published sources. The primary outcome was cost-per-cure reported in 2015 USD. Treatment efficacy, costs, and adherence were varied in sensitivity analysis to assess robustness of results. Treatment with miltefosine resulted in substantially lower cost-per-cure from a societal and patient perspective, and slightly higher cost-per-cure from a government payer perspective compared to MA. Mean societal cost-per-cure were $531 (SD±$239 for MA and $188 (SD±$100 for miltefosine, a mean cost-per-cure difference of +$343. Mean cost-per-cure from a patient perspective were $442 (SD ±$233 for MA and $30 (SD±$16 for miltefosine, a mean difference of +$412. Mean cost-per-cure from a government perspective were $89 (SD±$55 for MA and $158 (SD±$98 for miltefosine, with a mean difference of -$69. Results were robust across a variety of assumptions in univariate and multi-way analysis.Treatment of pediatric cutaneous leishmaniasis with miltefosine via cDOT is cost saving from patient and societal perspectives, and moderately more costly from the government payer perspective compared to treatment with MA. Results were robust over a range of sensitivity

  3. Leishmaniasis vector behaviour in Kenya

    International Nuclear Information System (INIS)

    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)

  4. Phenotyping of circulating CD8(+) T cell subsets in human cutaneous leishmaniasis

    Czech Academy of Sciences Publication Activity Database

    Khamesipour, A.; Rostami, M.N.; Tasbihi, M.; Mohammadi, A.M.; Shahrestani, T.; Sarrafnejad, A.; Sohrabi, Yahya; Eskandari, S.E.; Valian, H.K.

    2012-01-01

    Roč. 14, č. 9 (2012), s. 702-711 ISSN 1286-4579 Institutional research plan: CEZ:AV0Z50520514 Institutional support: RVO:68378050 Keywords : CD8(+) T cells * memory T cells * cutaneous leishmania sis * IFN-gamma Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.920, year: 2012

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

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    Sharma Nand

    2009-01-01

    Full Text Available Background: The newly recognized endemic focus of leishmaniasis in Satluj river valley of Himachal Pradesh (India has both localized cutaneous leishmaniasis (LCL and visceral leishmaniasis (VL predominantly caused by Leishmania donovani. Rapid rK39 immunochromatographic dipstick test detects circulating antibodies to recombinant K39 antigen of L. donovani-infantum complex and is highly specific/sensitive in diagnosing symptomatic or asymptomatic infection in humans and dogs. Methods: The sera from two VL patients and 13 LCL patients, and 31 dogs were subjected to rK39 immunochromatographic dipstick testing with an aim to identify possible animal reservoir for leishmaniasis in this endemic focus. Results and Conclusion: The positive rapid rK39 immunochromatographic dipstick test in 100% VL and 31.8% LCL patients, and 6.5% dogs suggests that both VL and LCL in this focus are apparently being caused by L. donovani-infantum and that reservoir infection is perhaps being chiefly maintained in asymptomatic dogs. However, it needs corroborative evidence in the form of in-vitro parasite cultivation and/or PCR studies for confirmation. A more elaborate study is recommended.

  6. The Elderly Respond to Antimony Therapy for Cutaneous Leishmaniasis Similarly to Young Patients but Have Severe Adverse Reactions.

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    Lago, Alexsandro Souza do; Nascimento, Maurício; Carvalho, Augusto M; Lago, Neuza; Silva, Juliana; Queiroz, José Roberto; Carvalho, Lucas P; Schriefer, Albert; Wilson, Mary; Machado, Paulo; Carvalho, Edgar M

    2018-03-26

    There is evidence that elderly patients with cutaneous leishmaniasis (CL) have more mucosal and disseminated diseases than young patients and their cells produce less antigen-induced interferon (IFN)-γ. Herein, we compared the roles of interleukin (IL)-10 and IL-15 as modulators of antigen-induced immune responses and the incidence of adverse reaction and response to therapy in young versus elderly patients with CL. Study participants included 35 senior (60-85 years) and 35 young (18-40 years) patients who had a diagnosis of CL documented by typical cutaneous lesions containing Leishmania braziliensis DNA. Elderly patients had less lymph node enlargement. Antigen-induced blood cell cytokine responses were studied in the absence or presence of IL-10 Ab or exogenously added recombinant IL-15. The ratio of IFN-γ/IL-10 was lower in elderly patients, and IFN-γ production was enhanced by either neutralization of IL-10 or exogenous recombinant IL-15 in blood cells from elderly but not young patients. Patients were treated three times weekly with antimony at 20 mg/kg/day for 20 doses. Although there was no difference in response to therapy between the two groups, two young patients needed rescue therapy with amphotericin B. Ventricular arrhythmias and ventricular overload were more frequent in elderly patients. We conclude that elderly patients have alterations in the immune response that may influence clinical manifestations, but we did not find that they had a higher failure rate than young subjects to antimony therapy. However, because of the high rate of electrocardiographic abnormalities during therapy, antimony should not be used in elderly patients with CL.

  7. [Mefloquine in the treatment of cutaneous leishmaniasis in an endemic area of Leishmania (Viannia) braziliensis].

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    Laguna-Torres, V A; Silva, C A; Correia, D; Carvalho, E M; Magalhães, A V; Macêdo, V de O

    1999-01-01

    The aim of this study was to evaluate the efficacy of mefloquine in the treatment of skin leishmaniasis in patients infected with Leishmania (Viannia) braziliensis at an endemic region. Mefloquine is an oral drug effective against malaria with a prolonged half-life, less toxicity and easier administration than pentavalent antimonials. At Corte de Pedra in the Southern litoral of Bahia State, two randomized groups of ten patients with leishmaniasis were treated. The first group was treated with oral mefloquine, 250 mg per day in a single dose for six days and repeated three weeks later. The second group received meglumine antimoniate (Glucantime), 20 mg/kg daily administered intravenously for 20 days. Only one patient in the group treated with mefloquine showed evidence of clinical success. During treatment, one patient with four lesions developed a new lesion. The other three patients with clinical leismaniasis did not show evidence of clinical success after nine weeks of treatment. The group treated with Glucantime showed evident clinical improvement of the skin lesions.

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

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    V. M. A. Passos

    1993-03-01

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

  9. High density of Leishmania major and rarity of other mammals' Leishmania in zoonotic cutaneous leishmaniasis foci, Iran.

    Science.gov (United States)

    Bordbar, Ali; Parvizi, Parviz

    2014-03-01

    Only Leishmania major is well known as a causative agent of zoonotic cutaneous leishmaniasis (ZCL) in Iran. Our objective was to find Leishmania parasites circulating in reservoir hosts, sand flies and human simultaneously. Sand flies, rodents and prepared smears of humans were sampled. DNA of Leishmania parasites was extracted, and two fragments of ITS-rDNA gene amplified by PCR. RFLP and sequencing were employed to identify Leishmania parasites. Leishmania major and L. turanica were identified unequivocally by targeting and sequencing ITS-rDNA from humans, rodents and sand flies. The new Leishmania species close to gerbilli (GenBank Accession Nos. EF413076; EF413087) was discovered only in sand flies. Based on parasite detection of ITS-rDNA in main and potential reservoir hosts and vectors and humans, we conclude that at least two Leishmania species are common in the Turkmen Sahra ZCL focus. Phylogenetic analysis proved that the new Leishmania is closely related to Leishmania mammal parasites (Leishmania major, Leishmania turanica, Leishmania gerbilli). Its role as a principal agent of ZCL is unknown because it was found only in sand flies. Our findings shed new light on the transmission cycles of several Leishmania parasites in sand flies, reservoir hosts and humans. © 2014 John Wiley & Sons Ltd.

  10. A molecular and parasitological survey on cutaneous leishmaniasis patients from historical city of Kashan in Isfahan province, center of Iran

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    Mohammad Reza Shiee

    2012-12-01

    Full Text Available Objective: To study cutaneous leishmaniasis (CL for identifying the dominant Leishmania species on CL patients referred to medical health centers of historical Kashan city and suburbs located in Isfahan province in central part of Iran during 2010 to 2011. Methods: From 137 CL cases, were microscopically positive, the skin lesion serosity materials of 103 cases were cultured in monophasic culture media (RPMI 1 640. We used the PCR-RFLP method for characterization the Leishmania isolates, by using specific internal transcribed spacer (ITS1 primers and HAEШ as the restriction fast enzyme. DNA was extracted from 63 samples. Results: L. tropica is main species in 58 (92.1% cases and L. major is identified in 5 (7.9% cases. Indeed randomly two isolates were the species characterized as L. major produced ulcer at the base tail of BALB/c mice after 3 weeks but from three L. tropica isolates none of them produced any lesion during 6 months post inoculation. Conclusions: The parasitological, epidemiological aspect and molecular methods of this study showed that, Kashan and suburb are anthroponetic CL area despite this city located in Isfahan province as an ancient focus of zoonotic CL in Iran.

  11. Evaluation of PCR for cutaneous leishmaniasis diagnosis and species identification using filter paper samples in Panama, Central America.

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    Miranda, A; Saldaña, A; González, K; Paz, H; Santamaría, G; Samudio, F; Calzada, J E

    2012-09-01

    Cutaneous leishmaniasis (CL) is a major vectorborne disease in Panama. In this study, the diagnostic performance and usefulness of two DNA extraction procedures from skin scraping samples collected on FTA filter paper for subsequent PCR diagnosis of CL was evaluated. A positive CL laboratory diagnosis was based on a positive parasitological test (Giemsa-stained smears or in vitro culture) and/or positive PCR test performed from skin scrapings collected in TE buffer (PCR-TE). Of 100 patients with skin lesions suggestive of CL, 82 (82%) were confirmed as CL positive. The sensitivity was calculated for each of the PCR approaches from samples collected on filter paper. The highest sensitivity was achieved by PCR-FTA processed by Chelex 100 (PCR-Chelex) (0.94). PCR-FTA extracted using the FTA purification reagent presented a lower sensitivity (0.60). Good concordance between routine PCR-TE and PCR-Chelex was observed (percent agreement=0.88, κ index=0.65). In conclusion, use of FTA filter paper for skin scraping collection combined with PCR is a reliable and convenient method for CL diagnosis in Panama, with comparable performance to the routine PCR method and with improved sensitivity compared with those of conventional parasitological methods. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  12. Epidemiological trends of cutaneous leishmaniasis in Al-Madinah Al-Munawarah Province, Western Region of Saudi Arabia

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    Miskelyemen Abdelatti Elmekki

    2017-01-01

    Full Text Available Objective: To investigate the epidemiological trends of cutaneous leishmaniasis (CL in Al-Madinah Al-Munawarah, western region of KSA. Materials and Methods: Four hundred and sixty-seven parasitologically confirmed CL cases attending Al-Meeqat Hospital, Al-Madinah, during 2012–2015, were included in this study. Results: Both Saudi and non-Saudi nationals were infected, with the highest infection rate being among Saudis (68.7%. Males were more affected than females as 86.9% of the total CL cases were males. Moreover, CL was prevalent in all age groups with higher frequency among young adults and adolescents (23.1% and 22.7%, respectively. Interestingly, almost all the patients in the adolescent and child age groups were Saudis (96.2% and 93.5%, respectively. Considering geographical distribution, the highest percentage of the cases (40.5% were from the northern parts of Al-Madinah province while the eastern parts reported the least infection rate (7.3%. Few cases (2.5% were supposed to encounter the infection abroad. Additionally, the frequency of infection was found to follow a seasonal distribution. Regarding treatment, pentostam, ketoconazole, or cryotherapy were the treatment options usually used. Conclusion: CL is prevalent in Al-Madinah Al-Munawarah area and new foci are being introduced. Thus, detailed studies with large surveillances regarding vector and reservoir hosts in and around the area are needed.

  13. Epidemiologic profile of oriental sore caused by Leishmania parasites in a new endemic focus of cutaneous leishmaniasis, southern Iran.

    Science.gov (United States)

    Khosravani, Moosa; Moemenbellah-Fard, Mohammad Djaefar; Sharafi, Mehdi; Rafat-Panah, Azam

    2016-09-01

    Cutaneous leishmaniasis (CL) is the first and most important vector-borne zoonotic disease transmitted by sand flies in Iran. As a parasitic disease in the Old World, it is a complex zoonosis with multiple vertebrate hosts and arthropod vectors of pathogenic flagellate protozoan in the genus of Leishmania in different parts of its range. Phlebotomine sand flies are proven as vectors of this parasite which can be transmitted through the bite of an infected female sand fly distributed in almost all parts of Iran. This research performed on all CL patients as that were registered into special forms by physicians and experts during the study period 2006-2013 in the county town of Fasa, Iran. Data were analyzed by Chi square test using SPSS 17 statistics software. Overall, 1,908 patients (59.18 %) lived in rural and 1,316 (40.82 %) lived in urban areas. All ages were between 1 and ≥30 year. The most frequent age group was ≥20 years (54.6 %). Sex ratio of patients was almost 1:1 (1,561; 48.42 % male vs. 1,663; 51.58 % female). Most of them (66.84 %) had wet lesions and those with dry lesions were less frequent (33.16 %). There was a significant difference between the frequencies of these two groups (P counties in Iran showed that it was most likely an endemic disease in this region.

  14. Rodenticide Comparative Effect of Klerat® and Zinc Phosphide for Controlling Zoonotic Cutaneous Leishmaniasis in Central Iran

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    Arshad VEYSI

    2016-12-01

    Full Text Available Background: Zoonotic cutaneous leishmaniasis (ZCL is a neglected disease with public health importance that is common in many rural areas of Iran. In recent years, behavioral resistance and/or bait shyness against the common rodenticide among reservoir hosts of ZCL have been reported. The aim of this study was to evaluate the effectiveness of Klerat® and zinc phosphide against natural reservoir of ZCL.Methods: This survey was carried out in four villages located 45 to 95 km far from Esfahan City Esfahan province, central Iran from April to November 2011. The rodent burrows were counted destroyed and reopened holes baited around all villages. Effect of rodent control operation on the main vector density and incidence of ZCL were evaluated.Results: The reduction rate of rodent burrows after intervention calculated to be at 62.8% in Klerat® and 58.15% in zinc phosphide treated areas. Statistical analysis showed no difference between the densities of the vector in indoors and outdoors in intervention and control areas. The incidence of the disease between treated and control areas after intervention was statistically different (P< 0.05.Conclusion: Klerat® could be a suitable alternative for zinc phosphide in a specific condition such as behavior resistance or occurrence of bait shyness.

  15. First molecular detection of Leishmania major within naturally infected Phlebotomus salehi from a zoonotic cutaneous leishmaniasis focus in southern Iran.

    Science.gov (United States)

    Azizi, K; Fakoorziba, M R; Jalali, M; Moemenbellah-Fard, M D

    2012-03-01

    Human cutaneous leishmaniasis (CL) is a major notifiable public health problem in many parts of Iran. It is often caused by the zooflagellate parasite Leishmania major which is mainly transmitted by the bites of female phlebotomine sandflies belonging to the genus Phlebotomus (Diptera: Psychodidae). The annual incidence of CL in Fars province, southern Iran, was about 108-144 in 2007. The leishmanial infections of wild sandflies that may act as vectors were thus investigated at an endemic focus in this province. In all 330 female Phlebotomus sandflies were screened for the detection of Leishmania-specific kinetoplast DNA (kDNA) by polymerase chain reaction (PCR) methods. A two stage nested PCR protocol was used to establish the identity of Leishmania major species in naturally infected sandflies. The L. major kDNA was detected in 18 (5.5%) individual sandflies which belonged to four different Phlebotomus species (Phlebotomus papatasi, Phlebotomus salehi, Phlebotomus sergenti and P. major group). For the first time, one naturally infected P. salehi specimen contained the kDNA of the protozoan parasite, L. major, with a main band of 560 base pairs identified using the nested PCR method. It seems most likely therefore that P. salehi is potentially a rare sylvatic vector of L. major parasites in parts of this province. This is the first combined morphological and molecular studies of P. salehi in Iran.

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

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    Léa Cristina Castellucci

    2014-06-01

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

  17. Factors associated to adherence to different treatment schemes with meglumine antimoniate in a clinical trial for cutaneous leishmaniasis.

    Science.gov (United States)

    Ribeiro, Madelon Novato; Pimentel, Maria Inês Fernandes; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhães de; Teixeira, José Liporage; Leite, Madson Pedro da Silva; Fonseca, Monique; Santos, Ginelza Peres Lima dos; Salgueiro, Mariza Matos; Ferreira e Vasconcellos, Erica de Camargo; Lyra, Marcelo Rosandiski; Saheki, Mauricio Naoto; Valete-Rosalino, Claudia Maria

    2014-01-01

    The favorable outcome of the treatment of a disease is influenced by the adherence to therapy. Our objective was to assess factors associated with adherence to treatment of patients included in a clinical trial of equivalence between the standard and alternative treatment schemes with meglumine antimoniate (MA) in the treatment of cutaneous leishmaniasis (CL), in the state of Rio de Janeiro. Between 2008 and 2011, 57 patients with CL were interviewed using a questionnaire to collect socioeconomic data. The following methods were used for adherence monitoring: counting of vial surplus, monitoring card, Morisky test and modified Morisky test (without the question regarding the schedule); we observed 82.1% (vial return), 86.0% (monitoring card), 66.7% (Morisky test) and 86.0% (modified Morisky test) adherence. There was a strong correlation between the method of vial counting and the monitoring card and modified Morisky test. A significant association was observed between greater adherence to treatment and low dose of MA, as well as with a lower number of people sleeping in the same room. We recommend the use of the modified Morisky test to assess adherence to treatment of CL with MA, because it is a simple method and with a good performance, when compared to other methods.

  18. FACTORS ASSOCIATED TO ADHERENCE TO DIFFERENT TREATMENT SCHEMES WITH MEGLUMINE ANTIMONIATE IN A CLINICAL TRIAL FOR CUTANEOUS LEISHMANIASIS

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    Madelon Novato Ribeiro

    2014-07-01

    Full Text Available The favorable outcome of the treatment of a disease is influenced by the adherence to therapy. Our objective was to assess factors associated with adherence to treatment of patients included in a clinical trial of equivalence between the standard and alternative treatment schemes with meglumine antimoniate (MA in the treatment of cutaneous leishmaniasis (CL, in the state of Rio de Janeiro. Between 2008 and 2011, 57 patients with CL were interviewed using a questionnaire to collect socioeconomic data. The following methods were used for adherence monitoring: counting of vial surplus, monitoring card, Morisky test and modified Morisky test (without the question regarding the schedule; we observed 82.1% (vial return, 86.0% (monitoring card, 66.7% (Morisky test and 86.0% (modified Morisky test adherence. There was a strong correlation between the method of vial counting and the monitoring card and modified Morisky test. A significant association was observed between greater adherence to treatment and low dose of MA, as well as with a lower number of people sleeping in the same room. We recommend the use of the modified Morisky test to assess adherence to treatment of CL with MA, because it is a simple method and with a good performance, when compared to other methods.

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

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    Carolina Bioni Garcia TELES

    2015-08-01

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

  20. Studies on the sand fly fauna (Diptera: Psychodidae) in high-transmission areas of cutaneous leishmaniasis in the Republic of Suriname

    Science.gov (United States)

    2013-01-01

    Background Sand flies (Diptera: Psychodidae) are the vectors of Leishmania parasites, the causative agents of leishmaniasis. Cutaneous leishmaniasis is an increasing public health problem in the Republic of Suriname and is mainly caused by Leishmania (Vianna) guyanensis, but L. (V.) braziliensis, L. (L.) amazonensis, and L. (V.) naiffi also infect humans. Transmission occurs predominantly in the forested hinterland of the country. Information regarding the potential vectors of leishmaniasis in Suriname is limited. This study aims to broaden the knowledge about vectors involved in the transmission of cutaneous leishmaniasis in Suriname. For this purpose, sand flies were characterized in various foci of cutaneous leishmaniasis in the country, the districts of Para, Brokopondo, and Sipaliwini. Methods Sand flies were collected in areas around mining plots and villages using CDC light traps in the period between February 2011 and March 2013. They were categorized by examination of the spermathecea (females) and the external genitalia (males). Results A total of 2,743 sand fly specimens belonging to 34 different species were captured, including four species (Lutzomyia aragaoi, Lu. ayrozai, Lu. damascenoi, and Lu. sordellii) that had never before been described for Suriname. Five percent of the catch comprised Lu. squamiventris sensu lato, one female of which was positive with L. (V.) braziliensis and was captured in a gold mining area in Brokopondo. Other sand fly species found positive for Leishmania parasites were Lu. trichopyga, Lu. ininii, and Lu. umbratilis, comprising 32, 8, and 4%, respectively, of the catch. These were captured at gold mining areas in Brokopondo and Sipaliwini, but the Leishmania parasites they had ingested could not be identified due to insufficient amounts of DNA. Conclusions The sand fly fauna in Suriname is highly diverse and comprises Lutzomyia species capable of transmitting Leishmania parasites. Four new Lutzomyia species have been found

  1. Double blind, randomized controlled trial, to evaluate the effectiveness of a controlled nitric oxide releasing patch versus meglumine antimoniate in the treatment of cutaneous leishmaniasis [NCT00317629

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    Silva Federico A

    2006-05-01

    Full Text Available Abstract Background Cutaneous Leishmaniasis is a worldwide disease, endemic in 88 countries, that has shown an increasing incidence over the last two decades. So far, pentavalent antimony compounds have been considered the treatment of choice, with a percentage of cure of about 85%. However, the high efficacy of these drugs is counteracted by their many disadvantages and adverse events. Previous studies have shown nitric oxide to be a potential alternative treatment when administered topically with no serious adverse events. However, due to the unstable nitric oxide release, the topical donors needed to be applied frequently, making the adherence to the treatment difficult. The electrospinning technique has allowed the production of a multilayer transdermal patch that produces a continuous and stable nitric oxide release. The main objective of this study is to evaluate this novel nitric oxide topical donor for the treatment of cutaneous leishmaniasis. Methods and design A double-blind, randomized, double-masked, placebo-controlled clinical trial, including 620 patients from endemic areas for Leishmaniasis in Colombia was designed to investigate whether this patch is as effective as meglumine antimoniate for the treatment of cutaneous leishmaniasis but with less adverse events. Subjects with ulcers characteristic of cutaneous leishmaniasis will be medically evaluated and laboratory tests and parasitological confirmation performed. After checking the inclusion/exclusion criteria, the patients will be randomly assigned to one of two groups. During 20 days Group 1 will receive simultaneously meglumine antimoniate and placebo of nitric oxide patches while Group 2 will receive placebo of meglumine antimoniate and active nitric oxide patches. During the treatment visits, the medications will be daily administered and the presence of adverse events assessed. During the follow-up, the research group will visit the patients at days 21, 45, 90 and 180. The

  2. What about Th1/Th2 in cutaneous leishmaniasis vaccine discovery?

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    Campos-Neto A.

    2005-01-01

    Full Text Available The T helper cell type 1 (Th1 response is essential to resist leishmaniasis, whereas the Th2 response favors the disease. However, many leishmanial antigens, which stimulate a Th1 immune response during the disease or even after the disease is cured, have been shown to have no protective action. Paradoxically, antigens associated with an early Th2 response have been found to be highly protective if the Th1 response to them is generated before infection. Therefore, finding disease-associated Th2 antigens and inducing a Th1 immune response to them using defined vaccination protocols is an interesting unorthodox alternative approach to the discovery of a leishmania vaccine.

  3. Lésion ulcérocroûteuse de l’angle interne de l’œil droit: a leishmaniose cutanée en est une cause [A crushing ulcerous lesion of the internal angle of the right eye: Cutaneous leishmaniasis is one of the causes

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    Laouali Salissou

    2018-04-01

    Full Text Available Niger is a tropical country where leishmaniasis is endemic. The first case was reported in 1911. Leishmania major is practically the pathogen found in Niger, a country lying between 8° and 20° north latitudes from the Atlantic to the Chadian border. We report a case of cutaneous leishmaniasis in the type of ulcerative lesion, characterized by its localization at the internal angle of the right eye posing a diagnostic problem. The diagnosis of leishmaniasis was made by parasitological examination. Anatomipathologic examination eliminated cutaneous tuberculosis, pyogenic granuloma, molluscum contagiosum and basal cell epithelioma. Metronidazole management has accelerated healing. Thus in a tropical country, in front of any chronic, painless ulcerative lesion and resistant to all therapeutics, the diagnosis of cutaneous leishmaniasis must be evoked, for a consequent management after confirmation.

  4. Sporotrichosis in Iran: A mini review of reported cases in patients suspected to cutaneous leishmaniasis

    OpenAIRE

    shahram mahmoudi; farideh zaini

    2015-01-01

    Sporotrichosis is a chronic subcutaneous fungal infection with global distribution. It is a rare fungal infection with nine reported cases in Iran, including eight humans and one animal, within the past 30 years. Among the human cases, seven were of the fixed cutaneous type?of sporotrichosis and one had sporotrichoid?lymphocutaneous. The reported patients were within the age range of 23-60 years, and six of them were female. The most frequent sites of infection were forearms and hands, as wel...

  5. Psammomys obesus Cretzschmar, 1828 and zoonotic cutaneous leishmaniasis in Sinai Peninsula, Egypt.

    Science.gov (United States)

    Morsy, T A; Sabry, A H; Rifaat, M M; Wahba, M M

    1996-08-01

    In the Middle East, the fat sand rat Psammomys obesus is the most important reservoir host of zoonotic cutaneous leishmamiasis (ZCL). It is the most incriminated host in outbreaks. Two P. obesus caught in Wadi El Gedeiret (Al Arish, North Sinai) were found naturally infected with Leishmania major as indicated by enzyme electrophoresis. In Egypt, the already known reservoir hosts are Gerbillus pyramidum I. Geoffroy St. Hilaire, 1825; Meriones crassus Sundevall, 1984 and Meriones sacramenti Thomas, 1922. The hostal role of P. obesus was discussed.

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

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    Amalia Monroy-Ostria

    2014-01-01

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

  7. The new situation of cutaneous leishmaniasis after Syrian civil war in Gaziantep city, Southeastern region of Turkey.

    Science.gov (United States)

    Özkeklikçi, Ahmet; Karakuş, Mehmet; Özbel, Yusuf; Töz, Seray

    2017-02-01

    Cutaneous leishmaniasis (CL) is an important public health problem with around 2.000 autochthonous reported cases each year in Turkey. Due to the civil war in Syria, Turkey received around three million refugees and they are mainly located at either camps or homes in south/southeastern part of Turkey. In the present study, we aimed to collect samples from CL suspected patients admitting to State Hospital in Gaziantep City and perform parasitological and DNA-based techniques for diagnosis as well as species identification of the parasite for better understanding the prevalence of each species among Turkish and Syrian patients in the region. The collection of samples was carried out between January 2009 and July 2015. The lesion aspiration samples were taken and stained with Giemsa stain followed by microscopical examination for parasitological diagnosis. After the DNA extraction from Giemsa stained slides, real time and semi-nested PCRs both targeting ITS1 region were performed for molecular diagnosis and species identification. A total of 567 people were admitted to the hospital with the suspicion of CL and 263 (46.4%) of them were found to be positive by parasitological examination. One hundred seventy-four (66.15%), 88 (33.46%) and 1 (0.38%) of them were Turkish, Syrians and Afghan, respectively. Slide samples obtained from 34 CL suspected patients were analyzed by PCR and 20 of them were found positive. Eighteen (13 Turkish and 13 Syrians) of the positive samples were identified as L. tropica, while two (1 Turkish and 1 Syrian) of them were L. infantum. In conclusion, the effects of Syrian civil war on the epidemiology of CL in Gaziantep city is demonstrated in the present study. The use of molecular tool in the diagnosis of leishmaniasis is effective, sensitive and time saving which will enable the species typing. Species typing of the causative agent in endemic areas will bring valuable data to epidemiological knowledge. Copyright © 2016 Elsevier B.V. All

  8. Canine Cutaneous Leishmaniasis: Dissemination and Tissue Tropism of Genetically Distinct Leishmania (Viannia braziliensis Populations

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    Guilherme Marx de Oliveira

    2013-01-01

    Full Text Available Little is known regarding the internal dissemination of initial cutaneous lesions and tissue tropism of Leishmania (Viannia braziliensis populations in naturally infected dogs. The aim of this study was to investigate genetic polymorphisms of L. (V. braziliensis populations in different anatomic sites of naturally infected dogs by using polymerase chain reaction (PCR and low-stringency single specific primer-PCR (LSSP-PCR techniques. The amplified products were analyzed by LSSP-PCR to investigate the genetic variability of the parasite populations present in different anatomical sites. Twenty-three out of the 52 samples gave PCR-positive results. The existence of L. (V. braziliensis strains that remained restricted to cutaneous lesions and others showing characteristics of dissemination to internal organs and healthy skin was observed. LSSP-PCR and numerical analyses revealed that parasite populations that do not disseminate were genetically similar and belonged to a separate phenetic cluster. In contrast, populations that showed spreading to internal organs displayed a more polymorphic genetic profile. Despite the heterogeneity, L. (V. braziliensis populations with identical genetic profiles were observed in popliteal and cervical lymph nodes of the same animal. Our results indicate that infection in dogs can be manifested by dissemination and tissue tropism of genetically distinct populations of L. (V. braziliensis.

  9. The Study of Sand Fly Fauna in an Endemic Focus for Cutaneous Leishmaniasis in Fasa from April to October in the year 2013

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    Mehdi Sharafi

    2015-02-01

    Full Text Available Background & Objectives: Leishmaniasis as a zoonosis disease seen in three forms including Cutaneous, mucocutaneous, and visceral (kala- azar. The Leishmania transferred by sand flies is the causative agent of this disease. Considering that leishmaniasis is an endemic disease in Fasa, this study was performed to determine the sand fly species of Fasa, Materials & Methods: In this cross- sectional study from April to September 2014, the fauna of sand flies was investigated. Sampling was done in villages with above, medium, and low incidence by using sticky traps every 15 days. Then, captured specimens were mounted and identified by specific key. Results: 3842 sand flies were captured for ecological studies. 2305 of them (60% were males and the rest of them were females. 1152 specimens (30% of them were from indoors and the rest were from outdoors. Totally, 10 species were identified including Phlebotomus. Papatasi, Ph. Alexandri, Ph. Sergenti, Ph. Mongolensis, Ph. Bergeroti, Ph. Caucasicus, Sergentomyia theodori, S. Baghdadis, S. sintuni, and S. antennata. Among captured specimens Phlebotomus Papatasi, Ph. Sergenti had the first and the second places, respectively. Conclusion: Sandflies in Fasa are very active with high prevalence and species diversity. Phlebotomus Papatasi as the predominant species transfers Leishmania from rodents to humans. This subject is related to the prevalence of rural leishmaniasis in this area. According to the semi-domestic vector, spraying is not helpful in a rural foci of cutaneous leishmaniasis. But the control of reservoir and educating the residents about prevention ways of bite are effective in disease control and prevention.

  10. Physiological age in Lutzomyia youngi (Diptera: Psychodidae populations from an endemic area for cutaneous leishmaniasis, Venezuela

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    Scorza José V.

    1994-01-01

    Full Text Available Batches of sylvatic females of Lutzomyia youngi (Phlebotominae captured in a Shannon trap on twelve occasions over one year in a locality where subcutaneous leishmaniasis is endemic, near the city of Trujillo, Venezuela, were used to study: 1 the percentages of parous females according to previously established criteria and 2 the average number of eggs laid spontaneously by isolated females during 7 days after feeding on hamsters. The data on the batches of females captured on nights previous to the rainy period (prepluvial were compared with those on females captured after the rains (postpluvial . Significant differences were detected by variation analysis for two variables and different number of N, as also were consistent groupings by Duncan's Test for pre-and postpluvial lots of females. The females captured on nights prior to the rainy periods (January-March and August-September presented higher rates of nulliparity (86-72% and contained or laid a greater number of eggs (71-67 than those captured after the rains (March-June and November-December which presented lower rates of nulliparity (60-24% and a smaller number of eggs (50-30. The rainfall peaks occurred in April and September-October, respectively. It is considered that these differences can be used by epidemiological studies as a means of estimating the physiological age of female populations of L. youngy.

  11. The Effect of Sun Radiation on the Course of Cutaneous Leishmaniasis in BALB/c Mice

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    Amir Abas Azarian

    2011-03-01

    Full Text Available Objective(sStudies have described immunomedulatory effects of sun exposure and ultraviolet radiation on infectious and neoplastic diseases. Here the effect of exposure to low potency radiation of sun on the course of leishmaniasis in mice was studied. Materials and MethodsFifteen BALB/c mice were exposed to suberythemogenic doses of sun (mean 180 mJ/cm2/day of UVB 2 months before and 4 months after Leishmania major inoculation to food pad. Control group was kept in the sun protected environment. From 2nd to 17th week after inoculation, size of the lesion was recorded in each group weekly and at last week the parasite burden in spleen was detected. Results were compared between two groups. ResultsSeven mice from case group and 9 mice from control group survived up to last week. The mean lesion size was 0.90±0.59 cm in exposed and 4.01±3.59 cm in unexposed mice (P= 0.037. Parasite burden in spleen of case and control groups were 5.5±4.61 and 106.94±279.76 respectively (P= 0.006.ConclusionChronic exposure of BALB/c mice to suberythemogenic doses of sun suppressed skin lesion and decreased the extension of L. major to spleen.

  12. Risk Mapping and Situational Analysis of Cutaneous Leishmaniasis in an Endemic Area of Central Iran: A GIS-Based Survey.

    Science.gov (United States)

    Abedi-Astaneh, Fatemeh; Hajjaran, Homa; Yaghoobi-Ershadi, Mohammad Reza; Hanafi-Bojd, Ahmad Ali; Mohebali, Mehdi; Shirzadi, Mohammad Reza; Rassi, Yavar; Akhavan, Amir Ahmad; Mahmoudi, Bagher

    2016-01-01

    Cutaneous leishmaniasis (CL) is among the top 10 infectious disease priorities in the world, and the leading cause of morbidity in Iran. The present study was conducted to assess the risk of CL, and to determine some epidemiological features of the disease in endemic areas of Qom Province in Central Iran during 2009 to 2013. Data regarding human cases of the disease were obtained from the Qom Province Health Center, prepared and stored in a spatial database created in ArcGIS10.3. A total of 9 out of 212 Leishmania spp. positive slides taken in 2013 from patients residing in Qom city were examined using molecular methods and the species of Leishmania was identified by PCR-RFLP. Those 9 patients had no history of travel outside the city. Spatial analysis and clustering methods were applied to find major hot spots and susceptible areas for the establishment of novel foci of the disease. Transmission patterns were examined for spatial autocorrelation using the Moran's I statistical application, and for the clustering of high or low values using the Getis-Ord Gi* statistics. During the period of study, a total of 1767 CL cases were passively reported in the area, out of which were 65% males and 35% females. The highest and lowest numbers of cases were reported in 2010 and 2013, respectively. Importantly, 979 cases were reported from urban areas, while the remainder came from rural areas. Leishmania major was detected as the causative agent of CL in the city of Qom. Remarkably, most patients recorded in Qom city were associated with a history of travel to the endemic areas of CL within the province, or to other endemic areas of the disease in Iran. Spatial distribution of CL cases revealed northeastern and southwestern quarters of the city were the major hot spots of the disease (P<0.05). Hot spot and CL transmission risk analysis across the province indicated that more than 40 villages were located in high and very high risk areas of CL transmission. Due to the

  13. Nota sobre leishmaniose tegumentar no litoral sul do Estado de São Paulo, Brasil Cutaneous leishmaniasis at the South Coastal region of the S. Paulo State, Brazil

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    Oswaldo Paulo Forattini

    1973-12-01

    Full Text Available Relata-se a existência de área endêmica de leishmaniose tegumentar na região Sul do litoral do Estado de São Paulo, Brasil. Descrevem-se 17 casos a maioria dos quais foram diagnosticados parasitologicamente. As características observadas permitem supor a possibilidade de transmissão intradomiciliar.An endemic area of cutaneous leishmaniasis, in the South Coastal region of S. Paulo State, Brazil, is reported. Seventeen cases were found and diagnostic was made mainly through parasitologic evidences. Probability of local intradomiciliary transmission is suspected.

  14. Is paromomycin an effective and safe treatment against cutaneous leishmaniasis? A meta-analysis of 14 randomized controlled trials.

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    Dae Hyun Kim

    Full Text Available BACKGROUND: High cost, poor compliance, and systemic toxicity have limited the use of pentavalent antimony compounds (SbV, the treatment of choice for cutaneous leishmaniasis (CL. Paromomycin (PR has been developed as an alternative to SbV, but existing data are conflicting. METHODOLOGY/PRINCIPAL FINDINGS: We searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials, without language restriction, through August 2007, to identify randomized controlled trials that compared the efficacy or safety between PR and placebo or SbV. Primary outcome was clinical cure, defined as complete healing, disappearance, or reepithelialization of all lesions. Data were extracted independently by two investigators, and pooled using a random-effects model. Fourteen trials including 1,221 patients were included. In placebo-controlled trials, topical PR appeared to have therapeutic activity against the old world and new world CL, with increased local reactions, when used with methylbenzethonium chloride (MBCL compared to when used alone (risk ratio [RR] for clinical cure, 2.58 versus 1.01: RR for local reactions, 1.60 versus 1.07. In SbV-controlled trials, the efficacy of topical PR was not significantly different from that of intralesional SbV in the old world CL (RR, 0.70; 95% confidence interval, 0.26-1.89, whereas topical PR was inferior to parenteral SbV in treating the new world CL (0.67; 0.54-0.82. No significant difference in efficacy was found between parenteral PR and parenteral SbV in the new world CL (0.88; 0.56-1.38. Systemic side effects were fewer with topical or parenteral PR than parenteral SbV. CONCLUSIONS/SIGNIFICANCE: Topical PR with MBCL could be a therapeutic alternative to SbV in selected cases of the old world CL. Development of new formulations with better efficacy and tolerability remains to be an area of future research.

  15. An α-Gal-containing neoglycoprotein-based vaccine partially protects against murine cutaneous leishmaniasis caused by Leishmania major.

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    Eva Iniguez

    2017-10-01

    Full Text Available Protozoan parasites from the genus Leishmania cause broad clinical manifestations known as leishmaniases, which affect millions of people worldwide. Cutaneous leishmaniasis (CL, caused by L. major, is one the most common forms of the disease in the Old World. There is no preventive or therapeutic human vaccine available for L. major CL, and existing drug treatments are expensive, have toxic side effects, and resistant parasite strains have been reported. Hence, further therapeutic interventions against the disease are necessary. Terminal, non-reducing, and linear α-galactopyranosyl (α-Gal epitopes are abundantly found on the plasma membrane glycolipids of L. major known as glycoinositolphospholipids. The absence of these α-Gal epitopes in human cells makes these glycans highly immunogenic and thus potential targets for vaccine development against CL.Here, we evaluated three neoglycoproteins (NGPs, containing synthetic α-Gal epitopes covalently attached to bovine serum albumin (BSA, as vaccine candidates against L. major, using α1,3-galactosyltransferase-knockout (α1,3GalT-KO mice. These transgenic mice, similarly to humans, do not express nonreducing, linear α-Gal epitopes in their cells and are, therefore, capable of producing high levels of anti-α-Gal antibodies. We observed that Galα(1,6Galβ-BSA (NGP5B, but not Galα(1,4Galβ-BSA (NGP12B or Galα(1,3Galα-BSA (NGP17B, was able to significantly reduce the size of footpad lesions by 96% in comparison to control groups. Furthermore, we observed a robust humoral and cellular immune response with production of high levels of protective lytic anti-α-Gal antibodies and induction of Th1 cytokines.We propose that NGP5B is an attractive candidate for the study of potential synthetic α-Gal-neoglycoprotein-based vaccines against L. major infection.

  16. Detection of DNA from Leishmania (Viannia: accuracy of polymerase chain reaction for the diagnosis of cutaneous leishmaniasis.

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    Herintha Coeto Neitzke-Abreu

    Full Text Available Cutaneous leishmaniasis (CL can occur in skin and mucosa, causing disfiguring lesions. The laboratory diagnosis of CL involves immunological methods and optical detection of the parasite, al of which have limitations. There is a need for more effective diagnostic methods for CL which wil allow treatment to be initiated more promptly in order to help prevent the development of severe forms of mucosal disease, and to estimate the prognosis of the infection. The polymerase chain reaction (PCR has been widely used to diagnose CL, because of its higher sensitivity. This study estimated the accuracy and compared PCRs of samples from lesion scarification (PCR-L and blood sample-enriched leukocytes (PCR-B with three conventional diagnostic techniques: parasite direct search (DS, Montenegro skin test (MST, and indirect immunofluorescence reaction (IIF. The study included 276 patients under suspicion of CL. We conducted a cross-sectional study, in which patients were selected by convenience sampling. We used MP3H/MP1L primers to generate a Leishmania (Viannia (minicircle kDNA fragment of 70-bp. Of 106 patients with CL, 83.87%, 51.67%, 64.52%, 85.71%, or 96.10% tested positive by PCR-L, PCR-B, DS, IIF, or MST, respectively. Five patients tested positive only by PCR-L, and two other patients only by PCR-B. PCR-L is indicated for use in patients with chronic lesions or Leishmania reinfection, which may progress to mucosal lesion. PCR-B is indicated for use in patients with negative results in conventional tests or for patients with no apparent lesion. PCR is not only useful in diagnosing CL but also helps to identify the infecting species.

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

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    Koji Yamada

    2016-06-01

    Full Text Available American Cutaneous Leishmaniasis (ACL is a neglected vector-borne zoonosis that persists despite increasing socio-economic development and urbanization in Panamá. Here, we investigate the association between environmental changes and spatio-temporal ACL transmission in the Republic of Panamá (1980–2012. We employ a macroecological approach, where patterns of variation in ACL incidence at the spatially coarse-grained scale of health areas are studied considering factors linked to the ecology of ACL transmission. We specifically study impacts of climatic variability, measured by the different phases of El Niño Southern Oscillation (ENSO, within diverse ecosystems and sand fly (Diptera: Psychodidae vector species, as well as heterogeneous local climatic patterns, deforestation, population growth rates, and changes in social marginalization. We found that over the study period, patterns of ACL incidence: (i were asynchronous with clusters changing from east to west of the Panamá Canal, (ii trends increased in the west, and decreased or remained nearly constant in the east, independent of human population growth, (iii generally increased in years following El Niño, and (iv decreased as forest cover increased. We found no significant association between changes in socio-economic indicators and ACL transmission. Regarding vector abundance and presence, we found that studies had been biased to locations east of the Panamá canal, and that, in general, the abundance of dominant vector species decreased during the cold phase of ENSO. Finally, our results indicate that a macroecological approach is useful to understand heterogeneities related to environmental change impacts on ACL transmission.

  18. Risk Mapping of Cutaneous Leishmaniasis via a Fuzzy C Means-based Neuro-Fuzzy Inference System

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    P. Akhavan

    2014-10-01

    Full Text Available Finding pathogenic factors and how they are spread in the environment has become a global demand, recently. Cutaneous Leishmaniasis (CL created by Leishmania is a special parasitic disease which can be passed on to human through phlebotomus of vector-born. Studies show that economic situation, cultural issues, as well as environmental and ecological conditions can affect the prevalence of this disease. In this study, Data Mining is utilized in order to predict CL prevalence rate and obtain a risk map. This case is based on effective environmental parameters on CL and a Neuro-Fuzzy system was also used. Learning capacity of Neuro-Fuzzy systems in neural network on one hand and reasoning power of fuzzy systems on the other, make it very efficient to use. In this research, in order to predict CL prevalence rate, an adaptive Neuro-fuzzy inference system with fuzzy inference structure of fuzzy C Means clustering was applied to determine the initial membership functions. Regarding to high incidence of CL in Ilam province, counties of Ilam, Mehran, and Dehloran have been examined and evaluated. The CL prevalence rate was predicted in 2012 by providing effective environmental map and topography properties including temperature, moisture, annual, rainfall, vegetation and elevation. Results indicate that the model precision with fuzzy C Means clustering structure rises acceptable RMSE values of both training and checking data and support our analyses. Using the proposed data mining technology, the pattern of disease spatial distribution and vulnerable areas become identifiable and the map can be used by experts and decision makers of public health as a useful tool in management and optimal decision-making.

  19. Risk map for cutaneous leishmaniasis in Ethiopia based on environmental factors as revealed by geographical information systems and statistics

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    Ahmed Seid

    2014-05-01

    Full Text Available Cutaneous leishmaniasis (CL is a neglected tropical disease strongly associated with poverty. Treatment is problematic and no vaccine is available. Ethiopia has seen new outbreaks in areas previously not known to be endemic, often with co-infection by the human immunodeficiency virus (HIV with rates reaching 5.6% of the cases. The present study concerns the development of a risk model based on environmental factors using geographical information systems (GIS, statistical analysis and modelling. Odds ratio (OR of bivariate and multivariate logistic regression was used to evaluate the relative importance of environmental factors, accepting P ≤0.056 as the inclusion level for the model’s environmental variables. When estimating risk from the viewpoint of geographical surface, slope, elevation and annual rainfall were found to be good predictors of CL presence based on both probabilistic and weighted overlay approaches. However, when considering Ethiopia as whole, a minor difference was observed between the two methods with the probabilistic technique giving a 22.5% estimate, while that of weighted overlay approach was 19.5%. Calculating the population according to the land surface estimated by the latter method, the total Ethiopian population at risk for CL was estimated at 28,955,035, mainly including people in the highlands of the regional states of Amhara, Oromia, Tigray and the Southern Nations, Nationalities and Peoples’ Region, one of the nine ethnic divisions in Ethiopia. Our environmental risk model provided an overall prediction accuracy of 90.4%. The approach proposed here can be replicated for other diseases to facilitate implementation of evidence-based, integrated disease control activities.

  20. Parasitological Confirmation and Analysis of Leishmania Diversity in Asymptomatic and Subclinical Infection following Resolution of Cutaneous Leishmaniasis.

    Science.gov (United States)

    Rosales-Chilama, Mariana; Gongora, Rafael E; Valderrama, Liliana; Jojoa, Jimena; Alexander, Neal; Rubiano, Luisa C; Cossio, Alexandra; Adams, Emily R; Saravia, Nancy G; Gomez, María Adelaida

    2015-12-01

    The contribution of individuals with subclinical infection to the transmission and endemicity of cutaneous leishmaniasis (CL) is unknown. Immunological evidence of exposure to Leishmania in residents of endemic areas has been the basis for defining the human population with asymptomatic infection. However, parasitological confirmation of subclinical infection is lacking. We investigated the presence and viability of Leishmania in blood and non-invasive mucosal tissue samples from individuals with immunological evidence of subclinical infection in endemic areas for CL caused by Leishmania (Viannia) in Colombia. Detection of Leishmania kDNA was conducted by PCR-Southern Blot, and parasite viability was confirmed by amplification of parasite 7SLRNA gene transcripts. A molecular tool for genetic diversity analysis of parasite populations causing persistent subclinical infection based on PCR amplification and sequence analysis of an 82bp region between kDNA conserved blocks 1 and 2 was developed. Persistent Leishmania infection was demonstrated in 40% (46 of 114) of leishmanin skin test (LST) positive individuals without active disease; parasite viability was established in 59% of these (27 of 46; 24% of total). Parasite burden quantified from circulating blood monocytes, nasal, conjunctival or tonsil mucosal swab samples was comparable, and ranged between 0.2 to 22 parasites per reaction. kDNA sequences were obtained from samples from 2 individuals with asymptomatic infection and from 26 with history of CL, allowing genetic distance analysis that revealed diversity among sequences and clustering within the L. (Viannia) subgenus. Our results provide parasitological confirmation of persistent infection among residents of endemic areas of L. (Viannia) transmission who have experienced asymptomatic infection or recovered from CL, revealing a reservoir of infection that potentially contributes to the endemicity and transmission of disease. kDNA genotyping establishes proof

  1. Molecular identification and polymorphism determination of cutaneous and visceral leishmaniasis agents isolated from human and animal hosts in Iran.

    Science.gov (United States)

    Hajjaran, Homa; Mohebali, Mehdi; Mamishi, Setareh; Vasigheh, Farzaneh; Oshaghi, Mohammad Ali; Naddaf, Saied Reza; Teimouri, Aref; Edrissian, Gholam Hossein; Zarei, Zabiholah

    2013-01-01

    Amplification of internal transcript spacer 1 of ribosomal RNA (ITS1-RNA) gene followed by RFLP analysis and sequencing was used to identify the causing agents of cutaneous and visceral leishmaniasis (CL and VL) in humans and animal reservoir hosts from various geographical areas in Iran. We also used random amplified polymorphic DNA (RAPD-PCR) to obtain polymorphisms among isolates of Leishmania spp. Totally, 362 suspected human and animal cases including 173 CL, 49 VL, 60 rodents, and 80 domestic dogs were examined for Leishmania infection. From 112 culture-positive samples prepared from CL cases, 75 (67%) were infected with L. major and 37 (33%) with L. tropica. Of the 60 rodents examined, 25 (41.6%) harbored the Leishmania infection; 21 were infected with L. major and 4 with L. turanica. From 49 suspected VL, 29 were positive by direct agglutination test (DAT), whereas microscopy detected parasite in bone marrow of 25 and culture in 28 of the patients. Two VL patients were infected with L. tropica and 26 with L. infantum. Of the 80 domestic dogs, 56 showed anti-Leishmania antibodies with DAT. Of these, 55 were positive by both microscopy and culture. Molecular identity, obtained only for 47 samples, revealed L. infantum in 43 and L. tropica in 4 dogs. The polymorphisms among L. tropica and L. major isolates were 3.6% and 7.3%; the rate among human and canine VL isolates was 2.8% and 9.8%, respectively. Our results showed that at least four different Leishmania species with various polymorphisms circulate among humans and animal hosts in Iran.

  2. Molecular Identification and Polymorphism Determination of Cutaneous and Visceral Leishmaniasis Agents Isolated from Human and Animal Hosts in Iran

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    Homa Hajjaran

    2013-01-01

    Full Text Available Amplification of internal transcript spacer 1 of ribosomal RNA (ITS1-RNA gene followed by RFLP analysis and sequencing was used to identify the causing agents of cutaneous and visceral leishmaniasis (CL and VL in humans and animal reservoir hosts from various geographical areas in Iran. We also used random amplified polymorphic DNA (RAPD-PCR to obtain polymorphisms among isolates of Leishmania spp. Totally, 362 suspected human and animal cases including 173 CL, 49 VL, 60 rodents, and 80 domestic dogs were examined for Leishmania infection. From 112 culture-positive samples prepared from CL cases, 75 (67% were infected with L. major and 37 (33% with L. tropica. Of the 60 rodents examined, 25 (41.6% harbored the Leishmania infection; 21 were infected with L. major and 4 with L. turanica. From 49 suspected VL, 29 were positive by direct agglutination test (DAT, whereas microscopy detected parasite in bone marrow of 25 and culture in 28 of the patients. Two VL patients were infected with L. tropica and 26 with L. infantum. Of the 80 domestic dogs, 56 showed anti-Leishmania antibodies with DAT. Of these, 55 were positive by both microscopy and culture. Molecular identity, obtained only for 47 samples, revealed L. infantum in 43 and L. tropica in 4 dogs. The polymorphisms among L. tropica and L. major isolates were 3.6% and 7.3%; the rate among human and canine VL isolates was 2.8% and 9.8%, respectively. Our results showed that at least four different Leishmania species with various polymorphisms circulate among humans and animal hosts in Iran.

  3. Risk Mapping of Cutaneous Leishmaniasis via a Fuzzy C Means-based Neuro-Fuzzy Inference System

    Science.gov (United States)

    Akhavan, P.; Karimi, M.; Pahlavani, P.

    2014-10-01

    Finding pathogenic factors and how they are spread in the environment has become a global demand, recently. Cutaneous Leishmaniasis (CL) created by Leishmania is a special parasitic disease which can be passed on to human through phlebotomus of vector-born. Studies show that economic situation, cultural issues, as well as environmental and ecological conditions can affect the prevalence of this disease. In this study, Data Mining is utilized in order to predict CL prevalence rate and obtain a risk map. This case is based on effective environmental parameters on CL and a Neuro-Fuzzy system was also used. Learning capacity of Neuro-Fuzzy systems in neural network on one hand and reasoning power of fuzzy systems on the other, make it very efficient to use. In this research, in order to predict CL prevalence rate, an adaptive Neuro-fuzzy inference system with fuzzy inference structure of fuzzy C Means clustering was applied to determine the initial membership functions. Regarding to high incidence of CL in Ilam province, counties of Ilam, Mehran, and Dehloran have been examined and evaluated. The CL prevalence rate was predicted in 2012 by providing effective environmental map and topography properties including temperature, moisture, annual, rainfall, vegetation and elevation. Results indicate that the model precision with fuzzy C Means clustering structure rises acceptable RMSE values of both training and checking data and support our analyses. Using the proposed data mining technology, the pattern of disease spatial distribution and vulnerable areas become identifiable and the map can be used by experts and decision makers of public health as a useful tool in management and optimal decision-making.

  4. Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the vector Lutzomyia sand flies and reservoir mammals.

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    Hashiguchi, Yoshihisa; Gomez L, Eduardo A; Cáceres, Abraham G; Velez, Lenin N; Villegas, Nancy V; Hashiguchi, Kazue; Mimori, Tatsuyuki; Uezato, Hiroshi; Kato, Hirotomo

    2018-02-01

    The vector Lutzomyia sand flies and reservoir host mammals of the Leishmania parasites, causing the Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador were thoroughly reviewed, performing a survey of literatures including our unpublished data. The Peruvian L. (V.) peruviana, a principal Leishmania species causing Andean-CL in Peru, possessed three Lutzomyia species, Lu. peruensis, Lu. verrucarum and Lu. ayacuchensis as vectors, while the Ecuadorian L. (L.) mexicana parasite possessed only one species Lu. ayacuchensis as the vector. Among these, the Ecuadorian showed a markedly higher rate of natural Leishmania infections. However, the monthly and diurnal biting activities were mostly similar among these vector species was in both countries, and the higher rates of infection (transmission) reported, corresponded to sand fly's higher monthly-activity season (rainy season). The Lu. tejadai sand fly participated as a vector of a hybrid parasite of L. (V.) braziliensis/L. (V.) peruviana in the Peruvian Andes. Dogs were considered to be principal reservoir hosts of the L. (V.) peruviana and L. (L.) mexicana parasites in both countries, followed by other sylvatic mammals such as Phyllotis andium, Didelphis albiventris and Akodon sp. in Peru, and Rattus rattus in Ecuador, but information on the reservoir hosts/mammals was extremely poor in both countries. Thus, the Peruvian disease form demonstrated more complicated transmission dynamics than the Ecuadorian. A brief review was also given to the control of vector and reservoirs in the Andes areas. Such information is crucial for future development of the control strategies of the disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the causative Leishmania parasites and clinico-epidemiological features.

    Science.gov (United States)

    Hashiguchi, Yoshihisa; Gomez, Eduardo A L; Cáceres, Abraham G; Velez, Lenin N; Villegas, Nancy V; Hashiguchi, Kazue; Mimori, Tatsuyuki; Uezato, Hiroshi; Kato, Hirotomo

    2018-01-01

    This study provides comprehensive information on the past and current status of the Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador, mainly focusing on the causative Leishmania parasites and clinico-epidemiological features. Available information and data including our unpublished works were analyzed thoroughly. Endemic regions of the Andean-CL (uta) in Peru run from the north Piura/Cajamarca to the south Ayacucho at a wide range of the Pacific watersheds of the Andes through several departments, while in Ecuador those exist at limited and spotted areas in the country's mid-southwestern two provinces, Azuay and Chimborazo. The principal species of the genus Leishmania are completely different at subgenus level, L. (Viannia) peruviana in Peru, and L. (Leishmania) mexicana and L. (L.) major-like (infrequent occurrence) in Ecuador. The Peruvian uta is now prevalent in different age and sex groups, being not clearly defined as found in the past. The precise reasons are not known and should be elucidated further, though probable factors, such as emergence of other Leishmania parasites, non-immune peoples' migration into the areas, etc., were discussed briefly in the text. The Andean-CL cases in Ecuador are more rural than before, probably because of a rapid development of the Leishmania-positive communities and towns, and the change of life-styles of the inhabitants, including newly constructed houses and roads in the endemic areas. Such information is helpful for future management of the disease, not only for Leishmania-endemic areas in the Andes but also for other endemic areas. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Parasitological Confirmation and Analysis of Leishmania Diversity in Asymptomatic and Subclinical Infection following Resolution of Cutaneous Leishmaniasis.

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    Mariana Rosales-Chilama

    2015-12-01

    Full Text Available The contribution of individuals with subclinical infection to the transmission and endemicity of cutaneous leishmaniasis (CL is unknown. Immunological evidence of exposure to Leishmania in residents of endemic areas has been the basis for defining the human population with asymptomatic infection. However, parasitological confirmation of subclinical infection is lacking.We investigated the presence and viability of Leishmania in blood and non-invasive mucosal tissue samples from individuals with immunological evidence of subclinical infection in endemic areas for CL caused by Leishmania (Viannia in Colombia. Detection of Leishmania kDNA was conducted by PCR-Southern Blot, and parasite viability was confirmed by amplification of parasite 7SLRNA gene transcripts. A molecular tool for genetic diversity analysis of parasite populations causing persistent subclinical infection based on PCR amplification and sequence analysis of an 82bp region between kDNA conserved blocks 1 and 2 was developed.Persistent Leishmania infection was demonstrated in 40% (46 of 114 of leishmanin skin test (LST positive individuals without active disease; parasite viability was established in 59% of these (27 of 46; 24% of total. Parasite burden quantified from circulating blood monocytes, nasal, conjunctival or tonsil mucosal swab samples was comparable, and ranged between 0.2 to 22 parasites per reaction. kDNA sequences were obtained from samples from 2 individuals with asymptomatic infection and from 26 with history of CL, allowing genetic distance analysis that revealed diversity among sequences and clustering within the L. (Viannia subgenus.Our results provide parasitological confirmation of persistent infection among residents of endemic areas of L. (Viannia transmission who have experienced asymptomatic infection or recovered from CL, revealing a reservoir of infection that potentially contributes to the endemicity and transmission of disease. kDNA genotyping

  7. Triphenylmethane derivatives have high in vitro and in vivo activity against the main causative agents of cutaneous leishmaniasis.

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    Renata Celi Carvalho de Souza Pietra

    Full Text Available The current standard of care for cutaneous leishmaniasis (CL is organic antimonial compounds, but the administration of these compounds is complicated by a low therapeutic - toxic index, as well as parenteral administration. Thus, there is an urgent need for the development of new and inexpensive therapies for the treatment of CL. In this study, we evaluate the activity of the triphenylmethane (TPM class of compounds against three species of Leishmania which are pathogenic in humans. The TPM have a history of safe use in humans, dating back to the use of the original member of this class, gentian violet (GV, from the early 20(th century. Initially, the in vitro efficacy against Leishmania (Viannia braziliensis, L. (Leishmania amazonensis and L. (L. major of 9 newly synthesized TPM, in addition to GV, was tested. Inhibitory concentrations (IC IC(50 of 0.025 to 0.84 µM had been found in promastigotes in vitro assays. The four most effective compounds were then tested in amastigote intracellular assays, resulting in IC(50 of 0.10 to 1.59 µM. A high degree of selectivity of antiparasitic activity over toxicity to mammalian cells was observed. Afterwards, GV and TPM 6 were tested in a topical formulation in mice infected with L. (L. amazonensis leading to elimination of parasite burdens at the site of lesion/infection. These results demonstrated that TPM present significant anti-leishmanial activities and provide a rationale for human clinical trials of GV and other TPM. TPM are inexpensive and safe, thus using them for treatment of CL may have a major impact on public health.

  8. Temporal dynamics and impact of climate factors on the incidence of zoonotic cutaneous leishmaniasis in central Tunisia.

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    Amine Toumi

    Full Text Available Old world Zoonotic Cutaneous Leishmaniasis (ZCL is a vector-borne human disease caused by Leishmania major, a unicellular eukaryotic parasite transmitted by pool blood-feeding sand flies mainly to wild rodents, such as Psammomys obesus. The human beings who share the rodent and sand fly habitats can be subverted as both sand fly blood resource. ZCL is endemic in the Middle East, Central Asia, Subsaharan and North Africa. Like other vector-borne diseases, the incidence of ZCL displayed by humans varies with environmental and climate factors. However, so far no study has addressed the temporal dynamics or the impact of climate factors on the ZCL risk.Seasonality during the same epidemiologic year and interval between ZCL epidemics ranging from 4 to 7 years were demonstrated. Models showed that ZCL incidence is raising i by 1.8% (95% confidence intervals CI:0.0-3.6% when there is 1 mm increase in the rainfall lagged by 12 to 14 months ii by 5.0% (95% CI: 0.8-9.4% when there is a 1% increase in humidity from July to September in the same epidemiologic year.Higher rainfall is expected to result in increased density of chenopods, a halophytic plant that constitutes the exclusive food of Psammomys obesus. Consequently, following a high density of Psammomys obesus, the pool of Leishmania major transmissible from the rodents to blood-feeding female sand flies could lead to a higher probability of transmission to humans over the next season. These findings provide the evidence that ZCL is highly influenced by climate factors that could affect both Psammomys obesus and the sand fly population densities.

  9. Variability of Cutaneous Leishmaniasis Lesions Is Not Associated with Genetic Diversity of Leishmania tropica in Khyber Pakhtunkhwa Province of Pakistan.

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    Khan, Nazma Habib; Llewellyn, Martin S; Schönian, Gabriele; Sutherland, Colin J

    2017-11-01

    Leishmania tropica is the causative agent of cutaneous leishmaniasis in Pakistan. Here, intraspecific diversity of L. tropica from northern Pakistan was investigated using multilocus microsatellite typing. Fourteen polymorphic microsatellite markers were typed in 34 recently collected L. tropica isolates from Pakistan along with 158 archival strains of diverse Afro-Eurasian origins. Previously published profiles for 145 strains of L. tropica originating from different regions of Africa, Central Asia, Iran, and Middle East were included for comparison. Six consistently well-supported genetic groups were resolved: 1) Asia, 2) Morroco A, 3) Namibia and Kenya A, 4) Kenya B/Tunisia and Galilee, 5) Morocco B, and 6) Middle East. Strains from northern Pakistan were assigned to Asian cluster except for three that were placed in a geographically distant genetic group; Morocco A. Lesion variability among these Pakistani strains was not associated with specific L. tropica genetic profile. Pakistani strains showed little genetic differentiation from strains of Iraq, Afghanistan, and Syria (F ST = 0.00-0.06); displayed evidence of modest genetic flow with India (F ST = 0.14). Furthermore, genetic structuring within these isolates was not geographically defined. Pak-Afghan cluster was in significant linkage disequilibrium (I A = 1.43), had low genetic diversity, and displayed comparatively higher heterozygosity (F IS = -0.62). Patterns of genetic diversity observed suggest dominance of a minimally diverse clonal lineage within northern Pakistan. This is surprising as a wide clinical spectrum was observed in patients, suggesting the importance of host and other factors. Further genotyping studies of L. tropica isolates displaying different clinical phenotypes are required to validate this potentially important observation.

  10. 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 ... whqlibdoc.who.int/trs/WHO_TRS_949_eng.pdf . Chapter 3 - Leishmaniasis, Cutaneous Chapter 3 - Leptospirosis File ...

  11. Effects of Bone Marrow Mesenchymal Stromal Cell Therapy in Experimental Cutaneous Leishmaniasis in BALB/c Mice Induced by Leishmania amazonensis

    Science.gov (United States)

    Pereira, Joyce Carvalho; Ramos, Tadeu Diniz; Silva, Johnatas Dutra; de Mello, Mirian França; Pratti, Juliana Elena Silveira; da Fonseca-Martins, Alessandra Marcia; Firmino-Cruz, Luan; Kitoko, Jamil Zola; Chaves, Suzana Passos; Gomes, Daniel Claudio De Oliveira; Diaz, Bruno Lourenço; Rocco, Patricia R. M.; de Matos Guedes, Herbert Leonel

    2017-01-01

    Cutaneous leishmaniasis remains both a public health and a therapeutic challenge. To date, no ideal therapy for cutaneous leishmaniasis has been identified, and no universally accepted therapeutic regimen and approved vaccines are available. Due to the mesenchymal stromal cell (MSC) immunomodulatory capacity, they have been applied in a wide variety of disorders, including infectious, inflammatory, and allergic diseases. We evaluated the potential effects of bone marrow MSC therapy in a murine model of cutaneous leishmaniasis. In vitro, coculture of infected macrophages with MSC increased parasite load on macrophages in comparison with controls (macrophages without MSCs). In vivo, BALB/c mice were infected with 2 × 106 Leishmania amazonensis (Josefa strain) promastigotes in the footpad. 7 and 37 days after infection, animals were treated with 1 × 105 MSCs, either intralesional (i.l.), i.e., in the same site of infection, or intravenously (i.v.), through the external jugular vein. Control animals received the same volume (50 µL) of phosphate-buffered saline by i.l. or i.v. routes. The lesion progression was assessed by its thickness measured by pachymetry. Forty-two days after infection, animals were euthanized and parasite burden in the footpad and in the draining lymph nodes was quantified by the limiting dilution assay (LDA), and spleen cells were phenotyped by flow cytometry. No significant difference was observed in lesion progression, regardless of the MSC route of administration. However, animals treated with i.v. MSCs presented a significant increase in parasite load in comparison with controls. On the other hand, no harmful effect due to MSCs i.l. administered was observed. The spleen cellular profile analysis showed an increase of IL-10 producing T CD4+ and TCD8+ cells in the spleen only in mice treated with i.v. MSC. The excessive production of IL-10 could be associated with the disease-aggravating effects of MSC therapy when intravenously

  12. A targeted and adjuvanted nanocarrier lowers the effective dose of liposomal amphotericin B and enhances adaptive immunity in murine cutaneous leishmaniasis.

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    Daftarian, Pirouz M; Stone, Geoffrey W; Kovalski, Leticia; Kumar, Manoj; Vosoughi, Aram; Urbieta, Maitee; Blackwelder, Pat; Dikici, Emre; Serafini, Paolo; Duffort, Stephanie; Boodoo, Richard; Rodríguez-Cortés, Alhelí; Lemmon, Vance; Deo, Sapna; Alberola, Jordi; Perez, Victor L; Daunert, Sylvia; Ager, Arba L

    2013-12-01

    Amphotericin B (AmB), the most effective drug against leishmaniasis, has serious toxicity. As Leishmania species are obligate intracellular parasites of antigen presenting cells (APC), an immunopotentiating APC-specific AmB nanocarrier would be ideally suited to reduce the drug dosage and regimen requirements in leishmaniasis treatment. Here, we report a nanocarrier that results in effective treatment shortening of cutaneous leishmaniasis in a mouse model, while also enhancing L. major specific T-cell immune responses in the infected host. We used a Pan-DR-binding epitope (PADRE)-derivatized-dendrimer (PDD), complexed with liposomal amphotericin B (LAmB) in an L. major mouse model and analyzed the therapeutic efficacy of low-dose PDD/LAmB vs full dose LAmB. PDD was shown to escort LAmB to APCs in vivo, enhanced the drug efficacy by 83% and drug APC targeting by 10-fold and significantly reduced parasite burden and toxicity. Fortuitously, the PDD immunopotentiating effect significantly enhanced parasite-specific T-cell responses in immunocompetent infected mice. PDD reduced the effective dose and toxicity of LAmB and resulted in elicitation of strong parasite specific T-cell responses. A reduced effective therapeutic dose was achieved by selective LAmB delivery to APC, bypassing bystander cells, reducing toxicity and inducing antiparasite immunity.

  13. Protective Effect of Vitamin D3 and Gp63 Conjugated with Tetanus Toxoid on Outcome of Cutaneous Leishmaniasis Lesions in Balb/C Mice

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    S Soudi

    2006-01-01

    Full Text Available Introduction: GP63 is a major surface protease of Leishmania promastigotes that plays an important role in its virulance. As GP63 on its own can not develop an effective protection against leishmaniasis, the goal of this study was to evaluate the protective effect of GP63 conjugated with tetanus toxoid (TT and Vitamin D3 in susceptible BALB/c mice against cutaneous leishmaniasis. Methods: This study was a basic-applied experimental study performed in Tarbiat Modarres University from September 2002 to April 2005. Cloned virulant Leishmania (L. major [MRHO / IR / 75 / ER] strain was cultured and 5109 cells were harvested. GP63 Molecule was purified and conjugated with TT and conjugated molecule was used for immunization of 8 groups of female BALB/c mice. Results: Results showed that the group of mice receiving conjugated molecule with Vitamin D3 had significant differences from other groups regarding lesion progression (P0.05. The culture of spleen cells showed that the disease did not become systemic in this group. Conclusion: Conjugation of GP63 with TT strengthens cell immunity and its use along with vitamin D3 provokes macrophages activity. This basis can be used for production of an appropriate preparation for protection against Leishmaniasis.

  14. A rapid molecular diagnosis of cutaneous leishmaniasis by colorimetric malachite green-loop-mediated isothermal amplification (LAMP) combined with an FTA card as a direct sampling tool.

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    Nzelu, Chukwunonso O; Cáceres, Abraham G; Guerrero-Quincho, Silvia; Tineo-Villafuerte, Edwin; Rodriquez-Delfin, Luis; Mimori, Tatsuyuki; Uezato, Hiroshi; Katakura, Ken; Gomez, Eduardo A; Guevara, Angel G; Hashiguchi, Yoshihisa; Kato, Hirotomo

    2016-01-01

    Leishmaniasis remains one of the world's most neglected diseases, and early detection of the infectious agent, especially in developing countries, will require a simple and rapid test. In this study, we established a quick, one-step, single-tube, highly sensitive loop-mediated isothermal amplification (LAMP) assay for rapid detection of Leishmania DNA from tissue materials spotted on an FTA card. An FTA-LAMP with pre-added malachite green was performed at 64°C for 60min using a heating block and/or water bath and DNA amplification was detected immediately after incubation. The LAMP assay had high detection sensitivity down to a level of 0.01 parasites per μl. The field- and clinic-applicability of the colorimetric FTA-LAMP assay was demonstrated with 122 clinical samples collected from patients suspected of having cutaneous leishmaniasis in Peru, from which 71 positives were detected. The LAMP assay in combination with an FTA card described here is rapid and sensitive, as well as simple to perform, and has great potential usefulness for diagnosis and surveillance of leishmaniasis in endemic areas. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. [Species of Lutzomyia (Psychodidae, Phlebotominae) in endemic cutaneous and visceral leishmaniasis foci of the department of Santander, in the eastern range of the Colombian Andes].

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    Sandoval, Claudia Magaly; Gutiérrez, Reinaldo; Cárdenas, Rocío; Ferro, Cristina

    2006-10-01

    Phlebotomine sand flies are the only known vectors of leishmaniasis and show an interesting biodiversity in the Andean mountain range of South America. We update the registry of species prevalent in the municipalities and endemic areas of the department of Santander, in the eastern range of the Colombian Andes. To present an updated inventory and distribution of the Lutzomyia species in the department of Santander and to discuss some ecological aspects of the principal species of medical importance. Phlebotomines were collected in 12 municipalities in the years 1998 to 2001 between 19:00-6:00 using CDC miniature light traps, manual aspirators on protected human baits between 18:00 and 20:00, and occasionally by direct aspiration on tree trunks between 8:00-11:00 and resting on walls at different times of the day. 3.972 phlebotomines of 41 species were captured, of which 16 species were new records for this area of the country. In zones of endemic American cutaneous leishmaniasis, L. gomezi, L. trapidoi, L. panamensis, L. ovallesi and L.yuilli were remarkable for their abundance, their presence within dwellings and their epidemiological relevance. In areas of visceral leishmaniasis, the most relevant species was L. longipalpis. The significant presence of vectors within human dwellings and the prevalence of human infection are continuing evidence of household transmission of Leishmania as an important public health problem in this department of Colombia.

  16. Flow Cytometric Analysis of Leishmania Reactive CD4+/CD8+ Lymphocyte Proliferation in Cutaneous Leishmaniasis

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    H Keshavarz

    2008-12-01

    Full Text Available Background: Determination of the division history of T cells in vitro is helpful in the study of effector mechanisms against infections. Technique described here uses the intracellular fluorescent label carboxyfluorescein diacetate succinimidyl ester (CFSE to monitor the proliferation. Methods: In a cross sectional study, blood samples were collected from 7 volunteers with history of cutaneous leishmania­sis (CL and one healthy control from endemic areas in Isfahan province who referred to the Center for Research and Training in Skin Diseases and Leprosy (CRTSDL, then CD4+/CD8+ lymphocytes and CD14+ monocytes were isolated from peri­pheral blood mononuclear cells (PBMC using mAbs and magnetic nanoparticles. CFSE labeled CD4+ or CD8+ lympho­cytes cultured with autologous monocytes in the presence of PHA, SLA, live Leishmania major or as control with­out sti­mulation. Cells were harvested after 7 days and were analyzed using flow cytometry. Results: Five consecutive divisions were monitored separately. Stimulation of CD4+ or CD8+ lymphocytes from CL sub­jects with SLA showed a significant difference in proliferation comparing with unstimulated cells (P< 0.05. The signifi­cant difference in the percentages of CD4+ cells stimulated with SLA was revealed at different divisions for each subject. In CD8+ lymphocyte, significant stronger stimulation of SLA was evident later in the proliferation process. The mean number of divisions in both CD4+/CD8+ lymphocytes stimulated with SLA was significantly greater than when stimulated with live L. major (P=0.007 / P=0.012, respectively Conclusion: The percentage of divided cells might be calculated separately in each division. The cells remained active following CFSE staining and there is possibility of functional analysis simultaneously.

  17. Assessment of β-lapachone loaded in lecithin-chitosan nanoparticles for the topical treatment of cutaneous leishmaniasis in L. major infected BALB/c mice.

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    Moreno, Esther; Schwartz, Juana; Larrea, Esther; Conde, Iosune; Font, Maria; Sanmartín, Carmen; Irache, Juan Manuel; Espuelas, Socorro

    2015-11-01

    Patients affected by cutaneous leishmaniasis need a topical treatment which cures lesions without leaving scars. Lesions are produced not only by the parasite but also by an uncontrolled and persistent inflammatory immune response. In this study, we proposed the loading of β-lapachone (β-LP) in lecithin-chitosan nanoparticles (NP) for targeting the drug to the dermis, where infected macrophages reside, and promote wound healing. Although the loading of β-LP in NP did not influence the drug antileishmanial activity it was critical to achieve important drug accumulation in the dermis and permeation through the skin. When topically applied in Leishmania major infected BALB/c mice, β-LP NP achieved no parasite reduction but they stopped the lesion progression. Immuno-histopathological assays in CL lesions and quantitative mRNA studies in draining lymph nodes confirmed that β-LP exhibited anti-inflammatory activity leading to the down-regulation of IL-1β and COX-2 expression and a decrease of neutrophils infiltrate. Cutaneous leishmaniasis often leaves patients with unsightly scars due to the body's inflammatory response to the infection. The authors in this paper described topical treatment using β-lapachone (β- LP) loaded in lecithin-chitosan nanoparticles (NP) in an animal model. Results confirmed the reduction of inflammatory response without affecting the parasite killing efficacy. These findings would pave way for further clinical testing in the near future. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Molecular characterization of sandflies and Leishmania detection in main vector of zoonotic cutaneous leishmaniasis in Abarkouh district of Yazd province, Iran.

    Science.gov (United States)

    Jafari, R; Najafzadeh, N; Sedaghat, M M; Parvizi, P

    2013-10-01

    To assess molecular characterization, distribution, seasonal activities of sandfly species and Leishmania parasites infecting them for this zoonotic cutaneous leishmaniasis focus. The collections were carried out in 2009-2011 using CDC traps, Sticky Papers and manual aspirator in and around the villages in Abarkouh district. Individual sandflies were characterized by PCR amplification and sequencing of fragments of their mitochondrial cytochrome b gene. Leishmania parasite infections within sandflies were performed by targeting Cyt b, ITS-rDNA, k-DNA and microsatellite genes. The PCR assays detected only Leishmania major (L. major). All infections (30) were found in the abundant and widespread vector Phlebotomus papatasi (P. papatasi). Small numbers of other sandfly species were also screened for infections, but none was found. Sergentomyia sintoni and P. papatasi were the predominant members in all locations of this district and in all habitats throughout the trapping season. Only five other sandfly species were found, namely Phlebotomus ansari, Phlebotomus caucasicus, Phlebotomus sergenti, Sergentomyia dentata and Sergentomyia merviney. In the current survey, the only infections detected are of L. major in females of P. papatasi (30 out of 190). The rates of infection of P. papatasi by L. major are not significantly different in compare with other locations in Iran with no diversity of parasite strains. Zoonotic cutaneous leishmaniasis may have emerged only recently in Abarkouh district, and the reason may well be the instability of the transmission cycles there. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  19. Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.

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    Mustafa Aksoy

    2016-07-01

    Full Text Available Cutaneous leishmaniasis (CL is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking.In this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL cases, and how children respond to antimonial therapy. CL was observed most frequently in children between 6-10 years old. Interestingly this group showed shorter duration of disease and smaller lesions compared to 0-5 year and 11-15 year old groups. Females were more affected in all groups. Lesion localization and types varied among groups, with 0-5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this could be associated to the longest duration of the disease in this group. Eleven-15 year old group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0-5 year old received intramuscular treatment more often than the other groups. Furthermore, the majority of 0-5 year old group which received intra-lesional treatment did not received subsequent intra-lesional cycles, as did children in the range of 6-15 years old.We report an increase in pediatric CL patients within the last four years. Analysis of pediatric CL patients by age revealed significant differences in CL progression. The data suggest that children between 0-5 years old responded better than other groups to intralesional treatment, since they received more often a single cycle of IL treatment, although follow up observation is required since they were more prone to develop recidivans. Eleven-15 year old patients comprise the largest percentage of patients receiving two or three cycles of intralesional treatment, suggesting that this group did not respond efficiently to

  20. The Cure Rate after Placebo or No Therapy in American Cutaneous Leishmaniasis: A Systematic Review and Meta-Analysis.

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    Gláucia Fernandes Cota

    Full Text Available There are few drugs with proven efficacy in cutaneous leishmaniasis (CL, and pentavalent antimonial derivatives are still the main first-line therapeutic agents worldwide, despite their recognized high toxicities. Randomized controlled clinical trials assessing the efficacy and safety of new therapeutic modalities are of high priority, and the definition of the design of such trials raises debate about the use of placebo as a comparator. To support the use of placebo as a comparator, two main points need to be addressed: 1--the cure rate without any therapeutic intervention and 2--the damage caused by CL and its impact on patients.The aim of this study was to systematically assess the spontaneous cure rate for American CL and to broaden the discussion about placebo use in CL trials.The PRISMA guidelines for systematic reviews and the Cochrane manual were followed. The sources used were the PubMed and LILACS databases. Studies were included if they reported cure rates using placebo or no treatment in American CL.Thirteen studies of a total of 352 patients were ultimately included in this review. The summarized global cure rates for all Leishmania species according to the intention-to-treat analyses performed at approximately three ("initial cure" and nine ("definitive cure" months after "no treatment" or placebo use were 26% (CI95%: 16 to 40% and 26% (CI95%:16 to 38%, respectively. Notably, a significantly lower cure rate was observed for L. braziliensis infection (6.4%, CI95%:0.2 to 20% than for L. mexicana infection (44%, CI95%:19 to 72%, p = 0.002. Of note, relapse occurred in 20% of patients with initial healing (CI95%:9.2 to 38.9%.These results clearly demonstrate a low spontaneous cure rate following no-treatment or placebo use, confirming that this strategy for the control group in CL studies expose patients to greater morbidity, especially for CL caused by L. braziliensis. Therefore, from this point, the crucial question to consider

  1. El Conjuro: una práctica de cuidado cultural para la Leishmaniasis Cutánea Americana en Florián, Santander (Colombia The Pray: a cultural care practice for American Cutaneous Leishmaniasis in Florian, Santander (Colombia

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    Celmira Laza Vásquez

    2009-09-01

    Full Text Available Justificación: La Leishmaniasis Cutánea Americana (LAC es una patología cutánea tropical endémica en Colombia, que en las últimas décadas ha recibido especial atención de los servicios nacionales de salud en cuanto al registro, atención básica y prevención entre otros, mejorando la epidemiología local y regional de esta dolencia en el país. Sin embargo, en el Departamento de Santander aún persiste un escaso conocimiento de las prácticas utilizadas por la población rural afectada en el cuidado cultural o genérico de la enfermedad. Objetivo: Describir las prácticas de cuidado, factores que determinan su uso y creencias culturales para la curación de la Leishmaniasis Cutánea Americana en la población rural del municipio de Florián-Santander (Colombia. Metodología: Estudio cualitativo descriptivo realizado en zona rural durante marzo de 2008, con la participaron pobladores y conjuradores de Florián Santander. La información se recolectó mediante entrevistas semi-estructuradas individuales, para realizar el posterior análisis de contenido. Resultados y conclusión: el Conjuro realizado por un Conjurador emergió como la práctica central de cuidado cultural, alrededor de la cual se realizan cuidados complementarios que incrementen la eficacia. La modesta situación socioeconómica, la deficiencia en infraestructura vial, la escasez de los medios de transporte, así como las creencias entorno al tratamiento médico con Glucantime®, se identificaron como los factores que ayudan a consolidar el Conjuro en la población rural como la práctica más utilizada para "sanar el encono".Justification: The American Cutaneous Leishmaniasis is an endemic tropical cutaneous pathology in Colombia that during the last decade has received special attention from the national health services regarding the registry, basic attention and prevention among others, improving the local and regional epidemiology of this ailment in the country

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

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    Vicente Silva Goncalves Neto

    2013-06-01

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

  3. 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.

  4. Detection and identification of cutaneous leishmaniasis isolates by culture, Polymerase chain reaction and sequence analyses in Syrian and Central Anatolia patients.

    Science.gov (United States)

    Beyhan, Yunus E; Karakus, Mehmet; Karagoz, Alper; Mungan, Mesut; Ozkan, Aysegul T; Hokelek, Murat

    2017-09-01

    To characterize the cutaneous leishmaniasis (CL) isolates of Syrian and Central Anatolia patients at species levels. Methods: Skin scrapings of 3 patients (2 Syrian, 1 Turkish) were taken and examined by direct examination, culture in Novy-MacNeal-Nicole (NNN) medium, internal transcribed spacer polymerase chain reaction and sequence analysis (PCR). Results:According to microscopic examination, culture and PCR methods, 3 samples were detected positive. The sequencing results of all isolates in the study were identified as Leishmania tropica. The same genotypes were detected in the 3 isolates and nucleotide sequence submitted into GenBank with the accession number: KP689599. Conclusion: This finding could give information about the transmission of CL between Turkey and Syria. Because of the Syrian civil war, most of the Syrian citizens circulating in Turkey and different part of Europe, this can be increase the risk of spreading the disease. So, prevention measurements must be taken urgently.

  5. Detection and identification of cutaneous leishmaniasis isolates by culture, Polymerase chain reaction and sequence analyses in Syrian and Central Anatolia patients

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    Yunus E. Beyhan

    2017-09-01

    Full Text Available Objectives: To characterize the cutaneous leishmaniasis (CL isolates of Syrian and Central Anatolia patients at species levels. Methods: Skin scrapings of 3 patients (2 Syrian, 1 Turkish were taken and examined by direct examination, culture in Novy-MacNeal-Nicole (NNN medium, internal transcribed spacer polymerase chain reaction and sequence analysis (PCR. Results:According to microscopic examination, culture and PCR methods, 3 samples were detected positive. The sequencing results of all isolates in the study were identified as Leishmania tropica. The same genotypes were detected in the 3 isolates and nucleotide sequence submitted into GenBank with the accession number: KP689599. Conclusion: This finding could give information about the transmission of CL between Turkey and Syria. Because of the Syrian civil war, most of the Syrian citizens circulating in Turkey and different part of Europe, this can be increase the risk of spreading the disease. So, prevention measurements must be taken urgently.

  6. The predictive validity of naturally acquired delayed-type hypersensitivity to leishmanin in resistance to Leishmania major-associated cutaneous leishmaniasis.

    Science.gov (United States)

    Ben Salah, Afif; Louzir, Hechmi; Chlif, Sadok; Mokni, Mourad; Zaatour, Amor; Raouene, Mohamed; Ismail, Riadh Ben; Dellagi, Koussay

    2005-12-01

    To accurately quantify the different outcomes of Leishmania major infection and to evaluate the fraction of zoonotic cutaneous leishmaniasis (ZCL) cases prevented by naturally acquired leishmanin skin test (LST) reactivity, a cohort of 470 children was followed up in 2 endemic foci, Remada and Dhiba, in southern Tunisia. During May 1997, before the ZCL emergence season, LST was performed, and results were reassessed 12 months later. Active case detection during the ZCL emergence season showed a high incidence of ZCL: 57.0% in Remada and 13.7% in Dhiba. The preventive fraction of ZCL conferred by LST reactivity increased proportionally with the reaction size before the emergence season, revealing a dose-response effect of approximately 70%. In addition, asymptomatic L. major infection appeared to be a significant form of natural immunization, particularly in the context of relatively low transmission. These findings may help in the design and evaluation of vaccines.

  7. Coinfection of Leishmania guyanensis and Human Immunodeficiency Virus–Acquired Immune Deficiency Syndrome: Report of a Case of Disseminated Cutaneous Leishmaniasis in Ecuador

    Science.gov (United States)

    Calvopina, Manuel; Aguirre, Cristina; Cevallos, William; Castillo, Alberto; Abbasi, Ibrahim; Warburg, Alon

    2017-01-01

    Reported herein is the first case of Leishmania–human immunodeficiency virus (HIV) coinfection in Ecuador. In Ecuador, HIV infections overlap endemic areas of leishmaniasis. Immunosuppression is a well-established risk factor for developing severe disease. This is a severe case of a 32-year-old man presenting with disseminated pleomorphic ulcers, papules, and cutaneous plaque-like lesions over his whole body. Numerous amastigotes were observed in both skin scrapings and biopsies. The sequence of the cytochrome b gene confirmed the presence of Leishmania guyanensis. The patient was treated but failed to respond to meglumine antimoniate and amphotericin B. Six months later, the patient died due to bacterial septic shock. PMID:28193741

  8. Failure of fluconazole in treating cutaneous leishmaniasis caused by Leishmania guyanensis in the Brazilian Amazon: An open, nonrandomized phase 2 trial.

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    Valeska Albuquerque Francesconi

    2018-02-01

    Full Text Available The treatment of Leishmaniasis caused by Leishmania (Viannia guyanensis is based on a weak strength of evidence from very few clinical trials and some case series reports. Current treatment guidelines recommend pentamidine isethionate or meglumine antimoniate (Glucantime as the first-line choices. Both are parenteral drugs with a low therapeutic indexes leading to a high risk of undesired effects. Imidazole derivatives interfere with the production of leishmanial ergosterol, an essential component of their membrane structure. One drug that has been studied in different clinical presentations of Leishmania is fluconazole, a hydrophilic bis-triazole, which is easily absorbed through the oral route with a low toxicity profile and is considered safe for children. This drug is readily available in poor countries with a reasonable cost making it a potential option for treating leishmaniasis.An adaptive nonrandomized clinical trial with sequential groups with dose escalation of oral fluconazole was designed to treat adult men with localized cutaneous leishmaniasis (LCL in Manaus, Brazil. Eligible participants were patients with LCL with confirmed Leishmania guyanensis infection.Twenty adult male patients were treated with 450 mg of fluconazole daily for 30 days. One patient (5% was cured within 30 days of treatment. Of the 19 failures (95%, 13 developed a worsening of ulcers and six evolved lymphatic spreading of the disease. Planned dose escalation was suspended after the disappointing failure rate during the first stage of the trial.Oral fluconazole, at the dose of 450mg per day, was not efficacious against LCL caused by Leishmania guyanensis in adult men.Brazilian Clinical Trial Registration (ReBec-RBR-8w292w; UTN number-1158-2421.

  9. Detection of Leishmania amazonensis and Leishmania braziliensis in Culicoides (Diptera, Ceratopogonidae) in an endemic area of cutaneous leishmaniasis in the Brazilian Amazonia.

    Science.gov (United States)

    Rebêlo, José Manuel Macário; Rodrigues, Bruno Leite; Bandeira, Maria da Conceição Abreu; Moraes, Jorge Luiz Pinto; Fonteles, Raquel Silva; Pereira, Silma Regina Ferreira

    2016-12-01

    Biting midges in the genus Culicoides act as vectors of arboviruses throughout the world and as vectors of filariasis in Latin America, the Caribbean, and parts of Africa. Although Culicoides spp. are currently not considered to be vectors of Leishmania protozoa, the high abundance of biting midges in areas with active cutaneous leishmaniasis transmission points to the possibility of Culicoides infection by these pathogens. We used PCR to test captured Culicoides species for natural infection with Leishmania spp. We tested 450 Culicoides females, divided into 30 pools of 15 individuals each, as follows: nine pools of C. foxi (135 specimens), seven pools of C. filariferus (105), seven pools of C. insignis (105), five pools of C. ignacioi (75), and two pools of C. flavivenula (30). PCR confirmed the presence of Leishmania braziliensis DNA in C. ignacioi (0.14%), C. insignis (0.14%), and C. foxi (0.11); and Le. amazonensis DNA in C. filariferus (0.14%) and C. flavivenula (0.50%). We conclude that these Culicoides species can be naturally infected, but vector competence and transmission capability must be confirmed in future studies. Our results warrant further investigation into the role of these biting midge species in the leishmaniasis epidemiological cycle. © 2016 The Society for Vector Ecology.

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

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    Mauricio Baum

    2013-10-01

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

  11. Comparison between Combination Therapy of Oral Terbinafine and Cryotherapy versus Systemic Meglumine Antimoniate and Cryotherapy in Cutaneous Leishmaniasis: A Randomized Clinical Trial.

    Science.gov (United States)

    Farajzadeh, Saeedeh; Esfandiarpour, Iraj; Haghdoost, Ali Akbar; Mohammadi, Saman; Mohebbi, Azadeh; Mohebbi, Elham; Mostafavi, Mahshid

    2015-01-01

    Leishmaniasis is a parasitic infection that may lead to a variety of manifestations. In Iran, cutaneous leishmaniasis (CL) has a high prevalence. There are many treatment modalities for CL. The use of oral terbinafine in the treatment of CL has recently been considered. The aim of this study was to compare combination of oral terbinafine plus cryotherapy versus systemic meglumine antimoniate plus cryotherapy in CL. Patients with proven direct smear for CL were divided randomly in 2 groups of 40 cases. For the first group systemic glucantime prescribed (IM, 15 mg/kg/day) for 3 weeks. For the second group oral terbinafine as two folds of usual dose in the treatment of fungal diseases prescribed [125 mg/day for body weight (BW) 40 kg] for 4 weeks. Both groups received cryotherapy every 2 weeks for 4 weeks. The patients were followed monthly for 3 months after the treatment. Partial (HR= 0.55, CI 95%= 0.3-1.1) and complete (HR= 0.53, CI 95%= 0.3-0.98) clinical improvement in terbinafine group was much slower than glucantime group, although at the end of treatment protocols no significant difference between groups were statistically observed (P=0.27). Considering more convenient suitable route of administration and approximately comparable results, it seems that terbinafine can be used as an alternative treatment, especially in the case of allergy or resistance to systemic glucantime.

  12. Interleukin 10–Dominant Immune Response and Increased Risk of Cutaneous Leishmaniasis After Natural Exposure to Lutzomyia intermedia Sand Flies

    Science.gov (United States)

    Carvalho, Augusto M.; Cristal, Juqueline R.; Muniz, Aline C.; Carvalho, Lucas P.; Gomes, Regis; Miranda, José C.; Barral, Aldina; Carvalho, Edgar M.; de Oliveira, Camila I.

    2015-01-01

    Background. Leishmaniasis is caused by parasites transmitted to the vertebrate host by infected sand flies. During transmission, the vertebrate host is also inoculated with sand fly saliva, which exerts powerful immunomodulatory effects on the host's immune response. Methods. We conducted a prospective cohort analysis to characterize the human immune response to Lutzomyia intermedia saliva in 264 individuals, from an area for cutaneous leishmaniasis (CL) caused by Leishmania braziliensis. Results. Antibodies were found in 150 individuals (56.8%); immunoglobulin G1 and G4 were the predominant subclasses. Recall responses to salivary gland sonicate showed elevated production of interleukin 10 (IL-10), interleukin 13, interferon γ, CXCL9, and CCL2 compared with controls. CD4+CD25+ T cells, including Foxp3+ cells, were the main source of IL-10. L. braziliensis replication was increased (P intermedia sand flies skews the human immune response, facilitating L. braziliensis survival in vitro, and increases the risk of developing CL. PMID:25596303

  13. Comparison of small mammal prevalence of Leishmania (Leishmania) mexicana in five foci of cutaneous leishmaniasis in the State of Campeche, Mexico.

    Science.gov (United States)

    Van Wynsberghe, N R; Canto-Lara, S B; Sosa-Bibiano, E I; Rivero-Cárdenas, N A; Andrade-Narváez, F J

    2009-01-01

    In the Yucatan Peninsula of Mexico, 95% of the human cases of Cutaneous Leishmaniasis are caused by Leishmania (Leishmania) mexicana with an incidence rate of 5.08 per 100,000 inhabitants. Transmission is limited to the winter months (November to March). One study on wild rodents has incriminated Ototylomys phyllotis and Peromyscus yucatanicus as primary reservoirs of L. (L.) mexicana in the focus of La Libertad, Campeche. In the present study, the prevalence of both infection and disease caused by L. (L.) mexicana in small terrestrial mammals were documented during five transmission seasons (1994-2004) in five foci of Leishmaniasis in the state of Campeche. Foci separated by only 100 km, with similar relative abundances of small mammals, were found to differ significantly in their prevalence of both symptoms and infection. Transmission rates and reservoir species seemed to change in space as well as in time which limited the implementation of effective control measures of the disease even in a small endemic area such as the south of the Yucatan Peninsula.

  14. Therapy of Venezuelan patients with severe mucocutaneous or early lesions of diffuse cutaneous leishmaniasis with a vaccine containing pasteurized Leishmania promastigotes and bacillus Calmette-Guerin: preliminary report

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    Jacinto Convit

    2004-02-01

    Full Text Available Severe mucocutaneous (MCL and diffuse (DCL forms of American cutaneous leishmaniasis (ACL are infrequent in Venezuela. Chemotherapy produces only transitory remission in DCL, and occasional treatment failures are observed in MCL. We have evaluated therapy with an experimental vaccine in patients with severe leishmaniasis. Four patients with MCL and 3 with early DCL were treated with monthly intradermal injections of a vaccine containing promastigotes of Leishmania (Viannia braziliensis killed by pasteurization and viable Bacillus Calmette- Guerin. Clinical and immunological responses were evaluated. Integrity of protein constituents in extracts of pasteurized promastigotes was evaluated by gel electrophoresis. Complete remission of lesions occurred after 5-9 injections in patients with MCL or 7-10 injections in patients with early DCL. DCL patients developed positive skin reactions, average size 18.7 mm. All have been free of active lesions for at least 10 months. Adverse effects of the vaccine were limited to local reactivity to BCG at the injection sites and fever in 2 patients. Extracts of pasteurized and fresh promastigotes did not reveal differences in the integrity of protein components detectable by gel electrophoresis. Immunotherapy with this modified vaccine offers an effective, safe option for the treatment of patients who do not respond to immunotherapy with vaccine containing autoclaved parasites or to chemotherapy .

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

    Science.gov (United States)

    Baum, Mauricio; Ribeiro, Magda Clara Vieira da Costa; Lorosa, Elias Seixas; Damasio, Guilherme Augustto Costa; Castro, Edilene Alcântara de

    2013-01-01

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

  16. First-line therapy for human cutaneous leishmaniasis in Peru using the TLR7 agonist imiquimod in combination with pentavalent antimony.

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    Cesar Miranda-Verastegui

    2009-07-01

    Full Text Available Current therapies for cutaneous leishmaniasis are limited by poor efficacy, long-term course of treatment, and the development of resistance. We evaluated if pentavalent antimony (an anti-parasitic drug combined with imiquimod (an immunomodulator was more effective than pentavalent antimony alone in patients who had not previously been treated.A randomized double-blind clinical trial involving 80 cutaneous leishmaniasis patients was conducted in Peru. The study subjects were recruited in Lima and Cusco (20 experimental and 20 control subjects at each site. Experimental arm: Standard dose of pentavalent antimony plus 5% imiquimod cream applied to each lesion three times per week for 20 days. Control arm: Standard dose of pentavalent antimony plus placebo (vehicle cream applied as above. The primary outcome was cure defined as complete re-epithelization with no inflammation assessed during the 12 months post-treatment period.Of the 80 subjects enrolled, 75 completed the study. The overall cure rate at the 12-month follow-up for the intention-to-treat analysis was 75% (30/40 in the experimental arm and 58% (23/40 in the control arm (p = 0.098. Subgroup analyses suggested that combination treatment benefits were most often observed at the Cusco site, where L. braziliensis is the prevalent species. Over the study period, only one adverse event (rash was recorded, in the experimental arm.The combination treatment of imiquimod plus pentavalent antimony performed better than placebo plus pentavalent antimony, but the difference was not statistically significant.Clinical Trials.gov NCT00257530.

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

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    Paulo Silva de Almeida

    2013-03-01

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

  18. Travelers' Health: Leishmaniasis, Cutaneous

    Science.gov (United States)

    ... are disturbed (for example, if hikers brush against tree trunks or other sites where sand flies are ... assist in all aspects of the diagnostic evaluation. Identification of the Leishmania species can be important, particularly ...

  19. Chemotherapy of Cutaneous Leishmaniasis

    Science.gov (United States)

    2012-10-01

    WY, Milhous WK, Ohrt C, Spaventi R. Antimalarial Activity of 9a-N Substituted 15-Membered Azalides with Improved in Vitro and in Vivo Activity over... Activity Relationships of Peroxide- Based Artemisinin Antimalarials . In: Biologically Active Natural Products: Pharmaceuticals, Cutler, S.J., Cutler...Landek G, Jelić D, Hutinec A, Mesić M, Ager A, Ellis WY, Milhous WK, Ohrt C, Spaventi R. Antimalarial Activity of 9a-N Substituted 15-Membered Azalides

  20. 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),

  1. A Comparative Assessment of Epidemiologically Different Cutaneous Leishmaniasis Outbreaks in Madrid, Spain and Tolima, Colombia: An Estimation of the Reproduction Number via a Mathematical Model

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    Anuj Mubayi

    2018-04-01

    Full Text Available Leishmaniasis is a neglected tropical disease caused by the Leishmania parasite and transmitted by the Phlebotominae subfamily of sandflies, which infects humans and other mammals. Clinical manifestations of the disease include cutaneous leishmaniasis (CL, mucocutaneous leishmaniasis (MCL and visceral leishmaniasis (VL with a majority (more than three-quarters of worldwide cases being CL. There are a number of risk factors for CL, such as the presence of multiple reservoirs, the movement of individuals, inequality, and social determinants of health. However, studies related to the role of these factors in the dynamics of CL have been limited. In this work, we (i develop and analyze a vector-borne epidemic model to study the dynamics of CL in two ecologically distinct CL-affected regions—Madrid, Spain and Tolima, Colombia; (ii derived three different methods for the estimation of model parameters by reducing the dimension of the systems; (iii estimated reproduction numbers for the 2010 outbreak in Madrid and the 2016 outbreak in Tolima; and (iv compared the transmission potential of the two economically-different regions and provided different epidemiological metrics that can be derived (and used for evaluating an outbreak, once R0 is known and additional data are available. On average, Spain has reported only a few hundred CL cases annually, but in the course of the outbreak during 2009–2012, a much higher number of cases than expected were reported and that too in the single city of Madrid. Cases in humans were accompanied by sharp increase in infections among domestic dogs, the natural reservoir of CL. On the other hand, CL has reemerged in Colombia primarily during the last decade, because of the frequent movement of military personnel to domestic regions from forested areas, where they have increased exposure to vectors. In 2016, Tolima saw an unexpectedly high number of cases leading to two successive outbreaks. On comparing, we

  2. Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia Termoterapia efectiva y más segura que la miltefosina en el tratamiento de la leishmaniasis cutánea en Colombia

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    Liliana López

    2013-06-01

    Full Text Available In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems, cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145 or a thermotherapy (Thermomed® application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149. Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients and 69% (85/145 patients, respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol between the two treatments. ClinicalTrials.gov: NCT00471705.En Colombia antimoniales pentavalentes y miltefosina son los medicamentos de primera elección para el tratamiento de la leishmaniosis cutánea; sin embargo, su toxicidad, duración (que lleva a problemas de adherencia, costo y la disminución de la sensibilidad de los parásitos a los mismos, hacen necesaria la búsqueda de nuevas alternativas de tratamiento para la leishmaniosis cutánea americana. A partir de resultados derivados de un ensayo clínico controlado abierto, aleatorizado, fase III, se comparó la eficacia y seguridad de la miltefosina con la de la termoterapia, para el

  3. [On the origin and spread of cutaneous and mucosal leishmaniasis, based on pre- and post- colombian historical source].

    Science.gov (United States)

    Altamirano-Enciso, Alfredo J; Marzochi, Mauro C A; Moreira, João S; Schubach, Armando O; Marzochi, Keyla B F

    2003-01-01

    Drawing from four sixteenth-century sources, the article reports some apparent incidents of American Tegumentary Leishmaniasis within the territory of the Andes. Reinterpretation of these sources affords a look at the longstanding issue of the origin of espundia,or mucosal Leishmaniasis (ML). The study reinforces the hypothesis that ML originated in the western Amazon region, from there climbing into the high forests and later into hot inter-Andean lands via Bolivia's and Peru's borders with Brazil, above al through human migration. dating to archeological times, this process intensified during the Inca period under the social policies of the mitmaq or mitimaes. These events transpired within the historical and social context of the fall of the Inca Empire and the advent of Spanish colonization.

  4. Leishmaniasis in rheumatoid arthritis

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    M. Cutolo

    2011-09-01

    Full Text Available Leishmaniasis represents a complex of diseases with an important clinical and epidemiological diversity. Visceral leishmaniasis is of higher priority than cutaneous leishmaniasis as it is a fatal disease in the absence of treatment. The clinical spectrum of leishmaniasis and control of the infection are influenced by the parasite-host relationship. The role of cellular immune responses of the Th1 type in the protection against disease in experimental and human leishmaniasis is well established. TNF-α has been implicated in cytokine-induced macrophage activation and tissue granuloma formation, two activities linked to control of intracellular visceral infection caused by Leishmania donovani. Anti- tumor necrosis factor-alpha (TNF-α strategies have had a marked and substantial impact in the treatment of rheumatoid arthritis, however the clinical use of TNF-α antagonists has been accompanied by increased reporting of infections. Here we report the first case of visceral leishmaniasis in a patient treated for a long period of time with human anti TNF-α monoclonal antibody, adalimumab. Due to the low incidence rate of Mediterranean visceral leishmaniasis, a systematic screening for leishmaniasis in all patients treated with biologics may be not recommended. However, for those patients living at high risk of leishmaniasis exposure, a periodical serological monitoring should be performed during therapy with anti-TNF monoclonal antibodies.

  5. Obtaining membranes for alternative treatment hydrogels of cutaneous leishmaniasis; Obtencao de membranas de hidrogeis para tratamento alternativo da leishmaniose tegumentar

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Maria Jose Alves de

    2013-07-01

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

  6. Evaluation of Interferon-gamma Application for Recognition of Patients Afflicted by Non-healing Cutaneous Leishmaniasis

    OpenAIRE

    Mohammad Moafi; Hossein Rezvan; Roya Sherkat; Sayyed Hamid Zarkesh-Esfahani; Roya Taleban; Ali Asilian; Mohammad Ali Nilforoushzadeh; Fariba Jaffary; Marjan Mansourian; Fatemeh Sokhanvari; Nazli Ansari

    2017-01-01

    Introduction:Different studies undertaken in the animal modeling show that Interferon-gamma deficiency impairs healing process of Leishmania infection. It seems that the level of Interferon-gamma production could also affect the healing duration of Leishmania lesion in humans. The current study aims to investigate the possibility of Interferon-gamma application for recognition of cases afflicted by non-healing Leishmaniasis. Materials and methods: Peripheral blood mononuclear cells (PBMCs) of...

  7. Use of FTA Cards for Direct Sampling of Patients' Lesions in the Ecological Study of Cutaneous Leishmaniasis

    OpenAIRE

    Kato, Hirotomo; Cáceres, Abraham G.; Mimori, Tatsuyuki; Ishimaru, Yuka; Sayed, Amal S. M.; Fujita, Megumi; Iwata, Hiroyuki; Uezato, Hiroshi; Velez, Lenin N.; Gomez, Eduardo A. L.; Hashiguchi, Yoshihisa

    2010-01-01

    The FTA card (Whatman) was assessed for its utility as a molecular epidemiological tool in collecting samples from patients with leishmaniasis in Peru because the card has a variety of merits; it is less invasive for patients and easy to handle for both physicians and other medical personnel for sample collection or diagnosis, in addition to its simplicity and easy countrywide and/or intercountry transportation for analysis. Samples were collected from 132 patients suspected of having leishma...

  8. Evaluation of Interferon-gamma Application for Recognition of Patients Afflicted by Non-healing Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Mohammad Moafi

    2017-06-01

    Full Text Available Introduction:Different studies undertaken in the animal modeling show that Interferon-gamma deficiency impairs healing process of Leishmania infection. It seems that the level of Interferon-gamma production could also affect the healing duration of Leishmania lesion in humans. The current study aims to investigate the possibility of Interferon-gamma application for recognition of cases afflicted by non-healing Leishmaniasis. Materials and methods: Peripheral blood mononuclear cells (PBMCs of 32 patients, who were afflicted by healing or non-healing Leishmaniasis, were isolated and the levels of interferon-gamma were determined, using ELISA method. Afterwards, the cut-off point of interferon-gamma to identify patients afflicted by non-healing Leishmaniasis was calculated through ROC-Curve analysis. Furthermore, Leishmanin Skin Test (LST was performed for every patient. Results: Levels of Interferon-gamma produced by PBMCs stimulated with Soluble Leishmania Antigen (SLA or Phytohemaglotinine were significantly higher in healing patients, compared with non-healing individuals (p

  9. Fauna, Abundance and Dispersion of Sandflies in Three Endemic Areas of Cutaneous Leishmaniasis in Rural Fars Province

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    F Ahmadipour

    2011-05-01

    Full Text Available Introduction: Leishmaniasis is one of important tropical diseases caused by Leishmania parasites which is transmitted by biting of female phlebotomine sandfies. Regarding high densities' and distribution of sandflies in majority areas of Iran, understanding of sandflies identification and distribution as vectors is importation to control disease. Methods: This is a descriptive survey which was done temporarily, Sandflies were sampled from 17 villages of three studied regions to coordinate with authorities of sanitary province to provide the necessary facilities .foci using sticky papers and CDC traps. All sandflies were identified based on external and internal morphological characters of the head and abdominal terminalia, which were slide-mounted in Berlese fluid. Results: In total 3178 Sandflies were sampled and identified. Sandfies species are P. papatasi, P. bergeroti, P. alexandri, P. sergenti, P. mongolensis, P. tobbi and S. dentate, S. sintoni and S. tiberiadis. sandfly species identified and separated based on habitat collections. Females analysed according to their gonotrophic stage which majority were unfed. Conclusion: The collections contained the important putative vectors of Leishmaniasis in Iran. P. papatasi was abundant in three study foci. Of the sandflies recorded from Iran, only P. papatasi was judged to be a proven vector of Leishmaniasis. Understanding criteria of vectors, population variations and ecological aspect of sandflies can help to control better of diseases.

  10. The applicability of real-time PCR in the diagnostic of cutaneous leishmaniasis and parasite quantification for clinical management: Current status and perspectives.

    Science.gov (United States)

    Moreira, Otacilio C; Yadon, Zaida E; Cupolillo, Elisa

    2017-09-29

    Cutaneous leishmaniasis (CL) is spread worldwide and is the most common manifestation of leishmaniasis. Diagnosis is performed by combining clinical and epidemiological features, and through the detection of Leishmania parasites (or DNA) in tissue specimens or trough parasite isolation in culture medium. Diagnosis of CL is challenging, reflecting the pleomorphic clinical manifestations of this disease. Skin lesions vary in severity, clinical appearance, and duration, and in some cases, they can be indistinguishable from lesions related to other diseases. Over the past few decades, PCR-based methods, including real-time PCR assays, have been developed for Leishmania detection, quantification and species identification, improving the molecular diagnosis of CL. This review provides an overview of many real-time PCR methods reported for the diagnostic evaluation of CL and some recommendations for the application of these methods for quantification purposes for clinical management and epidemiological studies. Furthermore, the use of real-time PCR for Leishmania species identification is also presented. The advantages of real-time PCR protocols are numerous, including increased sensitivity and specificity and simpler standardization of diagnostic procedures. However, despite the numerous assays described, there is still no consensus regarding the methods employed. Furthermore, the analytical and clinical validation of CL molecular diagnosis has not followed international guidelines so far. A consensus methodology comprising a DNA extraction protocol with an exogenous quality control and an internal reference to normalize parasite load is still needed. In addition, the analytical and clinical performance of any consensus methodology must be accurately assessed. This review shows that a standardization initiative is essential to guide researchers and clinical laboratories towards the achievement of a robust and reproducible methodology, which will permit further evaluation

  11. Surto de leishmaniose tegumentar americana em Canoa, Santo Amaro, Bahia, Brasil An outbreak of American cutaneous leishmaniasis in Canoa, Santo Amaro, Bahia, Brazil

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    Ivonise Follador

    1999-10-01

    Full Text Available Em 1993, um surto leishmaniose tegumentar americana (LTA foi detectado no povoado rural de Canoa, município de Santo Amaro, Bahia. Um estudo observacional prospectivo delineou-se, com objetivo de determinar as taxas de freqüência e caracterizar clinicamente a doença. Foram acompanhados 555 indivíduos, registrando-se 29 casos de LTA, 11 casos sugestivos de LTA pregressa e 529 sadios. Desses 529 sadios, 65 apresentaram reação de Montenegro positiva sem qualquer evidência presente ou passada de doença. A prevalência de LTA no período de estudo foi de 5,2% (29/555. A leishmania envolvida foi caracterizada como Leishmania braziliensis e o vetor, Lutzomyia intermedia. Foram detectados cães e equídeos infectados por leishmania O acometimento de crianças menores de 10 anos, o acometimento igual entre os sexos e um componente de agregação familiar sugerem um padrão de transmissão peri ou intradomiciliar.An outbreak of American cutaneous leishmaniasis (ACL was detected in the village of Canoa in 1993. A prospective observational study was outlined to determine the frequency rates and to clinically characterize the disease. A total of 555 people were followed up. There were 29 cases of ACL, 11 cases of probably previous ACL (scars and 529 healthy individuals. Of these 529 individuals, 65 had a positive Montenegro reaction without any present or past evidence of leishmaniasis. The prevalence of ACL during the two years was 5.2% (29/555. The leishmania involved was Leishmania braziliensis and the vector, Lutzomyia intermedia. Evidence of infection was detected in dogs and horses. The high frequency of the disease among children under ten years, the similar sex distribution of cases and a component of familial aggregation suggest a peri- or intra-domiciliary transmission.

  12. Leishmania OligoC-TesT as a simple, rapid, and standardized tool for molecular diagnosis of cutaneous leishmaniasis in Peru.

    Science.gov (United States)

    Espinosa, Diego; Boggild, Andrea K; Deborggraeve, Stijn; Laurent, Thierry; Valencia, Cristian; Pacheco, Rosa; Miranda-Verástegui, César; Llanos-Cuentas, Alejandro; Leclipteux, Thierry; Dujardin, Jean-Claude; Büscher, Philippe; Arévalo, Jorge

    2009-08-01

    Molecular methods such as PCR have become attractive tools for diagnosis of cutaneous leishmaniasis (CL), both for their high sensitivity and for their specificity. However, their practical use in routine diagnosis is limited due to the infrastructural requirements and the lack of any standardization. Recently, a simplified and standardized PCR format for molecular detection of Leishmania was developed. The Leishmania OligoC-TesT is based on simple and rapid detection using a dipstick with PCR-amplified Leishmania DNA. In this study, we estimated the diagnostic accuracy of the Leishmania OligoC-TesT for 61 specimens from 44 CL-suspected patients presenting at the leishmaniasis clinic of the Instituto de Medicina Tropical Alexander von Humboldt, Peru. On the basis of parasitological detection and the leishmanin skin test (LST), patients were classified as (i) confirmed CL cases, (ii) LST-positive cases, and (iii) LST-negative cases. The sensitivities of the Leishmania OligoC-TesT was 74% (95% confidence interval (CI), 60.5% to 84.1%) for lesion aspirates and 92% (95% CI, 81.2% to 96.9%) for scrapings. A significantly higher sensitivity was observed with a conventional PCR targeting the kinetoplast DNA on the aspirates (94%) (P = 0.001), while there was no significant difference in sensitivity for the lesion scrapings (88%) (P = 0.317). In addition, the Leishmania OligoC-TesT was evaluated for 13 CL-suspected patients in two different peripheral health centers in the central jungle of Peru. Our findings clearly indicate the high accuracy of the Leishmania OligoC-TesT for lesion scrapings for simple and rapid molecular diagnosis of CL in Peru.

  13. Leishmania OligoC-TesT as a Simple, Rapid, and Standardized Tool for Molecular Diagnosis of Cutaneous Leishmaniasis in Peru▿

    Science.gov (United States)

    Espinosa, Diego; Boggild, Andrea K.; Deborggraeve, Stijn; Laurent, Thierry; Valencia, Cristian; Pacheco, Rosa; Miranda-Verástegui, César; Llanos-Cuentas, Alejandro; Leclipteux, Thierry; Dujardin, Jean-Claude; Büscher, Philippe; Arévalo, Jorge

    2009-01-01

    Molecular methods such as PCR have become attractive tools for diagnosis of cutaneous leishmaniasis (CL), both for their high sensitivity and for their specificity. However, their practical use in routine diagnosis is limited due to the infrastructural requirements and the lack of any standardization. Recently, a simplified and standardized PCR format for molecular detection of Leishmania was developed. The Leishmania OligoC-TesT is based on simple and rapid detection using a dipstick with PCR-amplified Leishmania DNA. In this study, we estimated the diagnostic accuracy of the Leishmania OligoC-TesT for 61 specimens from 44 CL-suspected patients presenting at the leishmaniasis clinic of the Instituto de Medicina Tropical Alexander von Humboldt, Peru. On the basis of parasitological detection and the leishmanin skin test (LST), patients were classified as (i) confirmed CL cases, (ii) LST-positive cases, and (iii) LST-negative cases. The sensitivities of the Leishmania OligoC-TesT was 74% (95% confidence interval (CI), 60.5% to 84.1%) for lesion aspirates and 92% (95% CI, 81.2% to 96.9%) for scrapings. A significantly higher sensitivity was observed with a conventional PCR targeting the kinetoplast DNA on the aspirates (94%) (P = 0.001), while there was no significant difference in sensitivity for the lesion scrapings (88%) (P = 0.317). In addition, the Leishmania OligoC-TesT was evaluated for 13 CL-suspected patients in two different peripheral health centers in the central jungle of Peru. Our findings clearly indicate the high accuracy of the Leishmania OligoC-TesT for lesion scrapings for simple and rapid molecular diagnosis of CL in Peru. PMID:19553579

  14. Clinical Efficacy Associated with Enhanced Antioxidant Enzyme Activities of Silver Nanoparticles Biosynthesized Using Moringa oleifera Leaf Extract, Against Cutaneous Leishmaniasis in a Murine Model of Leishmania major.

    Science.gov (United States)

    El-Khadragy, Manal; Alolayan, Ebtesam M; Metwally, Dina M; El-Din, Mohamed F Serag; Alobud, Sara S; Alsultan, Nour I; Alsaif, Sarah S; Awad, Manal A; Abdel Moneim, Ahmed E

    2018-05-22

    Leishmaniasis is one of the most significant vector-borne syndromes of individuals. This parasitic infection can be affected by many species of Leishmania, most of which are zoonotic. Natural products have made and are continuing to make important contributions to the search for new antileishmanial agents. The use of plants in the production assembly of silver nanoparticles has drawn attention because of its rapid, eco-friendly, non-pathogenic, economical protocol and provides a single step technique for the biosynthetic process. Hence, we aimed to biosynthesize silver nanoparticles (Ag-NPs) using Moringa oleifera leaf extract and investigated the antileishmanial activity of these nanoparticles in a murine model of Leishmania major infection. A total of 50 mice were used and divided into five groups-healthy control, infected, infected mice treated with pentostam, infected mice treated with Ag-NPs and infected mice pretreated with Ag-NPs. In the present study, the leaf extract of the plant species Moringa oleifera was found to be a good source for the synthesis of silver nanoparticles, their formation being confirmed by color change and stability in solution. In the present murine model of Leishmania major infection, we found that oral treatment with silver nanoparticles biosynthesized using Moringa oleifera extract resulted in a significant reduction in the average size of leishmaniasis cutaneous lesions compared with untreated mice. Furthermore, the clinical efficacy of Moringa oleifera extract was associated with enhanced antioxidant enzyme activities. In conclusion, treatment with silver nanoparticles biosynthesized using Moringa oleifera extract has higher and faster clinical efficacy than standard pentavalent antimonial treatment, probably by boosting the endogenous antioxidant activity.

  15. Study of sand flies (Diptera: Psychodidae) in visceral and cutaneous leishmaniasis areas in the central-western state of Minas Gerais, Brazil.

    Science.gov (United States)

    Nascimento, Bruno Warlley Leandro; Saraiva, Lara; Neto, Rafael Gonçalves Teixeira; Meira, Paula Cavalcante Lamy Serra e; Sanguinette, Cristiani de Castilho; Tonelli, Gabriel Barbosa; Botelho, Helbert Antônio; Belo, Vinícius Silva; Silva, Eduardo Sérgio da; Gontijo, Célia Maria Ferreira; Filho, José Dilermando Andrade

    2013-03-01

    The transmission of Leishmania involves several species of sand flies that are closely associated with various parasites and reservoirs, with differing transmission cycles in Brazil. A study on the phlebotomine species composition has been conducted in the municipality of Divinópolis, Minas Gerais, Brazil, an endemic area for cutaneous leishmaniasis (CL), which has intense occurrence of visceral leishmaniasis (VL) cases. In order to study the sand flies populations and their seasonality, CDC light traps (HP model) were distributed in 15 houses which presented at least one case of CL or VL and in five urban parks (green areas). Collections were carried out three nights monthly from September 2010 to August 2011. A total of 1064 phlebotomine specimens were collected belonging to two genera and seventeen species: Brumptomyia brumpti, Lutzomyia bacula, Lutzomyia cortelezzii, Lutzomyia lenti, Lutzomyia sallesi, Lutzomyia longipalpis, Lutzomyia migonei, Lutzomyia intermedia, Lutzomyia neivai, Lutzomyia whitmani, Lutzomyia christenseni, Lutzomyia monticola, Lutzomyia pessoai, Lutzomyia aragaoi, Lutzomyia brasiliensis, Lutzomyia lutziana, and Lutzomyia sordellii. L. longipalpis, the main vector of Leishmania infantum in Brazil, was the most frequent species, accounting for 76.9% of the total, followed by L. lenti with 8.3%, this species is not a proven vector. Green and urban areas had different sand flies species composition, whereas the high abundance of L. longipalpis in urban areas and the presence of various vector species in both green and urban areas were also observed. Our data point out to the requirement of control measures against phlebotomine sand flies in the municipality of Divinópolis and adoption of strategies aiming entomological surveillance. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Usefullness of Honey from the Islamic Point of View and Evaluation of Its Effects on Cutaneous Leishmaniasis Wounds in Balb/C Rats Invitro

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    J Hossein Zadeh

    2007-01-01

    Full Text Available Introduction: Honey has been one of the most complete and a delicious edible since ages and there has been a special consideration towards it in Islam. In the Holy Quran, there is a full chapter named “The Bee (Nahl” and there is a verse in it as follows: “And your lord revealed to the bee saying make hives in the mountains and in the trees and in what they build, then eat of all of fruits and walk in the ways of your lord submissively. There comes forth from within it a beverage of many colors, in which there is healing for men, most surely there is a sign in this for a people who reflect.” (2 Honey has been used traditionally in medicine throughout history, for healing chronic wounds resistant to antibiotics and various kinds of burns. Because honey has low humidity, high osmotic pressure and pH, it causes stasis of growth of infectious agents and a sterile layer on sorts. A former survey showed that honey contains 20 types of sugars, 8 types of vitamins, 11 types of mineral substances,16 types of amino acids, a large of enzymes and so on. In this study we surveyed the properties of honey from the Islamic point of view and its effects on cutaneous leishmaniasis wounds in BALB/c rats in the laboratory. Methods: Sufficient natural honey from Golpayegan, a city in Isfahan province renown for its natural, good quality honey and ointment Paramo-U (made in Iran were obtained. 30 BALB/c mice were infected with the parasiteLeishmania(Lmajor[MRHO/IR/75/ER] (Parasitology Dept on Faculty Medicine in Tarbiat Modares University. They were divided into three groups Honey study group, Negative and Positive groups and as soon as the Leishmania lesion was obvious, weight of the mice and size of the lesion were measured in all by using Scale and Coliss(Mettler,Switzerlandweekly until the death of the last mouse in the Negative control group. The data was analyzed using SPSS software. Results: The mean weight of the mice that received honey was not

  17. Study on Sand Flies as a Vector(s of Cutaneous Leishmaniasis by Nested PCR in Rural Areas of Damghan District, Semnan Province

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    Y. Rasi

    2012-01-01

    Full Text Available Introduction & Objective: Cutaneous Leishmaniasis is caused by obligatory intracellular parasite of genus Lieshmania. The disease is reported from more than half of Iran's provinces. Various species of sand flies are vector of the disease. Determination of vectors and gaining knowledge about them are important for devising of control program. Materials & Methods: This survey was performed as a cross-sectional study in order to determine the vector(s of cutaneous leishmaniasis in Damghan district during 2008-2009. Sand flies were collected from indoors and outdoors by sticky traps twice in month from April to November. Head and last abdominal segments of the samples were removed and mounted in a drop of Puri’s medium and identified. The rest of the sand flies' bodies was subjected to DNA extraction for molecular detection of Leishmania parasite by Nested PCR using specific primers of minicircle kinetoplast DNAResults: Totally, 6110 sand flies in 8 species were collected. P. papatasi had high density (46.7%. Examination of 280 female sand flies by Nested PCR showed that 28 sand flies (10%include 24 specimens P.papatasi (85.7% and 4 specimens P.caucasicus(14.3%were found naturally infected with L.major. The highest rate of infected sandflies were observed in rodents burrow (42.9%. Maximum rate of sand fly infection was in September (89.3%. Conclusion: With respect to high density of P.papatasi and isolation of L.major from it, this species was the main vector of the disease. Detection of L.major from P.caucasicus shows that this species was the secondary vector in rodent burrow. The highest rate of sand leis infected was in September, so personal protection in this month is very important and necessary. Regarding to the high density of vectors and high infection rate of them taking actions to decrease the sand fly abundance and prevention of human biting are suggested.(Sci J Hamadan Univ Med Sci 2012;18(4:47-52

  18. Observações sobre a leishmaniose tegumentar, cinco anos após profilaxia Observations of cutaneous leishmaniasis in Brazil, after five years of prophylaxis

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    Lais Clark Lima

    1988-02-01

    Full Text Available Em 1974 foram diagnosticados vários casos de leishmaniose tegumentar americana, no Município do Rio de Janeiro, RJ (Brasil. Naquela ocasião, foram usadas como medidas profiláticas o tratamento dos doentes e a dedetização dos domicílios e anexos, resultando na interrupção da transmissão. Com o aparecimento de novos casos, a partir de 1979, foram reestudadas algumas características de uma das localidades (Camorim do mesmo município. De junho de 1979 a agosto de 1981, foram comprovados nessa localidade 19 casos novos de leishmaniose tegumentar americana (18 humanos e um em cão. Coletaram-se 1.149 flebótomos (11,4% fêmeas e 88,6% machos com predomínio de Lutzomyia intermedia (95%. De acordo com o estudo dos casos, pressupõe-se que a transmissão tenha ocorrido no domicílio ou peridomicílio. Acredita-se, pois, que na área estudada, as medidas de controle, adotadas em 1974, foram eficientes por um período de aproximadamente quatro anos.In 1974 several cases of cutaneous leishmaniasis were diagnosed in Jacarepaguá, Rio de Janeiro, RJ (Brazil. At that time the patients were treated, the houses and surroundings were sprayed with DDT, and this resulted in the interruption of transmission. The emergence of new cases in 1979 led to a resumption to the study of some characteristics of one of the localities (Camorim in this area. Eighteen new human cases of cutaneous leishmaniasis and one in a dog were confirmed between June 1979 and August 1981. One thousand hundred and forty nine sand flies were collected (11.4% females and 88.6% males with predominance of Lutzomyia intermedia (95%. The study of the human cases led to the supposition that the transmission of the disease may take place in the domiciliary or peridomiciliary environment. It is believed that, at least for the studied area, the control measures taken in 1974 were efficient for four years.

  19. Use of FTA cards for direct sampling of patients' lesions in the ecological study of cutaneous leishmaniasis.

    Science.gov (United States)

    Kato, Hirotomo; Cáceres, Abraham G; Mimori, Tatsuyuki; Ishimaru, Yuka; Sayed, Amal S M; Fujita, Megumi; Iwata, Hiroyuki; Uezato, Hiroshi; Velez, Lenin N; Gomez, Eduardo A L; Hashiguchi, Yoshihisa

    2010-10-01

    The FTA card (Whatman) was assessed for its utility as a molecular epidemiological tool in collecting samples from patients with leishmaniasis in Peru because the card has a variety of merits; it is less invasive for patients and easy to handle for both physicians and other medical personnel for sample collection or diagnosis, in addition to its simplicity and easy countrywide and/or intercountry transportation for analysis. Samples were collected from 132 patients suspected of having leishmaniasis, and Leishmania species were successfully identified in samples from 81 patients in 15 departments of Peru by cytochrome b and mannose phosphate isomerase gene analyses. Of these, 61.7% were identified as Leishmania (Viannia) peruviana, 22.2% as L. (V.) braziliensis, 12.3% as L. (V.) guyanensis, 2.5% as L. (V.) shawi, and 1.2% as L. (V.) lainsoni. The three predominant species, L. (V.) peruviana, L. (V.) braziliensis, and L. (V.) guyanensis, were mainly found in the Andean highlands, in the tropical rainforest, and in northern and central rainforest regions, respectively. This is the first time L. (V.) shawi has been identified outside Brazil. The present study showed that the FTA card will be a useful tool for the ecological study of different forms of leishmaniasis. Furthermore, collecting samples directly from patients' lesions by using the FTA card eliminates (i) the possibility of contamination of Leishmania isolates during short- and/or long-term passages of culture in vitro in each laboratory and (ii) pain and suffering of patients from taking samples by skin biopsy.

  20. Use of FTA Cards for Direct Sampling of Patients' Lesions in the Ecological Study of Cutaneous Leishmaniasis

    Science.gov (United States)

    Kato, Hirotomo; Cáceres, Abraham G.; Mimori, Tatsuyuki; Ishimaru, Yuka; Sayed, Amal S. M.; Fujita, Megumi; Iwata, Hiroyuki; Uezato, Hiroshi; Velez, Lenin N.; Gomez, Eduardo A. L.; Hashiguchi, Yoshihisa

    2010-01-01

    The FTA card (Whatman) was assessed for its utility as a molecular epidemiological tool in collecting samples from patients with leishmaniasis in Peru because the card has a variety of merits; it is less invasive for patients and easy to handle for both physicians and other medical personnel for sample collection or diagnosis, in addition to its simplicity and easy countrywide and/or intercountry transportation for analysis. Samples were collected from 132 patients suspected of having leishmaniasis, and Leishmania species were successfully identified in samples from 81 patients in 15 departments of Peru by cytochrome b and mannose phosphate isomerase gene analyses. Of these, 61.7% were identified as Leishmania (Viannia) peruviana, 22.2% as L. (V.) braziliensis, 12.3% as L. (V.) guyanensis, 2.5% as L. (V.) shawi, and 1.2% as L. (V.) lainsoni. The three predominant species, L. (V.) peruviana, L. (V.) braziliensis, and L. (V.) guyanensis, were mainly found in the Andean highlands, in the tropical rainforest, and in northern and central rainforest regions, respectively. This is the first time L. (V.) shawi has been identified outside Brazil. The present study showed that the FTA card will be a useful tool for the ecological study of different forms of leishmaniasis. Furthermore, collecting samples directly from patients' lesions by using the FTA card eliminates (i) the possibility of contamination of Leishmania isolates during short- and/or long-term passages of culture in vitro in each laboratory and (ii) pain and suffering of patients from taking samples by skin biopsy. PMID:20720027

  1. An ecosystem approach to human health and the prevention of cutaneous leishmaniasis in Tumaco, Colombia Una propuesta de ecosistemas para la salud humana y la prevención de leishmaniasis cutánea en Tumaco, Colombia

    Directory of Open Access Journals (Sweden)

    Carlos A. Rojas

    2001-01-01

    Full Text Available A study was conducted during 1996-1997 in 20 villages of Tumaco, Colombia, to evaluate the effectiveness of personal protective measures against cutaneous leishmaniasis (CL. The intervention was effective, but the high costs of the preventive measures and the lack of a more holistic approach hampered the intervention's sustainability. This paper analyzes the results using an ecosystem approach to human health. Using this approach, we found that CL has been present in the study area for a long time and affects farmers and those living closest to the forest. The forest constitutes the habitat for insect vectors (sandflies and parasite reservoirs (wild mammals. Four spatial scales were identified in this ecosystem: residential, village, regional, and global. From the ecosystem perspective, three interventions are proposed to prevent CL in the 20 villages: improve housing construction, organize village housing in clusters, and make diagnosis and treatment of CL more accessible. The design and implementation of these interventions require active involvement by people with the disease (village inhabitants and decision-makers (local authorities.Durante 1996-1997 se realizó un estudio en 20 veredas de Tumaco, Colombia, para evaluar la efectividad de medidas de protección para leishmaniasis cutánea (LC. La intervención fué efectiva, sin embargo, los altos costos de las medidas de protección y la falta de una propuesta más holistica no permitieron sostener la intervención. Los resultados de este estudio son analizados en este artículo usando una propuesta de ecosistemas para la salud humana. Usando esta propuesta, vemos que LC ha estado presente en la zona de estudio por mucho tiempo y que afecta a agricultores y a aquellos que vivien cerca del bosque. El bosque constituye el hábitat para los insectos vectores (sandflies y los reservorios del parásito (mamiferos salvajes. Cuatro escalas espaciales fueron identificadas en este ecosistema

  2. A time series analysis of environmental and metrological factors impact on cutaneous leishmaniasis incidence in an endemic area of Dehloran, Iran.

    Science.gov (United States)

    Nikonahad, Ali; Khorshidi, Ali; Ghaffari, Hamid Reza; Aval, Hamideh Ebrahimi; Miri, Mohammad; Amarloei, Ali; Nourmoradi, Heshmatollah; Mohammadi, Amir

    2017-06-01

    The aim of this study was to investigate the relationship between the environmental and metrological variables and cutaneous leishmaniasis (CL) transmission and its prediction in a region susceptible to this disease prevalence using a time series model. The accurate locations of 4437 CL diagnosed from 2011 to 2015 were obtained to be used in the time series model. Temperature, number of days with temperature over 30 °C, and number of earthquake were related to CL incidence using the Seasonal Auto-correlated Integrated Moving Average (SARIMA) model according to the Box-Jenkins method. In addition, the relationship between land use and surface soil type in 500- and 1000-m radius around the CL patients were investigated. The SARIMA models showed significant associations between environmental and meteorological variables and CL incidence adjusted for seasonality and auto-correlation. The result indicated that there are need more robust preventive programs in earthquake-prone areas with high temperature and inceptisol soil type than other areas. In addition, the region with these characteristics should be considered as high-risk areas for CL prevalence.

  3. Effectiveness and Cost of Insecticide-Treated Bed Nets and Indoor Residual Spraying for the Control of Cutaneous Leishmaniasis: A Cluster-Randomized Control Trial in Morocco

    Science.gov (United States)

    Faraj, Chafika; Yukich, Joshua; Adlaoui, El Bachir; Wahabi, Rachid; Mnzava, Abraham Peter; Kaddaf, Mustapha; El Idrissi, Abderrahmane Laamrani; Ameur, Btissam; Kleinschmidt, Immo

    2016-01-01

    Cutaneous leishmaniasis (CL) remains an important public health problem in Morocco. A cluster-randomized trial was conducted with the following three study arms: 1) long-lasting insecticide-treated nets (LLINs) plus standard of care environmental management (SoC-EM), 2) indoor residual spraying (IRS) with α-cypermethrin plus SoC-EM, and 3) SoC-EM alone. Incidence of new CL cases by passive and active case detection, sandfly abundance, and cost and cost-effectiveness was compared between study arms over 5 years. Incidence of CL and sandfly abundance were significantly lower in the IRS arm compared with SoC-EM (CL incidence rate ratio = 0.32, 95% confidence interval [CI] = 0.15–0.69, P = 0.005 and sandfly abundance ratio = 0.39, 95% CI = 0.18–0.85, P = 0.022). Reductions in the LLIN arm of the study were not significant, possibly due to poor compliance. IRS was effective and more cost-effective for the prevention of CL in Morocco. PMID:26811431

  4. [Molecular typing of Leishmania (Leishmania) amazonensis and species of the subgenus Viannia associated with cutaneous and mucosal leishmaniasis in Colombia: A concordance study].

    Science.gov (United States)

    Ovalle-Bracho, Clemencia; Camargo, Carolina; Díaz-Toro, Yira; Parra-Muñoz, Marcela

    2018-03-15

    Multilocus enzyme electrophoresis (MLEE) is the reference standard for the characterization of Leishmania species. The test is restricted to specialized laboratories due to its technical complexity, cost, and time required to obtain results. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) is used to identify Leishmania species. To establish the concordance between the two tests as identifying methods for circulating species in Colombia. A total of 96 isolates from patients with cutaneous or mucosal leishmaniasis were selected and identified by MLEE and PCR-RFLP with miniexon and hsp70 as the molecular targets, which were used sequentially. Restriction enzymes HaeIII and BccI were similarly applied. Cohen's kappa coefficient and the 95% confidence interval (CI) were calculated. The kappa coefficient and the 95% CI between MLEE and PCR-RFLP displayed "very good" concordance with a coefficient of 0.98 (CI95%: 0.98 to 1.00). The identified species were Leishmania Viannia braziliensis, Leishmania Viannia panamensis, Leishmania Viannia guyanensis and Leishmania Leishmania amazonensis. A total of 80 of the 96 isolates were sequenced and the results obtained by PCR-RFLP were confirmed. Due to the concordance obtained between tests results with the amplification of the genes miniexon and hsp70, PCR-RFLP is proposed as an alternative for identifying circulating Leishmania species in Colombia.

  5. Clinical profile of cutaneous leishmaniasis in Faifa-Gizan, South west province of Kingdom of Saudi Arabia (A study of 140 cases

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    Rao Raghu

    1998-01-01

    Full Text Available A preliminary study was conducted to know the age, sex distribution and clinical pattern of cutaneous leishmaniasis (CL in a remote hilly area, Faifa, Gizan situated in the South West region of the Kingdom of Saudi Arabia. C L accounted for nearly 5% of the new outpatient attendance in the study period (1988-90 of 20 months. Out of the 140 new patients who formed the study group, 82 were males (58.57% and 58 females (41.43% in the age range of 9 months to 60 years. Ninety two patients were children (65.71% below 15 years. including 58 boys and 34 girls and CL is a major public health problem in children of this area. The fact that out of 140 affected individuals, 134 were local Saudis and 6 non-Saudis reveals the autochthonous nature of the disease in this region. The clinical spectrum included dry crusted ulcers, erythematous indurated plaques, nodules, papules, and oozing shallow ulcers. The lesions were distributed mostly on face and extremities. Response to pentostam (Sodium stibogluconate was highly satisfactory.

  6. Effect of integrated pest management on controlling zoonotic cutaneous leishmaniasis in Emamzadeh Agha Ali Abbas (AS) District, Isfahan province, 2006-2009.

    Science.gov (United States)

    Nilforoushzadeh, Mohammad Ali; Shirani-Bidabadi, Leila; Saberi, Sedigheh; Hosseini, Seyed Mohsen; Jaffary, Fariba

    2014-01-01

    Cutaneous leishmaniasis (CL) is still considered as a health problem in the world. Several methods of control in different regions, together with obtaining integrated information on its natural foci, are needed to decrease its prevalence. This study was designed to evaluate the effects of simultaneous interventions on CL control. A standard questionnaire was used to identify patients among pilgrims to Emamzadeh Agha Ali Abbas (Isfahan Province, Iran). Subsequently, three methods of controlling the disease, including, spraying residential buildings with Baygon, baiting with zinc phosphide poisons, changing the vegetative cover of the region, improving the environment, and mounting a mesh on all doors and windows of buildings in residential areas were used. The control measures were then evaluated by comparing the number of pilgrims affected by CL after and before the interventions. While 23 pilgrims (1.4%) were affected with CL before the intervention (pretest), five (0.3%) persons were found to have CL after taking control measures. The Chi-square test did not indicate any significant difference in the relative frequency of CL (P = 0.731). The only scientific method for preventing and controlling zoonotic CL (ZCL) is a combination of the control methods (improving the environment and fighting off the disease districts and vectors) together with changing the vegetative cover of the region. Any measure for controlling this disease must be taken and programmed in accordance with the relevant experts' views, in coordination with the participation of other organizations and the society.

  7. Monitoring the response of patients with cutaneous leishmaniasis to treatment with pentamidine isethionate by quantitative real-time PCR, and identification of Leishmania parasites not responding to therapy.

    Science.gov (United States)

    Mans, D R A; Kent, A D; Hu, R V; Lai A Fat, E J; Schoone, G J; Adams, E R; Rood, E J; Alba, S; Sabajo, L O A; Lai A Fat, R F; de Vries, H J C; Schallig, H D F H

    2016-08-01

    Leishmania (Viannia) guyanensis is believed to be the principal cause of cutaneous leishmaniasis (CL) in Suriname. This disease is treated with pentamidine isethionate (PI), but treatment failure has increasingly been reported. To evaluate PI for its clinical efficacy, to compare parasite load, and to assess the possibility of treatment failure due to other infecting Leishmania species. Parasite load of patients with CL was determined in skin biopsies using real-time quantitative PCR before treatment and 6 and 12 weeks after treatment. Clinical responses were evaluated at week 12 and compared with parasite load. In parallel, molecular species differentiation was performed. L. (V.) guyanensis was the main infecting species in 129 of 143 patients (about 90%). PI treatment led to a significant decrease (P Leishmania (Viannia) braziliensis, Leishmania (Leishmania) amazonensis and L. (V.) guyanensis (1/92, 1/92 and 22/92 evaluable cases, respectively). There was substantial agreement beyond chance between the parasite load at week 6 and the clinical outcome at week 12, as indicated by the κ value of 0.61. L. (V.) guyanensis is the main infecting species of CL in Suriname, followed by L. (V.) braziliensis and L. (L.) amazonensis. Furthermore, patient response to PI can be better anticipated based on the parasite load 6 weeks after the treatment rather than on parasite load before treatment. © 2015 The Authors Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists, North American Clinical Dermatologic Society and St Johns Dermatological Society.

  8. Natural Leishmania (Viannia) infections of phlebotomines (Diptera: Psychodidae) indicate classical and alternative transmission cycles of American cutaneous leishmaniasis in the Guiana Shield, Brazil.

    Science.gov (United States)

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

    2017-01-01

    From 1996 to 1999 multi-trapping methods (Center of Diseases Control, CDC) light traps, light-baited Shannon traps, and aspiration on tree bases) were used to study the phlebotomine fauna of the "Serra do Navio" region of the Brazilian State of Amapá, which is part of the Guiana Shield. Fifty-three species were identified among 8,685 captured individuals. The following species, associated with the transmission of American cutaneous leishmaniasis in Amazonian Brazil, were captured: Nyssomyia umbratilis (3,388), Psychodopygus squamiventris maripaensis (995), Ny. anduzei (550), Trichophoromyia ubiquitalis (400), Ny. whitmani (291), Ps. paraensis (116), and Bichromomyia flaviscutellata (50). Flagellate infections were detected in 45 flies. Of the 19 parasites isolated in vitro, 15 were Leishmania (Viannia) guyanensis (13 in Ny. umbratilis, 1 in Ny. whitmani, 1 in Ny. anduzei) and three were L. (V.) naiffi (2 in Ps. s. maripaensis, 1 in Ny. anduzei). The results indicate the participation of three phlebotomine species in the transmission of L. (V.) guyanensis and two species in that of L. (V.) naiffi, and show that the same phlebotomine species is involved in the transmission of different Leishmania (Viannia) species in the Guianan/Amazon region. A review of the literature together with the results of the present study, and other published and unpublished results, indicate that eight phlebotomine species potentially participate in the transmission of Leishmania (Viannia) naiffi in Amazonia. © A.A.A. de Souza et al., published by EDP Sciences, 2017.

  9. Phlebotomine sandfly (Diptera: Psychodidae) diversity and their Leishmania DNA in a hot spot of American Cutaneous Leishmaniasis human cases along the Brazilian border with Peru and Bolivia.

    Science.gov (United States)

    Teles, Carolina Bioni Garcia; Santos, Ana Paula de Azevedo Dos; Freitas, Rui Alves; Oliveira, Arley Faria José de; Ogawa, Guilherme Maerschner; Rodrigues, Moreno Souza; Pessoa, Felipe Arley Costa; Medeiros, Jansen Fernandes; Camargo, Luís Marcelo Aranha

    2016-06-10

    In this study, we identified the phlebotomine sandfly vectors involved in the transmission of American Cutaneous Leishmaniasis (ACL) in Assis Brasil, Acre, Brazil, which is located on the Brazil-Peru-Bolivia frontier. The genotyping of Leishmania in phlebotomines was performed using polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism. A total of 6,850 sandflies comprising 67 species were captured by using CDC light traps in rural areas of the municipality. Three sandfly species were found in the state of Acre for the first time: Lutzomyia georgii, Lu. complexa and Lu. evangelistai. The predominant species was Lu. auraensis/Lu. ruifreitasi and Lu. davisi (total 59.27%). 32 of 368 pools were positive for the presence of Leishmania DNA (16 pools corresponding to Lu. davisi, and 16 corresponding to Lu. auraensis/Lu. ruifreitasi), with a minimal infection prevalence of 1.85% in Lu. davisi and 2.05% in Lu. auraensis/Lu. ruifreitasi. The Leishmania species found showed maximum identity with L. (Viannia) guyanensis and L. (V.) braziliensis in both phlebotomine species. Based on these results and similar scenarios previously described along the Brazil/Peru/Bolivia tri-border, the studied area must take into consideration the possibility of Lu. davisi and Lu. auraensis/Lu. ruifreitasi as probable vectors of ACL in this municipality.

  10. Blood feeding patterns of Nyssomyia intermedia and Nyssomyia neivai (Diptera, Psychodidae in a cutaneous leishmaniasis endemic area of the Ribeira Valley, State of São Paulo, Brazil

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    Ana Maria Marassa

    2013-09-01

    Full Text Available Introduction The aim of this study was to identify the blood feeding sources of Nyssomyia intermedia (Ny. intermedia and Nyssomyia neivai (Ny. neivai, which are Leishmania vectors and the predominant sandfly species in the Ribeira Valley, State of São Paulo, Brazil, an endemic area for cutaneous leishmaniasis. Methods Specimens were captured monthly between February 2001 and December 2003 on a smallholding and a small farm situated in the Serra district in the Iporanga municipality. The blood meals of 988 engorged females were tested using the avidin-biotin immunoenzymatic enzyme-linked immunosorbent assay (ELISA. Seven blood meal sources were investigated: human, dog, chicken, bovine, pig, horse and rat. Results The results showed that among the females that fed on one or more blood sources, the respective percentages for Ny. intermedia and Ny. neivai, respectively, were as follows: human (23% and 36.8%, pig (47.4% and 26.4%, chicken (25.7% and 36.8% and dog (3.9% and 0%, and the differences in the blood sources between the two species were statistically significant (p = 0.043. Conclusions Both species had predominant reactivity for one or two blood sources, and few showed reactivity indicating three or four sources. Many different combinations were observed among the females that showed reactivity for more than one source, which indicated their opportunistic habits and eclecticism regarding anthropic environmental conditions.

  11. The sandfly fauna, anthropophily and the seasonal activities of Pintomyia spinicrassa (Diptera: Psychodidae: Phlebotominae in a focus of cutaneous leishmaniasis in northeastern Colombia

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    Fredy Galvis Ovallos

    2013-05-01

    Full Text Available This study was conducted to identify the sandfly fauna and the anthropophilic species in a coffee-growing area of Villanueva, Norte de Santander, Colombia, a focus of American cutaneous leishmaniasis, and to analyse the relationship between the most frequent species and rainfall, relative humidity and temperature, with the aim of contributing to epidemiological surveillance in the area. Sandfly collections were performed fortnightly between February 2006-September 2007 using automatic light traps, Shannon traps, protected human bait and aspiration in resting places. A total of 7,051 sandflies belonging to 12 species were captured. Pintomyia spinicrassa (95.7% predominated. Pintomyia oresbia and Lutzomyia sp. of Pichinde were found in the state of Norte de Santander for the first time. Pi. spinicrassa, Pintomyia nuneztovari, Micropygomyia venezuelensis, Lutzomyia (Helcocyrtomyia scorzai and Lu. (Helcocyrtomyia sp. were captured on the protected human bait. A significant association between Pi. spinicrassa abundance and the total rainfall and the average temperature and humidity 10 days before the collection was observed. The dominance of Pi. spinicrassa, a recognised vector of Leishmania braziliensis, especially during the dry periods, indicates that the risk of parasite transmission may increase.

  12. Accelerated healing of cutaneous leishmaniasis in non-healing BALB/c mice using water soluble amphotericin B-polymethacrylic acid.

    Science.gov (United States)

    Corware, Karina; Harris, Debra; Teo, Ian; Rogers, Matthew; Naresh, Kikkeri; Müller, Ingrid; Shaunak, Sunil

    2011-11-01

    Cutaneous leishmaniasis (CL) is a neglected tropical disease that causes prominent skin scaring. No water soluble, non-toxic, short course and low cost treatment exists. We developed a new water soluble amphotericin B-polymethacrylic acid (AmB-PMA) using established and scalable chemistries. AmB-PMA was stable for 9 months during storage. In vitro, it was effective against Leishmania spp. promastigotes and amastigote infected macrophages. It was also less toxic and more effective than deoxycholate-AmB, and similar to liposomal AmB. Its in vivo activity was determined in both early and established CL lesion models of Leishmania major infection in genetically susceptible non-healing BALB/c mice. Intradermal AmB-PMA at a total dose of 18 mg of AmB/kg body weight led to rapid parasite killing and lesion healing. No toxicity was seen. No parasite relapse occurred after 80 days follow-up. Histological studies confirmed rapid parasite clearance from macrophages followed by accelerated fibroblast mediated tissue repair, regeneration and cure of the infection. Quantitative mRNA studies of the CL lesions showed that accelerated healing was associated with increased Tumour Necrosis Factor-α and Interferon-γ, and reduced Interleukin-10. These results suggest that a cost-effective AmB-PMA could be used to pharmacologically treat and immuno-therapeutically accelerate the healing of CL lesions. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-01-01

    In Amazonian Brazil the etiological agents of American cutaneous leishmaniasis (ACL) belong to at least seven Leishmania species but little is known about the putative phlebotomine sand fly vectors in different biomes. In 2002–2003 a survey of the phlebotomine fauna was undertaken in the “Floresta Nacional do Tapajós”, Belterra municipality, in the lower Amazon region, western Pará State, Brazil, where we recently confirmed the presence of a putative hybrid parasite, L. (V.) guyanensis × L. (V.) shawi shawi. Sand flies were collected from Centers for Disease Control (CDC) light traps, Shannon traps and by aspiration on tree bases. Females were dissected and attempts to isolate any flagellate infections were made by inoculating homogenized midguts into Difco B45 medium. Isolates were characterized by monoclonal antibodies and isoenzyme electrophoresis. A total of 9,704 sand flies, belonging to 68 species or subspecies, were collected. Infections were found in the following sand flies: L. (V.) naiffi with Psychodopygus hirsutus hirsutus (1) and Ps. davisi (2); and L. (V.) shawi shawi with Nyssomyia whitmani (3) and Lutzomyia gomezi (1). These results provide strong evidence of new putative transmission cycles for L. (V.) naiffi and L. (V.) s. shawi. PMID:27235194

  14. Habitats of the sandfly vectors of Leishmania tropica and L. major in a mixed focus of cutaneous leishmaniasis in southeast Tunisia.

    Science.gov (United States)

    Tabbabi, Ahmed; Ghrab, Jamila; Aoun, Karim; Ready, Paul Donald; Bouratbine, Aïda

    2011-08-01

    From 2009 to 2010, 3129 sandflies were caught in CDC light traps placed in various habitats in Ghomrassen, Tataouine governorate, southeast Tunisia, a mixed focus of human cutaneous leishmaniasis caused by Leishmania tropica and Leishmania major. Species diversity was quantified in anthropogenic, semi-anthropogenic and semi-natural locations. Sandflies were identified according to morphological characters and also by the comparative sequence analysis of a fragment of the mitochondrial cytochrome b gene to distinguish between two putative local vectors of L. tropica, namely Phlebotomus chabaudi and Phlebotomus riouxi. The lowest sandfly diversities were found in L. major sites, where the incriminated vector P. papatasi predominated in the burrows of the rodent reservoir hosts (Meriones) as well as inside and outside houses of human cases. In L. tropica sites, the incriminated peri-domestic vector Phlebotomus sergenti was the most abundant species inside houses, whereas P. riouxi or P. chabaudi was the dominant species in the semi-natural rocky habitats favoured by the putative rodent reservoir, Ctenodactylus gundi. All specimens of P. chabaudi identified molecularly had the diagnostic cytochrome b characters of P. riouxi, indicating either that the latter represents only a geographical variant of P. chabaudi or that these two species may sometimes hybridize. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Phlebotomine sandfly (Diptera: Psychodidae) diversity and their Leishmania DNA in a hot spot of American Cutaneous Leishmaniasis human cases along the Brazilian border with Peru and Bolivia

    Science.gov (United States)

    Teles, Carolina Bioni Garcia; dos Santos, Ana Paula de Azevedo; Freitas, Rui Alves; de Oliveira, Arley Faria José; Ogawa, Guilherme Maerschner; Rodrigues, Moreno Souza; Pessoa, Felipe Arley Costa; Medeiros, Jansen Fernandes; Camargo, Luís Marcelo Aranha

    2016-01-01

    In this study, we identified the phlebotomine sandfly vectors involved in the transmission of American Cutaneous Leishmaniasis (ACL) in Assis Brasil, Acre, Brazil, which is located on the Brazil-Peru-Bolivia frontier. The genotyping of Leishmania in phlebotomines was performed using polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism. A total of 6,850 sandflies comprising 67 species were captured by using CDC light traps in rural areas of the municipality. Three sandfly species were found in the state of Acre for the first time: Lutzomyia georgii, Lu. complexa and Lu. evangelistai. The predominant species was Lu. auraensis/Lu. ruifreitasi and Lu. davisi (total 59.27%). 32 of 368 pools were positive for the presence of Leishmania DNA (16 pools corresponding to Lu. davisi, and 16 corresponding to Lu. auraensis/Lu. ruifreitasi), with a minimal infection prevalence of 1.85% in Lu. davisi and 2.05% in Lu. auraensis/Lu. ruifreitasi. The Leishmania species found showed maximum identity with L. (Viannia) guyanensis and L. (V.) braziliensis in both phlebotomine species. Based on these results and similar scenarios previously described along the Brazil/Peru/Bolivia tri-border, the studied area must take into consideration the possibility of Lu. davisi and Lu. auraensis/Lu. ruifreitasi as probable vectors of ACL in this municipality. PMID:27304023

  16. The sandfly fauna, anthropophily and the seasonal activities of Pintomyia spinicrassa (Diptera: Psychodidae: Phlebotominae) in a focus of cutaneous leishmaniasis in northeastern Colombia.

    Science.gov (United States)

    Ovallos, Fredy Galvis; Silva, Yanis Ricardo Espinosa; Fernandez, Nelson; Gutierrez, Reynaldo; Galati, Eunice Aparecida Bianchi; Sandoval, Claudia Magaly

    2013-05-01

    This study was conducted to identify the sandfly fauna and the anthropophilic species in a coffee-growing area of Villanueva, Norte de Santander, Colombia, a focus of American cutaneous leishmaniasis, and to analyse the relationship between the most frequent species and rainfall, relative humidity and temperature, with the aim of contributing to epidemiological surveillance in the area. Sandfly collections were performed fortnightly between February 2006-September 2007 using automatic light traps, Shannon traps, protected human bait and aspiration in resting places. A total of 7,051 sandflies belonging to 12 species were captured. Pintomyia spinicrassa (95.7%) predominated. Pintomyia oresbia and Lutzomyia sp. of Pichinde were found in the state of Norte de Santander for the first time. Pi. spinicrassa, Pintomyia nuneztovari, Micropygomyia venezuelensis, Lutzomyia (Helcocyrtomyia) scorzai and Lu. (Helcocyrtomyia) sp. were captured on the protected human bait. A significant association between Pi. spinicrassa abundance and the total rainfall and the average temperature and humidity 10 days before the collection was observed. The dominance of Pi. spinicrassa, a recognised vector of Leishmania braziliensis, especially during the dry periods, indicates that the risk of parasite transmission may increase.

  17. Leishmaniosis cutánea en Colombia y género Gender and cutaneous leishmaniasis in Colombia

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    Iván Darío Velez

    2001-02-01

    Full Text Available En Colombia, tradicionalmente se ha visto la leishmaniosis como un problema de Salud Pública para hombres adultos dado que se considera que la transmisión es selvática y que ellos empiezan a infectarse cuando entran a los biotopos del vector con el fin de utilizar los recursos naturales. Sin embargo, el Programa de Estudio y Control de Enfermedades Tropicales (PECET ha observado iguales proporciones de hombres y mujeres con leishmaniosis activa y pruebas cutáneas positivas. Algunos factores, hasta ahora nunca analizados, parecen distorsionar el patrón de la enfermedad y al parecer existen diferencias inherentes al género relacionadas con el acceso a la atención en salud. Como consecuencia, el sufrimiento humano no es aliviado y las repercusiones socio-económicas para las amas de casa son significativas. El Ministerio de Salud subestima la magnitud de la transmisión intra y peridomiciliaria y la detección de casos activos se descuida para mujeres, por lo cual se deben mejorar los programas de control de leishmaniosis, especialmente en lo relacionado con la detección de casos activos, entrenamiento y educación, de tal forma que el diagnóstico se realice en forma más rápida.Leishmaniasis in Colombia has traditionally been seen as a health risk for adult males, as they become infected when they enter the vector's biotopes to tap natural resources. National health statistics seem to confirm this theory. However, during field studies, the Program for the Study and Control of Tropical Diseases (PECET observed both equal proportions of men and women with active leishmaniasis and delayed hypersensitivity skin tests and equal proportions of males and females having had contact with the parasite from early childhood. Several factors that have not been analyzed in depth in Colombia thus far appear to distort the disease's epidemiological pattern in the country, and gender-linked differences in access to health care appear to exist. As a

  18. Toll-like receptors 2, 4, and 9 expressions over the entire clinical and immunopathological spectrum of American cutaneous leishmaniasis due to Leishmania (V.) braziliensis and Leishmania (L.) amazonensis

    Science.gov (United States)

    Campos, Marliane Batista; Lima, Luciana Vieira do Rêgo; de Lima, Ana Carolina Stocco; Vasconcelos dos Santos, Thiago; Ramos, Patrícia Karla Santos; Gomes, Claudia Maria de Castro

    2018-01-01

    Leishmania (V.) braziliensis and Leishmania(L.) amazonensis are the most pathogenic agents of American Cutaneous Leishmaniasis in Brazil, causing a wide spectrum of clinical and immunopathological manifestations, including: localized cutaneous leishmaniasis (LCLDTH+/++), borderline disseminated cutaneous leishmaniasis (BDCLDTH±), anergic diffuse cutaneous leishmaniasis (ADCLDTH-), and mucosal leishmaniasis (MLDTH++++). It has recently been demonstrated, however, that while L. (V.) braziliensis shows a clear potential to advance the infection from central LCL (a moderate T-cell hypersensitivity form) towards ML (the highest T-cell hypersensitivity pole), L. (L.) amazonensis drives the infection in the opposite direction to ADCL (the lowest T-cell hypersensitivity pole). This study evaluated by immunohistochemistry the expression of Toll-like receptors (TLRs) 2, 4, and 9 and their relationships with CD4 and CD8 T-cells, and TNF-α, IL-10, and TGF-β cytokines in that disease spectrum. Biopsies of skin and mucosal lesions from 43 patients were examined: 6 cases of ADCL, 5 of BDCL, and 11 of LCL caused byL. (L.) amazonensis; as well as 10 cases of LCL, 4 of BDCL, and 6 of ML caused byL. (V.) braziliensis. CD4+ T-cells demonstrated their highest expression in ML and, in contrast, their lowest in ADCL. CD8+ T-cells also showed their lowest expression in ADCL as compared to the other forms of the disease. TNF-α+showed increased expression from ADCL to ML, while IL-10+and TGF-β+ showed increased expression in the opposite direction, from ML to ADCL. With regards to TLR2, 4, and 9 expressions, strong interactions of TLR2 and 4 with clinical forms associated with L. (V.) braziliensis were observed, while TLR9, in contrast, showed a strong interaction with clinical forms linked to L. (L.) amazonensis. These findings strongly suggest the ability of L. (V.) braziliensis and L. (L.) amazonensis to interact with those TLRs to promote a dichotomous T-cell immune response in ACL

  19. Oral Efficacy of Apigenin against Cutaneous Leishmaniasis: Involvement of Reactive Oxygen Species and Autophagy as a Mechanism of Action.

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    Fernanda Fonseca-Silva

    2016-02-01

    Full Text Available The treatment for leishmaniasis is currently based on pentavalent antimonials and amphotericin B; however, these drugs result in numerous adverse side effects. The lack of affordable therapy has necessitated the urgent development of new drugs that are efficacious, safe, and more accessible to patients. Natural products are a major source for the discovery of new and selective molecules for neglected diseases. In this paper, we evaluated the effect of apigenin on Leishmania amazonensis in vitro and in vivo and described the mechanism of action against intracellular amastigotes of L. amazonensis.Apigenin reduced the infection index in a dose-dependent manner, with IC50 values of 4.3 μM and a selectivity index of 18.2. Apigenin induced ROS production in the L. amazonensis-infected macrophage, and the effects were reversed by NAC and GSH. Additionally, apigenin induced an increase in the number of macrophages autophagosomes after the infection, surrounding the parasitophorous vacuole, suggestive of the involvement of host autophagy probably due to ROS generation induced by apigenin. Furthermore, apigenin treatment was also effective in vivo, demonstrating oral bioavailability and reduced parasitic loads without altering serological toxicity markers.In conclusion, our study suggests that apigenin exhibits leishmanicidal effects against L. amazonensis-infected macrophages. ROS production, as part of the mechanism of action, could occur through the increase in host autophagy and thereby promoting parasite death. Furthermore, our data suggest that apigenin is effective in the treatment of L. amazonensis-infected BALB/c mice by oral administration, without altering serological toxicity markers. The selective in vitro activity of apigenin, together with excellent theoretical predictions of oral availability, clear decreases in parasite load and lesion size, and no observed compromises to the overall health of the infected mice encourage us to supports

  20. Identification and phylogenetic relationship of Iranian strains of various Leishmania species isolated from cutaneous and visceral cases of leishmaniasis based on N-acetylglucosamine-1-phosphate transferase gene.

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    Hajjaran, Homa; Mohebali, Mehdi; Teimouri, Aref; Oshaghi, Mohammad Ali; Mirjalali, Hamed; Kazemi-Rad, Elham; Shiee, Mohammad Reza; Naddaf, Saied Reza

    2014-08-01

    The identity of Iranian Leishmania species has been resolved to some extent by some genetic markers. In this study, based on N-acetylglucosamine-1-phosphate transferase (nagt) gene, we further elucidated the identity and phylogeny of the prevalent species in this country. DNAs of 121 isolates belonging to cutaneous leishmaniasis (CL) patients, canine visceral leishmaniasis (CVL) cases, and Rhombomys opimus rodents were amplified by targeting a partial sequence of nagt gene. All the amplicons were analyzed with restriction fragment length polymorphism (RFLP) using Acc1 enzyme, and 49 amplicons representing different reservoir hosts were sequenced and aligned with similar sequences from GenBank database. The RFLP analysis revealed that 41 CL patients were infected Leishmania tropica and 36 with Leishmania major. Among 10 CVL isolates, 6 were identified as Leishmania infantum and 4 as L. tropica. Amongst 34 rodents' isolates, 11 and 23 isolates exhibited patterns similar to those of L. major, and L. tropica/Leishmania turanica, respectively. The sequencing results from all CL patients, CVL cases, and 4 reservoir rodents were in agreement with RFLP analysis and showed 99-100% homologies with the registered species of L. major, L. tropica, and L. infantum from Turkey, Tunisia, Iraq and Israel. Of the 7 rodent isolates exhibiting RFLP patterns similar to L. tropica/L. turanica, 3 exhibited the highest homologies (99-100%) with L. turanica and 4 with Leishmania gerbilli. The 49 nagt DNA sequences were grouped into five clusters representing L. major, L. tropica, L. infantum, L. turanica and L. gerbilli species, encompassing 19 haplotypes. No correlation was observed between intraspecies divergence and geographic distribution of haplotypes. The L. tropica haplotypes exhibited more homologies with those of L. infantum than L. major (97.2% vs. 96.9%), a probable indication to the potential ability of L. tropica to visceralize. Characterization of Iranian Leishmania isolates

  1. Study of a cutaneous leishmaniasis outbreak in General Vedia, Province of Chaco, 1996 Surto de leishmaniose cutânea em General Vedia, Provincia de Chaco, 1996

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    O. Daniel SALOMON

    2001-04-01

    Full Text Available Between March and July 1996, a focalized epidemic outbreak of cutaneous leishmaniasis in General Vedia, province of Chaco, associated to the gallery forest of the Oro river was verified. The incidence rate in the area, which was 0-2/000 cases in preceding years, reached 8/000 cases in 1996. The risk of symptomatic infection was similar between sexes, but was different when analizing the different age groups by sex, suggesting a greater relative importance of the peridomestic transmission for the females and of the transmission in the subtropical forest for the males. Specimens of Lutzomyia intermedia, a species already incriminated as a vector of Leishmaniasis in other provinces of northern Argentina, were captured and identified in the focus locality in May 1996. The possible causes of the outbreak related to the climatic variables and the vector abundance are analyzed and the results in the framework of possible preventive and control activities are discussed.Entre março e julho de 1996, foi verificado um surto epidêmico focalizado de leishmaniose cutânea na localidade de Geral Vedia, província de Chaco, associado com a floresta de galeria do rio de Oro. A taxa de incidência na área que era 0-2/000 casos em anos anteriores, alcançou 8/000 casos em 1996. O risco de infecção sintomática era semelhante entre sexos, mas era diferente quando foram analizados os grupos de idade diferentes segundo sexo, sugerindo maior importância relativa da transmissão na área peridoméstica nas mulheres e da transmissão na floresta subtropical nos homens. Espécimes de Lutzomyia intermedia, espécie já incriminada como vetor de Leishmaniose em outras províncias do norte da Argentina, foram capturadas e identificadas na localidade em maio de 1996. São analisadas as possíveis causas do surto relacionadas às variáveis climáticas e a abundância do vetor e os resultados são discutidas na estrutura de possíveis atividades de prevenção e

  2. Factores de riesgo para la transmisión de leishmaniasis cutánea en niños de 0 a 5 años en un área endémica de Leishmania (Viannia braziliensis Risk factors for cutaneous leishmaniasis transmission in children aged 0 to 5 years in an endemic area of Leishmania (Viannia braziliensis

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    Julia Ampuero

    2005-02-01

    Full Text Available Fue realizado un estudio caso-control pareado en Corte de Pedra, Bahía, Brasil, área endémica de Leishmania (Viannia braziliensis para evaluar los diferentes factores de riesgo asociados a la presencia de leishmaniasis cutánea en niños de 0 a 5 años. Fueron considerados como casos, los niños con prueba de leishmanina positiva y que presentaban en el examen físico, una o más lesiones clínicas, activas o cicatrizales, compatibles con leishmaniasis cutánea. Fueron seleccionados 40 casos y 71 controles que fueron pareados por edad y área de residencia. La presencia de algún otro miembro de la familia con antecedente de leishmaniasis cutánea durante el año anterior a la aparición de la enfermedad en el niño demostró ser un importante factor de riesgo (MÔR MH = 17,75; IC95%: 4,08-77,25. No se encontraron evidencias de asociación con otros factores, como hábitos del niño dentro y fuera de casa, características de la vivienda y del peridomicilio, presencia de vectores y animales como probables reservorios. Estos hallazgos apoyan la hipótesis que el ser humano podría comportarse como un posible reservorio y servir de fuente de contagio para este grupo de edad.With the purpose of identifying risk factors for cutaneous leishmaniasis transmission in children from 0 to 5 years, a matched case-control study was carried out in Corte de Pedra, Bahia, Brazil, an endemic area of Leishmania (Viannia braziliensis. Children with a positive leishmanin skin test and one or more active lesions or scars consistent with cutaneous leishmaniasis were defined as cases. Forty cases and 71 controls were selected and matched by age and place of residence. The presence of a family member with a history of cutaneous leishmaniasis in the year prior to the appearance of the disease in the child was found to be an important risk factor (MÔR MH = 17.75; 95%CI: 4.08-77.25. No evidence of association between the disease and other risk factors was found, such

  3. Evaluation of IL-12RB1, IL-12B, CXCR-3 and IL-17a expression in cases affected by a non-healing form of cutaneous leishmaniasis: an observational study design

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    Moafi, Mohammad; Rezvan, Hossein; Sherkat, Roya; Taleban, Roya; Asilian, Ali; Zarkesh Esfahani, Seyed Hamid; Nilforoushzadeh, Mohammad Ali; Jaffary, Fariba; Feizi, Awat

    2017-01-01

    Introduction Seldom cutaneous leishmaniasis (CL) may present as a lasting and active lesion(s), known as a non-healing form of CL (NHCL). Non-functional type 1 T helper (Th1) cells are assumed the most important factor in the outcome of the disease. The present study aims to assess some molecular defects that potentially contribute to Th1 impairment in NHCL. Methods and analysis This prospective observational study will be implemented among five groups. The first and second groups comprise pa...

  4. First Report on Isolation and Characterization of Leishmania major from Meriones hurrianae (Rodentia: Gerbillidae) of A Rural Cutaneous leishmaniasis Focus in South-Eastern Iran.

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    Kassiri, Hamid; Naddaf, Saied Reza; Javadian, Ezat-Aldin; Mohebali, Mehdi

    2013-09-01

    Zoonotic Cutaneous Leishmaniasis (ZCL) is an endemic health problem in many rural areas of Iran, with doubled number of incidences over the last decade. Different species of rodents serve as natural reservoir host for ZCL. The disease is considered as a major health problem in rural areas of Mirjaveh, Chabahar, and Konarak Counties of Sistan va Baluchistan Province. This study describes the identity of Leishmania species, isolated from Meriones hurrianae from Chabahar County using RAPD-PCR methodology. Rodents were entrapped by live traps baited with roasted walnut, tomato, and cucumber during spring and summer. All rodents were identified based on external features including fur color, ears characteristics, tail length, hind feet, body measurements, and internal features of teeth and cranium. Giemsa-stained impressions from rodents' ears were examined for amastigotes microscopically. The samples from infected rodents were cultured in NNN+LIT medium and then the harvested parasites at the stationary phase were subjected to DNA extraction followed by amplification with RAPD-PCR. All the 28 entrapped animals were identified as M. hurrianae. Five animals showed to harbor Leishmania parasite by microscopy. Leishmania DNA isolated from five M. hurrianae produced distinctive bands of L. major with four primers. However, the products that were amplified with primers AB1-07, 327, and 329 were stable and reproducible. This is the first report on the isolation and identification of L. major from M. hurrianae from Iran. Regarding infection rate of 17.8%, M. hurrianae seems to play the major role in the maintenance and transmission of disease to humans in this area.

  5. Species Composition of Sand Flies (Diptera: Psychodidae) and Modeling the Spatial Distribution of Main Vectors of Cutaneous Leishmaniasis in Hormozgan Province, Southern Iran.

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    Hanafi-Bojd, Ahmad Ali; Khoobdel, Mehdi; Soleimani-Ahmadi, Moussa; Azizi, Kourosh; Aghaei Afshar, Abbas; Jaberhashemi, Seyed Aghil; Fekri, Sajjad; Safari, Reza

    2018-02-28

    Cutaneous Leishmaniasis (CL) is one of the main neglected vector-borne diseases in the Middle East, including Iran. This study aimed to map the spatial distribution and species composition of sand flies in Hormozgan Province and to predict the best ecological niches for main CL vectors in this area. A database that included all earlier studies on sand flies in Hormozgan Province was established. Sand flies were also collected from some localities across the province. Prediction maps for main vectors were developed using MaxEnt model. A total of 27 sand fly species were reported from the study area. Phlebotomus papatasi Scopoli, Phlebotomus sergenti s.l. Parrot, Phlebotomus alexandri Sinton, Sergentomyia sintoni Pringle, Sergentomyia clydei Sinton, Sergentomyia tiberiadis Adler, and Sergentomyia baghdadis Adler (Diptera: Psychodidae) had the widest distribution range. The probability of their presence as the main vectors of CL was calculated to be 0.0003-0.9410 and 0.0031-0.8880 for P. papatasi and P. sergenti s.l., respectively. The best ecological niches for P. papatasi were found in the central south, southeast, and a narrow area in southwest, whereas central south to northern area had better niches for P. sergenti s.l. The endemic areas are in Bandar-e Jask, where transmission occurs, whereas in Bastak, the cases were imported from endemic foci of Fars province. In conclusion, proven and suspected vectors of CL and VL were recorded in this study. Due to the existence of endemic foci of CL, and favorite ecological niches for its vectors, there is potential risk of emerging CL in new areas.

  6. The effect of education based on the theory of planned behavior on preventive behaviors of cutaneous Leishmaniasis in mothers living in endemic city of Natanz

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    MH Baghianimoghadam

    2016-09-01

    Full Text Available Introduction: Due to the limited studies conducted on the educational interventions to change the preventive behaviors of cutaneous leishmaniasis(CL as well as mothers' critical role in creating and maintaining these behaviors, this study aimed to determine the impact of education based on theory of planned behavior on preventive behaviors of CL in mothers living in endemic city of Natanz. Methods: In this case experimental study, two health care centers in endemic areas of CL were randomly assigned into two groups of experimental and control. Using list of mothers covered by each center, 80 patients were selected by simple random sampling, who were required to complete a questionnaire that has been designed based on the theory of planned behavior, and its reliability and validity had been confirmed in the previous studies. Then 4 sessions were held for the experimental group mothers and 2 training sessions were held for people who influenced them, whereas control group received no interventions. Two months after training intervention, the study data were collected again and were analyzed using the SPSS software (ver. 18 via independent statistical t-test, paired t-test, Chi-square and Mann Whitney tests. Results: Before the intervention, no significant differences were observed between the mean scores of different constructs of this theory in the two groups (p>0/005. Though after intervention, a significant increase was observed (p<0/005 in the mean score of knowledge, attitude, subjective norms, perceived behavioral control, intention and action of groups and in control group, only a significant increase was observed in the mean scores of knowledge and attitude (p<0/005. Conclusions: As the findings of the present study revealed, training based on theory of planned behavior can promote preventive behaviors of CL in mothers.

  7. Direct comparison of the efficacy and safety of oral treatments with oleylphosphocholine (OlPC and miltefosine in a mouse model of L. major cutaneous leishmaniasis.

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    Anny Fortin

    2014-09-01

    Full Text Available Cutaneous leishmaniasis (CL represents a range of skin diseases caused by infection with Leishmania parasites and associated with tissue inflammation and skin ulceration. CL is clinically widespread in both the Old and New World but lacks treatments that are well tolerated, effective and inexpensive. Oleylphosphocholine (OlPC is a new orally bioavailable drug of the alkylphosphocholine family with potent antileishmanial activity against a broad range of Leishmania species/strains.The potential of OlPC against Old World CL was evaluated in a mouse model of Leishmania (L. major infection in BALB/c mice. Initial dose-response experiments showed that an oral daily dose of 40 mg/kg of OlPC was needed to impact time to cure and lesion sizes. This dose was then used to directly compare the efficacy of OlPC to the efficacy of the antileishmanial drugs miltefosine (40 mg/kg/day, fluconazole (160 mg/kg/day and amphotericin B (25 mg/kg/day. OlPC, miltefosine and fluconazole were given orally for 21 days while amphotericin B was administered intraperitoneally for 10 days. Ulcer sizes and animal weights were followed up on a weekly basis and parasitemia was determined by means of a real-time in vivo imaging system which detects luminescence emitted from luciferase-expressing infecting L. major parasites. Amphotericin B and OlPC showed excellent efficacy against L. major lesions in terms of reduction of parasitic loads and by inducing complete healing of established lesions. In contrast, treatment with miltefosine did not significantly affect parasitemia and lesion sizes, while fluconazole was completely ineffective at the dose regimen tested.Given the data showing the outstanding efficacy and tolerability of OlPC, our results suggest that OlPC is a promising new drug candidate to improve and simplify current clinical management of L. major CL.

  8. Molecular detection of Leishmania infantum and Leishmania tropica in rodent species from endemic cutaneous leishmaniasis areas in Morocco.

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    Echchakery, Mohamed; Chicharro, Carmen; Boussaa, Samia; Nieto, Javier; Carrillo, Eugenia; Sheila, Ortega; Moreno, Javier; Boumezzough, Ali

    2017-10-02

    Leishmaniasis remains a major public health problem in African nations, including Morocco, where little is known about the vertebrate reservoirs involved in the causal parasites' transmission cycles. The present study investigates the role of rodent species as potential reservoirs of Leishmania spp. in central Morocco, where both L. tropica and L. infantum have been reported. Rodents were caught from 22 sites in central Morocco, by using Sherman metal traps, and identified morphologically. For each specimen, genomic DNA was extracted from different tissues using the Speed Tools DNA extraction Kit. Then, samples were PCR-analyzed, targeting the SSU rRNA gene to detect Leishmania spp. DNA, followed by amplification of the internal transcribed spacer 1 (ITS1) and its sequencing to identify the species. A total of 197 rodents belonging to ten species were captured and identified: Rattus rattus (40.61%), Mus musculus (25.38%), Apodemus sylvaticus (8.63%), Mus spretus (7.11%), Meriones shawi (5.58%), Rattus norvegicus (4.57%), Meriones libycus (3.05%), Mastomys erythroleucus (2.03%), Gerbillus campestris (2.03%) and Lemniscomys barbarus (1.01%). Molecular analysis revealed the presence of Leishmania species in 18 specimens: six R. rattus (out of 80 captured; 7.5%), 11 M. musculus (out of 50 captured; 22%), and one R. norvegicus (out of 9 captured; 11.11%). To the best of our knowledge, L. infantum and L. tropica were identified in rodent species for the first time in Morocco. These findings suggest that rodent species may be involved in L. infantum and L. tropica transmission cycles in this country but that further studies are needed to confirm their role as reservoirs of Leishmania species in Morocco.

  9. Influence of apoptosis on the cutaneous and peripheral lymph node inflammatory response in dogs with visceral leishmaniasis.

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    Moreira, Pamela Rodrigues Reina; Bandarra, Marcio de Barros; Magalhães, Geórgia Modé; Munari, Danísio Prado; Machado, Gisele Fabrino; Prandini, Marcelo Martinasso; Alessi, Antonio Carlos; de Oliveira Vasconcelos, Rosemeri

    2013-02-18

    In canine visceral leishmaniasis (CVL), the abnormalities most commonly observed in clinical examination on the animals are lymphadenomegaly and skin lesions. Dogs are the main domestic reservoir for the protozoon Leishmania (L.) chagasi and the skin is the main site of contamination by the vector insect. Some protozoa use apoptosis as an immunological escape mechanism. The aim of this study was to correlate the presence of apoptosis with the parasite load and with the inflammatory response in the skin and lymph nodes of dogs naturally infected with Leishmania (L.) chagasi. Thirty-three dogs from the municipality of Araçatuba (São Paulo, Brazil) were used, an endemic area for CVL. Muzzle, ear and abdominal skin and the popliteal, subscapular, iliac and mesenteric lymph nodes of symptomatic (S), oligosymptomatic (O) and asymptomatic (A) dogs were analyzed histologically. The parasite load and percentage apoptosis were evaluated using an immunohistochemical technique. Microscopically, the lymph nodes presented chronic lymphadenitis and the skin presented plasmacytic infiltrate and granulomatous foci in the superficial dermis, especially in the ear and muzzle regions. The inflammation was most severe in group S. The parasite load and apoptotic cell density were also greatest in this group. The cause of the lymphoid atrophy in these dogs was correlated with T lymphocyte apoptosis, thus leaving the dogs more susceptible to CVL. The peripheral lymph nodes presented the greatest inflammatory response. Independent of the clinical picture, the predominant inflammatory response was granulomatous and plasmacytic, both in the skin and in the peripheral lymph nodes. The ear skin presented the greatest intensity of inflammation and parasite load, followed by the muzzle skin, in group S. The ear skin area presented a non-significant difference in cell profile, with predominance of macrophages, and a significant difference from group A to groups O and S. It was seen that in

  10. 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

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

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    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.

  12. Leishmaniasis — Surprise from the East

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    I.V. Bogadelnikov

    2012-03-01

    Full Text Available The clinical case of cutaneous leishmaniasis in a 4-year-old child is presented in the article. The child came to the Crimea from area where leishmaniasis is endemic — Republic of Uzbekistan. Clinical case is interesting for consideration in terms of differential diagnosis of specific rash.

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

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    A.C.C. Botelho

    1998-02-01

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

  14. Species composition of sand flies and bionomics of Phlebotomus papatasi and P. sergenti (Diptera: Psychodidae) in cutaneous leishmaniasis endemic foci, Morocco.

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    Boussaa, Samia; Kahime, Kholoud; Samy, Abdallah M; Salem, Abdelkrim Ben; Boumezzough, Ali

    2016-02-02

    Cutaneous Leishmaniasis (CL) is one of the most neglected tropical diseases in Morocco. Leishmania major and L. tropica are the main culprits identified in all endemic foci across the country. These two etiological agents are transmitted by Phlebotomus papatasi and P. sergenti, the two most prevalent sand fly species in Morocco. Previous studies reflected gaps of knowledge regarding the environmental fingerprints that affect the distribution of these two potential vectors across Morocco. The sand flies were collected from 48 districts across Morocco using sticky paper traps. Collected specimens were preserved in 70% ethanol for further processing and identification. Male and female densities were calculated in each site to examine their relations to the environmental conditions across these sites. The study used 19 environmental variables including precipitation, aridity, elevation, soil variables and a composite representing maximum, minimum and mean of day- and night-time Land Surface Temperature (LST), and Normalized Difference Vegetation Index (NDVI). A total of 11,717 specimens were collected during this entomological survey. These specimens represented 11 species of two genera; Phlebotomus and Sergentomyia. Correlations of the sand fly densities with the environmental variables were estimated to identify the variables which influence the distribution of the two potential vectors, Phlebotomus papatasi and P. sergenti, associated with all CL endemic foci across the country. The density of P. papatasi was most affected by temperature changes. The study showed a significant positive correlation between the densities of both sexes of P. papatasi and night-time temperatures. Both P. papatasi and P. sergenti showed a negative correlation with aridity, but, such correlation was only significant in case of P. papatasi. NDVI showed a positive correlation only with densities of P. sergenti, while, soil PH and soil water stress were negatively correlated with the

  15. Temporal distribution and behaviour of sand flies (Diptera: Psychodidae) in a cutaneous leishmaniasis focus of the Kani Tribe settlements in the Western Ghats, India.

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    Srinivasan, R; Jambulingam, P; Kumar, N Pradeep; Selvakumar, M; Edwin, B; Kumar, T Dilip

    2015-08-01

    The temporal distribution of sand flies in relation to environmental factors was studied in the Kani tribe settlements located on the southernmost part of the Western Ghats, Kerala, India, between June 2012 and May 2013. This area is known for occurrence of cutaneous leishmaniasis (CL) cases. Employing hand-held aspirator, light trap and sticky-trap collection methods, a total of 7874 sand fly specimens, comprising 19 species was collected. Sergentomyia baghdadis was predominant species, followed by Phlebotomus argentipes. Sand fly abundance was significantly higher indoors (χ(2)=9241.8; p=0.0001) than outdoors. Mean density of P. argentipes in human dwellings, cattle sheds and outdoors was 7.2±2.9, 27.33±21.1 and 0.64±0.2 females/per man-hour (MHR), respectively. No sand fly species other than P. argentipes was obtained from cattle sheds. Although, sand fly populations were prevalent throughout the year, their abundance fluctuated with seasonal changes. Multiple regression analysis with backward elimination indicated that the increase in precipitation and relative humidity contributed to a significant positive association with the increase in sand fly abundance, while the increase in temperature showed no association. Fully engorged female sand flies tested for blood meal source showed multiple host-blood feeding. Analysis of resting populations of sand flies collected from human shelters indicated that the populations were found maximum on interior walls at 6-8 and >8 ft height, including ceiling during summer (F=83.7, df=6, p=0.001) and at the lower half of the wall at 0 and 0-2 ft height, during monsoon season (F=41.4, df=6, p=0.001). In cooler months, no preference to any height level (F=1.67, df=6, p=0.2) was observed. Proportion of females sand flies with Sella's classification of abdominal stages, namely full-fed, half-gravid and gravid females did not vary significantly (t=1.98, p=0.13827) indoors, confirming their endophilic behaviour. Risk of CL

  16. CD8 cells of patients with diffuse cutaneous leishmaniasis display functional exhaustion: the latter is reversed, in vitro, by TLR2 agonists.

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    Joselín Hernández-Ruiz

    Full Text Available Leishmania mexicana (Lm causes localized (LCL and diffuse (DCL cutaneous leishmaniasis. DCL patients have a poor cellular immune response leading to chronicity. It has been proposed that CD8 T lymphocytes (CD8 play a crucial role in infection clearance, although the role of CD8 cytotoxicity in disease control has not been elucidated. Lesions of DCL patients have been shown to harbor low numbers of CD8, as compared to patients with LCL, and leishmanicidal treatment restores CD8 numbers. The marked response of CD8 towards Leishmania parasites led us to analyze possible functional differences between CD8 from patients with LCL and DCL. We compared IFNγ production, antigen-specific proliferation, and cytotoxicity of CD8 purified from PBMC against autologous macrophages (MO infected with Leishmania mexicana (MOi. Additionally, we analyzed tissue biopsies from both groups of patients for evidence of cytotoxicity associated with apoptotic cells in the lesions. We found that CD8 cell of DCL patients exhibited low cytotoxicity, low antigen-specific proliferation and low IFNγ production when stimulated with MOi, as compared to LCL patients. Additionally, DCL patients had significantly less TUNEL+ cells in their lesions. These characteristics are similar to cellular "exhaustion" described in chronic infections. We intended to restore the functional capacity of CD8 cells of DCL patients by preincubating them with TLR2 agonists: Lm lipophosphoglycan (LPG or Pam3Cys. Cytotoxicity against MOi, antigen-specific proliferation and IFNγ production were restored with both stimuli, whereas PD-1 (a molecule associated with cellular exhaustion expression, was reduced. Our work suggests that CD8 response is associated with control of Lm infection in LCL patients and that chronic infection in DCL patients leads to a state of CD8 functional exhaustion, which could facilitate disease spread. This is the first report that shows the presence of functionally exhausted CD8

  17. Epidemiology of Imported Leishmaniasis in Italy: Implications for a European Endemic Country.

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    Trentina Di Muccio

    Full Text Available In the past decade, the number of imported leishmaniasis cases has increased in countries of Western Europe. The trend is associated with increasing travels, ecotourism activity, military operations and immigration. While in endemic countries leishmaniasis is usually well diagnosed, accurate patient history and parasite identification are necessary to distinguish between autochthonous and imported cases. This is particularly important, as new Leishmania species/genotypes may be introduced and transmitted by local phlebotomine vectors without appropriate surveillance, with unpredictable consequences. We report on the surveillance of imported leishmaniasis performed by the Leishmania Identification Reference Centre of Rome from 1986 through 2012, involving health care centres from 16/20 Italian regions. Suspected imported cases were analyzed and conclusions were based on clinical, epidemiological and diagnostic findings. Over the years, different parasite identification methods were employed, including MultiLocus Enzyme Electrophoresis and molecular techniques combining disease diagnosis (SSU rDNA nested-PCR and Leishmania typing (nuclear repetitive sequence and ITS-1 PCR-RFLPs. A total of 105 imported cases were recorded (annual range: 0-20 of which 36 were visceral (VL (16 HIV-coinfections and 69 cutaneous (CL cases; 85 cases (52 CL were from the Old World and 20 (17 CL from the New World. Eight Leishmania species were identified, of which 7 were exotic to Italy. VL importation until 1995 was associated with the spread of Mediterranean Leishmania-HIV co-infections in early 1990s. Following the introduction of HAART treatment, such cases became occasional in Italians but relatively frequent among immigrants. In contrast, a steady increase of CL cases was observed from different areas of the Old and New Worlds, that in recent years included mainly immigrants 'visiting friends and relatives' and Italian tourists. This positive trend likely depends

  18. The traditional and conventional medical treatment of cutaneous leishmaniasis in rural Ecuador Los tratamientos médicos tradicional y convencional de la leishmaniasis cutánea en una zona rural de Ecuador

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    M. Margaret Weigel

    2001-12-01

    Full Text Available Objective. To explore the knowledge, beliefs, and practices (KBPs regarding cutaneous leishmaniasis (CL treatment held by an endemic population in Ecuador. Methods. A follow-up to research done several years before, this study used random cluster sampling to select 529 adults who lived in rural northwestern Ecuador. Data were collected over a 24-month period using in-depth interviews supplemented with qualitative methods. Results. Most of the subjects were familiar with CL. The interviewed persons described a large, diverse ethnomedical treatment inventory. Contrary to expectations, few treatment KBPs were predicted by gender, age, or prior CL experience. Factors reported as important in treatment decisions included female reproductive status, CL "type" (perceived form of the illness, lesion location, number of other infected household members, cost of the various treatments, treatment availability, and perceived treatment effectiveness. Subjects' strong motivation for prompt treatment appeared to be associated with beliefs regarding the inability of CL lesions to heal spontaneously, the disease's propensity to progress into fatal illnesses, and disfigurement. Despite increased familiarity with Glucantime® (meglumine antimonate, the conventional pentavalent antimonial drug used to treat CL in Ecuador, the proportion of subjects who had used it in their treatment remained low (20% while the prevalence of premature drug discontinuance appeared to have doubled in comparison to our earlier study. Conclusions. By itself, increased access to Glucantime® is unlikely to increase usage of the drug and to reduce its frequent premature discontinuance unless public health planners accommodate the health and illness world views of local populations. Efficacy and safety studies should be undertaken to investigate promising traditional remedies as possible alternatives to Glucantime®.Objetivo. Investigar los conocimientos, creencias y pr

  19. First description of Leishmania (Viannia) infection in Evandromyia saulensis, Pressatia sp. and Trichophoromyia auraensis (Psychodidae: Phlebotominae) in a transmission area of cutaneous leishmaniasis in Acre state, Amazon Basin, Brazil

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    de Araujo-Pereira, Thais; de Pita-Pereira, Daniela; Boité, Mariana Côrtes; Melo, Myllena; da Costa-Rego, Taiana Amancio; Fuzari, Andressa Alencastre; Brazil, Reginaldo Peçanha; Britto, Constança

    2017-01-01

    Studies on the sandfly fauna to evaluate natural infection indexes are still limited in the Brazilian Amazon, a region with an increasing incidence of cutaneous leishmaniasis. Here, by using a multiplex polymerase chain reaction directed to Leishmania kDNA and hybridisation, we were able to identify L. (Viannia) subgenus in 12 out of 173 sandflies captured in the municipality of Rio Branco, Acre state, revealing a positivity of 6.94%. By sequencing the Leishmania 234 bp-hsp70 amplified products from positive samples, infection by L. (V.) braziliensis was confirmed in five sandflies: one Evandromyia saulensis, three Trichophoromyia auraensis and one Pressatia sp. The finding of L. (Viannia) DNA in two Ev. saulensis corresponds to the first record of possible infection associated with this sandfly. Moreover, our study reveals for the first time in Brazil, Th. auraensis and Pressatia sp. infected by L. (Viannia) parasites. PMID:28076470

  20. Recent observations on the sand fly (Diptera: Psychodidae fauna of the State of Rondônia, Western Amazônia, Brazil: the importance of Psychdopygus davisi as a vector of zoonotic cutaneous leishmaniasis

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    Gil Luis HS

    2003-01-01

    Full Text Available Sand flies were collected in the central region of the state of Rondônia (W 64º30' to 63º00' and S 10º00'to 11º00' using Shannon and CDC light traps from October 1997 to August 2000. A total of 85,850 specimens representing 78 named species were captured. Of these 14 were new records for Rondônia. The proportion of males/females was 1/1.131. Trypanosomatids, that are presently being identified, were detected in 11 species. Leishmania (Viannia naiffi was recorded from Psychodopygus davisi and P. hirsutus. In the present study the dominant species was P. davisi (39.6% followed by Lutzomyia whitmani (13.1%, P. carrerai (11.6%, and P. hirsutus (10.2%. The importance of P. davisi as a vector of zoonotic cutaneous leishmaniasis is discussed.

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

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    Sergio de Almeida Basano

    2004-09-01

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

  2. Histopatologia da forma localizada de leishmaniose cutânea por Leishmania (Leishmania amazonensis Histopathology of the localized form of cutaneous leishmaniasis due to Leishmania (Leishmania amazonensis

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    Mário A. P. Moraes

    1994-10-01

    Full Text Available São descritas as alterações microscópicas presentes na forma localizada (ulcerada da Leishmaniose cutânea produzida por Leishmania (Leishmania amazonensis. Nesse tipo de manifestação, menos conhecido do que a forma anérgica ou difusa devida ao mesmo agente, as lesões são clinicamente idênticas às de leishmaniose cutânea causada por espécies outras de Leishmania, pertencentes ao subgênero Viannia. Na infecção localizada por L. (L. amazonensis, entretanto, há um aspecto peculiar, só recentemente conhecido, ou seja, cerca de 50% dos indivíduos atingidos não reagem ao teste de Montenegro. A principal característica histológica observada foi a acumulação na derme, quase sempre focal, de numerosos macrófagos contendo no citoplasma um grande vacúolo cheio de amastigotas. O quadro é semelhante ao da forma difusa, porém sem o aspecto histiocitomatóide, próprio da última. Afora esses grupos de macrófagos, vêem-se também, na forma localizada, muitas células mononucleares da inflamação, principalmente plasmócitos e macrófagos não parasitados. Os acúmulos de macrófagos com amastigotas, quando volumosos, podem sofrer necrose na parte central; os parasitos, contidos nas células, são destruídos com elas ou liberados, e sua eliminação através da úlcera deve contribuir para a cura do processo. Esse tipo de necrose nunca foi descrito em casos da forma difusa. Não houve grande diferença, no quadro histológico, entre pacientes Montenegro-negativos e positivos. Apenas em alguns casos, do grupo Montenegro-positivo, havia granulomas formados por histiócitos epitelióides sem parasitos. Quanto à persistência das células com parasitos nas lesões, observou-se que aos seis meses ou mais de evolução, em ambos os grupos, ainda estavam elas presentes. Tal achado não é comum na leishmaniose tegumentar por L. (V. braziliensis.The microscopic changes found in the localized form of the human cutaneous leishmaniasis due

  3. The efficacy of Achilles millefolium topical gel along with intralesional injection of glucantime in the treatment of acute cutaneous leishmaniasis major

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    Fariba Jaffary

    2014-01-01

    Conclusions: Given the result of the present study, there is no significant difference in cure rates of lesions between yarrow and placebo topical gels as an adjuvant drugs with intralesional glucantime in treatment of acute cutaneous leishmanial lesions.

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

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    Mariza Fordellone Rosa Cruz

    2012-08-01

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

  5. Failure of both azithromycin and antimony to treat cutaneous leishmaniasis in Manaus, AM, Brazil Falha da azitromicina e do antimonial no tratamento da leishmaniose cutânea em Manaus, AM, Brasil

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    Alan César Teixeira

    2008-06-01

    Full Text Available A non-randomized controlled clinical trial was carried outin order to evaluate both azithromycin and antimony efficacy in cutaneous leishmaniasis in Manaus, AM, Brazil. Forty nine patients from both genders, aged 14 to 70, with cutaneous ulcers for less than three months and a positive imprint for Leishmania spp. amastigotes were recruited into two groups. Group I (26 patients received a daily-single oral dose of 500 mg of azithromycin for 20 days and Group II (23 patients received a daily-single intramuscular dose of 20 mg/kg of meglumine antimony, also for 20 days. Azithromycin cured three of 24 (12.5% patients on days 60, 90 and 120 respectively whereas therapeutic failure was considered in 21 of 24 (87.5% cases. In group II, antimony cured eight of 19 (42.1% cases as follows: three on day 30, one each on day 60 and day 90, and three on day 120. Therapeutic failure occurred in 11 of 19 (57.9% individuals. The efficacy of antimony for leishmaniasis was better than azithromycin but analysis for the intention-to-treat response rate did not show statistical difference between them. Although azithromycin was better tolerated, it showed a very low efficacy to treat cutaneous leishmaniasis in Manaus.Com o objetivo de avaliar a eficácia da azitromicina no tratamento da leishmaniose cutânea, foi realizado ensaio comparativo, em Manaus. Foram recrutados 49 pacientes de ambos os sexos, com idades entre 14 e 70 anos que apresentassem úlceras cutâneas com menos de três meses de evolução e que tivessem exame direto positivo para amastigotas de leishmânia. Estes pacientes foram alocados em dois grupos assim: Grupo I (26 recebeu uma dose diária de 500 mg de azitromicina pela via oral durante 20 dias e o Grupo II, recebeu uma dose diária de 20 mg/kg de antimoniato de meglumina por via intramuscular, durante 20 dias. Do grupo da azitromicina, três (12,5% de 24 pacientes curaram 60, 90 e 120 dias, respectivamente, enquanto, em 21 (87,5% de 24 houve

  6. Cutaneous leishmaniasis susceptibility mapping using multi-criteria decision-making techniques, analytic hierarchy process (AHP and analytic network process (ANP

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    SEYED VAHID RAZAVI TERMEH

    2018-02-01

    Full Text Available Background & objective:Cutaneous leech is one of the six major diseases and an example of epidemic diseases in tropical regions. Prevalence and spread of this disease is affected by environmental factors and climatic conditions as well as economic, social and cultural issues. In this research, Analytic Hierarchy Process and network analyzes are used to prepare susceptible cutaneous leeches map. Considering high incidence of cutaneous leech in Khuzestan province, Izeh city was selected as a case study.   Materials & Methods: For this purpose, the number of patients affected by this disease in Izeh was obtained from the Provincial Health Center from 2009 to 2014. Information layers of elevation, rainfall, temperature, humidity, distance from river, distance from rural areas and land use were identified as effective parameter and their maps were prepared in GIS environment. Parameters were compared in pairs by using AHP and ANP and weight of each factors determining their impacts was calculated in Expert Choice and Super Decision software. Then these parameters were combined based on their obtained weights in ArcGIS software and the final cutaneous leech map was prepared. Evaluation of these methods was performed using relative operation curve (ROC and 16 points related to leech disease. Result: The results of weighting effective parameters using AHP and ANP showed that the highest weight is related to elevation, temperature and rainfall parameters, respectively. The results of ROC assessment showed that in preparing the map, ANP had an accuracy of 87.8% and AHP had an accuracy of 68.9%. Conclusion:The results of ANP showed that this model had suitable accuracy in preparing susceptible cutaneous leech map and AHP had moderate accuracy in preparing susceptible cutaneous leech map.

  7. Evaluation of IL-12RB1, IL-12B, CXCR-3 and IL-17a expression in cases affected by a non-healing form of cutaneous leishmaniasis: an observational study design.

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    Moafi, Mohammad; Rezvan, Hossein; Sherkat, Roya; Taleban, Roya; Asilian, Ali; Zarkesh Esfahani, Seyed Hamid; Nilforoushzadeh, Mohammad Ali; Jaffary, Fariba; Feizi, Awat

    2017-01-27

    Seldom cutaneous leishmaniasis (CL) may present as a lasting and active lesion(s), known as a non-healing form of CL (NHCL). Non-functional type 1 T helper (Th1) cells are assumed the most important factor in the outcome of the disease. The present study aims to assess some molecular defects that potentially contribute to Th1 impairment in NHCL. This prospective observational study will be implemented among five groups. The first and second groups comprise patients afflicted with non-healing and healing forms of CL, respectively. The third group consists of those recovered participants who have scars as a result of CL. Those participants who have never lived or travelled to endemic areas of leishmaniasis will comprise the fourth group. The fifth group comprises participants living in hyperendemic areas for leishmaniasis, although none of them have been afflicted by CL. The aim is to recruit 10 NHCL cases and 30 participants in each of the other groups. A leishmanin skin test (LST) will be performed to assess in vivo immunity against the Leishmania infection. The cytokine profile (interleukin (IL)-12p70, interferon (IFN)-γ, C-X-C motif chemokine ligand (CXCL)-11 and IL-17a) of the isolated peripheral blood mononuclear cells (PBMCs) will be evaluated through ELISA. Real-time PCR will determine the C-X-C motif chemokine receptor (CXCR)-3 and IL-17a gene expression and expression of IL-12Rβ1 will be assessed by flow cytometry. Furthermore, IL-12B and IL-12RB1 mutation analysis will be performed. It is anticipated that the outcome of the current study will identify IL-12B and IL-12RB1 mutations, which lead to persistent lesions of CL. Furthermore, our expected results will reveal an association between NHCL and pro-inflammatory cytokines (IL-12p70, IFN-γ IL-17a and CXCL-11), as well as CXCR-3 expression. This study has been approved by a local ethical committee. The final results will be disseminated through peer-reviewed journals and scientific conferences

  8. Bayesian geostatistical modeling of leishmaniasis incidence in Brazil.

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    Dimitrios-Alexios Karagiannis-Voules

    Full Text Available BACKGROUND: Leishmaniasis is endemic in 98 countries with an estimated 350 million people at risk and approximately 2 million cases annually. Brazil is one of the most severely affected countries. METHODOLOGY: We applied Bayesian geostatistical negative binomial models to analyze reported incidence data of cutaneous and visceral leishmaniasis in Brazil covering a 10-year period (2001-2010. Particular emphasis was placed on spatial and temporal patterns. The models were fitted using integrated nested Laplace approximations to perform fast approximate Bayesian inference. Bayesian variable selection was employed to determine the most important climatic, environmental, and socioeconomic predictors of cutaneous and visceral leishmaniasis. PRINCIPAL FINDINGS: For both types of leishmaniasis, precipitation and socioeconomic proxies were identified as important risk factors. The predicted number of cases in 2010 were 30,189 (standard deviation [SD]: 7,676 for cutaneous leishmaniasis and 4,889 (SD: 288 for visceral leishmaniasis. Our risk maps predicted the highest numbers of infected people in the states of Minas Gerais and Pará for visceral and cutaneous leishmaniasis, respectively. CONCLUSIONS/SIGNIFICANCE: Our spatially explicit, high-resolution incidence maps identified priority areas where leishmaniasis control efforts should be targeted with the ultimate goal to reduce disease incidence.

  9. A rapid molecular diagnosis of cutaneous leishmaniasis bycolorimetric malachite green-loop-mediated isothermal amplification(LAMP) combined with an FTA card as a direct sampling tool

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    Nzelu, Chukwunonso O.; Cáceres, Abraham G.; Guerrero-Quincho, Silvia; Tineo-Villafuerte, Edwin; Rodriquez-Delfin, Luis; Mimori, Tatsuyuki; Uezato, Hiroshi; Katakura, Ken; Gomez, Eduardo A.; Guevara, Angel G.; Hashiguchi, Yoshihisa; Kato, Hirotomo

    2015-01-01

    Leishmaniasis remains one of the world's most neglected diseases, and early detection of the infectious agent, especially in developing countries, will require a simple and rapid test. In this study, we established a quick, one-step, single-tube, highly sensitive loop-mediated isothermal amplification (LAMP) assay for rapid detection of Leishmania DNA from tissue materials spotted on an FTA card. An FTA-LAMP with pre-added malachite green was performed at 64 degrees C for 60 mm using a heatin...

  10. Integrated Analysis Reveals That miR-193b, miR-671, and TREM-1 Correlate With a Good Response to Treatment of Human Localized Cutaneous Leishmaniasis Caused by Leishmania braziliensis

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    Sara Nunes

    2018-04-01

    Full Text Available Localized cutaneous leishmaniasis (LCL is a chronic disease characterized by ulcerated skin lesion(s and uncontrolled inflammation. The mechanisms underlying the pathogenesis of LCL are not completely understood, and little is known about posttranscriptional regulation during LCL. MicroRNAs (miRNAs are non-coding small RNAs that regulate gene expression and can be implicated in the pathogenesis of LCL. We investigated the involvement of miRNAs and their targets genes in human LCL using publicly available transcriptome data sets followed by ex vivo validation. Initial analysis highlighted that miRNA expression is altered during LCL, as patients clustered separately from controls. Joint analysis identified eight high confidence miRNAs that had altered expression (−1.5 ≤ fold change ≥ 1.5; p < 0.05 between cutaneous ulcers and uninfected skin. We found that the expression of miR-193b and miR-671 are greatly associated with their target genes, CD40 and TNFR, indicating the important role of these miRNAs in the expression of genes related to the inflammatory response observed in LCL. In addition, network analysis revealed that miR-193b, miR-671, and TREM1 correlate only in patients who show faster wound healing (up to 59 days and not in patients who require longer cure times (more than 60 days. Given that these miRNAs are associated with control of inflammation and healing time, our findings reveal that they might influence the pathogenesis and prognosis of LCL.

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

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    Allan Kardec Ribeiro Galardo

    2015-06-01

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

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

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    Galardo, Allan Kardec Ribeiro; Galardo, Clícia Denis; Silveira, Guilherme Abbad; Ribeiro, Kaio Augusto Nabas; Hijjar, Andréa Valadão; Oliveira, Liliane Leite; Dos Santos, Thiago Vasconcelos

    2015-01-01

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

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

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    Maurício Luiz Vilela

    2013-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Sinval P. Brandão-Filho

    1998-12-01

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

  15. Lutzomyia (Pintomyia) fischeri (Diptera: Psychodidae: Phlebotominae), a probable vector of American cutaneous leishmaniasis: detection of natural infection by Leishmania (Viannia) DNA in specimens from the municipality of Porto Alegre (RS), Brazil, using multiplex PCR assay.

    Science.gov (United States)

    Pita-Pereira, Daniela de; Souza, Getúlio D; Pereira, Thaís de Araújo; Zwetsch, Adriana; Britto, Constança; Rangel, Elizabeth F

    2011-12-01

    In order to determine natural Leishmania (Viannia) infection in Lutzomyia (Pintomyia) fischeri, a multiplex PCR methodology coupled to non-isotopic hybridization was adopted for the analysis of sand fly samples collected by CDC light traps in an endemic area of American Cutaneous Leishmaniasis (ACL) in the periurban region of the municipality of Porto Alegre, Rio Grande do Sul State, Brazil. We analyzed by PCR methodology 560 specimens of Lutzomyia (Pintomyia) fischeri (520 females and 40 males). The wild sand flies were grouped into 56 pools (52 females and 4 males) of 10 each, and positive results were detected in 2 of the 52 female pools, representing a minimum infection rate of 0.38% based on the presence of at least 1 infected insect in the pool. This result associated with some local evidence such as anthopophily, spatial distribution in accordance with the transmission area and human case incidence, suggests that L. (P.)fischeri may be considered as a secondary vector of ACL in the studied locality. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. [Nasal leishmaniasis in an HIV-positive patient].

    Science.gov (United States)

    Grasa, J M; Lorente, J; Crego, F; Naches, S; Subirana, F X; Calderón, J R; Pollán, C; Encarnación, L F; Quesada, P

    2000-03-01

    Leishmania is currently one of the most clinically important protozoa in otorhinolaryngology. Mediterranean countries, including Spain, have endemic HIV and L. infantum. Dogs are the most important Leishmania reservoir. Leishmaniasis is transmitted basically by the bite of infected female Phlebotomus sandflies. Its clinical development depends mainly on the host's cellular immunity (TCD4+ lymphocyte count). About 400 cases of HIV-visceral leishmaniasis have been reported in Spain. However, exclusively cutaneous presentation of HIV-leishmaniasis coinfection has been observed in only 2-3% of cases. We report the case of a female HIV+ patient who developed cutaneous leishmaniasis of the nasal vestibule by L. infantum. The patient was treated satisfactorily with a combination of parenteral Pentostam (sodium stilbogluconate) and periodic intralesional injections of Pentostam. The patient was included in a secondary prophylaxis protocol for visceral leishmaniasis with a monthly dose of Glucantime (meglumine antimoniate) for life.

  17. Aporte de la etnografía en el conocimiento de los códigos socioculturales de la leishmaniasis cutánea localizada en un programa de educación para la salud, en Venezuela The contribution of ethnography to knowledge on socio-cultural codes related to localized cutaneous leishmaniasis in a health education program in Venezuela

    Directory of Open Access Journals (Sweden)

    Baílde García Guevara

    2007-01-01

    Full Text Available Este artículo presenta la experiencia de validación de la metodología etnográfica como una alternativa de aproximación objetiva y oportuna en la construcción de escenarios socioculturales de las comunidades afectadas por la leishmaniasis cutánea en Venezuela. Comienza con una breve presentación del resurgimiento de la leishmaniasis en las Américas y en Venezuela en el contexto de las desigualdades sociales. Continúa con una revisión del papel de la educación para la salud en los programas de control de endemias. Luego destaca el papel de la etnografía en la construcción de la racionalidad de la vida cotidiana, sus significados e interpretación de las personas que sufren la enfermedad, para la elaboración de programas de educación para la salud permanente y sostenible. La validación de la metodología se hizo a través de un taller, donde se hizo un análisis de la historia clínica y epidemiológica utilizada habitualmente para recoger información sobre la enfermedad. Entre los principales hallazgos se encuentra la inoperancia del diseño de la historia clínica para la obtención de información relativa a los factores socioculturales vinculantes a la enfermedad, expresada por territorios geográficos específicos con el apoyo de la georreferencia.This article presents the experience with the validation of the ethnographic methodology as an alternative for an objective and timely approach to the construction of socio-cultural scenarios in communities affected by cutaneous leishmaniasis in Venezuela. It begins with a brief presentation on the resurgence of leishmaniasis in the Americas as a whole and in Venezuela in the context of social inequalities. It proceeds with a review of the role of health education in programs to control endemic diseases. It then highlights the role of ethnography in the construction of rationality in daily life, its meanings, and interpretation by persons with the disease in order to elaborate

  18. Miltefosine: een nieuw geneesmiddel voor leishmaniasis

    NARCIS (Netherlands)

    Dorlo, T. P. C.; Eggelte, T. A.; Beijnen, J. H.; de Vries, P. J.

    2006-01-01

    There is a need for a safe and effective oral treatment for cutaneous and visceral leishmaniasis. Miltefosine is the first oral drug that is efficacious against different forms ofleishmaniasis, however it is not equally effective against all Leishmania species. Miltefosine is an alkylphosphocholine,

  19. Attractiveness of black and white modified Shannon traps to phlebotomine sandflies (Diptera, Psychodidae in the Brazilian Amazon Basin, an area of intense transmission of American cutaneous leishmaniasis

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    Brilhante Andreia Fernandes

    2017-01-01

    Full Text Available In the Amazon region the phlebotomine fauna is considered one of the most diverse in the world. The use of Shannon traps may provide information on the anthropophily of the species and improve the traps’ performance in terms of diversity and quantity of insects collected when white and black colored traps are used together. This study sought to verify the attractiveness of the traps to the phlebotomine species of the Brazilian Amazon basin using Shannon traps under these conditions. The insects were collected using two Shannon traps installed side by side, one white and the other black, in a primary forest area of the municipality of Xapuri, Acre, Brazil. Samples were collected once a month during the period August 2013 to July 2015. A sample of females was dissected to test for natural infection by flagellates. A total of 6,309 (864 males and 5,445 females specimens (36 species were collected. Psychodopygus carrerai carrerai (42%, Nyssomyia shawi (36%, and Psychodopygus davisi (13%, together represented 90% of the insects collected. Nyssomyia shawi and Psychodopygus davisi were more attracted by the white color. Specimens of Nyssomyia shawi, Nyssomyia whitmani, and Psychodopygus hirsutus hirsutus were found naturally infected by flagellates in the mid and hindgut. This is the first study in Acre state using and comparing both black and white Shannon traps, demonstrating the richness, diversity, and anthropophilic behavior of the phlebotomine species and identifying proven and putative vectors of the etiological agents of leishmaniasis.

  20. Laryngeal Leishmaniasis

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    Moraes, Bruno Teixeira de

    2012-01-01

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

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

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    Guilherme Almeida Rosa da Silva

    2014-01-01

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

  2. T-cell response in human leishmaniasis

    DEFF Research Database (Denmark)

    Kharazmi, A; Kemp, K; Ismail, A

    1999-01-01

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

  3. CD3+CD4negCD8neg (double negative) T lymphocytes and NKT cells as the main cytotoxic-related-CD107a+ cells in lesions of cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis.

    Science.gov (United States)

    Ferraz, Raquel; Cunha, Clarissa F; Pimentel, Maria Inês F; Lyra, Marcelo R; Pereira-Da-Silva, Tatiana; Schubach, Armando O; Da-Cruz, Alda Maria; Bertho, Alvaro Luiz

    2017-05-03

    Cutaneous leishmaniasis (CL) is caused by Leishmania (Viannia) braziliensis, which infects dermal macrophages and dendritic cells, causing an intense immune-mediated-tissue inflammation and a skin ulcer with elevated borders that can heal spontaneously or after antimonial therapy. The resolution of lesions depends on an adaptive immune response, and cytotoxic cells seem to have a fundamental role in this process. The aim of this study is to better understand the role of cytotoxicity mediated mechanisms that occur during the immune response in the CL lesion milieu, considering distinct cytotoxic-related CD107a + cells, such as CD8 + , CD4 + , CD4 neg CD8 neg (double-negative, DN) and CD4 + CD8 + (double-positive, DP) T lymphocytes, as well as NK and NKT cells. Lesion derived cells were assessed for T cell subpopulations and NK cells, as well as CD107a expression by flow cytometry. In addition, cytometric bead array (CBA) was used to quantify cytokines and granzyme B concentrations in supernatants from macerated lesions. Flow cytometry analyses revealed that NKT cells are the major CD107a-expressing cell population committed to cytotoxicity in CL lesion, although we also observed high frequencies of CD4 + and DN T cells expressing CD107a. Analysing the pool of CD107a + -cell populations, we found a higher distribution of DN T cells (44%), followed by approximately 25% of NKT cells. Interestingly, NK and CD8 + T cells represented only 3 and 4% of the total-CD107a + -cell pool, respectively. The cytotoxicity activity that occurs in the lesion milieu of CL patients seems to be dominated by DN T and NKT cells. These findings suggest the need for a reevaluation of the role of classical-cytotoxic NK and CD8 + T cells in the pathogenesis of CL, implicating an important role for other T cell subpopulations.

  4. Phenotypic characterization of Leishmania spp. causing cutaneous leishmaniasis in the lower Amazon region, western Pará state, Brazil, reveals a putative hybrid parasite, Leishmania (Viannia guyanensis × Leishmania (Viannia shawi shawi

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    Jennings Yara Lins

    2014-01-01

    Full Text Available We phenotypically characterized 43 leishmanial parasites from cutaneous leishmaniasis by isoenzyme electrophoresis and the indirect immunofluorescence antibody test (23 McAbs. Identifications revealed 11 (25.6% strains of Leishmania (V. braziliensis, 4 (9.3% of L. (V. shawi shawi, 7 (16.3% of L. (V. shawi santarensis, 6 (13.9% of L. (V. guyanensis and L. (V. lainsoni, 2 (4.7% of L. (L. amazonensis, and 7 (16.3% of a putative hybrid parasite, L. (V. guyanensis/L. (V. shawi shawi. McAbs detected three different serodemes of L. (V. braziliensis: I-7, II-1, and III-3 strains. Among the strains of L. (V. shawi we identified two populations: one (7 strains expressing the B19 epitope that was previously considered to be species-specific for L. (V. guyanensis. We have given this population sub-specific rank, naming it L. (V. s. santarensis. The other one (4 strains did not express the B19 epitope like the L. (V. shawi reference strain, which we now designate as L. (V. s. shawi. For the first time in the eastern Brazilian Amazon we register a putative hybrid parasite (7 strains, L. (V. guyanensis/L. (V. s. shawi, characterized by a new 6PGDH three-band profile at the level of L. (V. guyanensis. Its PGM profile, however, was very similar to that of L. (V. s. shawi. These results suggest that the lower Amazon region – western Pará state, Brazil, represents a biome where L. (V. guyanensis and L. (V. s. shawi exchange genetic information.

  5. Phenotypic characterization of Leishmania spp. causing cutaneous leishmaniasis in the lower Amazon region, western Pará state, Brazil, reveals a putative hybrid parasite, Leishmania (Viannia) guyanensis × Leishmania (Viannia) shawi shawi

    Science.gov (United States)

    Jennings, Yara Lins; de Souza, Adelson Alcimar Almeida; Ishikawa, Edna Aoba; Shaw, Jeffrey; Lainson, Ralph; Silveira, Fernando

    2014-01-01

    We phenotypically characterized 43 leishmanial parasites from cutaneous leishmaniasis by isoenzyme electrophoresis and the indirect immunofluorescence antibody test (23 McAbs). Identifications revealed 11 (25.6%) strains of Leishmania (V.) braziliensis, 4 (9.3%) of L. (V.) shawi shawi, 7 (16.3%) of L. (V.) shawi santarensis, 6 (13.9%) of L. (V.) guyanensis and L. (V.) lainsoni, 2 (4.7%) of L. (L.) amazonensis, and 7 (16.3%) of a putative hybrid parasite, L. (V.) guyanensis/L. (V.) shawi shawi. McAbs detected three different serodemes of L. (V.) braziliensis: I-7, II-1, and III-3 strains. Among the strains of L. (V.) shawi we identified two populations: one (7 strains) expressing the B19 epitope that was previously considered to be species-specific for L. (V.) guyanensis. We have given this population sub-specific rank, naming it L. (V.) s. santarensis. The other one (4 strains) did not express the B19 epitope like the L. (V.) shawi reference strain, which we now designate as L. (V.) s. shawi. For the first time in the eastern Brazilian Amazon we register a putative hybrid parasite (7 strains), L. (V.) guyanensis/L. (V.) s. shawi, characterized by a new 6PGDH three-band profile at the level of L. (V.) guyanensis. Its PGM profile, however, was very similar to that of L. (V.) s. shawi. These results suggest that the lower Amazon region – western Pará state, Brazil, represents a biome where L. (V.) guyanensis and L. (V.) s. shawi exchange genetic information. PMID:25083790

  6. Efficacy of cryotherapy plus topical Juniperus excelsa M. Bieb cream versus cryotherapy plus placebo in the treatment of Old World cutaneous leishmaniasis: A triple-blind randomized controlled clinical trial.

    Science.gov (United States)

    Parvizi, Mohammad Mahdi; Handjani, Farhad; Moein, Mahmoodreza; Hatam, Gholamreza; Nimrouzi, Majid; Hassanzadeh, Jafar; Hamidizadeh, Nasrin; Khorrami, Hamid Reza; Zarshenas, Mohammad Mehdi

    2017-10-01

    Cutaneous leishmaniasis is one of the highly prevalent endemic diseases in the Middle East and North Africa. Many treatment modalities have been recommended for this condition but success rates remain limited. Herbal remedies have also been used for treatment but evidence-based clinical trials with these products are sparse. In-vitro and in-vivo studies have shown the anti-leishmanial and curative effects of extract of fruits and leaves of Juniperus excelsa (J. excelsa). The aim of this study was to determine the efficacy of topical J. excelsa M. Bieb extract as an adjuvant to cryotherapy for the treatment of human CL. This study was designed as a two-arm triple-blind randomized placebo-controlled clinical trial using a parallel design. Seventy-two patients with clinical diagnosis of CL confirmed by leishmania smears were allocated to receive either a topical formulation of leaf of J. excelsa extract (group A) or placebo (group B) for 3 months. Both groups received cryotherapy as baseline standard treatment. Patients were evaluated before and weekly after the intervention was initiated until complete cure. Overall, 82% of patients in group A, experienced complete cure and 9% of them had partial cure. On the other hand, 34% in group B reported complete cure, while 14% of them had partial cure at the end of treatment protocol with a significant difference between the two groups (Pcryotherapy for accelerating the time to cure in addition to increasing the complete cure rate in CL. ClinicalTrials.gov IRCT2015082523753N1.

  7. Dispersal and survival of Nyssomyia intermedia and Nyssomyia neivai (Diptera: Psychodidae: Phlebotominae) in a cutaneous leishmaniasis endemic area of the speleological province of the Ribeira Valley, state of São Paulo, Brazil.

    Science.gov (United States)

    Galati, Eunice A B; Fonseca, Mauro Breviglieri; Marassá, Ana Maria; Bueno, Edna Fátima M

    2009-12-01

    The dispersal and survival of the phlebotomines Nyssomyia intermedia and Nyssomyia neivai (both implicated as vectors of the cutaneous leishmaniasis agent) in an endemic area was investigated using a capture-mark-release technique in five experiments from August-December 2003 in municipality of Iporanga, state of São Paulo, Brazil. A total of 1,749 males and 1,262 females of Ny. intermedia and 915 males and 411 females of Ny. neivai were marked and released during the five experiments. Recapture attempts were made using automatic light traps, aspiration in natural resting places and domestic animal shelters and Shannon traps. A total of 153 specimens (3.48%) were recaptured: 2.59% (78/3,011) for Ny. intermedia and 5.35% (71/1,326) for Ny. neivai. Both species were recaptured up to 144 h post-release, with the larger part of them recaptured within 48 h. The median dispersion distances for Ny. intermedia and Ny. neivai, respectively, were 109 m and 100 m. The greatest dispersal range of Ny. intermedia was 180 m, while for Ny. neivai one female was recaptured in a pasture at 250 m and another in a pigsty at 520 m, showing a tendency to disperse to more open areas. The daily survival rates calculated based on regressions of the numbers of marked insects recaptured on the six successive days after release were 0.746 for males and 0.575 for females of Ny. intermedia and 0.649 for both sexes of Ny. neivai. The size of the populations in the five months ranged from 8,332-725,085 for Ny. intermedia males, 2,193-104,490 for Ny. intermedia females, 1,687-350,122 for Ny. neivai males and 254-49,705 for Ny. neivai females.

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

    Science.gov (United States)

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

    2015-09-01

    The description of the first and autochthonous case of diffuse cutaneous leishmaniasis in the municipality of Paraty, State of Rio de Janeiro, brought the interest of this study. Sand flies were captured over a 3-yr period. Using manual suction tubes, sand flies were collected from the inner and outer walls of homes, in the living spaces of domestic animals, and in Shannon light traps, which were set up outside homes and in the forest. CDC light traps were installed inside homes, around the exterior of the houses, and along the divide and within the forest. A total of 102,937 sand flies were collected, representing 23 species--three from the genus Brumptomyia and 20 from the genus Lutzomyia. Of these, six species, Lutzomyia intermedia, Lutzomyia fischeri, Lutzomyia migonei, Lutzomyia whitmani, and Lutzomyia pessoai have already been recorded as being naturally infected by Leishmania braziliensis, and one species, Lutzomyia ayrozai, by Leishmania naiffi. Lu. intermedia is the vector of Le. braziliensis in the study area, particularly inside the homes and on the exterior of the houses. Lu. fischeri can also act as vector of Le. braziliensis in domestic environments and particularly in the wild. The third-ranked Lu. migonei was the most abundant in kennels, suggesting its canine affinity. Lu. whitmani, ranked fourth, still has characteristics indicative of the wild, but with a significant number located on the edge of the forest, suggesting a selection process of adaptation to the anthropic environment. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Coinjection with CpG-Containing Immunostimulatory Oligodeoxynucleotides Reduces the Pathogenicity of a Live Vaccine against Cutaneous Leishmaniasis but Maintains Its Potency and Durability

    Science.gov (United States)

    Mendez, Susana; Tabbara, Khaled; Belkaid, Yasmine; Bertholet, Sylvie; Verthelyi, Daniela; Klinman, Dennis; Seder, Robert A.; Sacks, David L.

    2003-01-01

    The inoculation of live, nonattenuated Leishmania major to produce a lesion in a selected site that heals, referred to as leishmanization, is to date the only vaccine against leishmaniasis that has proven to be effective in humans. Its use has been restricted or abandoned entirely, however, due to safety concerns. In an attempt to develop a leishmanization protocol that minimizes pathology while maintaining long-term protection, live parasites were coinjected with CpG-containing immunostimulatory oligodeoxynucleotides (CpG ODNs) alone or in combination with whole-cell lysates of heat-killed L. major promastigotes bound to alum (ALM). C57BL/6 mice infected intradermally by using L. major plus CpG ODN with or without ALM developed few or no dermal lesions and showed an early containment of parasite growth, while mice infected with L. major with or without ALM developed sizable dermal lesions that required up to 10 weeks to heal. The CpG ODNs provoked a transient inflammation that included an early recruitment and accumulation of gamma interferon-producing CD4+ lymphocytes in the site. Attenuation of the live vaccine did not compromise its ability to confer long-term immunity, as mice receiving L. major and CpG ODN plus ALM were totally protected against reinfection with L. major for up to 6 months. By comparison, the immunity elicited by two efficient nonlive vaccines began to wane by 6 months. Our results suggest that immune modulation using CpG ODNs might be a practical approach to improving the safety of a highly effective live vaccine that has already been widely applied. PMID:12933855

  10. Flebotomíneos de áreas com notificações de casos autóctones de leishmaniose visceral canina e leishmaniose tegumentar americana em Angra dos Reis, Rio de Janeiro, Brasil Phlebotomine fauna in areas of autochthonous cases of canine visceral leishmaniasis and American cutaneous leishmaniasis in Angra dos Reis, Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Marcos Barbosa de Souza

    2009-01-01

    Full Text Available Flebótomos de áreas com notificações de casos autóctones de leishmaniose visceral canina e leishmaniose tegumentar americana em Angra dos Reis, Rio de Janeiro, Brasil. O município de Angra dos Reis apresenta casos humanos de leishmaniose tegumentar americana desde 1945. Inquéritos flebotomínicos realizados em 1978 revelaram a presença de Nyssomyia intermedia e a primeira notificação de Lutzomyia longipalpis no Rio de Janeiro, Ilha Grande, Angra dos Reis. Em agosto de 2002 foi notificado o primeiro caso canino de leishmaniose visceral na Ilha Grande, Angra dos Reis. Inquéritos flebotomínicos realizados nos peridomicílios, no período de novembro de 2002 a maio de 2003, em quatro localidades de Angra dos Reis, resultaram em 12.554 flebotomíneos e a presença de nove espécies: Brumptomyia sp.; Nyssomyia intermedia, Migonemyia migonei, Micropygomyia schreiberi, Pintomyia fischeri, Psychodopygus davisi, Psychodopygus ayrosai, Evandromyia tupinambay, Psathyromyia pelloni. foi Nyssomyia intermedia, predominante em todas as localidades, seguida por M.migonei. O principal vetor da LVA, Lutzomyia longipalpis, não foi detectado nas localidades, incluindo áreas do entorno, onde um cão infectado residia.The city of Angra dos Reis presents human cases of American cutaneous leishmaniasis since 1945. Phlebotomine surveys in 1978 had disclosed the presence of Nyssomyia intermedia and the first notification of Lutzomyia longipalpis in Rio de Janeiro, Ilha Grande, Angra dos Reis. In August of 2002 the first canine case of visceral leishmaniasis in the Ilha Grande, Angra dos Reis was notified. Surveys of phlebotomines in the peridomiciliary areas, in the period of November, 2002, through May, 2003, in four localities of Angra dos Reis, resulted in 12,554 specimens belonging to nine species: Brumptomyia sp. Nyssomyia intermedia, Migonemyia migonei, Micropygomyia schreiberi, Pintomyia fischeri, Psychodopygus davisi, Psychodopygus ayrosai

  11. Miltefosine: oral treatment of leishmaniasis.

    Science.gov (United States)

    Soto, Jaime; Soto, Paula

    2006-04-01

    The well-known problems of classic treatment of the leishmaniases with pentavalent antimony (reduced efficacy), difficulties of administration and increasing frequency and severity of adverse events have stimulated the search for new drugs to treat these diseases. Other injectable, oral and topical drugs have not been consistently effective, especially in the modern World. Beginning in 1998, Indian researchers conducted several trials with hexadecylphosphocholine (miltefosine) in patients with visceral leishmaniasis, and in 1999, clinical studies were initiated in Colombia for cutaneous disease. More than 2500 patients have been treated, including patients with diffuse cutaneous leishmaniasis, mucosal disease and patients coinfected with HIV. Cure rates between 91 and 100% were reached with a dose of 2.5 mg/kg/day for 28 days, with no difference between treatment-naive and relapsing patients. Mild gastrointestinal events were present in 35-60% of patients and 10-20% had mild transaminase and creatinine elevations. Miltefosine has potent leishmanicidal activity as a consequence of its interference in parasite metabolic pathways and the induction of apoptosis. Miltefosine is the first effective and safe oral agent with the potential to treat all major clinical presentations of leishmaniasis.

  12. Comparative Field Evaluation of Different Traps for Collecting Adult Phlebotomine Sand Flies (Diptera: Psychodidae) in an Endemic Area of Cutaneous Leishmaniasis in Quintana Roo, Mexico.

    Science.gov (United States)

    Rodríguez-Rojas, Jorge J; Arque-Chunga, Wilfredo; Fernández-Salas, Ildefonso; Rebollar-Téllez, Eduardo A

    2016-06-01

    Phlebotominae are the vectors of Leishmania parasites. It is important to have available surveillance and collection methods for the sand fly vectors. The objectives of the present study were to evaluate and compare traps for the collection of sand fly species and to analyze trap catches along months and transects. Field evaluations over a year were conducted in an endemic area of leishmaniasis in the state of Quintana Roo, Mexico. A randomized-block design was implemented in study area with tropical rainforest vegetation. The study design utilized 4 transects with 11 trap types: 1) Centers for Disease Control and Prevention (CDC) light trap with incandescent bulb (CDC-I), 2) CDC light trap with blue light-emitting diodes (LEDs) (CDC-B), 3) CDC light trap with white LEDs (CDC-W), 4) CDC light trap with red LEDs (CDC-R), 5) CDC light trap with green LEDs (CDC-G), 6) Disney trap, 7) Disney trap with white LEDs, 8) sticky panels, 9) sticky panels with white LEDs, 10) delta-like trap, and 11) delta-like trap with white LEDs. A total of 1,014 specimens of 13 species and 2 genera (Lutzomyia and Brumptomyia) were collected. There were significant differences in the mean number of sand flies caught with the 11 traps; CDC-I was (P  =  0.0000) more effective than the other traps. Other traps exhibited the following results: CDC-W (17.46%), CDC-B (15.68%), CDC-G (14.89%), and CDC-R (14.30%). The relative abundance of different species varied according to trap types used, and the CDC-I trap attracted more specimens of the known vectors of Leishmania spp., such as like Lutzomyia cruciata, Lu. shannoni, and Lu. ovallesi. Disney trap captured more specimens of Lu. olmeca olmeca. Based on abundance and number of species, CDC light traps and Disney traps appeared to be good candidates for use in vector surveillance programs in this endemic area of Mexico.

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

    Directory of Open Access Journals (Sweden)

    Ueslei Teodoro

    1991-04-01

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

  14. Leishmaniasis in Yemen: a clinicoepidemiological study of leishmaniasis in central Yemen.

    Science.gov (United States)

    Al-Kamel, Mohamed A

    2016-08-01

    Leishmaniasis is a serious public health problem in Yemen. This study was designed to identify clinical and epidemiological features of leishmaniasis in Yemen. The study was conducted at the Regional Leishmaniasis Control Center in central Yemen. Data sourced from the medical records of 152 patients with confirmed active leishmaniasis, managed during April-August 2013, were analyzed. A total of 94.1% of patients were rural residents. Al Bayda was the most endemic governorate (59.9%). Children represented the group at highest risk (57.2%), followed by adult females (32.9%); together these groups accounted for 90.1% of all patients. Mucocutaneous leishmaniasis was the most prevalent form (49.3%), followed by cutaneous leishmaniasis (47.4%), and visceral leishmaniasis (3.3%). The wet ulcer was the most common type of lesion (49.7%) and the single lesion (69.4%) represented the most common presentation. All patients were ignorant of the nature of the disease, and 55.9% had a history of using "popular" treatments. Cutaneous, mucocutaneous, and visceral leishmaniases have significant endemicity in Yemen, especially in central areas. Al Bayda is the governorate with the highest endemicity, and rural children and women represent the populations at highest risk. Mucocutaneous leishmaniasis seems to be the most prevalent form and a single wet ulcer is the most common presentation. Infected refugees may represent new foci for imported Leishmania species. Ecology, geography, climate change, cultural gender- and age-specific duties, urban night activities, and use of popular treatments are among proven risk factors. © 2015 The International Society of Dermatology.

  15. Leishmaniasis in travelers: a literature review.

    Science.gov (United States)

    Mansueto, Pasquale; Seidita, Aurelio; Vitale, Giustina; Cascio, Antonio

    2014-01-01

    Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum ranges from asymptomatic infection to fatal visceral leishmaniasis. Over the last decades, an increase in imported leishmaniasis cases in developed, non-endemic countries, have been pointed-out from a review of the international literature. Among the possible causes are increasing international tourism, influx of immigrants from endemic regions and military operations. The main area for the acquisition of cutaneous leishmaniasis, especially for adventure travelers on long-term trips in highly-endemic forested areas, is represented from South America, whereas popular Mediterranean destinations are emerging as the main areas to acquire visceral variant. Leishmaniasis should be considered in the diagnostic assessment of patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years before. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas, should receive counseling regarding leishmaniasis and appropriate protective measures. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Leishmaniasis, an emerging infection in travelers.

    Science.gov (United States)

    Pavli, Androula; Maltezou, Helena C

    2010-12-01

    Leishmaniasis is a vector-borne protozoan infection with a wide clinical spectrum, which ranges from asymptomatic infection to fatal visceral leishmaniasis. A review of the recent literature indicates a sharp increase in imported leishmaniasis cases in developed, non-endemic countries over the last decade, in association with increasing international tourism, military operations, and the influx of immigrants from endemic countries. South America is the main area for the acquisition of cutaneous leishmaniasis, and adventure travelers on long-term trips in highly-endemic forested areas are at particular risk. Popular Mediterranean destinations are emerging as the main areas of acquisition of visceral leishmaniasis for European travelers. Leishmaniasis should be considered in patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years ago. Appropriate counseling should be provided to adventure travelers, military personnel, researchers, and other groups of travelers likely to be exposed to sandflies in endemic areas. Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  17. Voice disorders in mucosal leishmaniasis.

    Directory of Open Access Journals (Sweden)

    Ana Cristina Nunes Ruas

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

  18. Ocorrência de leishmaniose tegumentar em cães de área endêmica no Estado do Paraná Occurrence of cutaneous leishmaniasis in dogs of endemic area, Paraná State

    Directory of Open Access Journals (Sweden)

    E. Pittner

    2009-06-01

    Full Text Available Investigou-se a infecção por parasitas do complexo Leishmania braziliensis em 50 cães da cidade de Maringá, PR, onde ocorreram casos humanos de leishmaniose tegumentar americana (LTA, entre agosto e dezembro de 2006. Os casos humanos de LTA ocorreram nos anos de 2003 a 2004. Nenhum animal apresentou lesão, mas 12 (24,0% tinham sorologia e/ou PCR positivas, e a positividade tanto da IFI como da PCR foi de 14,0%. Trinta e cinco animais eram de residências, e oito deles (22,8% tiveram testes laboratoriais para LTA positivos. Os outros 15 eram cães errantes, sendo que quatro deles (26,7% apresentaram PCR positiva. A presença de animais com infecção assintomática por Leishmania em área onde a LTA é endêmica pode ser um indicador do potencial de sua transmissão para o homem e uma referência para a implantação de medidas de controle e prevenção da doença.The infection by Leishmania braziliensis complex was studied in 50 dogs from Maringá, PR, where American Cutaneous Leishmaniasis (ACL in humans have been detected. Data were collected from August to December 2006 in an area in which ACL cases in humans were reported from 2003 to 2004. Indirect immunofluorescent test (IIF and polymerase chain reaction (PCR were applied. No lesions were found in the animals, although 12 (24.0% had positive IIF and/or PCR. Positiveness was 14.0% for IIF and PCR. Lab tests showed that eight (22.8% out of the 35 home animals were ACL positive. The other 15 animals were stray dogs, out of which four (26.7% were PCR positive. The appearance of asymptomatic Leishmania-infected dogs in an ACL endemic area may be an indicator of ACL transmission potential for humans and a reference for the establishment of control measures and disease prevention.

  19. Condições de saneamento como indicador epidemiológico para Leishmaniose Tegumentar Americana na Amazônia sul ocidental brasileira | Sanitation conditions as an epidemiologic indicator for American Cutaneous Leishmaniasis in the Brazilian Southwestern Amazonia

    Directory of Open Access Journals (Sweden)

    Mateus Duarte Ribeiro

    2017-05-01

    Full Text Available Este estudo analisou as relações entre condições de saneamento e energia elétrica e a Leishmaniose Tegumentar Americana (LTA no estado do Acre. Utilizou-se os dados obtidos do Sistema de Informação de Agravos de Notificação entre 2001 e 2010 para correlacionar variáveis por meio da técnica de análise de componentes principais. O resultado indicou associação direta entre LTA e características inadequadas de moradia que podem ser agravantes à ocorrência dessa doença, como o abastecimento de água em rios ou lagos, o armazenamento de água da chuva, a destinação dos resíduos sólidos jogados em terrenos baldios e a falta de energia elétrica, estas em áreas rurais; em áreas rurais e urbanas, a ausência de banheiro ou esgotamento sanitário; e em áreas urbanas, em associação inversa, amenizando a ocorrência da LTA, o esgotamento sanitário utilizando fossa séptica. As associações encontradas sugerem que as condições inadequadas de saneamento contribuem para o aumento da exposição da população aos vetores da LTA. ================================================ This paper analyzes the relationship between sanitation and electricity service conditions, and American Cutaneous Leishmaniasis (ACL in Acre. For this study we considered the cases reported in the Brazilian System for Disease Notification between 2001 and 2010, using the principal component analysis. The analysis suggested a direct association between ACL and inadequate housing characteristics –that worsen the occurrence of this disease-, such as: water supply in river or lakes, rainwater storage, disposal of solid waste dumped in vacant lots, and absence of electricity service, in rural areas; and absence of bathrooms and sanitation, in both urban and rural areas. An inverse association arises, mitigating the occurrence of ACL, in urban areas, by using septic tanks for sewage. The associations found in this study suggest that inadequate housing

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

    DEFF Research Database (Denmark)

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

    1997-01-01

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

  1. Serum neopterin concentrations during treatment of leishmaniasis: useful as test of cure?

    NARCIS (Netherlands)

    Hamerlinck, F. F.; van Gool, T.; Faber, W. R.; Kager, P. A.

    2000-01-01

    Neopterin, a product of gamma-interferon-activated macrophages, was measured in sera from 28 patients (12 patients with cutaneous leishmaniasis and 16 patients with visceral leishmaniasis) to determine the utility as a marker of disease activity and therapeutic efficacy. Patients originated from

  2. Immunity and immunosuppression in experimental visceral leishmaniasis

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    Goto H.

    2004-01-01

    Full Text Available Leishmaniasis is a disease caused by protozoa of the genus Leishmania, and visceral leishmaniasis is a form in which the inner organs are affected. Since knowledge about immunity in experimental visceral leishmaniasis is poor, we present here a review on immunity and immunosuppression in experimental visceral leishmaniasis in mouse and hamster models. We show the complexity of the mechanisms involved and differences when compared with the cutaneous form of leishmaniasis. Resistance in visceral leishmaniasis involves both CD4+ and CD8+ T cells, and interleukin (IL-2, interferon (IFN- gamma, and IL-12, the latter in a mechanism independent of IFN- gamma and linked to transforming growth factor (TGF-ß production. Susceptibility involves IL-10 but not IL-4, and B cells. In immune animals, upon re-infection, the elements involved in resistance are different, i.e., CD8+ T cells and IL-2. Since one of the immunopathological consequences of active visceral leishmaniasis in humans is suppression of T-cell responses, many studies have been conducted using experimental models. Immunosuppression is mainly Leishmania antigen specific, and T cells, Th2 cells and adherent antigen-presenting cells have been shown to be involved. Interactions of the co-stimulatory molecule family B7-CTLA-4 leading to increased level of TGF-ß as well as apoptosis of CD4+ T cells and inhibition of macrophage apoptosis by Leishmania infection are other components participating in immunosuppression. A better understanding of this complex immune response and the mechanisms of immunosuppression in experimental visceral leishmaniasis will contribute to the study of human disease and to vaccine development.

  3. 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

  4. A produção do lugar de transmissão da leishmaniose tegumentar: o caso da Localidade Pau da Fome na cidade do Rio de Janeiro, Brasil Production of transmission foci for cutaneous leishmaniasis: the case of Pau da Fome, Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Hélia Kawa

    2010-08-01

    Full Text Available Este trabalho analisa as características de um dos lugares de transmissão de maior relevância da leishmaniose tegumentar na cidade do Rio de Janeiro, Brasil, considerando sua configuração territorial e as relações desta com processos de organização do espaço. Utilizou-se o modelo de análise do processo de ocupação e organização do espaço urbano, em escala local, considerando-se as novas funções adquiridas pelos elementos espaciais expressos por diferentes relações de trabalho, uso do solo e valor da terra. Empregaram-se técnicas de geoprocessamento e de classificação de imagens obtidas por sensoriamento remoto, localização de domicílios e casos de leishmaniose tegumentar, associados a dados qualitativos sobre o processo histórico de ocupação e uso do solo. A análise mostrou áreas com distintas condições de vulnerabilidade, e que mudanças destas condições viabilizaram a produção da epidemia em um determinado período e sua posterior redução. O estudo contribui para o monitoramento da enfermidade em nível local e para a aplicação de medidas eficazes para as ações de vigilância e controle da leishmaniose tegumentar.This study analyzes the characteristics of one of the main foci for cutaneous leishmaniasis transmission in the city of Rio de Janeiro, Brazil, examining its territorial configuration and the relations with spatial organization processes. An analytical model was applied to the process of occupation and organization of urban space on a local scale, considering the new functions acquired by the spatial elements expressed by different work relations, land use, and land value. The study employed geoprocessing techniques and classification of images obtained by remote sensing, localization of households, and cases of cutaneous leishmaniasis, associated with qualitative data on the historical process of land occupation and use. The analysis detected areas with distinct conditions of vulnerability

  5. Cytokine profile and pathology in human leishmaniasis

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    Ribeiro-de-Jesus A.

    1998-01-01

    Full Text Available The clinical spectrum of leishmaniasis and control of the infection are influenced by the parasite-host relationship. The role of cellular immune responses of the Th1 type in the protection against disease in experimental and human leishmaniasis is well established. In humans, production of IFN-g is associated with the control of infection in children infected by Leishmania chagasi. In visceral leishmaniasis, an impairment in IFN-g production and high IL-4 and IL-10 levels (Th2 cytokines are observed in antigen-stimulated peripheral blood mononuclear cells (PBMC. Moreover, IL-12 restores IFN-g production and enhances the cytotoxic response. IL-10 is the cytokine involved in down-regulation of IFN-g production, since anti-IL-10 monoclonal antibody (mAb restores in vitro IFN-g production and lymphoproliferative responses, and IL-10 abrogates the effect of IL-12. In cutaneous and mucosal leishmaniasis, high levels of IFN-g are found in L. amazonensis-stimulated PBMC. However, low or absent IFN-g levels were observed in antigen-stimulated PBMC from 50% of subjects with less than 60 days of disease (24 ± 26 pg/ml. This response was restored by IL-12 (308 ± 342 pg/ml and anti-IL-10 mAb (380 ± 245 pg/ml (P<0.05. Later during the disease, high levels of IFN-g and TNF-a are produced both in cutaneous and mucosal leishmaniasis. After treatment there is a decrease in TNF-a levels (366 ± 224 pg/ml before treatment vs 142 ± 107 pg/ml after treatment, P = 0.02. Although production of IFN-g and TNF-a might be involved in the control of parasite multiplication in the early phases of Leishmania infection, these cytokines might also be involved in the tissue damage seen in tegumentary leishmaniasis

  6. 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.

  7. Exploring Adaptation Scenarios : Cutaneous Leishmaniasis and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In Algeria, climate change is associated with modifications in land use and their interaction with water, with the result that the last 20 years have seen an increase in vector diseases. The health sector is responsible for dealing with epidemics, with no recourse to other sectors or to the affected population itself.

  8. The epidemiology and control of leishmaniasis in Andean countries

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    Davies Clive Richard

    2000-01-01

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

  9. The epidemiology and control of leishmaniasis in Andean countries

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    Clive Richard Davies

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

  10. Restricted Outbreak of American Tegumentary Leishmaniasis with High Microfocal Transmission

    Science.gov (United States)

    Krolewiecki, Alejandro J.; Gil, José F.; Quipildor, Marcelo; Cajal, Silvana P.; Pravia, Carlos; Juarez, Marisa; Villalpando, Carlos; Locatelli, Fabricio M.; Chanampa, Mariana; Castillo, Gabriela; Oreste, María F.; Hoyos, Carlos L.; Negri, Vanesa; Nasser, Julio R.

    2013-01-01

    Cutaneous leishmaniasis is endemic in Salta, the northwestern province of Argentina. We describe an outbreak involving five recreational hunters whose exposure was limited to several hours in a residual patch of primary forest. All patients presented with typical cutaneous lesions after a mean incubation period of 59 days (range 15–78), and one developed simultaneous mucosal involvement. Polymerase chain reaction analysis of lesions confirmed Leishmania (V.) braziliensis as the etiologic agent in three cases. All patients were cured with anti-Leishmania treatment. Entomologic surveys in the transmission area revealed a predominance of Lutzomyia neivai. This outbreak report confirms a microfocal transmission pattern of tegumentary leishmaniasis in the Americas and based on a well-determined exposure, allows the determination of incubation times for leishmaniasis caused by Leishmania braziliensis. PMID:23339200

  11. Estudo de dois anos com animais reservatórios em área de ocorrência de leishmaniose tegumentar americana humana em bairro de urbanização antiga na cidade de Manaus-AM, Brasil Two year study of reservoir animals in an old urban area with cutaneous Leishmaniasis occurrence in the city of Manaus-AM, Brazil

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    Jorge Augusto de Oliveira Guerra

    2007-01-01

    Full Text Available Os autores descrevem o resultado de dois anos de investigação de um foco de Leishmaniose Tegumentar Americana (LTA, ocorrida em área urbanizada em um conjunto habitacional na cidade da Manaus-AM. Chama atenção o fato de que este não é o padrão de ocorrência de surtos da doença na região, e sim interrupção da transmissão após urbanização. Foram investigados os animais considerados reservatórios em potencial para a leishmaniose em domicílios humanos e em áreas de floresta adjacentes. Foram testados anticorpos contra Leishmania spp em amostras de sangue de cães e detectada reatividade pela reação de imunofluorescencia indireta em oito (20,51 % dos examinados. Entre os animais silvestres examinados a espécie Didelphis marsupialis foi predominante, com 20 exemplares capturados, sendo encontrados homoflagelados em três destes e lesões suspeitas de leishmaniose cutanea em dois. Acredita-se que um assentamento populacional desordenado ocorrido nas adjacências tenha causado o deslocamento das populações de vetores e reservatórios naturais em direção às casas do conjunto Hiléia propiciando o surto.This is the result of a two year follow-up of a Cutaneous Leishmaniasis (CL foci in the Hileia urban neighborhood in Manaus. It is important to point out that this is not the usual pattern of Leishmaniasis occurrence in this area. The authors investigated the animal potential reservoir in households and in the surrounding forest area. Samples were tested for leishmaniasis antibodies by RIFI. Eight (20.51% of the examined domestic dogs showed reactivity. In captured wild animals, the Didelphis marsupialis was predominant in twenty specimens, three with homoflagelated in the blood and two with suspicious cutaneous lesions. We believe that the disordered population growth in the nearby area pushed the population of vectors and natural reservoir toward the homes in the Heleia neighborhood creating conditions for this outbreak.

  12. Geographic distribution and clinical description of leishmaniasis cases in Peru.

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    Lucas, C M; Franke, E D; Cachay, M I; Tejada, A; Cruz, M E; Kreutzer, R D; Barker, D C; McCann, S H; Watts, D M

    1998-08-01

    Studies were conducted from 1986 through 1993 to further define the geographic distribution and relative importance of different species of Leishmania as a cause of leishmaniasis in Peru. Patients with a clinical diagnosis of cutaneous and/or mucosal or diffuse cutaneous leishmaniasis were enrolled at the Naval Medical Research Institute Detachment (NAMRID) Laboratory in Lima, the Tropical Disease Clinic at San Marcos University Daniel A. Carrión, the Central Military Hospital, and a Ministry of Health hospital in Cusco, Peru. Clinical features, lesion aspirates, and biopsy tissue were obtained from each patient. All specimens were collected and assayed separately, including multiple specimens from some of the same patients for Leishmania parasites by inoculating aliquots of either aspirates or biopsy tissue suspensions onto Senekji's blood agar medium. Stocks of Leishmania isolates were used to prepare promastigotes to produce extracts for identifying the Leishmania species by the cellulose acetate electrophoresis enzyme technique. A total of 351 isolates of Leishmania were obtained from 350 patients who were infected primarily in the low and high jungle of at least 15 different Departments of Peru. Of the 351 isolates, 79% were identified as L. (V.) braziliensis, 7% as L. (V.) guyanensis, 10% as L. (V.) peruviana, 2% as L. (V.) lainsoni, and 1.7% as L. (L.) amazonensis. The clinical form of disease varied depending on the species of Leishmania, with L. (V.) braziliensis being associated most frequently with cutaneous, mucosal ulcers and mixed cutaneous and mucosal disease, and L. (V) peruviana, L. (V.) guyanensis, L. (V.) lainsoni with cutaneous lesions. Leishmania (L.) amazonensis was isolated from six patients, three with cutaneous lesions, one with mucosal lesions, and two with diffuse cutaneous lesions. Among all of the leishmaniasis cases, males were affected more frequently, and cases occurred among patients less than 10 to more than 51 years of age. These

  13. Recent advances in phlebotomine sand fly research related to leishmaniasis control.

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    Bates, Paul A; Depaquit, Jerôme; Galati, Eunice A B; Kamhawi, Shaden; Maroli, Michele; McDowell, Mary Ann; Picado, Albert; Ready, Paul D; Salomón, O Daniel; Shaw, Jeffrey J; Traub-Csekö, Yara M; Warburg, Alon

    2015-02-27

    Phlebotomine sand flies are the subject of much research because of the role of their females as the only proven natural vectors of Leishmania species, the parasitic protozoans that are the causative agents of the neglected tropical disease leishmaniasis. Activity in this field was highlighted by the eighth International Symposium on Phlebotomine Sand flies (ISOPS) held in September 2014, which prompted this review focusing on vector control. Topics reviewed include: Taxonomy and phylogenetics, Vector competence, Genetics, genomics and transcriptomics, Eco-epidemiology, and Vector control. Research on sand flies as leishmaniasis vectors has revealed a diverse array of zoonotic and anthroponotic transmission cycles, mostly in subtropical and tropical regions of Africa, Asia and Latin America, but also in Mediterranean Europe. The challenge is to progress beyond descriptive eco-epidemiology, in order to separate vectors of biomedical importance from the sand fly species that are competent vectors but lack the vectorial capacity to cause much human disease. Transmission modelling is required to identify the vectors that are a public health priority, the ones that must be controlled as part of the integrated control of leishmaniasis. Effective modelling of transmission will require the use of entomological indices more precise than those usually reported in the leishmaniasis literature.

  14. Leishmaniasis difusa

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    Gerzaín Rodríguez

    1985-12-01

    Full Text Available Se presentan cuatro pacientes con leishmaniasis difusa, procedentes de cuatro regiones de Colombia, diagnosticados inicialmente mediante el estudio histopatológico. Dos casos tenían lesiones diseminadas, en una niña de 10 años y en un hombre de 80 años. Los otros dos casos, hombres de 33 y 62 años, presentaron lesiones nodulares iniciales que curaron con calor local y Glucantime. Todos tuvieron leishmaninas negativas. Se confirma que la entidad puede curar cuando no está diseminada. El calor local fue muy útil en un caso con lesión única inicial. La inoculación al hamster con macerados de biopsias de dos de los pacientes les originó prominentes "histiocitomas" en el hocico y las almohadillas plantares. En un caso no diseminado se identificó el parásito como L. m. amazonensis mediante isoenzimas. En el paciente de 80 años, el agente causal fue una cepa de L. mexicana. llustramos las lesiones clínicas, enfatizamos el aspecto típico de la imagen histopatológica e ilustramos y discutimos la relación leishmaniamacrófago mediante imágenes de microscopía electrónica. Las características de la enfermedad y la literatura sobre la misma se revisa ampliamente.

  15. Species Typing in Dermal Leishmaniasis

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    Dujardin, Jean-Claude

    2015-01-01

    SUMMARY Leishmania is an infectious protozoan parasite related to African and American trypanosomes. All Leishmania species that are pathogenic to humans can cause dermal disease. When one is confronted with cutaneous leishmaniasis, identification of the causative species is relevant in both clinical and epidemiological studies, case management, and control. This review gives an overview of the currently existing and most used assays for species discrimination, with a critical appraisal of the limitations of each technique. The consensus taxonomy for the genus is outlined, including debatable species designations. Finally, a numerical literature analysis is presented that describes which methods are most used in various countries and regions in the world, and for which purposes. PMID:25672782

  16. Representaciones, actitudes y prácticas respecto a la Leishmaniasis Cutánea en la población del Cantón de Acosta, provincia de San José, Costa Rica: estudio antropológico exploratório Representation, attitudes, and practices related to Cutaneous Leishmaniasis in people from Acosta Country, San Jose province, Costa Rica: an exploratory anthropological astudy

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    Alvaro Dobles-Ulloa

    1994-06-01

    Full Text Available Estudio antropológico exploratorio sobre las representaciones, actitudes y prácticas relacionadas con la Leishmaniasis Cutánea (LC en la población rural del cantón de Acosta, Costa Rica, dirigido a estimar la posibilidad de aplicación de medidas de control propuestas sobre una base epidemiológica. Entrevistas abiertas con una pequeña muestra de personas, provenientes tanto de casas-caso como de casas-control proveyeron la base para un Análisis Proposicional del Discurso (APD. Los resultados son que la gente de Acosta considera la LC como una entidad nosológica diferenciada, pero se interesan sobre todo en sus manifestaciones clínicas en los niños (que son los más afectados, así como en su propia capacidad de acción mediante remedios populares. La idea de medidas de control sobre los reservorios, los vectores o el contexto espacio-temporal del contacto no asoma espontáneamente en el pensamiento de la gente. Sin embargo, la LC se percibe como una disrupción en el espacio doméstico y peridoméstico, considerado seguro; medidas de control que intervengan en ese ámbito podrían pues tener buenas posibilidades de éxito.An exploratory anthropological study on representations, attitudes, and practices related to Cutaneous Leishmaniasis (CL among the rural population of Acosta Vountry, Costa Rica, aimed to estimate the applicability of epidemiologically-based control measures. Open interviews with a small sample of individuals from both case and control households provided the basic for a Propositional Discourse Analysis (PDA. Results are that Acosta people consider CL a distinct nosologic entity, but they are mainly interested in its clinical manifestations in children (who are mainly affected, as well as in their own capacity to act on the disease using folk remedies. The idea of control measures on reservoirs, on vectors, or on the spatial and temporal context of contact does not arise spontaneously in people's thinking

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

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    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.

  18. 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.

  19. [Leishmaniasis transmission focus in El Hobo, Carmen de Bolívar, Bolívar, Colombia].

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    Cortés, Luis Alberto

    2006-10-01

    The epidemiological characteristics and the importance of the Lutzomyia species present in a leishmaniasis focus in the village El Hobo, Carmen de Bolívar, Department of Bolivar, Colombia, are described. To obtain a preliminary assessment of leishmaniasis transmission in the village of El Hobo, Carmen de Bolívar. Epidemiological data were analyzed and sandflies were collected with CDC traps and on protected human volunteers in the village of El Hobo. Sero prevalence of canine visceral leishmaniasis in dogs was evaluated using indirect inmunofluorescence (IFAT). Nine Lutzomyia species were collected: L. trinidadensis, L. evansi, L. cayennensis, L. venezuelensis, L. gomezi, L. dubitans, L. ylephiletor, L. yuilli, and L. walkeri. The species of greater importance based on their implication in the transmission of cutaneous and visceral leishmaniasis were L. gomezi, and L. evansi respectively. Specimens of L. venezuelensis, L. dubitans, L. ylephiletor, L. yuilli, and L. walkeri are reported for the first time for the Department of Bolivar. The sero prevalence of visceral leishmaniasis in dogs was 36%. According to the epidemiological records, in 2002 the municipality of Carmen de Bolivar presented a 40% increase in cases of cutaneous leishmaniasis and an 80% increase in canine visceral leishmaniasis as compared to 2001, due to the outbreak in the village of El Hobo. The results indicate that the village of El Hobo is an area of potential risk for transmission of both cutaneous and visceral leishmaniasis.

  20. Leishmaniasis: a review [version 1; referees: 2 approved

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    Edoardo Torres-Guerrero

    2017-05-01

    Full Text Available Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide, 1.5 to 2 million new cases occur each year, 350 million are at risk of acquiring the disease, and leishmaniasis causes 70,000 deaths per year. Clinical features depend on the species of Leishmania involved and the immune response of the host. Manifestations range from the localized cutaneous to the visceral form with potentially fatal outcomes. Many drugs are used in its treatment, but the only effective treatment is achieved with current pentavalent antimonials.

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

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

    2016-06-03

    A number of leishmaniasis vaccine candidates are at various stages of pre-clinical and clinical development. Leishmaniasis is a vector-borne neglected tropical disease (NTD) caused by a protozoan parasite of the genus Leishmania and transmitted to humans by the bite of a sand fly. Visceral leishmaniasis (VL, kala-azar) is a high mortality NTD found mostly in South Asia and East Africa, while cutaneous leishmaniasis (CL) is a disfiguring NTD highly endemic in the Middle East, Central Asia, North Africa, and the Americas. Estimates attribute 50,000 annual deaths and 3.3 million disability-adjusted life years to leishmaniasis. There are only a few approved drug treatments, no prophylactic drug and no vaccine. Ideally, an effective vaccine against leishmaniasis will elicit long-lasting immunity and protect broadly against VL and CL. Vaccines such as Leish-F1, F2 and F3, developed at IDRI and designed based on selected Leishmania antigen epitopes, have been in clinical trials. Other groups, including the Sabin Vaccine Institute in collaboration with the National Institutes of Health are investigating recombinant Leishmania antigens in combination with selected sand fly salivary gland antigens in order to augment host immunity. To date, both VL and CL vaccines have been shown to be cost-effective in economic modeling studies. Copyright © 2016 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

  2. Epidemiological changes in leishmaniasis in Spain according to hospitalization-based records, 1997-2011: raising awareness towards leishmaniasis in non-HIV patients.

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    Zaida Herrador

    2015-03-01

    Full Text Available In Spain, Leishmania infantum is endemic, human visceral and cutaneous leishmaniasis cases occurring both in the Peninsula, as well as in the Balearic Islands. We aimed to describe the clinical characteristics of leishmaniasis patients and the changes in the disease evolution after the introduction of antiretroviral therapy in 1997. In this descriptive study, we used Spanish Centralized Hospital Discharge Database for the hospitalized leishmaniasis cases between 1997 and 2011. We included in the analysis only the records having leishmaniasis as the first registered diagnosis and calculated the hospitalization rates. Disease trend was described taking into account the HIV status. Adjusted odds-ratio was used to estimate the association between clinical and socio-demographic factors and HIV co-infection. Of the total 8010 Leishmaniasis hospitalizations records, 3442 had leishmaniasis as first diagnosis; 2545/3442 (75.6% were males and 2240/3442