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Konate I, Sangare I, Zoungrana J, Meda ZC, Kafando C, Sawadogo Y, Dabiré R, Meda N, Diallo B, Andonaba JB, Barro-Traoré F, Niamba P, Traoré A. Description d’un nouveau foyer épidémique de leishmaniose cutanée à Leishmania major à l’Ouest du Burkina Faso. Pan Afr Med J 2020; 35:65. [PMID: 32537069 PMCID: PMC7250217 DOI: 10.11604/pamj.2020.35.65.20825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 11/14/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction au Burkina Faso, le seul foyer de leishmaniose cutanée (LC) avec confirmation biologique dans la littérature à notre connaissance est celui de Ouagadougou au centre. Nous rapportons les résultats épidémiologiques, cliniques et biologiques de l’investigation d’un nouveau foyer épidémique à Larama, à l’ouest du Burkina. Méthodes la méthode du camp a été utilisée pour recevoir les cas. Les données sociodémographiques et cliniques ont été recueillies à l’aide d’un questionnaire. La confirmation a été faite par la microscopie puis par réaction en chaîne par polymérase (PCR). Résultats au total, 108 cas suspects ont été recensés à Larama, soit un taux d’attaque de 5,8%. Le sex ratio était de 1,08. Les patients concernés étaient le plus souvent des cultivateurs (35,2%) et des commerçants (33,3%). La population active (15 à 49 ans) représentait 51,9%. Le nombre de lésion variait entre 1 et 5 dans 91,7% des cas. Les lésions qui se présentaient sous formes ulcéro-crouteuses surélevées et infiltrées, étaient localisées sur les membres (87%) avec une durée d’évolution entre un et cinq mois dans 96,3% des cas. Sur les deux cas prélevés, la microscopie a montré des leishmanies et la PCR a confirmé l’espèce Leishmania major. Conclusion nos résultats confirment l’existence d’une épidémie de leishmaniose cutanée à L. major dans l’ouest du pays. Des enquêtes complémentaires sont nécessaires pour préciser la charge de morbidité des leishmanioses au Burkina Faso.
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Affiliation(s)
- Issouf Konate
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
- Centre Muraz, Institut National de Santé Publique, Bobo-Dioulasso, Burkina Faso
| | - Ibrahim Sangare
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
- Centre Muraz, Institut National de Santé Publique, Bobo-Dioulasso, Burkina Faso
| | - Jacques Zoungrana
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Ziemlé Clément Meda
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
- Centre Muraz, Institut National de Santé Publique, Bobo-Dioulasso, Burkina Faso
| | - Christophe Kafando
- Direction de la Protection de la Santé, Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Yacouba Sawadogo
- Direction de la Protection de la Santé, Ministère de la Santé, Ouagadougou, Burkina Faso
- Direction Régionale de la Santé des Hauts Bassins, Bobo-Dioulasso, Burkina Faso
| | - Rock Dabiré
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso
| | - Nicolas Meda
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
- Unité de Formation et de Recherche en Sciences de la Santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Boukary Diallo
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Jean-Baptiste Andonaba
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Fatou Barro-Traoré
- Unité de Formation et de Recherche en Sciences de la Santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Pascal Niamba
- Unité de Formation et de Recherche en Sciences de la Santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Adama Traoré
- Unité de Formation et de Recherche en Sciences de la Santé, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
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Sunyoto T, Verdonck K, el Safi S, Potet J, Picado A, Boelaert M. Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review. PLoS Negl Trop Dis 2018; 12:e0006914. [PMID: 30359376 PMCID: PMC6219817 DOI: 10.1371/journal.pntd.0006914] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/06/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Cutaneous leishmaniasis (CL) is the most frequent form of leishmaniasis, with 0.7 to 1.2 million cases per year globally. However, the burden of CL is poorly documented in some regions. We carried out this review to synthesize knowledge on the epidemiological burden of CL in sub-Saharan Africa. METHODS We systematically searched PubMed, CABI Global health, Africa Index Medicus databases for publications on CL and its burden. There were no restrictions on language/publication date. Case series with less than ten patients, species identification studies, reviews, non-human, and non-CL focused studies were excluded. Findings were extracted and described. The review was conducted following PRISMA guidelines; the protocol was registered in PROSPERO (42016036272). RESULTS From 289 identified records, 54 met eligibility criteria and were included in the synthesis. CL was reported from 13 of the 48 sub-Saharan African countries (3 eastern, nine western and one from southern Africa). More than half of the records (30/54; 56%) were from western Africa, notably Senegal, Burkina Faso and Mali. All studies were observational: 29 were descriptive case series (total 13,257 cases), and 24 followed a cross-sectional design. The majority (78%) of the studies were carried out before the year 2000. Forty-two studies mentioned the parasite species, but was either assumed or attributed on the historical account. Regional differences in clinical manifestations were reported. We found high variability across methodologies, leading to difficulties to compare or combine data. The prevalence in hospital settings among suspected cases ranged between 0.1 and 14.2%. At the community level, CL prevalence varied widely between studies. Outbreaks of thousands of cases occurred in Ethiopia, Ghana, and Sudan. Polymorphism of CL in HIV-infected people is a concern. Key information gaps in CL burden here include population-based CL prevalence/incidence, risk factors, and its socio-economic burden. CONCLUSION The evidence on CL epidemiology in sub-Saharan Africa is scanty. The CL frequency and severity are poorly identified. There is a need for population-based studies to define the CL burden better. Endemic countries should consider research and action to improve burden estimation and essential control measures including diagnosis and treatment capacity.
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Affiliation(s)
- Temmy Sunyoto
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Policy Department, Médecins Sans Frontières - Campaign for Access to Medicines, Geneva, Switzerland
| | - Kristien Verdonck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sayda el Safi
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Julien Potet
- Policy Department, Médecins Sans Frontières - Campaign for Access to Medicines, Geneva, Switzerland
| | - Albert Picado
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Aronson N, Herwaldt BL, Libman M, Pearson R, Lopez-Velez R, Weina P, Carvalho EM, Ephros M, Jeronimo S, Magill A. Diagnosis and Treatment of Leishmaniasis: Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016; 63:e202-e264. [PMID: 27941151 DOI: 10.1093/cid/ciw670] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/22/2016] [Indexed: 12/25/2022] Open
Abstract
It is important to realize that leishmaniasis guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. The IDSA and ASTMH consider adherence to these guidelines to be voluntary, with the ultimate determinations regarding their application to be made by the physician in the light of each patient's individual circumstances.
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Affiliation(s)
- Naomi Aronson
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Michael Libman
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Peter Weina
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | | | | | - Selma Jeronimo
- Federal University of Rio Grande do Norte, Natal, Brazil
| | - Alan Magill
- Bill and Melinda Gates Foundation, Seattle, Washington
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Kone AK, Niare DS, Thera MA, Kayentao K, Djimde A, Delaunay P, Kouriba B, Giudice PD, Izri A, Marty P, Doumbo OK. Epidemiology of the outbreak, vectors and reservoirs of cutaneous leishmaniasis in Mali: A systematic review and meta-analysis. ASIAN PAC J TROP MED 2016; 9:985-990. [PMID: 27794393 DOI: 10.1016/j.apjtm.2016.07.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/03/2016] [Accepted: 07/10/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To compile available data and to estimate the burden, characteristics and risks factors of cutaneous leishmaniasis (CL) in Mali. METHODS Articles in English and French were searched in Hinari, Google scholar and PubMed. Unpublished studies were identified by searching in Google.com. Terms used were cutaneous leishmaniasis Mali; Leishmaniasis Mali, Leishmania major Mali; or Phlebotomus Mali or Sergentomyia Mali. We select descriptive studies on CL and sandflies in Mali. Data were extracted and checked by the author, then analyzed by region, by study population and type of biological tests, meta-analysis approach with STATA software was used. RESULTS Nineteen published (n = 19) and three unpublished were included. CL epidemiology was characterized by occurrence of clinical cases in different areas of Mali, outbreaks restricted to known areas of transmission and isolated cases diagnosed in travelers. In endemic areas, population at risk are young age persons, farmers, ranchers, housewives, teachers and military personnel. The annual incidence ranged from 290 to 580 cases of CL. Leishmania major is the main species encountered throughout the country (North Savanna, Sahel and Sub-Saharan areas), and Phlebotomus duboscqi has been identified as the vector and Sergentomyia (Spelaeomyia) darlingi as possible vector. The overall estimated prevalence of positive LST (Leishmanin Skin Test) was 22.1%. The overall frequency of CL disease among suspected cases was 40.3%. CONCLUSIONS Although descriptive, hospital-based and cross-sectional studies are robust enough to determine the extent of CL in Mali; future well-designed eco-epidemiological studies at a nationwide scale are needed to fully characterize CL epidemiology and risk factors in Mali.
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Affiliation(s)
- Abdoulaye Kassoum Kone
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali.
| | - Doumbo Safiatou Niare
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Mahamadou Ali Thera
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Kassoum Kayentao
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Pascal Delaunay
- Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Université de Nice-Sophia Antipolis, 151, route St Antoine de Ginestière, BP 2 3194, 06204 Nice Cedex, France; Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, France
| | - Bourema Kouriba
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Pascal Del Giudice
- Unit of Infectious et Tropical Diseases, Hospital Bonnet, 83700 Fréjus, France
| | - Arezki Izri
- Parasitology-Mycology, Hospital Avicenne, Paris 13 University, UMR 190, Aix-Marseille University, France
| | - Pierre Marty
- Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Université de Nice-Sophia Antipolis, 151, route St Antoine de Ginestière, BP 2 3194, 06204 Nice Cedex, France; Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, France
| | - Ogobara K Doumbo
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali; Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Université de Nice-Sophia Antipolis, 151, route St Antoine de Ginestière, BP 2 3194, 06204 Nice Cedex, France.
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Ouadi Z, Akhdari N, Hocar O, Amal S, Tassi N. [Polymorphic lesions of cutaneous leishmaniasis revealing human immunodeficiency virus infection]. Med Mal Infect 2016; 46:393-395. [PMID: 27389608 DOI: 10.1016/j.medmal.2016.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/25/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Z Ouadi
- Service de dermatologie, hôpital Arrazi, CHU de Med VI, Marrakech, Maroc.
| | - N Akhdari
- Service de dermatologie, hôpital Arrazi, CHU de Med VI, Marrakech, Maroc
| | - O Hocar
- Service de dermatologie, hôpital Arrazi, CHU de Med VI, Marrakech, Maroc
| | - S Amal
- Service de dermatologie, hôpital Arrazi, CHU de Med VI, Marrakech, Maroc
| | - N Tassi
- Service de maladies infectieuses, hôpital Arrazi, CHU de Med VI, Marrakech, Maroc
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PKDL and other dermal lesions in HIV co-infected patients with Leishmaniasis: review of clinical presentation in relation to immune responses. PLoS Negl Trop Dis 2014; 8:e3258. [PMID: 25412435 PMCID: PMC4238984 DOI: 10.1371/journal.pntd.0003258] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Co-infection of leishmaniasis and HIV is increasingly reported. The clinical presentation of leishmaniasis is determined by the host immune response to the parasite; as a consequence, this presentation will be influenced by HIV-induced immunosuppression. As leishmaniasis commonly affects the skin, increasing immunosuppression changes the clinical presentation, such as in post-kala-azar dermal leishmaniasis (PKDL) and cutaneous leishmaniasis (CL); dermal lesions are also commonly reported in visceral leishmaniasis (VL) and HIV co-infection. Methods We reviewed the literature with regard to dermal manifestations in leishmaniasis and HIV co-infection, in three clinical syndromes, according to the primary presentation: PKDL, VL, or CL. Results A wide variety of descriptions of dermal leishmaniasis in HIV co-infection has been reported. Lesions are commonly described as florid, symmetrical, non-ulcerating, nodular lesions with atypical distribution and numerous parasites. Pre-existing, unrelated dermal lesions may become parasitized. Parasites lose their tropism and no longer exclusively cause VL or CL. PKDL in HIV co-infected patients is more common and more severe and is not restricted to Leishmania donovani. In VL, dermal lesions occur in up to 18% of patients and may present as (severe) localized cutaneous leishmaniasis, disseminated cutaneous leishmaniasis (DL) or diffuse cutaneous leishmaniasis (DCL); there may be an overlap with para-kala-azar dermal leishmaniasis. In CL, dissemination in the skin may occur resembling DL or DCL; subsequent spread to the viscera may follow. Mucosal lesions are commonly found in VL or CL and HIV co-infection. Classical mucocutaneous leishmaniasis is more severe. Immune reconstitution disease (IRD) is uncommon in HIV co-infected patients with leishmaniasis on antiretroviral treatment (ART). Conclusion With increasing immunosuppression, the clinical syndromes of CL, VL, and PKDL become more severe and may overlap. These syndromes may be best described as VL with disseminated cutaneous lesions (before, during, or after VL) and disseminated cutaneous leishmaniasis with or without visceralization.
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van Griensven J, Carrillo E, López-Vélez R, Lynen L, Moreno J. Leishmaniasis in immunosuppressed individuals. Clin Microbiol Infect 2014; 20:286-99. [DOI: 10.1111/1469-0691.12556] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Khandelwal K, Bumb RA, Mehta RD, Kaushal H, Lezama-Davila C, Salotra P, Satoskar AR. A patient presenting with diffuse cutaneous leishmaniasis (DCL) as a first indicator of HIV infection in India. Am J Trop Med Hyg 2011; 85:64-5. [PMID: 21734126 DOI: 10.4269/ajtmh.2011.10-0649] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Opportunistic parasitic infections such as leishmaniasis are common in human immunodeficiency virus (HIV)-infected patients and are usually acquired several days after initial diagnosis of HIV infection. Here, we report on a patient who presented with diffuse cutaneous leishmaniasis (DCL) caused by Leishmania tropica as the first and only clinical manifestation of HIV infection. To the best of our knowledge, this is the first case that illustrates that DCL could be the first clinical indicator of HIV infection. Cutaneous leishmaniasis (CL) and DCL are becoming frequent opportunistic infections in HIV-infected individuals throughout the world. To date, all documented cases of CL and HIV coinfections have been reported in patients who were known cases of HIV and who subsequently developed CL. In this report, we present a case that illustrates that DCL could be the first clinical indicator of HIV infection.
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Affiliation(s)
- Kanika Khandelwal
- Department of Dermatology, Sardar Patel Medical College, Bikaner, Rajasthan, India.
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Faye B, Bucheton B, Bañuls AL, Senghor MW, Niang AA, Diedhiou S, Konaté O, Dione MM, Hide M, Mellul S, Knecht R, Delaunay P, Marty P, Gaye O. Seroprevalence of Leishmania infantum in a rural area of Senegal: analysis of risk factors involved in transmission to humans. Trans R Soc Trop Med Hyg 2011; 105:333-40. [DOI: 10.1016/j.trstmh.2011.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 02/02/2011] [Accepted: 02/02/2011] [Indexed: 10/18/2022] Open
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Prasad N, Ghiya BC, Bumb RA, Kaushal H, Saboskar AA, Lezama-Davila CM, Salotra P, Satoskar AR. Heat, Oriental sore, and HIV. Lancet 2011; 377:610. [PMID: 21315946 DOI: 10.1016/s0140-6736(10)61495-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Neha Prasad
- Department of Dermatology, STD and Leprosy, SP Medical College, Bikaner, Rajasthan, India
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Iguermia S, Harmouche T, Mikou O, Amarti A, Mernissi F. Leishmaniose cutanéomuqueuse au Maroc, témoin d’un changement dans l’écologie du parasite ? Med Mal Infect 2011; 41:47-8. [DOI: 10.1016/j.medmal.2010.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2010] [Revised: 06/01/2010] [Accepted: 07/20/2010] [Indexed: 10/18/2022]
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Pérez-Ayala A, Norman F, Pérez-Molina JA, Herrero JM, Monge B, López-Vélez R. Imported leishmaniasis: a heterogeneous group of diseases. J Travel Med 2009; 16:395-401. [PMID: 19930379 DOI: 10.1111/j.1708-8305.2009.00341.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Leishmaniasis is endemic in many countries. The existence of different species combined with host factors may condition clinical presentation, treatment options, and disease outcome. In an endemic country, a predominance of certain species and presentations may be expected, whereas from the perspective of a tropical medicine referral unit a wider variety of cases from diverse geographical areas may be observed. METHODS Retrospective study of imported leishmaniasis cases diagnosed at a Tropical Medicine referral unit in Spain, during the period of January 1995 to June 2008. RESULTS In total, 18 cases were diagnosed: 12 cutaneous leishmaniasis (CL), 4 mucocutaneous leishmaniasis (ML), and 2 visceral leishmaniasis (VL) cases. Two patients were immunosuppressed. The majority of CL cases (9/12) occurring in travelers were acquired in New World countries and were treated with pentavalent antimonials. Three ML cases were acquired in the New World, two received initial treatment with pentavalent antimonials and two with liposomal amphotericin B (LAmB). For all four ML cases, a change in drug choice and multiple treatment courses were necessary, and one remained refractory to treatment. Both VL cases were acquired in Africa and responded well to LAmB treatment. CONCLUSION The management of leishmaniasis in non-endemic countries is still a challenge for physicians. With the variety of cases presented, both in immigrants and travelers from different geographical areas, this series illustrates the great diversity of imported leishmaniasis in terms of presentation, treatment options, and outcome. We consider this entity is becoming increasingly more frequent and clinicians should be aware of strategies for its correct management.
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Affiliation(s)
- Ana Pérez-Ayala
- Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid, Spain
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Ramos Rincón JM, Zubero Sulibarría Z, Ena Muñoz J. [Immigration and HIV Infection. An approximation to parasitic and viral infections]. Enferm Infecc Microbiol Clin 2008; 26 Suppl 5:42-53. [PMID: 18590665 DOI: 10.1157/13123266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Highly-active antiretroviral therapy is effective in reducing opportunistic infections in industrialized countries. However, opportunistic parasitic infections remain the leading cause of HIV-related mortality in developing countries. These infections can also affect HIV-positive immigrants residing in Spain, as well as HIV-infected patients traveling to low-income countries. In addition, immigrants often have viral infections caused by herpesvirus, papillomavirus and polyomavirus, which are closely related to risk behaviors and commercial sex. The present article reviews the characteristics of parasitic and viral infections in patients with HIV infection with the aim of improving understanding of this vulnerable population group.
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The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 2008; 21:334-59, table of contents. [PMID: 18400800 DOI: 10.1128/cmr.00061-07] [Citation(s) in RCA: 566] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
To date, most Leishmania and human immunodeficiency virus (HIV) coinfection cases reported to WHO come from Southern Europe. Up to the year 2001, nearly 2,000 cases of coinfection were identified, of which 90% were from Spain, Italy, France, and Portugal. However, these figures are misleading because they do not account for the large proportion of cases in many African and Asian countries that are missed due to a lack of diagnostic facilities and poor reporting systems. Most cases of coinfection in the Americas are reported in Brazil, where the incidence of leishmaniasis has spread in recent years due to overlap with major areas of HIV transmission. In some areas of Africa, the number of coinfection cases has increased dramatically due to social phenomena such as mass migration and wars. In northwest Ethiopia, up to 30% of all visceral leishmaniasis patients are also infected with HIV. In Asia, coinfections are increasingly being reported in India, which also has the highest global burden of leishmaniasis and a high rate of resistance to antimonial drugs. Based on the previous experience of 20 years of coinfection in Europe, this review focuses on the management of Leishmania-HIV-coinfected patients in low-income countries where leishmaniasis is endemic.
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Barro-Traoré F, Preney L, Traoré A, Darie H, Tapsoba P, Bassolé A, Sawadogo S, Niamba P, Grosshans E, Geniaux M. [Cutaneous leishmaniasis due to Leishmania major involving the bone marrow in an AIDS patient in Burkina Faso]. Ann Dermatol Venereol 2008; 135:380-3. [PMID: 18457724 DOI: 10.1016/j.annder.2007.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 10/26/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Leishmaniasis covers three well-individualized clinical variants, each due to individual species found in different geographic areas. Herein we report the first case of cutaneous leishmaniasis due to Leishmania major involving bone marrow in an AIDS patient in Burkina Faso. CASE REPORT A 38-year-old HIV-positive man presented with generalized, copper-coloured, painless, infiltrated, itching, papulonodular lesions present over the previous 10 months. Skin biopsy confirmed the diagnosis of diffuse cutaneous leishmaniasis. The bone-marrow smear showed numerous leishmania. The culture was positive and L. major was identified. The patient was being treated with antiretroviral medication and a pentavalent antimonial compound. The disease progression consisted of attacks and remissions separated by an average of three weeks. DISCUSSION L. major is the Leishmania species identified in Burkina Faso. It is responsible for typical cutaneous leishmaniasis but particular clinical forms have been described in immunodeficient patients, especially with diffuse cutaneous involvement. The spread of L. major infection to bone marrow could represent a public health problem in our country, where the HIV epidemic is still not under control, and particular vigilance is thus called for.
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Affiliation(s)
- F Barro-Traoré
- Service de dermatologie et de vénéréologie de Ouagadougou, B.P. 3016, Ouagadougou 01, Burkina Faso.
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Barro-Traoré F, Preney L, Traoré A, Darie H, Tapsoba P, Diatto G, Bassolé A, Sawadogo S, Niamba P, Grosshans E, Geniaux M. CO26 - Premier cas de leishmaniose cutanée à Leishmania major avec extension viscérale à la moelle chez un patient infecté par le VIH au Burkina Faso. Ann Dermatol Venereol 2007. [DOI: 10.1016/s0151-9638(07)89059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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