Molecular Identification of Leishmania spp. in Sand Flies (Diptera: Psychodidae, Phlebotominae) From Ecuador

Phylogenetic relations among Mexican phlebotomine sand flies (Diptera: Psychodidae) and their divergence time estimation

Phlebotomine sand flies (Diptera: Psychodidae: Phlebotominae) have biological relevance as vectors of several pathogens. To ensure periodic entomological monitoring it is necessary to have efficient and accurate tools for an adequate taxonomic identification. There are only few studies on phylogenetic analyses of phlebotomine sand flies from Neotropics, based mostly on morphological and/or molecular data, which makes the delimitation of intra- and interspecific variability of species challenging. Here we generated new molecular information on sand fly species distributed in endemic areas of leishmaniasis in Mexico, using mitochondrial and ribosomal genes, and incorporating morphological information available. Specifically, we established their phylogenetic relationships, and estimated their divergence time. Our study provides molecular information for 15 phlebotomine sand fly species from different areas of Mexico, contributing to the genetic inventory and phylogenetic relations among Neotropical species of the subfamily Phlebotominae. Mitochondrial genes proved to be suitable markers for the molecular identification of phlebotomine sand flies. However, the incorporation of additional nuclear gene information could increase the significance of phylogenetic inferences. We also provided evidence about a possible divergence time of phlebotomine sand fly species, supporting their presumable origin in the Cretaceous period.

Leishmania (Viannia) naiffi Lainson & Shaw 1989

Just over 30 years ago, a new species of Leishmania of the subgenus Leishmania (Viannia) was described infecting the armadillo Dasypus novemcinctus; then, a report of human infection followed. From the Brazilian Amazon and apparently restricted to this region and its close borders, Leishmania (Viannia) naiffi has been characterized as a species that grows easily in axenic culture medium and causes few to no lesions after inoculation in experimental animal models. Results in the last decade indicate the occurrence of L. naiffi in vectors and human infections, including a report of therapeutic failure possibly associated with Leishmania RNA virus 1. Overall, such accounts suggest that the parasite is more dispersed and the disease less self-healing than previously expected.

Ecological interactions of sand flies, hosts, and Leishmania panamensis in an endemic area of cutaneous leishmaniasis in Colombia

BACKGROUND

The transmission dynamics of leishmaniasis are complex. There is also a lack of information about the ecological relationships between the vector/host/parasite at a more local and specific level. The Andean region concentrates more than 50% of Colombia's cutaneous leishmaniasis (CL) cases. The study of the ecological interactions of sand flies through the identification of blood sources has provided information on the female's opportunistic behavior, feeding on various hosts. Therefore, this study aimed to determine sand flies' ecological interactions with Leishmania parasites and their blood sources in an endemic area of CL.

RESULTS

A total of 4,621 sand flies were collected, comprising 20 species, in which the most abundant were Nyssomyia yuilli yuilli (55.4%), Psychodopygus ayrozai (14.5%) and Ps. panamensis (13.4%). Sequences of 12S gene fragment were analyzed using the BLASTn search tool. Blood-meal source identification was successfully performed for 47 sand flies, detecting seven vertebrate species, human and armadillo being the most frequent. Leishmania DNA was amplified in four female pools, constituted by Ny. yuilli yuilli and Ps. ayrozai, and the identification through RFLP detected Leishmania (Viannia) panamensis in the positive pools.

CONCLUSIONS

The interactions between the sand fly species, local mammalian fauna and the Leishmania parasite in this active focus of CL, provide evidence of the potential role of two different species in the maintenance of the parasite transmission, important information for the understanding of the ecoepidemiology and transmission dynamics of the disease in Andean endemic areas. However its necessary further evaluations of the vector and host competence in the transmission and maintenance of Leishmania spp, in these complex and diverse areas.

Update of the Phlebotominae Fauna with New Records for Argentina and Observations on Leishmaniasis Transmission Scenarios at a Regional Scale

Phlebotominae are small insects distributed in the Americas from Canada to Argentina and Uruguay, counting with more than 500 neotropical species. Some of them have a vectorial role in the transmission of Leishmania Ross, the causative agent of leishmaniases, a group of worldwide distributed diseases with different clinical manifestations and transmission cycles. Our aim was to update the Phlebotominae fauna of Argentina and to make observations on the American Cutaneous (ACL) and Visceral Leishmaniasis (AVL) transmission scenarios, according to the distribution of proven or suspected Leishmania vector species and recent changes in land use. Primary data (entomological captures) and secondary data (review of 65 scientific publications with Phlebotominae records) were used. With 9 new records, 46 Phlebotominae species are now recorded through the area comprising 14 political jurisdictions and 6 phytogeographic provinces. Distribution maps were constructed for the 5 proven or incriminated Leishmania vector species, and the evidence supporting the vectorial incrimination of these species is discussed. Three main ACL transmission scenarios are described in the phytogeographic provinces of the Yungas, Chaco, and Paranaense, associated with deforestation processes, while the transmission scenarios of AVL are urban outbreaks and scattered cases in rural areas. We update the available knowledge on the Phlebotominae fauna present in Argentina, emphasizing its epidemiological relevance in the current context of the increasing frequency of ACL outbreaks and geographic spread of AVL.

Diversity, distribution and natural Leishmania infection of sand flies from communities along the Interoceanic Highway in the Southeastern Peruvian Amazon

The Peruvian-Brazilian border is a highly endemic tegumentary leishmaniasis region in South America. The interoceanic highway is a commercial route that connects Peru and Brazil through Madre de Dios and has raised concerns about its impact on previously undisturbed areas. In order to assess leishmaniasis transmission risk along this highway, we conducted a surveillance study of the sand fly populations in this area. Sand flies were collected between 2009 and 2010 along transects at 200 m, 600 m and 1000 m from six study sites located along the highway (Iberia, La Novia, Alto Libertad, El Carmen, Florida Baja, Mazuko and Mavila) and an undisturbed area (Malinowski). Collected specimens were identified based on morphology and non-engorged females of each species were pooled and screened by kinetoplast PCR to detect natural Leishmania infections. A total of 9,023 specimens were collected belonging to 54 different Lutzomyia species including the first report of Lu. gantieri in Peru. Four species accounted for 50% of all specimens (Lutzomyia carrerai carrerai, Lu. davisi, Lu. shawi and Lu. richardwardi). El Carmen, Alto Libertad, Florida Baja and Malinowski presented higher Shannon diversity indexes (H = 2.36, 2.30, 2.17 and 2.13, respectively) than the most human disturbed sites of Mazuko and La Novia (H = 1.53 and 1.06, respectively). PCR detected 10 positive pools belonging to Lu. carrerai carrerai, Lu. yuilli yuilli, Lu. hirsuta hirsuta, Lu. (Trichophoromyia) spp., and Lu. (Lutzomyia) spp. Positive pools from 1,000 m transects had higher infectivity rates than those from 600 m and 200 m transects (9/169 = 5.3% vs 0/79 = 0% and 1/127 = 0.8%, p = 0.018). El Carmen, accounted for eight out of ten positives whereas one positive was collected in Florida Baja and Mazuko each. Our study has shown differences in sand fly diversity, abundance and species composition across and within sites. Multiple clustered Lutzomyia pools with natural Leishmania infection suggest a complex, diverse and spotty role in leishmaniasis transmission in Madre de Dios, with increased risk farther from the highway.

Molecular detection of Leishmania donovani, Leishmania major, and Trypanosoma species in Sergentomyia squamipleuris sand flies from a visceral leishmaniasis focus in Merti sub-County, eastern Kenya

BACKGROUND

Visceral leishmaniasis (VL) and zoonotic cutaneous leishmaniasis (ZCL) are of public health concern in Merti sub-County, Kenya, but epidemiological data on transmission, vector abundance, distribution, and reservoir hosts remain limited. To better understand the disease and inform control measures to reduce transmission, we investigated the abundance and distribution of sand fly species responsible for Leishmania transmission in the sub-County and their blood-meal hosts.

METHODS

We conducted an entomological survey in five villages with reported cases of VL in Merti sub-County, Kenya, using CDC miniature light traps and castor oil sticky papers. Sand flies were dissected and identified to the species level using standard taxonomic keys and PCR analysis of the cytochrome c oxidase subunit 1 (cox1) gene. Leishmania parasites were detected and identified by PCR and sequencing of internal transcribed spacer 1 (ITS1) genes. Blood-meal sources of engorged females were identified by high-resolution melting analysis of vertebrate cytochrome b (cyt-b) gene PCR products.

RESULTS

We sampled 526 sand flies consisting of 8 species, Phlebotomus orientalis (1.52%; n = 8), and 7 Sergentomyia spp. Sergentomyia squamipleuris was the most abundant sand fly species (78.71%; n = 414) followed by Sergentomyia clydei (10.46%; n = 55). Leishmania major, Leishmania donovani, and Trypanosoma DNA were detected in S. squamipleuris specimens. Humans were the main sources of sand fly blood meals. However, we also detected mixed blood meals; one S. squamipleuris specimen had fed on both human and mouse (Mus musculus) blood, while two Ph. orientalis specimens fed on human, hyrax (Procavia capensis), and mouse (Mus musculus) blood.

CONCLUSIONS

Our findings implicate the potential involvement of S. squamipleuris in the transmission of Leishmania and question the dogma that human leishmaniases in the Old World are exclusively transmitted by sand flies of the Phlebotomus genus. The presence of Trypanosoma spp. may indicate mechanical transmission, whose efficiency should be investigated. Host preference analysis revealed the possibility of zoonotic transmission of leishmaniasis and other pathogens in the sub-County. Leishmania major and L. donovani are known to cause ZCL and VL, respectively. However, the reservoir status of the parasites is not uniform. Further studies are needed to determine the reservoir hosts of Leishmania spp. in the area.

Ecology of Sand Flies (Psychodidae: Phlebotominae) and Natural Infection of Pintomyia townsendi With Leishmania amazonensis in a Cutaneous Leishmaniasis Focus in Colombia

Humans have influenced the epidemiological patterns of American cutaneous leishmaniasis by habitat disturbance, which has led to the emergence of new transmission foci. In these transmission areas, detecting natural infection of sand fly species with Leishmania parasites is of prime importance in epidemiological studies. In this study, we examined the species composition, spatial distribution, seasonality, and natural infection with Leishmania of the sand fly fauna in an emergent leishmaniasis focus located in Colombia. Sand flies were collected from September 2014 to June 2015 using CDC light traps located in indoor, peridomestic, and outdoor habitats within areas with confirmed clinical patients. In total, 13,488 sand flies of 12 species and seven genera were collected. Among these, Pintomyia townsendi (Ortiz) was the most abundant species comprising 76.3% of total flies collected. The sand fly richness and abundance were influenced by habitat and weather conditions. Outdoor areas harbored the greatest diversity of sand flies. Rainfall negatively affected abundance, whereas increased temperature showed a low positive effect. We detected Leishmania amazonensis parasites in Pi. townsendi for the first time.

Leishmania naiffi and lainsoni in French Guiana: Clinical features and phylogenetic variability

In French Guiana, five species are associated with Cutaneous Leishmaniasis (CL). Though infections with Leishmania guyanensis, L. (V.) braziliensis and L. (L.) amazonensis have been extensively described, there are few available clinical and genetic data on L. (V.) lainsoni and L. (V.) naiffi. We determined the clinical and epidemiological features of all cases of CL due to L. (V.) naiffi and L. (V.) lainsoni diagnosed in French Guiana between 2003 and 2019. Phylogenetic analysis was performed by sequencing a portion of HSP70 and cyt b genes. Five cases of L. naiffi and 25 cases of L. lainsoni were reported. Patients infected by L. (V.) lainsoni were usually infected on gold camps, mostly along the Maroni river (60%), while L. naiffi was observed in French patients infected on the coast (100%). A high number of pediatric cases (n = 5; 20%) was observed for L. (V.) lainsoni. A mild clinical course was observed for all cases of L. (V.) naiffi. HSP70 and cyt b partial nucleotide sequence analysis revealed different geographical clusters within L. (V.) naiffi and L. (V.) lainsoni but no association were found between phylogenetic and clinical features. Our data suggest distinct socio-epidemiological features for these two Leishmania species. Patients seem to get infected with L. (V.) naiffi during leisure activities in anthropized coastal areas, while L. (V.) lainsoni shares common features with L. (V.) guyanensis and braziliensis and seems to be acquired during professional activities in primary forest regions. Phylogenetic analysis has provided information on the intraspecific genetic variability of L. (V.) naiffi and L. (V.) lainsoni and how these genotypes are distributed at the geographic level.

Molecular detection of Leishmania infantum in sand flies (Diptera: Psychodidae: Phlebotominae) from Veracruz, Mexico

Phlebotomine sand flies are vectors of Leishmania parasites causing different clinical forms of leishmaniases that represent a serious emerging public health problem worldwide. Mexico harbours a large diversity of sand flies, yet only six species have been considered suspected vectors of Leishmania. The disease has been recorded in 25 states, where the State of Veracruz has recorded the highest number of cases with leishmaniases, although no systematic or epidemiological surveillance studies of Leishmania vectors have been carried out in the region. For that reason, the aim of this study was to perform the molecular detection of Leishmania DNA in phlebotomine sand flies collected from a humid tropical region in Veracruz. We confirmed the presence of Leishmania DNA in eight sand fly species. Sand flies with the highest infection were Psathyromyia aclydifera and Pychodopygus panamensis. This is also the first report of Leishmania DNA in Psathyromyia aclydifera, Psathyromyia carpenteri, Dampfomyia beltrani and Brumptomyia mesai. Our findings highlight the importance of entomological surveys and epidemiological studies, since they enable to determine whether sand fly species may be potential Leishmania vectors in a given area of the Mexico, as transmission dynamics can vary in the different regions.

Increasing putative vector importance of Trichophoromyia phlebotomines (Diptera: Psychodidae)

Despite some phlebotomines being well recognised as vectors of leishmaniasis agents, vector importance of those belonging to the genus Trichophoromyia has not been extensively studied. The present study provides evidence regarding the putative vector role played by some species of Trichophoromyia on leishmanine enzootics, based on literature reports and findings obtained from field experiments conducted in the ecotopes of Pará State, Brazil. The species Th. ubiquitalis, Th. velascoi, Th. auraensis, Th. ininii and Th. brachipyga possess minimal criteria to be included in the list of suspected leishmanine vectors. However, knowledge on man-biting behavior, substantiation of vector competence and determination of epidemiological implications are limited for all of the above mentioned species. Published studies together with present data draw attention to prioritize these phlebotomine species in entomological surveillance programs and studies on experimental susceptibility to Leishmania spp. infection.

Association of Phlebotomus guggisbergi with Leishmania major and Leishmania tropica in a complex transmission setting for cutaneous leishmaniasis in Gilgil, Nakuru county, Kenya

BACKGROUND

Phlebotomus (Larroussius) guggisbergi is among the confirmed vectors for cutaneous leishmaniasis (CL) transmission in Kenya. This scarring and stigmatizing form of leishmaniasis accounts for over one million annual cases worldwide. Most recent CL epidemics in Kenya have been reported in Gilgil, Nakuru County, where the disease has become a public health issue. However, little is known about the factors that drive its transmission. Here, we sought to determine the occurrence, distribution and host blood feeding preference of the vectors, and to identify Leishmania species and infection rates in sandflies using molecular techniques. This information could lead to a better understanding of the disease transmission and improvement of control strategies in the area.

METHODOLOGY/ PRINCIPAL FINDINGS

An entomological survey of sandflies using CDC light traps was conducted for one week per month in April 2016, and in June and July 2017 from five villages of Gilgil, Nakuru county; Jaica, Sogonoi, Utut, Gitare and Njeru. Sandflies were identified to species level using morphological keys and further verified by PCR analysis of cytochrome c oxidase subunit I (COI) gene. Midguts of female sandflies found to harbour Leishmania were ruptured and the isolated parasites cultured in Novy-MacNeal-Nicolle (NNN) media overlaid with Schneider's insect media to identify the species. Leishmania parasite screening and identification in 198 randomly selected Phlebotomus females and parasite cultures was done by PCR-RFLP analysis of ITS1 gene, nested kDNA-PCR and real-time PCR-HRM followed by sequencing. Bloodmeal source identification was done by real-time PCR-HRM of the vertebrate cytochrome-b gene. A total of 729 sandflies (males: n = 310; females: n = 419) were collected from Utut (36.6%), Jaica (24.3%), Sogonoi (34.4%), Njeru (4.5%), and Gitare (0.1%). These were found to consist of nine species: three Phlebotomus spp. and six Sergentomyia spp. Ph. guggisbergi was the most abundant species (75.4%, n = 550) followed by Ph. saevus sensu lato (11.3%, n = 82). Sandfly species distribution across the villages was found to be significantly different (p<0.001) with Jaica recording the highest diversity. The overall Leishmania infection rate in sandflies was estimated at 7.07% (14/198). Infection rates in Ph. guggisbergi and Ph. saevus s.l. were 9.09% (12/132) and 3.57% (2/56) respectively. L. tropica was found to be the predominant parasite in Gilgil with an overall infection rate of 6.91% (13/188) in Ph. guggisbergi (n = 11) and Ph. saevus s.l. (n = 2) sandflies. However, PCR analysis also revealed L. major infection in one Ph. guggisbergi specimen. Bloodmeal analysis in the 74 blood-fed sandflies disclosed a diverse range of vertebrate hosts in Ph. guggisbergi bloodmeals, while Ph. saevus s.l. fed mainly on humans.

CONCLUSIONS/ SIGNIFICANCE

The high infection rates of L. tropica and abundance of Ph. guggisbergi in this study confirms this sandfly as a vector of L. tropica in Kenya. Furthermore, isolation of live L. tropica parasites from Ph. saevus s.l. suggest that there are at least three potential vectors of this parasite species in Gilgil; Ph. guggisbergi, Ph. aculeatus and Ph. saevus s.l. Molecular identification of L. major infections in Ph. guggisbergi suggested this sandfly species as a potential permissive vector of L. major, which needs to be investigated further. Sandfly host preference analysis revealed the possibility of zoonotic transmissions of L. tropica in Gilgil since the main vector (Ph. guggisbergi) does not feed exclusively on humans but also other vertebrate species. Further investigations are needed to determine the potential role of these vertebrate species in L. tropica and L. major transmission in the area.

Data scarcity and ecological complexity: the cutaneous leishmaniasis dynamics in Ecuador

Cutaneous leishmaniasis (CL) is a neglected tropical disease transmitted by species of Phlebotominae sand flies. CL is responsible for more than 1000 reported cases per year in Ecuador. Vector collection studies in Ecuador suggest that there is a strong association between the ecological diversity of an ecosystem, the presence of potential alternative or reservoir hosts and the abundance of sand fly species. Data collected from a coastal community in Ecuador showed that Leishmania parasites may be circulating in diverse hosts, including mammalian and potentially avian species, and these hosts may serve as potential hosts for the parasite. There has been limited reporting of CL cases in Ecuador because the disease is non-fatal and its surveillance system is passive. Hence, the actual incidence of CL is unknown. In this study, an epidemic model was developed and analysed to understand the complexity of CL transmission dynamics with potential non-human hosts in the coastal ecosystem and to estimate critical epidemiological quantities for Ecuador. The model is fitted to the 2010 CL outbreak in the town of Valle Hermoso in the Santo Domingo de los Tsachilas province of Ecuador and parameters such as CL transmission rates in different types of hosts (primary and alternative), and levels of case reporting in the town are estimated. The results suggest that the current surveillance in this region fails to capture 38% (with 95% CI (29%, 47%)) of the actual number of cases under the assumption that alternative hosts are dead-end hosts and that the mean CL reproduction number in the town is 3.9. This means that on the average 3.9 new human CL cases were generated by a single infectious human in the town during the initial period of the 2010 outbreak. Moreover, major outbreaks of CL in Ecuador in coastal settings are unavoidable until reporting through the surveillance system is improved and alternative hosts are managed properly. The estimated infection transmission probabilities from alternative hosts to sand flies, and sand flies to alternative hosts are 27% and 32%, respectively. The analysis highlights that vector control and alternative host management are two effective programmes for Ecuador but need to be implemented concurrently to avoid future major outbreaks.

Ecology and Molecular Detection of Leishmania infantum Nicolle, 1908 (Kinetoplastida: Trypanosomatida) in Wild-Caught Sand Flies (Psychodidae: Phlebotominae) Collected in Porto Alegre, Rio Grande do Sul: A New Focus of Visceral Leishmaniasis in Brazil

Phlebotomine sand flies are hematophagous insect vectors of the protozoan parasites of the genus Leishmania Ross, 1903 (Kinetoplastida: Trypanosomatida) that infect mammals, including humans, causing leishmaniasis. In Porto Alegre, Brazil, three autochthonous cases of human visceral leishmaniasis were reported in 2016 through 2017. We analyzed for the presence of Leishmania DNA in sand flies collected at the neighborhood of Agronomia, Porto Alegre, Brazil. Phlebotomine sand flies were collected at three sites from October 2014 to September 2015. Female sand flies were pooled in numbers from 1 to 20 depending upon species, locality, and date; all were screened for Leishmania infection by the amplification of the ITS1 region. In total 518 phlebotomine sand flies were collected: Psathyromyia lanei (Barretto and Coutinho, 1941) (Diptera: Psychodidae) (30.5%), Brumptomyia sp. (França and Parrrot, 1921) (Diptera: Psychodidae) (25.7%), Migonemyia migonei (Franca, 1920) (Diptera: Psychodidae) (21.4%), Pintomyia fischeri (Pinto, 1926) (Diptera: Psychodidae) (21.4%), and Nyssomyia neivai (Pinto, 1926) (Diptera: Psychodidae) (1.0%). Most sand flies were collected during the hot and rainy season from October 2014 to April 2015. Of the 113 pools analyzed, five pools of Pi. fischeri were PCR-positive with the amplicons possessing sequences similar (>95%) to that of Leishmania infantum Nicolle, 1908 (Kinetoplastida: Trypanosomatida). These results represent the first molecular detection of Le. infantum in Pi. fischeri. It is possible that Pi. fischeri is involved in the transmission cycle of Le. infantum in the studied area; however, further studies are needed to establish the true role of Pi. fischeri in the visceral leismaniasis cycle.

Seroprevalence and risk factors for infection with Bartonella bacilliformis in Loja province, Ecuador

The seroprevalence and epidemiology of Bartonella bacilliformis infection in the Andean highlands of Ecuador is largely unknown. We conducted a sero-epidemiologic survey of 319 healthy children aged 1-15 years living in six rural, mountain communities in Loja Province, Ecuador. Blood was collected by finger stick onto filter paper and dried, and the eluted sera analyzed for antibodies to B. bacilliformis by rPap31 ELISA. Demographic, entomologic, and household variables were assessed to investigate associated risk factors for antibody seropositivity to B. bacilliformis. Seroprevalence of 28% was found among children in the study communities. Increased risk of seropositivity was associated with the presence of lumber piles near houses. Decreased risk of seropositivity was observed with the presence of animal waste and incremental 100 meter increases in elevation. Although investigation of clinical cases of Carrion's disease was not within the scope of this study, our serology data suggest that infection of children with B. bacilliformis is prevalent in this region of Ecuador and is largely unrecognized and undiagnosed. This study highlights the need to further investigate the prevalence, pathogenesis, epidemiology, and disease impact of this pathogen in Ecuador.