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Gelaw YM, Gangneux JP, Alene GD, Robert-Gangneux F, Dawed AA, Hussien M, Enbiale W. Barriers and facilitators of visceral leishmaniasis case management in the Amhara Region, Northwest Ethiopia: an exploratory qualitative study. BMC Public Health 2024; 24:2500. [PMID: 39272019 PMCID: PMC11401257 DOI: 10.1186/s12889-024-20055-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 09/11/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is among the world's most serious public health threats, causing immense human suffering and death. In Ethiopia, little is known about the barriers and facilitators of visceral leishmaniasis case management. This study aimed to explore such barriers and facilitators in the Amhara Regional State, Northwest Ethiopia. METHODS An exploratory qualitative study was conducted on 16 purposively selected patients and key informants from May 8 to June 2, 2023. The study participants were recruited using the maximum variation technique. The interviews were audio recorded, transcribed verbatim, and translated into English. Thematic analysis was employed using Atlas.ti 9 software with a blended approach of both deductive and inductive coding. RESULTS The study identified a variety of issues that hinder the success of visceral leishmaniasis case management. Treatment centers face frequent interruptions of medicinal supplies, a lack of funding, and a lack of trained healthcare providers. A lack of support from health authorities, including weak supervision and feedback systems, is also a source of concern. Most patients receive treatments after significant delays, which is primarily due to low awareness, poor surveillance, and misdiagnosis by healthcare workers. The case management is further constrained by malnutrition, VL-HIV co-infection, and other comorbidities. Despite these issues, we found that effective collaboration between hospital units and VL treatment centers, acceptance by hospitals, and the caring attitude of healthcare workers play a positive role in facilitating the program's effectiveness. CONCLUSIONS Despite the existence of certain efforts that facilitate the program's effectiveness, VL remains largely neglected, with little government attention or intervention. Such inattention is the root cause of most of the issues. Despite limited resources, most issues could be resolved with cost-effective strategies if health authorities at all levels have the will and commitment to do so.
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Affiliation(s)
- Yared Mulu Gelaw
- Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France.
| | - Jean-Pierre Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France
| | - Getu Degu Alene
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Florence Robert-Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France
| | - Adisu Abebe Dawed
- Amhara Regional Health Bureau, Neglected Tropical Disease unit, Bahir Dar, Ethiopia
| | - Mohammed Hussien
- Department of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wendemagegn Enbiale
- Department of Dermatovenerology, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Li J, Liu L, Gao Z, Chuai X, Liu X, Zhang X, Zhang X, Su X, Xu Q, Deng Z. Bronchoalveolar Lavage Fluid Metagenomic Second-Generation Sequencing Assists in Guiding the Treatment of Visceral Leishmaniasis: A Case Report. Infect Drug Resist 2024; 17:3769-3775. [PMID: 39229329 PMCID: PMC11370764 DOI: 10.2147/idr.s468684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 08/19/2024] [Indexed: 09/05/2024] Open
Abstract
Purpose The incidence of visceral leishmaniasis (VL), a global infectious disease, has been on the rise in China's Hebei province. When patients achieve clinical cure, they often do not reach an etiological cure, which may lead to recurrence of the disease. Here, we report a case of visceral leishmaniasis with a negative blood smear and bone marrow cytology. Patients and Methods A 65-year-old man and bronchoalveolar lavage fluid mNGS. Results A 65-year-old man developed a chronic fever, anorexia, splenomegaly, and pancytopenia. The blood metagenomic second-generation sequencing (mNGS) revealed Leishmania sequence readings, which led to the diagnosis of VL. After sodium antimony gluconate treatment, the blood smear and bone marrow cytology revealed no Leishmania bodies. However, pancytopenia and respiratory failure did not fully subside, and cardiotoxic damage emerged. The bronchoalveolar lavage fluid (BALF) mNGS was performed to detect the pathogen. Through BALF mNGS, Leishmania sequence was still detectable. Therefore, after the ECG returned to normal, antimony sodium gluconate was administered as a next course of treatment. Conclusion BALF mNGS may assist in evaluating the therapeutic efficacy of VL with respiratory failure, especially in patients with negative blood and bone marrow cytology.
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Affiliation(s)
- Jian Li
- Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Li Liu
- Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Zhiyun Gao
- Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Xia Chuai
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega Science, Chinese Academy of Sciences, Wuhan, Hubei, People’s Republic of China
| | - Xiaokun Liu
- Department of Ophthalmology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Xiaobo Zhang
- Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Xinyu Zhang
- Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Xiaoqing Su
- Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Qian Xu
- Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Zhuojun Deng
- Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
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Sheikh SY, Hassan F, Shukla D, Bala S, Faruqui T, Akhter Y, Khan AR, Nasibullah M. A review on potential therapeutic targets for the treatment of leishmaniasis. Parasitol Int 2024; 100:102863. [PMID: 38272301 DOI: 10.1016/j.parint.2024.102863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/22/2023] [Accepted: 01/21/2024] [Indexed: 01/27/2024]
Abstract
Leishmania, a protozoan parasite, is responsible for the occurrence of leishmaniasis, a disease that is prevalent in tropical regions. Visceral Leishmaniasis (VL), also known as kala-azar in Asian countries, is one of the most significant forms of VL, along with Cutaneous Leishmaniasis (CL) and Mucocutaneous Leishmaniasis (ML). Management of this condition typically entails the use of chemotherapy as the sole therapeutic option. The current treatments for leishmaniasis present several drawbacks, including a multitude of side effects, prolonged treatment duration, disparate efficacy across different regions, and the emergence of resistance. To address this urgent need, it is imperative to identify alternative treatments that are both safer and more effective. The identification of appropriate pharmacological targets in conjunction with biological pathways constitutes the initial stage of drug discovery. In this review, we have addressed the key metabolic pathways that represent potential pharmacological targets as well as prominent treatment options for leishmaniasis.
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Affiliation(s)
- Sabahat Yasmeen Sheikh
- Department of Chemistry, Integral University, Dasauli, Kursi road, Lucknow 226026, India
| | - Firoj Hassan
- Department of Chemistry, Integral University, Dasauli, Kursi road, Lucknow 226026, India
| | - Deepanjali Shukla
- Department of Chemistry, Integral University, Dasauli, Kursi road, Lucknow 226026, India
| | - Shashi Bala
- Department of Chemistry, Lucknow University, Lucknow 226026, India
| | - Tabrez Faruqui
- Department of Biosciences, Integral University, Lucknow 226026, India
| | - Yusuf Akhter
- Department of Biotechnology, Babasaheb Bhimrao Ambedkar University, Vidya Vihar, Raebareli Road, Lucknow 226025, India
| | - Abdul Rahman Khan
- Department of Chemistry, Integral University, Dasauli, Kursi road, Lucknow 226026, India
| | - Malik Nasibullah
- Department of Chemistry, Integral University, Dasauli, Kursi road, Lucknow 226026, India.
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Na J, Engwerda C. The role of CD4 + T cells in visceral leishmaniasis; new and emerging roles for NKG7 and TGFβ. Front Cell Infect Microbiol 2024; 14:1414493. [PMID: 38881737 PMCID: PMC11176485 DOI: 10.3389/fcimb.2024.1414493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
Visceral leishmaniasis is a potentially devastating neglected tropical disease caused by the protozoan parasites Leishmania donovani and L. infantum (chagasi). These parasites reside in tissue macrophages and survive by deploying a number of mechanisms aimed at subverting the host immune response. CD4+ T cells play an important role in controlling Leishmania parasites by providing help in the form of pro-inflammatory cytokines to activate microbiocidal pathways in infected macrophages. However, because these cytokines can also cause tissue damage if over-produced, regulatory immune responses develop, and the balance between pro-inflammatory and regulatory CD4+ T cells responses determines the outcomes of infection. Past studies have identified important roles for pro-inflammatory cytokines such as IFNγ and TNF, as well as regulatory co-inhibitory receptors and the potent anti-inflammatory cytokine IL-10. More recently, other immunoregulatory molecules have been identified that play important roles in CD4+ T cell responses during VL. In this review, we will discuss recent findings about two of these molecules; the NK cell granule protein Nkg7 and the anti-inflammatory cytokine TGFβ, and describe how they impact CD4+ T cell functions and immune responses during visceral leishmaniasis.
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Affiliation(s)
- Jinrui Na
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Medicine, University of Queensland, Brisbane, QLD, Australia
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Vilas-Boas DF, Nakasone EKN, Gonçalves AAM, Lair DF, de Oliveira DS, Pereira DFS, Silva GG, Conrado IDSS, Resende LA, Zaldívar MF, Mariano RMDS, Dutra WO, Chávez-Fumagalli MA, Galdino AS, Silveira-Lemos D, Giunchetti RC. Global Distribution of Canine Visceral Leishmaniasis and the Role of the Dog in the Epidemiology of the Disease. Pathogens 2024; 13:455. [PMID: 38921753 PMCID: PMC11206782 DOI: 10.3390/pathogens13060455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/15/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Visceral leishmaniasis is a disease caused by protozoa of the species Leishmania (Leishmania) infantum (syn = Leishmania chagasi) and Leishmania (Leishmania) donovani, which are transmitted by hematophagous insects of the genera Lutzomyia and Phlebotomus. The domestic dog (Canis familiaris) is considered the main urban reservoir of the parasite due to the high parasite load on its skin, serving as a source of infection for sandfly vectors and, consequently, perpetuating the disease in the urban environment. Some factors are considered important in the perpetuation and spread of canine visceral leishmaniasis (CVL) in urban areas, such as stray dogs, with their errant behavior, and houses that have backyards with trees, shade, and organic materials, creating an attractive environment for sandfly vectors. CVL is found in approximately 50 countries, with the number of infected dogs reaching millions. However, due to the difficulty of controlling and diagnosing the disease, the number of infected animals could be even greater. In the four continents endemic for CVL, there are reports of disease expansion in endemic countries such as Brazil, Italy, Morocco, and Tunisia, as well as in areas where CVL is not endemic, for example, Uruguay. Socio-environmental factors, such as migration, drought, deforestation, and global warming, have been pointed out as reasons for the expansion into areas where it had been absent. Thus, the objective of this review is to address (i) the distribution of CVL in endemic areas, (ii) the role of the dog in the visceral leishmaniasis epidemiology and the factors that influence dog infection and the spread of the disease, and (iii) the challenges faced in the control of CVL.
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Affiliation(s)
- Diego Fernandes Vilas-Boas
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Eiji Kevin Nakasone Nakasone
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Ana Alice Maia Gonçalves
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Daniel Ferreira Lair
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Diana Souza de Oliveira
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Diogo Fonseca Soares Pereira
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Geralda Gabriele Silva
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Ingrid dos Santos Soares Conrado
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Lucilene Aparecida Resende
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Maykelin Fuentes Zaldívar
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Reysla Maria da Silveira Mariano
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Walderez Ornelas Dutra
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru;
| | - Alexsandro Sobreira Galdino
- Microorganism Biotechnology Laboratory, Federal University of São João Del-Rei (UFSJ), Midwest Campus, Divinópolis 35501-296, MG, Brazil;
| | - Denise Silveira-Lemos
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Rodolfo Cordeiro Giunchetti
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
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Abdullahi B, Mutiso J, Gicheru M. Social Demographic Characteristics Associated with Visceral Leishmaniasis in West Pokot, Kenya. Am J Trop Med Hyg 2024; 110:930-935. [PMID: 38531111 PMCID: PMC11066342 DOI: 10.4269/ajtmh.23-0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 01/14/2024] [Indexed: 03/28/2024] Open
Abstract
Visceral leishmaniasis is a tropical disease with a significant global public health burden. This study aimed to determine the social demographic characteristics associated with visceral leishmaniasis in West Pokot of Kenya. A mixed-methods research design was adopted where household questionnaires and key informant interviews were administered. Quantitative data was analyzed using SPSS version 22, and qualitative data were analyzed to establish patterns for interpretation. Male children aged 10 years or younger were the most infected by Leishmania donovani in the community. The hospital record indicated that 60% of previously treated visceral leishmaniasis patients were severely malnourished during admission. Risk factors associated with the disease included low formal education (adjusted odds ratio [aOR] = 4.39; 95% CI = 1.66-11.59; P <0.05), peasant farming (aOR = 8.49; 95% CI = 2.77-26.00; P <0.05), and dog ownership (aOR = 4.86; 95% CI = 1.87-12.60; P <0.05). Social demographic risk factors for visceral leishmaniasis remain a major public health concern in West Pokot.
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Affiliation(s)
- Bulle Abdullahi
- Department of Community Health and Epidemiology, School of Health Sciences, Kenyatta University, Nairobi, Kenya
| | - Joshua Mutiso
- Department of Zoological Sciences, School of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya
| | - Michael Gicheru
- Department of Zoological Sciences, School of Pure and Applied Sciences, Kenyatta University, Nairobi, Kenya
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Getnet M, Minaye Dejen A, Abebaw D, Fentahun GG, Birhanu E. Diagnostic accuracy of serological rk-39 test for visceral Leishmaniasis: Systematic review and meta-analysis. PLoS Negl Trop Dis 2024; 18:e0011938. [PMID: 38446789 PMCID: PMC10917292 DOI: 10.1371/journal.pntd.0011938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL), or kala-azar, is a vector-borne tropical disease caused by a group of intracellular hemoflagellate protozoa belonging to the family of Trypanosomatide and the genus Leishmania. The disease is distributed around the world and transmitted via the bite of infected female Phlebotomine sandflies, and there is variation in the diagnostic accuracy. Therefore, this systematic review and meta-analysis aimed to determine the pooled global sensitivity and specificity of the rk-39 test and to evaluate if there is a difference between the different parts of the world. METHODS A systematic review and meta-analysis have been conducted on the diagnostic accuracy of dermoscopy. After setting eligibility criteria, literature was searched in four databases and one searching engine. Articles were screened, critically appraised, and extracted independently by two reviewers, and any disagreements were resolved with the involvement of a third person. The quality of the included studies had been assessed by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS 2) tool. Pooled sensitivity and specificity were determined by bivariate random effect analysis. Heterogeneity was assessed by Higgins's I2, and when it was present, mitigation was conducted by using sensitivity analysis. RESULT A total of 409 studies were identified, and finally 18 articles were eligible for the review with a total sample size of 5, 253. The bivariate random effect meta-analysis of the 7 diagnostic accuracy studies showed a pooled sensitivity of 0.89 (0.76-0.95) and specificity of 0.86 (0.72-0.94). The +LR was 6.32 (95% CI: 2.85-14.02), the-LR was 0.13 (95% CI: 0.06-0.30), and the diagnostic odds ratio (DOR) was 47.8 (95% CI: 11.3-203.2). Abdel-Latif (2018) was both an outlier and influential for sensitivity, and Walter (2011) was both an outlier and influential for specificity, and removing them from sensitivity and specificity, respectively, was beneficial for reducing the heterogeneity. CONCLUSION Rk-39 is found to have highly accurate measures in the diagnosis of visceral leishmaniasis. Both sensitivity and specificity were found to be highly accurate in the diagnosis of leishmaniasis, with a pooled sensitivity of 0.91 (0.88-0.93) and a pooled specificity of 0.89 (0.85-0.91). ETHICAL CONSIDERATION As we will use secondary data for the systematic review and meta-analysis, ethical concerns are not necessary.
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Affiliation(s)
- Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Addisu Minaye Dejen
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Pathology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Gedefaw Fentahun
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Emebet Birhanu
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and biostatistics, Institute of public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Rassi Y, Parkhideh SZ, Rafizadeh S, Jalil-Navaz MR. A Comprehensive Review of the Situation of Visceral Leishmaniasis Vectors in Iran. J Arthropod Borne Dis 2024; 18:1-11. [PMID: 39005542 PMCID: PMC11239368 DOI: 10.18502/jad.v18i1.15667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 02/04/2024] [Indexed: 07/16/2024] Open
Abstract
Background This study's major aim is to investigate the situation of visceral leishmaniasis vectors, with a focus on their distribution and relationships to the disease in Iran and some other old-world nations. Methods The terms Iran and the Old World, along with the keywords sand flies, vectors, visceral leishmaniasis, distribution, and Phlebotomus, were searched in electronic databases from 1930 to 2018, including Pub-Med, Web of Science, Google Scholar, and MEDLINE. Results According to the findings, Phlebotomus tobbi was a mountain species, but it was also found in the plains, rodent nests, and rock crevices. This species was considered to be one of the vectors of visceral leishmaniasis in Iran. Phlebotomus kandelakii has been caught in Afghanistan, Iran, Lebanon, Turkey and Georgia. In Iran, the first infection of Phlebotomus kandelakii and Ph. perfiliewi transcaucasicus with Leishmania infantum were reported in northwest of Iran. Phlebotomus major was one of the complex sand flies, and its members include Ph. major (India, Nepal, and Pakistan), Ph. neglectus (Southern Europe, Crimea and Iran), Ph. syriacus (Southwest Asia, Caucasus), Ph. notus (Afghanistan and Iran), Ph. wenyoni (Iran and Iraq), and Ph. wui (China). The first natural infection of Ph. alexandri with Leishmania infantum was reported in 2006 in endemic foci of visceral leishmaniasis in Fars Province, southern Iran. Conclusion The findings of this project suggest that sand fly species of the subgenus Larrousisus play a key role in the transmission of all types of visceral leishmaniasis in Iran.
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Affiliation(s)
- Yavar Rassi
- Department of Vector Biology and Control of Diseases, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Zahra Parkhideh
- Department of Vector Biology and Control of Diseases, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Kumar A. Articulate Chemotherapeutic Strategies for the Development of Effective Drugs against a Fatal Disease, Visceral Leishmaniasis. Curr Drug Discov Technol 2024; 21:e211223224757. [PMID: 38141191 DOI: 10.2174/0115701638277134231218150109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/25/2023]
Abstract
Visceral Leishmaniasis (VL) control relies mainly on chemotherapy in the absence of no effective vaccines. However, available anti-VL drugs are limited in number, having toxicity issues, adverse reactions, low efficacy, and resistance observed against antileishmanial. A significant decrease in efficacy (~tenfold increase in dosage and duration) was reported against the usual treatment with Pentavalent antimonials (the most recommended antileishmanial drug discovered 90 years ago). Amphotericin B is the second line of treatment but limits wider use due to its high cost. Pentamidine is another anti-VL drug, but its therapeutic efficacy has decreased significantly in different areas. These conventional therapeutics for VL have become almost outdated due to a significant increase in therapeutic failure in terms of percentage. Due to this, the search for an effective future anti-VL drug spans several decades, and now it is in high demand in the current situation. Some conventional therapeutics are modified, but they are also not satisfactory. Therefore, this article aimed to discuss conventional and modified therapeutics while emphasizing innovative chemotherapeutic measures against VL that could speed up the slow pace of antileishmanial drugs and overcome the drug resistance problem in the future.
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Affiliation(s)
- Awanish Kumar
- Department of Biotechnology, National Institute of Technology, Raipur, 492010 (CG), India
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10
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Kaye PM, Matlashewski G, Mohan S, Le Rutte E, Mondal D, Khamesipour A, Malvolti S. Vaccine value profile for leishmaniasis. Vaccine 2023; 41 Suppl 2:S153-S175. [PMID: 37951693 DOI: 10.1016/j.vaccine.2023.01.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 11/14/2023]
Abstract
Leishmania infections are global, occurring in 98 countries and all World Health Organization (WHO) regions with 600 million to 1 billion people at risk of infection. Visceral leishmaniasis is associated with almost 20,000 reported deaths annually, with children under 5 years of age being at the greatest risk of mortality. Amongst WHO-recognised Neglected Tropical Diseases (NTDs), leishmaniasis is one of the most important in terms of mortality and morbidity. With an increasing global burden of disease and a growing threat from climate change, urbanisation and drug resistance, there remains an imperative to develop leishmaniasis vaccines. New tools to understand correlates of protection and to assess vaccine efficacy are being developed to ease the transition into larger scale efficacy trials or provide alternate routes to licensure. Early indications suggest a diverse portfolio of manufacturers exists in endemic countries with an appetite to develop leishmaniasis vaccines. This Vaccine Value Profile (VVP) provides a high-level, comprehensive assessment of the currently available data to inform the potential public health, economic, and societal value of leishmaniasis vaccines. The leishmaniasis VVP was developed by a working group of subject matter experts from academia, public health groups, policy organizations, and non-profit organizations. All contributors have extensive expertise on various elements of the leishmaniasis VVP and have collectively described the state of knowledge and identified the current gaps. The VVP was developed using only existing and publicly available information.
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Affiliation(s)
- Paul M Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK.
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada.
| | - Sakshi Mohan
- Center for Health Economics (CHE), University of York, York, UK.
| | - Epke Le Rutte
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Dinesh Mondal
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
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11
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Hotez PJ, Bottazzi ME, Kaye PM, Lee BY, Puchner KP. Neglected tropical disease vaccines: hookworm, leishmaniasis, and schistosomiasis. Vaccine 2023; 41 Suppl 2:S176-S179. [PMID: 38407985 PMCID: PMC10713477 DOI: 10.1016/j.vaccine.2023.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 02/28/2024]
Affiliation(s)
- Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston TX, USA.
| | - Maria Elena Bottazzi
- Texas Children's Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston TX, USA
| | - Paul M Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, Heslington York, UK
| | - Bruce Y Lee
- Center for Advanced Technology and Communication in Health (CATCH), Public Health Informatics Computational and Operations Research (PHICOR), and Department of Health Policy and Management, City University of New York, School of Public Health, New York, NY, USA
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12
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Kumar R, Dahal P, Singh-Phulgenda S, Siddiqui NA, Munir A, Naylor C, Wilson J, Buck G, Rahi M, Malaviya P, Alves F, Sundar S, Ritmeijer K, Stepniewska K, Guérin PJ, Pandey K. Host, parasite and drug determinants of clinical outcomes following treatment of visceral leishmaniasis: a protocol for individual participant data meta-analysis. BMJ Open 2023; 13:e074679. [PMID: 37898487 PMCID: PMC10618999 DOI: 10.1136/bmjopen-2023-074679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/04/2023] [Indexed: 10/30/2023] Open
Abstract
INTRODUCTION Visceral leishmaniasis (VL) is a parasitic disease with an estimated 30 000 new cases occurring annually. There is an observed variation in the efficacy of the current first-line therapies across different regions. Such heterogeneity could be a function of host, parasite and drug factors. An individual participant data meta-analysis (IPD-MA) is planned to explore the determinants of treatment outcomes. METHODS AND ANALYSIS The Infectious Diseases Data Observatory (IDDO) VL living systematic review (IDDO VL LSR) library is an open-access resource of all published therapeutic studies in VL since 1980. For this current review, the search includes all clinical trials published between 1 January 1980 and 2 May 2021. Studies indexed in the IDDO VL LSR library were screened for eligibility for inclusion in this IPD-MA. Corresponding authors and principal investigators of the studies meeting the eligibility criteria for inclusion were invited to be part of the collaborative IPD-MA. Authors agreeing to participate in this collaborative research were requested to share the IPD using the IDDO VL data platform. The IDDO VL data platform currently holds data sets from clinical trials standardised to a common data format and provides a unique opportunity to identify host, parasite and drug determinants of treatment outcomes. Multivariable regression models will be constructed to identify determinants of therapeutic outcomes using generalised linear mixed-effects models accounting for within-study site clustering. ETHICS AND DISSEMINATION This IPD-MA meets the criteria for waiver of ethical review as defined by the Oxford Tropical Research Ethics Committee (OxTREC) granted to IDDO, as the research consists of secondary analysis of existing anonymised data (Exempt granted on 29 March 2023, OxTREC REF: IDDO) Ethics approval was granted by the ICMR-Rajendra Memorial Research Institute of Medical Sciences ethics committee (Letter no: RMRI/EC/30/2022) on 04-07-2022. The results of this IPD-MA will be disseminated at conferences, IDDO website and any peer-reviewed publications. All publications will be open source. Findings of this research will be critically important for the control programmes at regional/global levels, policy makers and groups developing new VL treatments. PROSPERO REGISTRATION CRD42021284622.
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Affiliation(s)
- Rishikesh Kumar
- Indian Council of Medical Research (ICMR)-Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, India
| | - Prabin Dahal
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sauman Singh-Phulgenda
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Niyamat Ali Siddiqui
- Indian Council of Medical Research (ICMR)-Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, India
| | - Abdalla Munir
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Caitlin Naylor
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - James Wilson
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Gemma Buck
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Manju Rahi
- Epidemiology and Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, Delhi, India
| | - Paritosh Malaviya
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Fabiana Alves
- Drugs for Neglected Disease Initiative, Geneva, Switzerland
| | - Shyam Sundar
- Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | | | - Kasia Stepniewska
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Philippe J Guérin
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Krishna Pandey
- Indian Council of Medical Research (ICMR)-Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, India
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Sutrave S, Richter MH. The Truman Show for Human Helminthic Parasites: A Review of Recent Advances in In Vitro Cultivation Platforms. Microorganisms 2023; 11:1708. [PMID: 37512881 PMCID: PMC10384154 DOI: 10.3390/microorganisms11071708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/20/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023] Open
Abstract
Throughout history, parasites and parasitic diseases have been humankind's constant companions, as evidenced by the findings of tapeworm eggs in ancient, mummified remains. Helminths are responsible for causing severe, long-term, and debilitating infectious diseases worldwide, especially affecting economically challenged nations due to prevailing deficits in access to sanitation, proper hygiene practices, and healthcare infrastructure. Socio-ecological drivers, such as poverty, migration, and climate change, continue to contribute to parasites and their disease vectors being spread beyond known endemic zones. The study of parasitic diseases has had a fair amount of success leading to the development of new chemotherapeutic agents and the implementation of parasite eradication programs. However, further progress in this direction has been hampered by the challenges of culturing some of these parasites in in vitro systems for efficient availability, basic life cycle, infection studies, and effectiveness of novel treatment strategies. The complexity of the existing models varies widely, depending on the parasite and its life cycle, ranging from basic culture methods to advanced 3D systems. This review aims to highlight the research conducted so far in culturing and maintaining parasites in an in vitro setting, thereby contributing to a better understanding of pathogenicity and generating new insights into their lifecycles in the hopes of leading to effective treatments and prevention strategies. This work is the first comprehensive outline of existing in vitro models for highly transmissible helminth diseases causing severe morbidity and mortality in humans globally.
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Affiliation(s)
- Smita Sutrave
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
| | - Martin Heinrich Richter
- Department of Biological Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
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Boodman C, van Griensven J, Gupta N, Diro E, Ritmeijer K. Anticipating visceral leishmaniasis epidemics due to the conflict in Northern Ethiopia. PLoS Negl Trop Dis 2023; 17:e0011188. [PMID: 36952454 PMCID: PMC10035745 DOI: 10.1371/journal.pntd.0011188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Affiliation(s)
- Carl Boodman
- Clinical Investigator Program, University of Manitoba, Winnipeg, Canada
- Unit of HIV and Neglected Tropical Diseases, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | - Johan van Griensven
- Unit of HIV and Neglected Tropical Diseases, Institute of Tropical Medicine, Antwerp, Belgium
| | - Nitin Gupta
- Department of Infectious Diseases, Kasturba Medical College, Manipal, India
| | - Ermias Diro
- Department of Internal Medicine, University of Washington, Seattle, United States of America
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Abdulslam Abdullah A, Ahmed M, Gadeed A, Eltayeb A, Ahmed S, Hamad S, Hussein M. Five-year retrospective hospital-based study on epidemiological data regarding human leishmaniasis in West Kordofan state, Sudan. World J Clin Infect Dis 2022; 12:61-68. [DOI: 10.5495/wjcid.v12.i2.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/15/2022] [Accepted: 08/21/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Leishmaniasis is a neglected zoonotic disease, endemic in Sudan. Estimating this disease is very important to inform the health care policymakers and the governments to apply proper health and economic policies.
AIM To find out the frequency and distribution of human leishmaniasis based on sex and age for 5 years in the West Kordofan state, Sudan.
METHODS A 5-year retrospective study from 2016 through 2020 was carried out using local hospital records of leishmaniasis patients. The positive results were recorded after performing at least one of the following leishmaniasis standard tests: direct agglutination test, enzyme-linked immunosorbent assay and leishmania skin test. The sex and age of each patient were recorded. The collected data were analyzed using STATA package version 16.
RESULTS A total of 162443 patient records from 2016 to 2020 were retrieved. Of these, 4.39% were found to be positive for leishmaniasis. The disease has been more common in males (65.3%) than in females (34.7%). The highest reported prevalence (6.58%) was in patients 15-44 years, and the lowest prevalence (1.95%) was among patients ≥ 65 years.
CONCLUSION The results of the current study indicate that leishmaniasis is endemic in the study area even though the numbers of patients in the 5 consecutive years were varying. In addition, the disease was common in males and adults. The interpretation of these findings should take into consideration the absence of information about some important confounding factors.
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Affiliation(s)
- Abdullah Abdulslam Abdullah
- Department of Biomedical Sciences, Faculty of Veterinary Sciences, University of Gadarif, Gadarif 208, Sudan
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo State, Nigeria
| | - Musa Ahmed
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo State, Nigeria
- Department of Veterinary Surgery and Anaesthesia, Faculty of Veterinary Medicine, ALsalam University, Al-fula 120, West Kordofan State, Sudan
| | - Ahmed Gadeed
- Environmental Studies and Research Center, Al-Salam University, Al-fula 120, West Kordofan State, Sudan
| | - Adam Eltayeb
- Environmental Studies and Research Center, Al-Salam University, Al-fula 120, West Kordofan State, Sudan
| | - Safa Ahmed
- Al-Sadaga Hospital, Al-fula 124, West Kordofan State, Sudan
| | - Suad Hamad
- Department of Zoonotic Disease and Disease Control, Ministry of Animal Resources, Al-Hamadi 215, South Kordofan State, Sudan
| | - Mohammed Hussein
- Department of Statistics and Health Information, Ministry of Health, Al-fula 127, West Kordofan State, Sudan
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Makau-Barasa LK, Ochol D, Yotebieng KA, Adera CB, de Souza DK. Moving from control to elimination of Visceral Leishmaniasis in East Africa. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.965609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Visceral leishmaniasis (VL) is arguably one of the deadliest neglected tropical diseases. People in poverty bear the largest burden of the disease. Today, the largest proportion of persons living with VL reside in the Eastern African countries of Ethiopia, Kenya, Somalia, South Sudan, and Sudan. These East African countries are among the top 10 countries reporting the highest number of cases and deaths. If left undiagnosed and untreated, VL almost always results in death. Subsequently, there is a need for integrated efforts across human, animal, and vector-control programs to address the scourge of VL in East Africa. In the East African region, the challenges including socio-cultural beliefs, poor health system, political instability, and limited epidemiological understanding impede the implementation of effective VL control strategies. The availability of funding, as well as diagnostics and treatment options, are also devastatingly limited. Furthermore, given the realities of climate change and population movement in the region, to effectively address the scourge of visceral leishmaniasis in East Africa, a regional approach is imperative. In this paper, we highlight some of the key challenges and opportunities to effectively move towards an effective control, and eventually elimination, of VL in East Africa. To do this, we underline the need for a fully integrated program in East Africa, inclusive of effective diagnostics and treatment, to effectively reduce and eliminate the burden of VL in the region, subsequently paving the way to achieve global elimination goals.
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Naylor-Leyland G, Collin SM, Gatluak F, den Boer M, Alves F, Mullahzada AW, Ritmeijer K. The increasing incidence of visceral leishmaniasis relapse in South Sudan: A retrospective analysis of field patient data from 2001-2018. PLoS Negl Trop Dis 2022; 16:e0010696. [PMID: 35981057 PMCID: PMC9426874 DOI: 10.1371/journal.pntd.0010696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 08/30/2022] [Accepted: 07/23/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Visceral Leishmaniasis (VL) is endemic in South Sudan, manifesting periodically in major outbreaks. Provision of treatment during endemic periods and as an emergency response is impeded by instability and conflict. Médecins Sans Frontières (MSF) has provided health care in South Sudan since the late 1980's, including treatment for 67,000 VL patients. In recent years, MSF monitoring data have indicated increasing numbers of VL relapse cases. A retrospective analysis of these data was performed in order to provide insight into the possible causes of this increase. METHODOLOGY/PRINCIPAL FINDINGS Programme monitoring data from the MSF hospital in Lankien, Jonglei State, South Sudan, for the period 2001-2018 were analysed to detect trends in VL relapse as a proportion of all VL cases presenting to MSF treatment centres. Routinely collected patient-level data from relapse and primary VL cases treated at all MSF sites in South Sudan over the same period were analysed to describe patient characteristics and treatments received. VL relapse as a proportion of all VL cases increased by 6.5% per annum (95% CI 0.3% to 13.0%, p = 0.04), from 5.2% during 2001-2003 to 14.4% during 2016-2018. Primary VL and VL relapse patients had similar age, sex and anthropometric characteristics, the latter indicating high indices of undernutrition which were relatively constant over time. Clinical factors (Hb, spleen size, and VL severity score) also did not vary substantially over time. SSG/PM was the main treatment regimen from 2001-2018, used in 68.7% of primary and 70.9% of relapse VL cases; AmBisome was introduced in 2013, received by 22.5% of primary VL and 32.6% of VL relapse cases from 2013-2018. CONCLUSION Increasing incidence of VL relapse in South Sudan does not appear to be explained by changes in patient characteristics or other factors. Our data are concerning and may indicate an emergence of treatment-resistant parasite strains, decreasing the effectiveness of treatment regimens. This warrants further investigation as a causal factor. New chemical entities that will enable safe and highly effective short-course oral treatments for VL are urgently needed.
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Affiliation(s)
| | - Simon M. Collin
- UK Health Security Agency (UKHSA), London, United Kingdom
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | | | - Fabiana Alves
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
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Ahmed M, Abdulslam Abdullah A, Bello I, Hamad S, Bashir A. Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis. World J Methodol 2022; 12:305-318. [PMID: 36159098 PMCID: PMC9350725 DOI: 10.5662/wjm.v12.i4.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/31/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There are three main forms of leishmaniasis in humans: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), and mucocutaneous leishmaniasis. The prevalence of human leishmaniasis varies widely in different countries and different regions of the same country. To date, there is no overall estimation of the prevalence of human leishmaniasis in Sudan.
AIM To determine the pooled prevalence of human leishmaniasis and the disease risk factors among Sudanese citizens.
METHODS From all articles written in English or Arabic languages conducted before the 4th of August 2021 from [Scopus, Web of Science, PubMed, and MEDLINE, African Journals Online (AJOL), ResearchGate, direct Google search, Google Scholar, and universities websites], just 20 articles with a total of 230960 participants were eligible for this study. Data synthesis and analysis were done using STATA software, version 16. EndNote citation manager version X9.3.3 and Reference Citation Analysis (RCA) were used to remove the duplicated studies and manage the citation respectively.
RESULTS The overall pooled prevalence of human leishmaniasis in Sudan was 21% (with confidence interval 12%-30%). CL was the most common type of leishmaniasis in Sudan, with a pooled prevalence of 26% followed by VL (18%). Nevertheless, the pooled prevalence of human leishmaniasis in Sudan was higher in males compared with females (60% vs 40%). The current results revealed that the people in the age group between 15 and 44 were the most affected group (60%), and central Sudan has the highest pooled prevalence of human leishmaniasis (27%) compared with other regions of Sudan. Finally, the prevalence of human leishmaniasis seems to decrease with time.
CONCLUSION This study showed that human leishmaniasis infection is still endemic in many regions in Sudan and highly prevalent in central and eastern Sudan, and CL is the most prevalent in the country. Males and adults were more susceptible to infection compared with females and children. However, the human leishmaniasis prevalence decreased relatively over time.
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Affiliation(s)
- Musa Ahmed
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Veterinary Surgery and Anaesthesia, Faculty of Veterinary Medicine, ALsalam University, Al-fula 120, West Kordofan state, Sudan
| | - Abdullah Abdulslam Abdullah
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Biomedical Sciences, Faculty of Veterinary Sciences, University of Gadarif, Gadarif 208, Sudan
| | - Idris Bello
- Department of Reproductive Health Sciences, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan 119, Oyo state, Nigeria
- Department of Animal Health and Production Technology, Oyo State College of Agriculture and Technology, Igboora 120, Oyo state, Nigeria
| | - Suad Hamad
- Department of Zoonotic Disease and Disease Control, Ministry of Animal Resources, Al-Hamadi 215, South Kordofan state, Sudan
| | - Aboelgassim Bashir
- Department of Pre-Clinical Sciences, Faculty of Veterinary Medicine, AL-Salam University, Al-Fulla 209, West Kordofan state, Sudan
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Transmission Risk Prediction and Evaluation of Mountain-Type Zoonotic Visceral Leishmaniasis in China Based on Climatic and Environmental Variables. ATMOSPHERE 2022. [DOI: 10.3390/atmos13060964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
With global warming and socioeconomic developments, there is a tendency toward the emergence and spread of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in China. Timely identification of the transmission risk and spread of MT-ZVL is, therefore, of great significance for effectively interrupting the spread of MT-ZVL and eliminating the disease. In this study, 26 environmental variables—namely, climatic, geographical, and 2 socioeconomic indicators were collected from regions where MT-ZVL patients were detected during the period from 2019 to 2021, to create 10 ecological niche models. The performance of these ecological niche models was evaluated using the area under the receiver-operating characteristic curve (AUC) and true skill statistic (TSS), and ensemble models were created to predict the transmission risk of MT-ZVL in China. All ten ecological niche models were effective at predicting the transmission risk of MT-ZVL in China, and there were significant differences in the mean AUC (H = 33.311, p < 0.05) and TSS values among these ten models (H = 26.344, p < 0.05). The random forest, maximum entropy, generalized boosted, and multivariate adaptive regression splines showed high performance at predicting the transmission risk of MT-ZVL (AUC > 0.95, TSS > 0.85). Ensemble models predicted a transmission risk of MT-ZVL in the provinces of Shanxi, Shaanxi, Henan, Gansu, Sichuan, and Hebei, which was centered in Shanxi Province and presented high spatial clustering characteristics. Multiple ensemble ecological niche models created based on climatic and environmental variables are effective at predicting the transmission risk of MT-ZVL in China. This risk is centered in Shanxi Province and tends towards gradual radiation dispersion to surrounding regions. Our results provide insights into MT-ZVL surveillance in regions at high risk of MT-ZVL.
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An In-depth Proteomic Map of Leishmania donovani Isolate from Post Kala-azar Dermal Leishmaniasis (PKDL) Patient. Acta Parasitol 2022; 67:687-696. [PMID: 35020128 DOI: 10.1007/s11686-021-00511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/09/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND The trypanosomatid protozoan parasite Leishmania donovani is the etiological agent of visceral leishmaniasis (VL) or kala-azar. The patients that have undergone treatment may still harbor the parasite and in a small fraction of the patients the disease re-erupts in the form of post kala-azar dermal leishmaniasis (PKDL). PKDL is a pathological condition found to be intermediate between VL and complete cure of VL. The PKDL disease progression is determined by the host immune response to L. donovani. The majority of the proteomic studies on L. donovani till date have been undertaken on parasites either isolated from kala-azar patients or on established laboratory strains of L. donovani. However, no proteomic information is available on the cutaneous localized isolates of L. donovani from PKDL patients. METHODS The promastigote stage of L. donovani isolate from PKDL patient was cultured and harvested. The cell lysates were trypsin digested, followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. The LC-MS/MS raw data were analyzed on Proteome Discoverer. Further bioinformatics analysis was carried out. RESULTS In the present, we have used high-resolution mass spectrometry to map the global proteome of a L. donovani isolate from PKDL patient. This in-depth study resulted in the identification of 5537 unique proteins from PKDL isolate of L. donovani which covered 64% of its proteome. OUTCOME This study also identified proteins previously shown to be upregulated in PKDL L. donovani. This is the most in-depth proteome of Leishmania donovani parasite till date.
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Leishmaniasis in Cameroon and neighboring countries: An overview of current status and control challenges. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2022; 2:100077. [PMID: 36589871 PMCID: PMC9795355 DOI: 10.1016/j.crpvbd.2022.100077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 01/04/2023]
Abstract
Leishmaniasis causes the ninth largest disease burden among infectious diseases but remains a very neglected tropical disease. Although the disease is endemic in Cameroon and some neighboring countries, data on its epidemiology are very scanty. The present review summarizes the available information on leishmaniasis in the central region of Africa. According to available records, Cameroon, Chad and Nigeria have been identified as endemic foci of both cutaneous (CL) and visceral leishmaniasis (VL). In addition, the phlebotomine vectors of leishmaniasis have been reported in these three countries and also in Congo and the Central African Republic. Although Gabon, Central African Republic, Equatorial Guinea and Congo are all situated next to the above leishmaniasis-endemic countries and are characterized by similar landscapes and vegetation, they lack published reports of autochthonous cases of leishmaniasis. Considering that many cases of the disease might remain unreported, it might not be an overstatement to recommend that research should be carried out in Gabon, Equatorial Guinea, Central African Republic and Congo to identify cases of leishmaniasis (CL and/or VL), the parasite and vector species, and the mammalian reservoir host. This review updates data on leishmaniasis and its insect vector in the geographical region of Central Africa. Such updates are basic requirement for the development of successful control programmes in individual countries and the whole region. In order to address the shortcomings identified in the present review, the authors recommend training of more scientists in leishmaniasis epidemiology in the region that should be accompanied by necessary funding. This training must be multidisciplinary and include development of laboratory and field skills for studies of the parasite, the vector, the reservoir, the vegetation and the soil in potential endemic foci. In addition, prospective studies involving geographers and other experts should develop a disease risk map of the Central Africa region.
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22
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Hagos DG, Schallig HDFH, Kiros YK, Abdulkadir M, Wolday D. Performance of rapid rk39 tests for the diagnosis of visceral leishmaniasis in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:1166. [PMID: 34789175 PMCID: PMC8600897 DOI: 10.1186/s12879-021-06826-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Visceral Leishmaniasis (VL) is a severely neglected disease affecting millions of people with high mortality if left untreated. In Ethiopia, the primary laboratory diagnosis of VL is by using an antigen from a 39-amino acid sequence repeat of a kinesin-related (rK39) of leishmania donovani complex (L. donovani), rapid diagnostic tests (RDT). Different rk39 RDT brands are available with very variable performance and studies from Ethiopia showed a very wide range of sensitivity and specificity. Therefore, a systematic review and meta-analysis were conducted to determine the pooled sensitivity and specificity of rk39 RDT in Ethiopia. Method PUBMED, EMBASE, and other sources were searched using predefined search terms to retrieve all relevant articles from 2007 to 2020. Heterogeneity was assessed by visually inspecting summary receiver operating curves (SROC), Spearman correlation coefficient (rs), Cochran Q test statistics, inconsistency square (I2) and subgroup analysis. The presence and statistical significance of publication bias were assessed by Egger's test at p < 0.05, and all the measurements showed the presence of considerable heterogeneity. Quality assessment of diagnostic accuracy studies (QUADAS-2) checklists was used to check the qualities of the study. Results A total of 664 articles were retrieved, and of this 12 articles were included in the meta-analysis. Overall pooled sensitivity and specificity of the rk39 RDT to diagnose VL in Ethiopia were 88.0% (95% CI 86.0% to 89.0%) and 84.0% (95% CI 82.0% to 86.0%), respectively. The sensitivity and specificity of the rk39 RDT commercial test kits were DiaMed: 86.9% (95% CI 84.3% to 89.1%) and 82.2% (95% CI 79.3% to 85.0%), and InBios: 80.0% (95% CI 77.0% to 82.8%) and 97.4% (95% CI 95.0% to 98.8%), respectively. Conclusion Referring to our result, rk39 RDT considered an essential rapid diagnostic test for VL diagnosis. Besides to the diagnostic accuracy, the features such as easy to perform, quick (10–20 min), cheap, equipment-free, electric and cold chain free, and result reproducibility, rk39 RDT is advisable to remains in practice as a diagnostic test at least in the remote VL endemic localities till a better test will come.
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Affiliation(s)
- Dawit Gebreegziabiher Hagos
- College of Health Sciences, School of Medicine, Department of Medical Microbiology and Immunology, Mekelle University, Mekelle, Ethiopia. .,Academic Medical Centre at the University of Amsterdam, Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Henk D F H Schallig
- Academic Medical Centre at the University of Amsterdam, Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Yazezew K Kiros
- College of Health Sciences, School of Medicine, Department of Internal Medicine, Mekelle University, Mekelle, Ethiopia
| | - Mahmud Abdulkadir
- College of Health Sciences, School of Medicine, Department of Medical Microbiology and Immunology, Mekelle University, Mekelle, Ethiopia
| | - Dawit Wolday
- College of Health Sciences, School of Medicine, Mekelle University, Mekelle, Ethiopia
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Towards global control of parasitic diseases in the Covid-19 era: One Health and the future of multisectoral global health governance. ADVANCES IN PARASITOLOGY 2021; 114:1-26. [PMID: 34696842 PMCID: PMC8503781 DOI: 10.1016/bs.apar.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human parasitic infections—including malaria, and many neglected tropical diseases (NTDs)—have long represented a Gordian knot in global public health: ancient, persistent, and exceedingly difficult to control. With the coronavirus disease (Covid-19) pandemic substantially interrupting control programmes worldwide, there are now mounting fears that decades of progress in controlling global parasitic infections will be undone. With Covid-19 moreover exposing deep vulnerabilities in the global health system, the current moment presents a watershed opportunity to plan future efforts to reduce the global morbidity and mortality associated with human parasitic infections. In this chapter, we first provide a brief epidemiologic overview of the progress that has been made towards the control of parasitic diseases between 1990 and 2019, contrasting these fragile gains with the anticipated losses as a result of Covid-19. We then argue that the complementary aspirations of the United Nations Sustainable Development Goals (SDGs) and the World Health Organization (WHO)’s 2030 targets for parasitic disease control may be achieved by aligning programme objectives within the One Health paradigm, recognizing the interdependence between humans, animals, and the environment. In so doing, we note that while the WHO remains the preeminent international institution to address some of these transdisciplinary concerns, its underlying challenges with funding, authority, and capacity are likely to reverberate if left unaddressed. To this end, we conclude by reimagining how models of multisectoral global health governance—combining the WHO's normative and technical leadership with greater support in allied policy-making areas—can help sustain future malaria and NTD elimination efforts.
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Recurrence and Driving Factors of Visceral Leishmaniasis in Central China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189535. [PMID: 34574459 PMCID: PMC8468393 DOI: 10.3390/ijerph18189535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 01/17/2023]
Abstract
Visceral leishmaniasis (VL) is an important vector-borne zoonosis caused by Leishmania spp. that has been spreading in China. It has been posing a significant risk to public health in central China due to its recurrence in recent decades. Yet, the spatiotemporal patterns and the driving factors of VL in central China remain unclear at present. The purpose of this study was to analyse spatiotemporal distribution, explore driving factors, and provide novel insight into prevention and control countermeasures of the VL spreading in central China. Based on data of human VL cases from 2006 to 2019 obtained from the Chinese Centres for Disease Control and Prevention (CDC), we depicted the map showing the spatiotemporal distribution of VL in central China. We further explored the driving factors contributing to the spread of VL through the general additive model (GAM) by combining maps of environmental, meteorological, and socioeconomic correlates. Most VL cases were reported in Shaanxi and Shanxi provinces, the number of which has been increasing every year in the last 14 years, from 3 new cases in 2006 to 101 new cases in 2019. The results of GAM revealed that environmental (i.e., changes in grasslands/forests), meteorological (i.e., temperature and relative humidity), and socioeconomic (i.e., population density) factors are significantly associated with the prevalence of VL in central China. Our results provide a better understanding regarding the current situation and the driving factors of VL in central China, assisting in developing the disease prevention and control strategies implemented by public health authorities.
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Almutairi H, Urbaniak MD, Bates MD, Jariyapan N, Kwakye-Nuako G, Thomaz Soccol V, Al-Salem WS, Dillon RJ, Bates PA, Gatherer D. Chromosome-scale genome sequencing, assembly and annotation of six genomes from subfamily Leishmaniinae. Sci Data 2021; 8:234. [PMID: 34489462 PMCID: PMC8421402 DOI: 10.1038/s41597-021-01017-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022] Open
Abstract
We provide the raw and processed data produced during the genome sequencing of isolates from six species of parasites from the sub-family Leishmaniinae: Leishmania martiniquensis (Thailand), Leishmania orientalis (Thailand), Leishmania enriettii (Brazil), Leishmania sp. Ghana, Leishmania sp. Namibia and Porcisia hertigi (Panama). De novo assembly was performed using Nanopore long reads to construct chromosome backbone scaffolds. We then corrected erroneous base calling by mapping short Illumina paired-end reads onto the initial assembly. Data has been deposited at NCBI as follows: raw sequencing output in the Sequence Read Archive, finished genomes in GenBank, and ancillary data in BioSample and BioProject. Derived data such as quality scoring, SAM files, genome annotations and repeat sequence lists have been deposited in Lancaster University's electronic data archive with DOIs provided for each item. Our coding workflow has been deposited in GitHub and Zenodo repositories. This data constitutes a resource for the comparative genomics of parasites and for further applications in general and clinical parasitology.
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Affiliation(s)
- Hatim Almutairi
- Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YT, UK
- Ministry of Health, Riyadh, Saudi Arabia
| | - Michael D Urbaniak
- Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YT, UK
| | - Michelle D Bates
- Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YT, UK
| | - Narissara Jariyapan
- Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Godwin Kwakye-Nuako
- Department of Biomedical Sciences, School of Allied Health Sciences, College of Health & Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Vanete Thomaz Soccol
- Laboratório de Biologia Molecular, Programa de Pós Graduação em Engenharia de Bioprocessos e Biotecnologia, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Rod J Dillon
- Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YT, UK
| | - Paul A Bates
- Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YT, UK
| | - Derek Gatherer
- Division of Biomedical & Life Sciences, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YT, UK.
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Hajjaran H, Saberi R, Borjian A, Fakhar M, Hosseini SA, Ghodrati S, Mohebali M. The Geographical Distribution of Human Cutaneous and Visceral Leishmania Species Identified by Molecular Methods in Iran: A Systematic Review With Meta-Analysis. Front Public Health 2021; 9:661674. [PMID: 34249836 PMCID: PMC8267797 DOI: 10.3389/fpubh.2021.661674] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/31/2021] [Indexed: 01/11/2023] Open
Abstract
Leishmaniasis is one of the most common vector-borne parasitic diseases in Iran. Leishmania species identification is necessary for epidemiological aspects, precise prognosis, control and treatment of the disease. We systematically searched all the studies, reports, and documentation related to species identification and geographical distribution of causative agents of cutaneous (CL), mucosal (ML), and visceral leishmaniasis (VL) using DNA-based molecular diagnostic techniques in Iran. International databases including PubMed, ScienceDirect, Embase, Google Scholar, Scopus, and Web of Science were systemically searched for English articles and Iran's databases including SID, IranMedex and Magiran were searched for Persian reports and articles. Searches were performed from 1999 to 2019 (20 years). The current review was conducted using the keywords: cutaneous leishmaniasis, visceral leishmaniasis, Leishmania species, Human, Molecular, PCR, and Iran. The study quality was evaluated using the NOS checklist. This meta-analysis procedure was accomplished using STATA, version 2.7.9. Of the 3,426 records identified in the initial search, 154 articles met inclusion criteria and qualified for the systematic review and meta-analysis. In subgroup analysis, the pooled frequency of causative agents of CL isolates was 67.3% (95% CI: 59.51–74.67%) for L. major and 32.1% (95% CI: 24.72–39.87%) for L. tropica. In addition, the pooled frequency of causative agents of VL isolates was 97.1% (95% CI: 94.6–98.8%) for L. infantum and 2.9% (95% CI: 1.12–5.37%) for L. tropica. The findings of this study showed that the main causative agents of CL and VL in Iran are L. major and L. infantum, respectively. Moreover, kinetoplast DNA (kDNA) and internal transcriber spacer (ITS) were the most used markers for identifying Leishmania species. The current study provides valuable data to encourage and direct researchers as well as public health managers in the comprehensive leishmaniasis control and prevention planning in Iran.
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Affiliation(s)
- Homa Hajjaran
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Saberi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Borjian
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Hosseini
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sajjad Ghodrati
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Grifferty G, Shirley H, McGloin J, Kahn J, Orriols A, Wamai R. Vulnerabilities to and the Socioeconomic and Psychosocial Impacts of the Leishmaniases: A Review. Res Rep Trop Med 2021; 12:135-151. [PMID: 34188584 PMCID: PMC8236266 DOI: 10.2147/rrtm.s278138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/06/2021] [Indexed: 11/23/2022] Open
Abstract
The leishmaniases are a group of four vector-borne neglected tropical diseases (NTDs) with 1.6 billion people in some 100 countries at risk. They occur in certain eco-epidemiological foci that reflect manipulation by human activities, such as migration, urbanization and deforestation, of which poverty, conflict and climate change are key drivers. Given their synergistic impacts, risk factors and the vulnerabilities of poor populations and the launch of a new 2030 roadmap for NTDs in the context of the global sustainability agenda, it is warranted to update the state of knowledge of the leishmaniases and their effects. Using existing literature, we review socioeconomic and psychosocial impacts of leishmaniasis within a framework of risk factors and vulnerabilities to help inform policy interventions. Studies show that poverty is an overarching primary risk factor. Low-income status fosters inadequate housing, malnutrition and lack of sanitation, which create and exacerbate complexities in access to care and treatment outcomes as well as education and awareness. The co-occurrence of the leishmaniases with malnutrition and HIV infection further complicate diagnosis and treatment, leading to poor diagnostic outcomes and therapeutic response. Even with free treatment, households may suffer catastrophic health expenditure from direct and indirect medical costs, which compounds existing financial strain in low-income communities for households and healthcare systems. The dermatological presentations of the leishmaniases may result in long-term severe disfigurement, leading to stigmatization, reduced quality of life, discrimination and mental health issues. A substantial amount of recent literature points to the vulnerability pathways and burden of leishmaniasis on women, in particular, who disproportionately suffer from these impacts. These emerging foci demonstrate a need for continued international efforts to address key risk factors and population vulnerabilities if leishmaniasis control, and ultimately elimination, is to be achieved by 2030.
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Affiliation(s)
- Grace Grifferty
- Department of Biology, Northeastern University, College of Science, Boston, MA, USA
| | - Hugh Shirley
- Department of Biochemistry, Northeastern University, College of Science, Boston, MA, USA.,Program in Medical Education, Harvard Medical School, Boston, MA, USA
| | - Jamie McGloin
- Department of Health Sciences, Northeastern University, Bouvé College of Health Sciences, Boston, MA, USA
| | - Jorja Kahn
- Department of Behavioral Neuroscience, Northeastern University, College of Science, Boston, MA, USA
| | - Adrienne Orriols
- Department of Behavioral Neuroscience, Northeastern University, College of Science, Boston, MA, USA
| | - Richard Wamai
- Department of Cultures, Societies and Global Studies, Northeastern University, College of Social Sciences and Humanities, Integrated Initiative for Global Health, Boston, MA, USA
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Hao Y, Hu X, Gong Y, Xue J, Zhou Z, Li Y, Wang Q, Zhang Y, Li S. Spatio-temporal clustering of Mountain-type Zoonotic Visceral Leishmaniasis in China between 2015 and 2019. PLoS Negl Trop Dis 2021; 15:e0009152. [PMID: 33750970 PMCID: PMC8016304 DOI: 10.1371/journal.pntd.0009152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/01/2021] [Accepted: 01/15/2021] [Indexed: 01/04/2023] Open
Abstract
With several decades of concerted control efforts, visceral leishmaniasis(VL) eradication had almost been achieved in China. However, VL cases continue to be detected in parts of western China recent years. Using data of reported cases, this study aimed to investigate the epidemiology and spatio⁃temporal distribution, of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in China between the years 2015 and 2019. Epidemiological data pertaining to patients with visceral leishmaniasis (VL) were collected in Gansu, Shaanxi, Sichuan, Shanxi, Henan and Hebei provinces between the years 2015 and 2019. Joinpoint regression analysis was performed to determine changes in the epidemic trend of MT-ZVL within the time period during which data was collected. Spatial autocorrelation of infection was examined using the Global Moran's I statistic wand hotspot analysis was carried out using the Getis-Ord Gi* statistic. Spatio-temporal clustering analysis was conducted using the retrospective space-time permutation flexible spatial scanning statistics. A total of 529 cases of MT-ZVL were detected in the six provinces from which data were collected during the study time period, predominantly in Gansu (55.0%), Shanxi (21.7%), Shaanxi (12.5%) and Sichuan (8.9%) provinces. A decline in VL incidence in China was observed during the study period, whereas an increase in MT-ZVL incidence was observed in the six provinces from which data was obtained (t = 4.87, P < 0.05), with highest incidence in Shanxi province (t = 16.91, P < 0.05). Significant differences in the Moran's I statistic were observed during study time period (P < 0.05), indicating spatial autocorrelation in the spatial distribution of MT-ZVL. Hotspot and spatial autocorrelation analysis revealed clustering of infection cases in the Shaanxi-Shanxi border areas and in east of Shanxi province, where transmission increased rapidly over the study duration, as well as in well know high transmission areas in the south of Gansu province and the north of the Sichuan province. It indicates resurgence of MT-ZVL transmission over the latter three years of the study. Spatial clustering of infection was observed in localized areas, as well as sporadic outbreaks of infection.
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Affiliation(s)
- Yuwan Hao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Xiaokang Hu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Yanfeng Gong
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Jingbo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Zhengbin Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Yuanyuan Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Qiang Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Yi Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research-School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shizhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; National Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research-School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Jones CM, Welburn SC. Leishmaniasis Beyond East Africa. Front Vet Sci 2021; 8:618766. [PMID: 33732738 PMCID: PMC7959848 DOI: 10.3389/fvets.2021.618766] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/15/2021] [Indexed: 01/25/2023] Open
Abstract
Climate change is having a substantial impact on our environment and ecosystems and has altered the way humans live, access, and utilize resources with increased risk of zoonotic infectious disease encounters. As global temperatures continue to increase, they impact on public health, migration, food security and land conflict, and as new environments become favorable, exposure to disease carrying vectors. Increased forests or natural habitat clearance for land repurposing, urbanization, road building, and water management are related to an increase in emerging vector borne parasitic diseases. The East African region remains one of the most impacted regions globally for leishmaniasis, a vector borne disease that impacts significantly on the health, wellbeing and livelihoods of affected communities and for which a lack of reporting and control interventions hinder progress toward elimination of this neglected tropical disease. As our world continues to transform, both politically and climatically, it is essential that measures are put in place to improve surveillance and disease management with implementation of control measures, including vector control, especially in low- and middle-income countries that are expected to be most impacted by changes in climate. Only through effective management, now, can we be sufficiently resilient to preventing the inevitable spread of vectors into suitable habitat and expansion of the geographical range of leishmaniasis. This review offers a current perspective on Leishmaniasis as an endemic disease in East Africa and examines the potential of the recent emergence of Leishmania infection in hitherto unaffected regions to become a public health concern if no disease management is achieved.
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Affiliation(s)
- Caitlin M Jones
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, International Campus, Zhejiang University, Haining, China.,Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Susan C Welburn
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, International Campus, Zhejiang University, Haining, China.,Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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Rossi IV, Ferreira Nunes MA, Vargas-Otalora S, da Silva Ferreira TC, Cortez M, Ramirez MI. Extracellular Vesicles during TriTryps infection: Complexity and future challenges. Mol Immunol 2021; 132:172-183. [PMID: 33601226 DOI: 10.1016/j.molimm.2021.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/24/2022]
Abstract
The trypanosomatid pathogens Leishmania spp., Trypanosoma cruzi, and Trypanosoma brucei, currently grouped as TriTryps, have evolved through the time to overcome the upfront innate immune response and establish the infection in humans adapting many aspects of the parasite-cell host interaction. Extracellular vesicles (EVs) emerge as critical structures carrying different key molecules from parasites and target cells that interact continuously during infection. Current information regarding the structure and composition of these vesicles provide new insights into the primary role of TriTryps-EVs reviewed in this work. Expanding knowledge about these critical vesicular structures will promote advances in basic sciences and in translational applications controlling pathogenesis in the neglected tropical diseases caused by TriTryps.
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Affiliation(s)
- Izadora Volpato Rossi
- Cell and Molecular Biology program, Federal University of Paraná, Curitiba, PR, Brazil
| | | | - Sandra Vargas-Otalora
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | | | - Mauro Cortez
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil.
| | - Marcel Ivan Ramirez
- Oswaldo Cruz Institute, Rio de Janeiro, RJ, Brazil; Department of Biochemistry, Federal University of Paraná, Curitiba, PR, Brazil.
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Goyal DK, Keshav P, Kaur S. Adjuvanted vaccines driven protection against visceral infection in BALB/c mice by Leishmania donovani. Microb Pathog 2021; 151:104733. [PMID: 33484811 DOI: 10.1016/j.micpath.2021.104733] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/19/2020] [Accepted: 01/02/2021] [Indexed: 11/30/2022]
Abstract
Kinteoplastid protozoan parasite of genus Leishmania is the pathogen that causes leishmaniasis. Its prevalence is highest after malaria and visceral leishmaniasis is the most dreaded form of infection. No vaccine is available for the disease management and it relies wholly on a few chemotherapeutic agents which are toxic and besides drug resistance their costs are the limitations. Therefore, development of an effective vaccine is urgently required. In this study, Montanide ISA 201 and AddaVax were assessed for their adjuvant potential along with formalin-inactivated or killed vaccine for the immune induction. Immunological and parasitological studies were conducted to evaluate the efficacy of different vaccine formulations in BALB/c mice before challenge infection as well as 4, 8, and 12 weeks after challenge. The efficacy of vaccines was evidenced with reduced parasite burden, the higher DTH response, Th1 cytokines, and IgG2a isotype antibody in immunized mice. All the vaccines showed their potential against Leishmania donovani infection and vaccine formulated with Montanide ISA 201 exhibited maximum efficacy. Our results suggest the potential of these vaccine formulations in controlling Leishmania infection.
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Affiliation(s)
- Deepak Kumar Goyal
- Parasitology Laboratory, Department of Zoology (UGC-CAS), Panjab University, Chandigarh, 160014, India
| | - Poonam Keshav
- Parasitology Laboratory, Department of Zoology (UGC-CAS), Panjab University, Chandigarh, 160014, India
| | - Sukhbir Kaur
- Parasitology Laboratory, Department of Zoology (UGC-CAS), Panjab University, Chandigarh, 160014, India.
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Henke O, Mapendo PJ, Mremi A, Mmbaga LG, Pallangyo AE, Harbaum T, Mkwizu E. Skin maculae, chronic diarrhea, cachexia, and splenomegaly-Late presentation of the first autochthonous case of visceral leishmaniasis in Tanzania. PLoS Negl Trop Dis 2021; 15:e0008925. [PMID: 33444339 PMCID: PMC7808674 DOI: 10.1371/journal.pntd.0008925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 20-year-old man from Simanjiro district in northern Tanzania presented with a 3-year history of splenomegaly, fatigue, cachexia, skin maculae, and recent onset of watery diarrhea at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. Due to laboratory findings of pancytopenia, diagnostic workup included bone marrow aspiration cytology and biopsy. Although the rapid test (IT LEISH, rK39 RDT) was negative, blood smear showed amastigote forms of leishmaniasis in macrophages. Repeat bone marrow aspiration and PCR eventually confirmed visceral leishmaniasis (VL). The patient denied travel to known endemic areas of VL. Treatment was initiated with Amphotericin B, but the patient died on the fourth day of treatment from respiratory insufficiency. An autopsy revealed massive organ manifestations of VL. This is the first reported autochthonous case of VL in Tanzania. Clark and colleagues detected the vector Phlebotomus martini in Northern Tanzania in 2013, in a region bordering the district of our patient. The negative rapid test draws attention to the fact that sensitivity and specificity were found to be low in East African VL patients as displayed earlier by a Kenyan study. Therefore, tissue samples (spleen or bone marrow) remain necessary for diagnosis. The variety of symptoms in this presented case was remarkable, including the occurrence of post-kala-azar dermal leishmaniasis (PKDL) and VL at the same time. This has been described in East African VL cases before as well as the occurrence of chronic diarrhea. An elongated undiagnosed period likely led to a mixed clinical picture that included hepato-splenomegaly, PKDL, cachexia, and diarrhea.
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Affiliation(s)
- Oliver Henke
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
- * E-mail:
| | - Priscus John Mapendo
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Lilian Gasper Mmbaga
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Angela Elisha Pallangyo
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Thomas Harbaum
- Joint Medical Service of the German Armed Forces, Department of Public Health, Koblenz, Germany
| | - Elifuraha Mkwizu
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
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Rioux JA, Gramiccia M, Léger N, Desjeux P, Depaquit J. Leishmaniasis and phlebotomine sand flies in Oman Sultanate. ACTA ACUST UNITED AC 2020; 27:68. [PMID: 33258444 PMCID: PMC7708229 DOI: 10.1051/parasite/2020064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/03/2020] [Indexed: 11/29/2022]
Abstract
There are few data on leishmaniases and sandflies in Oman Sultanate. We carried out an eco-epidemiological study in 1998 in the two main mountains of the country, the Sharqiyah and the Dhofar. This study allowed us to isolate and identify three Leishmania strains from patients exhibiting cutaneous leishmaniasis. The typing carried out by isoenzymatic study and by molecular biology were congruent: two strains of Leishmania donovani zymodeme (Z) MON-31 isolated in the Sharqiyah and one L. tropica ZROM102 (ZMON-39 variant for 4 isoenzymes) from the Dhofar. No strain was isolated from canids. The study of sandflies identified 14 species distributed in the genera Phlebotomus, Sergentomyia and Grassomyia: Ph. papatasi, Ph. bergeroti, Ph. duboscqi, Ph. alexandri, Ph. saevus, Ph. sergenti, Se. fallax, Se. baghdadis, Se. cincta, Se. christophersi, Se. clydei, Se. tiberiadis, Se. africana, and Gr. dreyfussi. In Sharqiyah, the only candidate for the transmission of L. donovani was Ph. alexandri, but the low densities observed of this species do not argue in favor of any role. In Dhofar, Ph. sergenti is the most important proven vector of L. tropica, but Ph. saevus, a locally much more abundant species, constitutes a good candidate for transmission.
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Affiliation(s)
- Jean-Antoine Rioux
- Faculté de Médecine, Université Montpellier 1, 1 rue de l'Éencole de Médecine, 34000 Montpellier, France
| | - Marina Gramiccia
- Department of Infectious Diseases, Unit of Vector-borne Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Nicole Léger
- Université de Reims Champagne-Ardenne, EA7510, Université de Reims Champagne-Ardenne, Faculté de Pharmacie, 51 rue Cognacq-Jay, 51096 Reims cedex, France
| | - Philippe Desjeux
- PATH OWH (formerly One World Health), A-9, Qutub Institutional area, USO Road, New Delhi 110067, India
| | - Jérôme Depaquit
- Université de Reims Champagne-Ardenne, EA7510, Université de Reims Champagne-Ardenne, Faculté de Pharmacie, 51 rue Cognacq-Jay, 51096 Reims cedex, France - ANSES, USC Transmission Vectorielle et Épidémiosurveillance de Maladies Parasitaires (VECPAR), 51100 Reims, France - Laboratoire de Parasitologie, Pôle de Biologie, Centre Hospitalier Universitaire de Reims, 51100 Reims, France
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Abstract
Visceral leishmaniasis is endemic in the western states of Eritrea, but it is rare in the city of Asmara. We report a case of an 18-month-old female with a high-grade fever, weight loss, and hepatosplenomegaly. No obvious cause of her illness was found. Routine blood investigations showed pancytopenia, and microscopic examination of bone marrow revealed intracellular and extracellular Leishmania amastigotes, so a diagnosis of leishmaniasis (kala-azar) was finally made. Visceral leishmaniasis should be considered when a child presents with fever, weight loss, organomegaly, and pancytopenia.
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Affiliation(s)
- Amin A Alamin
- Department of Pathology, College of Medicine, University of Al-Taif, Al-Taif, SAU
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Hong A, Zampieri RA, Shaw JJ, Floeter-Winter LM, Laranjeira-Silva MF. One Health Approach to Leishmaniases: Understanding the Disease Dynamics through Diagnostic Tools. Pathogens 2020; 9:pathogens9100809. [PMID: 33019713 PMCID: PMC7599840 DOI: 10.3390/pathogens9100809] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 01/19/2023] Open
Abstract
Leishmaniases are zoonotic vector-borne diseases caused by protozoan parasites of the genus Leishmania that affect millions of people around the globe. There are various clinical manifestations, ranging from self-healing cutaneous lesions to potentially fatal visceral leishmaniasis, all of which are associated with different Leishmania species. Transmission of these parasites is complex due to the varying ecological relationships between human and/or animal reservoir hosts, parasites, and sand fly vectors. Moreover, vector-borne diseases like leishmaniases are intricately linked to environmental changes and socioeconomic risk factors, advocating the importance of the One Health approach to control these diseases. The development of an accurate, fast, and cost-effective diagnostic tool for leishmaniases is a priority, and the implementation of various control measures such as animal sentinel surveillance systems is needed to better detect, prevent, and respond to the (re-)emergence of leishmaniases.
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Affiliation(s)
- Ahyun Hong
- Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo 05508-090, Brazil; (A.H.); (R.A.Z.); (L.M.F.-W.)
| | - Ricardo Andrade Zampieri
- Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo 05508-090, Brazil; (A.H.); (R.A.Z.); (L.M.F.-W.)
| | - Jeffrey Jon Shaw
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, Brazil;
| | - Lucile Maria Floeter-Winter
- Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo 05508-090, Brazil; (A.H.); (R.A.Z.); (L.M.F.-W.)
| | - Maria Fernanda Laranjeira-Silva
- Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo 05508-090, Brazil; (A.H.); (R.A.Z.); (L.M.F.-W.)
- Correspondence:
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Da'ar OB, Haji M, Jradi H. Coronavirus Disease 2019 (COVID-19): Potential implications for weak health systems and conflict zones in the Middle East and North Africa region. Int J Health Plann Manage 2020; 35:1240-1245. [PMID: 32557820 PMCID: PMC7323081 DOI: 10.1002/hpm.2982] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/02/2020] [Accepted: 04/28/2020] [Indexed: 12/21/2022] Open
Abstract
This short communication recognizes the underbelly of weak and conflict-prone health systems in the Middle East and North Africa region in the wake of COVID-19 pandemic. The communication highlights how the lack of basic resources, absence of a well-functioning health system and the dearth of well-coordinated communication channels, can bode ill for the successful fight against COVID-19. The article elucidates COVID-19 potential health, social, and economic implications for such countries. The communication cautions that if COVID-19 is left to incubate and makes a home in weak systems, it will have a much better chance of mutating and coming back to infect many people globally. The communication calls on the international institutions in collaboration with developed nations to be prepared to probe up health systems in weak and conflict-prone health systems with much-needed resources in order to nip COVID-19 in the bud.
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Affiliation(s)
- Omar B Da'ar
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Department of Health Systems Management, King Saud Bin Abdulaziz University for Health Sciences, College of Public Health and Health Informatics, Riyadh, Saudi Arabia.,Graduate School of Professional Studies, St. Mary's University of Minnesota, Minneapolis, Minnesota, USA
| | - Mohamed Haji
- Health and Development, Healthy Nations Foundations, Huonslow, UK
| | - Hoda Jradi
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Department of Community and Environmental Health, King Saud Bin Abdulaziz University for Health Sciences, College of Public Health and Health Informatics, Riyadh, Saudi Arabia
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Ayelign B, Jemal M, Negash M, Genetu M, Wondmagegn T, Zeleke AJ, Worku L, Bayih AG, Shumie G, Behaksra SW, Fenta T, Damte D, Yeshanew A, Gadisa E. Validation of in-house liquid direct agglutination test antigen: the potential diagnostic test in visceral Leishimaniasis endemic areas of Northwest Ethiopia. BMC Microbiol 2020; 20:90. [PMID: 32293265 PMCID: PMC7158028 DOI: 10.1186/s12866-020-01780-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/02/2020] [Indexed: 12/20/2022] Open
Abstract
Background Visceral leishmaniasis in Ethiopia is a re-emerging threat to public health, with increased geographical distribution and number of cases. It is a fatal disease without early diagnosis and treatment; thus, the availability of affordable diagnostic tools is crucial. However, due to delays caused by import regulations, procurement and late delivery of imported test kits, accessibility remains a problem in the control program. Therefore, we aimed to produce and evaluate the performance of an in-house liquid (AQ) direct agglutination test (DAT) antigen. Result The AQ-DAT was produced at the Armauer Hansen Research Institute, using Leishmania donovani strain (MHOM/ET/67/L82). Sera from 272 participants; 110 microscopically confirmed cases of VL, 76 apparently healthy and 86 patients who had infectious disease other than VL were tested with AQ-DAT, and standard kits: Freeze-dried DAT (FD-DAT) and rK39. Taking microscopy as a gold standard; the sensitivity and specificity of the AQ-DAT were 97.3 and 98.8%, respectively. It had high degrees of agreement (k > 0.8), with a significant (P < 0.05) correlation compared to microscopy, FD-DAT, and rK39. Conclusion Although further standardization is required, the in-house AQ-DAT could improve diagnostic accessibility, minimize intermittent stock outs and strengthen the national VL control program.
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Affiliation(s)
- Birhanu Ayelign
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Mohammedamin Jemal
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Markos Negash
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meaza Genetu
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadelo Wondmagegn
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayalew Jejaw Zeleke
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ligabaw Worku
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Genetu Bayih
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Girma Shumie
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Tiruwork Fenta
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Demekech Damte
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Arega Yeshanew
- Leishmania Research and Treatment Center, University of Gondar Hospital, Gondar, Ethiopia
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Pekelharing JE, Gatluak F, Harrison T, Maldonado F, Siddiqui MR, Ritmeijer K. Outcomes of visceral leishmaniasis in pregnancy: A retrospective cohort study from South Sudan. PLoS Negl Trop Dis 2020; 14:e0007992. [PMID: 31978116 PMCID: PMC7001985 DOI: 10.1371/journal.pntd.0007992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 02/05/2020] [Accepted: 12/12/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction Visceral leishmaniasis (VL) is endemic in South Sudan, where outbreaks occur frequently. Because of changes in the immune system during pregnancy, pregnant women are considered particularly vulnerable for developing complications of VL disease, including opportunistic infections. There is limited evidence available about clinical aspects and treatment outcomes of VL in pregnancy. We describe characteristics, maternal and pregnancy outcomes from a cohort of pregnant women with VL. Methods We conducted a retrospective analysis using routine programme data from a MSF health facility in Lankien, Jonglei State, South Sudan, between Oct 2014 and April 2018. Records were extracted of women diagnosed with VL while pregnant, and those symptomatic during pregnancy but diagnosed during the first two weeks postpartum. Records were matched with a random sample of non-pregnant women of reproductive age (15–45 years) with VL from the same period. Results We included 113 women with VL in pregnancy, and 223 non-pregnant women with VL. Women with VL in pregnancy presented with more severe anaemia, were more likely to need blood transfusion (OR 9.3; 95%CI 2.5–34.2) and were more often prescribed antibiotics (OR 6.0; 95%CI 3.4–10.6), as compared to non-pregnant women with VL. Adverse pregnancy outcomes, including miscarriage and premature delivery, were reported in 20% (16/81) where VL was diagnosed in pregnancy, and 50% 13/26) where VL was diagnosed postpartum. Postpartum haemorrhage was common. Pregnant women were more likely to require extension of treatment to achieve cure (OR 10.0; 95%CI 4.8–20.9), as compared to non-pregnant women with VL. Nevertheless, overall initial cure rates were high (96.5%) and mortality was low (1.8%) in this cohort of pregnant women with VL. Conclusion This is the largest cohort in the literature of VL in pregnancy. Our data suggest that good maternal survival rates are possible in resource-limited settings, despite the high incidence of complications. Visceral leishmaniases (VL), also known as ‘Kala azar’, is a parasitic disease transmitted by sand flies. South Sudan is one of the countries in the world with the highest disease burden of VL. Existing evidence about treatment and outcomes of VL in pregnancy is limited. We described outcomes of pregnant women with VL and women diagnosed with VL in the first two weeks postpartum. Pregnant women with VL were treated with liposomal amphotericin B (AmBisome) in this cohort. Survival rates and initial cure rates of women with VL in pregnancy treated in this resource constrained setting were high. However, these patients often required extension of treatment to achieve cure after the initial standard dose of 30mg/kg AmBisome in six doses. Careful evaluation of patients is needed at the end of the standard treatment regimen, in order to ensure proper (parasitological) cure before discharge. We reported a high incidence of complications (including severe anaemia with a need for blood transfusion), adverse pregnancy outcomes (including miscarriage and premature delivery), and obstetric complications. This research adds to the existing body of knowledge concerning VL in pregnancy, although several questions about this condition remain unanswered. Topics for future research include the immunological response to leishmania infection in pregnancy, and maternal, pregnancy and neonatal outcomes after discharge from VL treatment.
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Affiliation(s)
| | | | - Tim Harrison
- Médecins Sans Frontières, Amsterdam, Netherlands
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Youssef A, Harfouch R, El Zein S, Alshehabi Z, Shaaban R, Kanj SS. Visceral and Cutaneous Leishmaniases in a City in Syria and the Effects of the Syrian Conflict. Am J Trop Med Hyg 2020; 101:108-112. [PMID: 31162008 DOI: 10.4269/ajtmh.18-0778] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
War provides ideal grounds for the outbreak of infectious diseases, and the Syrian war is not an exception to this rule. Following the civil crisis, Syria and refugee camps of neighboring countries witnessed an outbreak of leishmaniasis. We accessed the database of the central leishmaniasis registry in Latakia city and obtained the leishmaniasis data of the period 2008-2016. Our data showed that the years 2013 and 2014 recorded a surge in the number of both cutaneous leishmaniases (CL) and visceral leishmaniasis (VL) cases. This surge coincided with the massive internal displacement waves that struck Latakia governorate during that time. Subsequently, after 2015, the number of recorded CL and VL cases gradually decreased. This drop coincided with a reduced influx of internally displaced persons into Latakia governorate. Our report depicts the effects of the Syrian crisis on the epidemiology of leishmaniasis by outlining the experience of Latakia governorate. Similar results may have occurred in other refugee-hosting Syrian governorates.
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Affiliation(s)
- Alexey Youssef
- Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Rim Harfouch
- Microbiology and Biochemistry Department, Faculty of Pharmacy, Al Andalus University, Tartous, Syria
| | - Said El Zein
- Infectious Diseases Division, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zuheir Alshehabi
- Pathology Department, Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Rafea Shaaban
- Biostatistics Department, Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Souha S Kanj
- Infectious Diseases Division, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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40
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Gil Z, Martinez-Sotillo N, Pinto-Martinez A, Mejias F, Martinez JC, Galindo I, Oldfield E, Benaim G. SQ109 inhibits proliferation of Leishmania donovani by disruption of intracellular Ca 2+ homeostasis, collapsing the mitochondrial electrochemical potential (ΔΨ m) and affecting acidocalcisomes. Parasitol Res 2020; 119:649-657. [PMID: 31897791 DOI: 10.1007/s00436-019-06560-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
Leishmania donovani is the causative agent of visceral leishmaniasis. Annually, 500 million new cases of infection are reported mainly in poor communities, decreasing the interest of the pharmaceutical industries. Therefore, the repositioning of new drugs is an ideal strategy to fight against these parasites. SQ109, a compound in phase IIb/III of clinical trials to treat resistant Mycobacterium tuberculosis, has a potent effect against Trypanosoma cruzi, responsible for Chagas' disease, and on Leishmania mexicana, the causative agent of cutaneous and muco-cutaneous leishmaniasis. In the latter, the toxic dose against intramacrophagic amastigotes is very low (IC50 ~ 11 nM). The proposed mechanism of action on L. mexicana involves the disruption of the parasite intracellular Ca2+ homeostasis through the collapse of the mitochondrial electrochemical potential (ΔΨm). In the present work, we show a potent effect of SQ109 on L. donovani, the parasite responsible for visceral leishmaniasis, the more severe and uniquely lethal form of these infections, obtaining a toxic effect on amastigotes inside macrophages even lower to that obtained in L. mexicana (IC50 of 7.17 ± 0.09 nM) and with a selectivity index > 800, even higher than in L. mexicana. We also demonstrated for first time that SQ109, besides collapsing ΔΨm of the parasite, induced a very rapid damage to the parasite acidocalcisomes, essential organelles involved in the bioenergetics and many other important functions, including Ca2+ homeostasis. Both effects of the drug on these organelles generated a dramatic increase in the intracellular Ca2+ concentration, causing parasite death.
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Affiliation(s)
- Zain Gil
- Instituto de Estudios Avanzados, Caracas, Venezuela
| | | | | | - Fabiola Mejias
- Instituto de Biologia Experimental, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Ivan Galindo
- Instituto de Estudios Avanzados, Caracas, Venezuela
| | - Eric Oldfield
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Gustavo Benaim
- Instituto de Estudios Avanzados, Caracas, Venezuela. .,Instituto de Biologia Experimental, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela.
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Melkamu HT, Beyene AM, Zegeye DT. Knowledge, attitude and practices of the resident community about visceral leishmaniasis in West Armachiho district, Northwest Ethiopia. Heliyon 2020; 6:e03152. [PMID: 32042949 PMCID: PMC7002804 DOI: 10.1016/j.heliyon.2019.e03152] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 06/04/2019] [Accepted: 11/27/2019] [Indexed: 01/02/2023] Open
Abstract
Visceral leishmaniasis (VL) or kala-azar is a tropical disease, which is caused by an obligate intracellular parasite of the genus Leishmania. It is transmitted by the bite of an infected phlebotomine sand fly. The disease is endemic in northwest part of Ethiopia particularly in areas bordering Sudan. Assessing the knowledge, attitude and practices (KAP) of the community is helpful to design and implement appropriate control and prevention strategies. A cross-sectional study was conducted to assess the KAP of the resident community on VL in West Armachiho district, northwest Ethiopia. Data were collected by using pretested and well-structured questionnaire. Two villages (Abderafi and Abrehajira) were selected randomly. Households engaged in the study were selected by systematic random sampling method and then finally, simple random sampling was used to engage a maximum of two individuals per household. A total of 422 participants were engaged in the study. Almost all participants heard about VL. The source of information was mainly from friends (80.8%). The highest proportion (88.2%) of participants thought that persistent enlargement of liver and spleen (enlargement of the abdomen) was the main symptom of VL. Of all participants, only 52.1% knew sand fly as the vector of the disease. The overall assessment of participants indicated that 21.1% were knowledgeable, 53.6% had positive attitudes and 14.9% had optimal practices on VL. In conclusion, the survey indicated that participants had better attitude about VL. However, there were a large gap in knowledge and practices. The misunderstanding and incorrect practices may remain serious concerns in the control and prevention of the disease. It is recommended that health education program should be strengthened to increase peoples' awareness and improve their practices on VL in the district and further studies are strongly suggested for better understanding of the dynamics of the disease in the area.
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Affiliation(s)
| | - Achenef Melaku Beyene
- Department of Veterinary Pharmacy and Biomedical Sciences, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
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Lanza JS, Pomel S, Loiseau PM, Frézard F. Recent advances in amphotericin B delivery strategies for the treatment of leishmaniases. Expert Opin Drug Deliv 2019; 16:1063-1079. [DOI: 10.1080/17425247.2019.1659243] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Juliane S. Lanza
- Faculty of Pharmacy, Antiparasite Chemotherapy, UMR 8076 CNRS BioCIS, University Paris-Saclay, Chatenay-Malabry, France
| | - Sébastien Pomel
- Faculty of Pharmacy, Antiparasite Chemotherapy, UMR 8076 CNRS BioCIS, University Paris-Saclay, Chatenay-Malabry, France
| | - Philippe M. Loiseau
- Faculty of Pharmacy, Antiparasite Chemotherapy, UMR 8076 CNRS BioCIS, University Paris-Saclay, Chatenay-Malabry, France
| | - Frédéric Frézard
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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de Lima Junior MM, Rodrigues GA, Lima MRD. Evaluation of emerging infectious disease and the importance of SINAN for epidemiological surveillance of Venezuelans immigrants in Brazil. Braz J Infect Dis 2019; 23:307-312. [PMID: 31472124 PMCID: PMC9428005 DOI: 10.1016/j.bjid.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/13/2019] [Accepted: 07/20/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Following socio-economic turmoil in Venezuela, millions of the Venezuelan people are migrating to the neighboring Latin American countries including Brazil. Besides the social and economic burden of these migrants, Brazil must manage the health-related issues arising as consequence of these Venezuelan migrants. Poor health services in Venezuela along with unhygienic travelling conditions, lack of food (malnutrition) and potable water, unhealthy and overcrowded refugee camps or shelters, poor availability of medical services have made the migrant Venezuelan population susceptible to various diseases, especially infectious diseases. SINAN system is a health-related system in Brazil that keeps track of different health occurrences in the society and allows health care workers and policymakers free access to these data. OBJECTIVES To evaluate the emergence of infectious diseases as a consequence of the arrival of Venezuelans immigrants in Brazil and to assess the importance of SINAN for epidemiological surveillance. METHODS Observational retrospective study. Data were collected from the SINAN system between 2015 and 2017 and was analyzed using descriptive statistics, and Mann-Whitney test (using SPSS tool version 12). Evaluated infectious diseases in this study were tuberculosis, sexually transmitted infections (STIs), HIV/AIDS, syphilis, viral hepatitis, leishmaniasis, and malaria. RESULTS STIs were the most commonly reported diseases. Compared to Brazilians, Venezuelan migrants reported significantly higher number of HIV/Aids (p < 0.046) and leishmaniasis cases (p < 0.049), while Brazilians reported significantly higher number of hepatitis cases (p < 0.046). Malaria was also more prevalent among Venezuelan migrants than native Brazilians. CONCLUSION Increased incidence of infectious diseases among the migrant population should be considered seriously as lack of adequate control of these diseases might lead to outbreaks.
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Saenz V, Mazzanti di Ruggiero MDLA. Propuestas bioéticas frente a los problemas sociales y éticos que generan las enfermedades infecciosas desatendidas. PERSONA Y BIOÉTICA 2019. [DOI: 10.5294/pebi.2019.23.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Este artículo de revisión se centra en el tema de las enfermedades infecciosas desatendidas (EID), grupo de 18 patologías de carácter incapacitante, a veces mortales y frecuentemente deformantes, que prevalecen en poblaciones de Asia, África y en las zonas tropicales de Sur América. Mediante una revisión bibliográfica se plantean los elementos que se relacionan con estas enfermedades, se categorizan y se analizan a la luz de la Declaración Universal sobre Bioética y Derechos Humanos de 2005, en cuanto a igualdad, justicia y equidad, el enfoque de no discriminación y estigmatización, responsabilidad social y salud. A lo largo de la revisión se concluye que la problemática alrededor de las EID es multifactorial y se presentan propuestas, desde una mirada de la bioética centrada en el respeto por la dignidad de la persona y de las poblaciones afectadas, para mitigar y solucionar la atención a partir de estrategias posibles que aborden determinantes sociales. Se propone incluir la bioética en el debate sobre la atención de las EID para analizar los problemas y examinar soluciones por medio de proyectos de investigación transdisciplinaria que impliquen un trabajo colaborativo y formativo entre las comunidades afectadas, entidades gubernamentales y profesionales de la salud y de las ciencias veterinarias.
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Abstract
Abstract
Leishmaniasis is a group of zoonotic diseases caused by a trypanosomatid parasite mostly in impoverished populations of low-income countries. In their different forms, leishmaniasis is prevalent in more than 98 countries all over the world and approximately 360-million people are at risk. Since no vaccine is currently available to prevent any form of the disease, the control strategy of leishmaniasis mainly relies on early case detection followed by adequate pharmacological treatment that may improve the prognosis and can reduce transmission. A handful of compounds and formulations are available for the treatment of leishmaniasis in humans, but only few of them are currently in use since most of these agents are associated with toxicity problems such as nephrotoxicity and cardiotoxicity in addition to resistance problems. In recent decades, very few novel drugs, new formulations of standard drugs or combinations of them have been approved against leishmaniasis. This review highlights the current drugs and combinations that are used medical practice and recent advances in new treatments against leishmaniasis that were pointed out in the recent 2nd Conference, Global Challenges in Neglected Tropical Diseases, held in San Juan, Puerto Rico in June 2018, emphasizing the plethora of new families of molecules that are bridging the gap between preclinical and first-in-man trials in next future.
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Hotez PJ. Science tikkun: A framework embracing the right of access to innovation and translational medicine on a global scale. PLoS Negl Trop Dis 2019; 13:e0007117. [PMID: 31170155 PMCID: PMC6553693 DOI: 10.1371/journal.pntd.0007117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, United States of America
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- James A. Baker III Institute for Public Policy, Rice University, Houston, Texas, United States of America
- Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
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Sunyoto T, Potet J, den Boer M, Ritmeijer K, Postigo JAR, Ravinetto R, Alves F, Picado A, Boelaert M. Exploring global and country-level barriers to an effective supply of leishmaniasis medicines and diagnostics in eastern Africa: a qualitative study. BMJ Open 2019; 9:e029141. [PMID: 31152044 PMCID: PMC6549606 DOI: 10.1136/bmjopen-2019-029141] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/14/2019] [Accepted: 04/18/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To understand stakeholders' perceptions of the access barriers to quality-assured diagnostics and medicines for leishmaniasis in the high-burden region of eastern Africa, and to identify key bottlenecks to improve the supply of commodities for neglected tropical diseases. DESIGN Desk reviews and qualitative in-depth interview study with purposive sampling. METHODS A landscape analysis through literature and desk review was performed. Next, 29 representatives from international organisations, non-governmental agencies, national control programmes from six countries (Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda) and manufacturers were interviewed between May and July 2018. Participants were selected purposively and expanded through a snowballing technique.Data analysis was aided by NVivo, applying the framework method as a part of the thematic content analysis approach. RESULTS The barriers along the visceral leishmaniasis (VL) supply chain were identified as emerging themes, grouped across supply chain activities and health systems component(s). Stakeholders expressed the perception of progress, but bottlenecks persist. VL medicines, in general, lack multisource production capacity and with small market volume, expansion of suppliers is difficult. Procurement is plagued by forecasting difficulties, complex regulatory policies and procedures, and distribution challenges. Weak communication and coordination across different levels resulted in shortages and loss of trust among different actors. Cross-cutting issues spanned from limited political and resource commitment due to low awareness and limited in-country capacity. However, study respondents were optimistic to pursue several remedies, most importantly to build bridges between supply and demand sides through continued dialogue and collaborations. Diagnostics supply has mostly been overlooked; thus, improved investment in this area is needed. CONCLUSIONS Addressing supply barriers in eastern Africa requires consistent, specific efforts at the global and national levels, progressing from current partnerships and agreements. Priority actions include pooled procurement, improved forecast, and increased commitment and resources. Sustainability remains an elusive goal, yet to be integrated into discussions moving forward.
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Affiliation(s)
- Temmy Sunyoto
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Julien Potet
- Medical Department, Médecins Sans Frontières Access Campaign, Paris, France
| | - Margriet den Boer
- Medical Department, Artsen zonder Grenzen, Amsterdam, The Netherlands
| | - Koert Ritmeijer
- Medical Department, Artsen zonder Grenzen, Amsterdam, The Netherlands
| | - Jose A R Postigo
- Neglected Tropical Diseases Programme, World Health Organization, Geneva, Switzerland
| | - Raffaella Ravinetto
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Fabiana Alves
- VL Clinical Program, Drugs for Neglected Disease Initiative, Geneva, Switzerland
| | - Albert Picado
- Instituto de Salud Global Barcelona, Barcelona, Spain
- Neglected Tropical Diseases Department, FIND, Geneva, Switzerland
| | - Marleen Boelaert
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
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Afrin F, Chouhan G, Islamuddin M, Want MY, Ozbak HA, Hemeg HA. Cinnamomum cassia exhibits antileishmanial activity against Leishmania donovani infection in vitro and in vivo. PLoS Negl Trop Dis 2019; 13:e0007227. [PMID: 31071090 PMCID: PMC6529017 DOI: 10.1371/journal.pntd.0007227] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 05/21/2019] [Accepted: 02/08/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is a pressing need for drug discovery against visceral leishmaniasis, a life-threatening protozoal infection, as the available chemotherapy is antiquated and not bereft of side effects. Plants as alternate drug resources has rewarded mankind in the past and aimed in this direction, we investigated the antileishmanial potential of Cinnamomum cassia. METHODOLOGY Dichloromethane, ethanolic and aqueous fractions of C. cassia bark, prepared by sequential extraction, were appraised for their anti-promastigote activity along with apoptosis-inducing potential. The most potent, C. cassia dichloromethane fraction (CBD) was evaluated for anti-amastigote efficacy in infected macrophages and nitric oxide (NO) production studied. The in vivo antileishmanial efficacy was assessed in L. donovani infected BALB/c mice and hamsters and various correlates of host protective immunity ascertained. Toxicity profile of CBD was investigated in vitro against peritoneal macrophages and in vivo via alterations in liver and kidney functions. The plant secondary metabolites present in CBD were identified by gas chromatography-mass spectroscopy (GC-MS). PRINCIPAL FINDINGS CBD displayed significant anti-promastigote activity with 50% inhibitory concentration (IC50) of 33.6 μg ml-1 that was mediated via apoptosis. This was evidenced by mitochondrial membrane depolarization, increased proportion of cells in sub-G0-G1 phase, ROS production, PS externalization and DNA fragmentation (TUNEL assay). CBD also inhibited intracellular amastigote proliferation (IC50 14.06 μg ml-1) independent of NO production. The in vivo protection achieved was 80.91% (liver) and 82.92% (spleen) in mice and 75.61% (liver) and 78.93% (spleen) in hamsters indicating its profound therapeutic efficacy. CBD exhibited direct antileishmanial activity, as it did not specifically induce a T helper type (Th)-1-polarized mileu in cured hosts. This was evidenced by insignificant modulation of NO production, lymphoproliferation, DTH (delayed type hypersensitivity), serum IgG2a and IgG1 levels and production of Th2 cytokines (IL-4 and IL-10) along with restoration of pro-inflammatory Th1 cytokines (INF-γ, IL-12p70) to the normal range. CBD was devoid of any toxicity in vitro as well as in vivo. The chemical constituents, cinnamaldehyde and its derivatives present in CBD may have imparted the observed antileishmanial effect. CONCLUSIONS Our study highlights the profound antileishmanial efficacy of C. cassia bark DCM fraction and merits its further exploration as a source of safe and effective antieishmanial compounds.
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Affiliation(s)
- Farhat Afrin
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia, Saudi Arabia
| | - Garima Chouhan
- Parasite Immunology Laboratory, Department of Biotechnology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Mohammad Islamuddin
- Parasite Immunology Laboratory, Department of Biotechnology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Muzamil Y. Want
- Parasite Immunology Laboratory, Department of Biotechnology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Hani A. Ozbak
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia, Saudi Arabia
| | - Hassan A. Hemeg
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia, Saudi Arabia
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Synthesis, Characterization, and Antileishmanial Activity of Certain Quinoline-4-carboxylic Acids. J CHEM-NY 2019. [DOI: 10.1155/2019/2859637] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Leishmaniasis is a fatal neglected parasitic disease caused by protozoa of the genusLeishmaniaand transmitted to humans by different species ofphlebotominesandflies. The disease incidence continues to increase due to lack of vaccines and prophylactic drugs. Drugs commonly used for the treatment are frequently toxic and highly expensive. The problem of these drugs is further complicated by the development of resistance. Thus, there is an urgent need to develop new antileishmanial drug candidates. The aim of this study was to synthesize certain quinoline-4-carboxylic acids, confirm their chemical structures, and evaluate their antileishmanial activity. Pfitzinger reaction was employed to synthesize fifteen quinoline-4-carboxylic acids (Q1-Q15) by reacting equimolar mixtures of isatin derivatives and appropriateα-methyl ketone. The products were purified, and their respective chemical structures were deduced using various spectral tools (IR, MS,1H NMR, and13C NMR). Then, they were investigated againstL. donovanipromastigote (clinical isolate) in different concentration levels (200 μg/mL to 1.56 μg/mL) against sodium stibogluconate and amphotericin B as positive controls. The IC50for each compound was determined and manipulated statistically. Among these compounds,Q1(2-methylquinoline-4-carboxylic acid) was found to be the most active in terms of IC50.
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Neglected tropical diseases in children: An assessment of gaps in research prioritization. PLoS Negl Trop Dis 2019; 13:e0007111. [PMID: 30695020 PMCID: PMC6368333 DOI: 10.1371/journal.pntd.0007111] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 02/08/2019] [Accepted: 12/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite the known burden of neglected tropical diseases (NTDs) on child health, there is limited information on current efforts to increase pediatric therapeutic options. Our objective was to quantify and characterize research activity and treatment availability for NTDs in children in order to inform the prioritization of future research efforts. METHODOLOGY/PRINCIPAL FINDINGS We conducted a review of the World Health Organization's (WHO) International Clinical Trials Registry Platform to assess research activity for NTDs. The burden of disease of each NTD was measured in terms of disability adjusted life years (DALYs), which was extracted from the Global Health Data Exchange. First- and second-line medications for each NTD were identified from WHO guidelines. We reviewed FDA drug labels for each medication to determine whether they were adequately labeled for use in children. Descriptive statistics, binomial tests, and Spearman's rank order correlations were calculated to assess research activity compared to burden of disease. Children comprised 34% of the 20 million DALYs resulting from NTDs, but pediatric trials contributed just 17% (63/369) of trials studying these conditions (p<0.001 for binomial test). Conditions that were particularly under-represented in pediatric populations compared to adults included rabies, leishmaniasis, scabies, and dengue. Pediatric drug trial activity was poorly correlated with pediatric burden of disease across NTDs (Spearman's rho = 0.41, p = 0.12). There were 47 medications recommended by the WHO for the treatment of NTDs, of which only 47% (n = 22) were adequately labeled for use in children. Of the 25 medications lacking adequate pediatric labeling, three were under study in pediatric trials. CONCLUSIONS/SIGNIFICANCE There is a substantial gap between the burden of disease for NTDs in children and research devoted to this population. Most medications lack adequate pediatric prescribing information, highlighting the urgency to increase pediatric research activity for NTDs with high burden of disease and limited treatment options.
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