Ecological aspects of Phlebotomines (Diptera: Psychodidae) and the transmission of American cutaneous leishmaniasis agents in an Amazonian/ Guianan bordering area

Diversity and natural infection of phlebotomine sand flies (Diptera, Psychodidae) in an endemic area of American tegumentary leishmaniasis in southeastern Bahia, Brazil

BACKGROUND

The Cacao Region spans several municipalities in the state of Bahia. It is one of the major foci of American tegumentary leishmaniasis (ATL) in Brazil. We report the findings of a pilot cross-sectional study describing the phlebotomine fauna found around living sites of newly diagnosed ATL cases in that area.

METHODS

The sand fly fauna was studied from May 2018 to June 2019 via an entomological survey, as recommended by the Brazilian Ministry of Health.

RESULTS

Six hundred nineteen phlebotomine sand flies of 20 species were captured: 272 males (44%) and 347 females (56%). Nyssomyia whitmani was the most prevalent (62.2%), followed by Nyssomyia intermedia (9.2%), Evandromyia bahiensis (6.3%), endemic to Bahia, and Trichophoromyia viannamartinsi (4.5%). Ninety-four percent of the female sand flies collected were screened for infection with Leishmania (Viannia) braziliensis by polymerase chain reaction (PCR). Of the 97 sand fly pools analyzed, seven were positive for L. (V.) braziliensis: three of Nyssomyia whitmani, two of Th. viannamartinsi and one each of Psychodopygus hirsutus hirsutus and Trichopygomyia longispina. The overall value of minimum infection rate (MIR) was 2.2%, and its stratification rates for the above species were 1.9, 10, 33 and 50%, respectively. All positive pools consisted of phlebotomine sand flies collected from the peridomiciles and extradomiciles of homes in the municipality of Taperoá in July 2018, resulting in an adjusted MIR of 7.8%, with 50% of the pools positive for L. (V.) braziliensis during that outbreak of ATL.

CONCLUSIONS

Our findings suggest that areas experiencing outbreaks of ATL in affected regions present high proportions of infected phlebotomine sand flies involving a variety of species, some not usually considered involved in the L. (V.) braziliensis transmission cycle, such as Th. viannamartinsi.

Nocturnal activity and forestry-urban dispersal of phlebotomine sand flies (Diptera: Psychodidae) from an ecotourism park in Amazonian Brazil

Phlebotomine sand flies are insects of notorious importance in public health, mainly due to their involvement in the transmission of Leishmania protozoa. Their flight activity occurs predominantly in the twilight/night period, being stimulated mainly by the need to search for food and reproduction. Despite being naturally wild, some species are able to invade anthropized environments. Present work aimed to assess the nocturnal activity and forestry-urban dispersal of phlebotomine sand flies from an ecotourism park in Belém, Amazonian Brazil. The study area comprised a horizontal transect, extending from a forest park to the neighboring urban environment, in Belém. Sampling was conducted with night-operating light traps. Nocturnal activity was assessed through time-set captures with a collection bottle rotator in the forest environment. Dispersal was assessed through captures carried out along the transect, starting from the forest edge (0 m), extending to the urban environment (50-200 m), phlebotomine sand flies were identified. Abundance, richness, diversity, and sampling sufficiency were estimated. Fourteen species were recorded in the surveyed environments, with Nyssomyia antunesi, Trichophoromyia brachipyga, and Trichophoromyia ubiquitalis being the most abundant. Nocturnal activity behavior of Ny. antunesi occurred between 8 PM and 4 AM while that of Th. brachipyga and Th. ubiquitalis occurred between 2 AM and 6 AM. In the urban environment, the 150 m site presented the highest abundance. Bichromomyia flaviscutellata was sampled in all sites. Gravid females of Pressatia choti and Bi. flaviscutellata were sampled in the urban environment. Putative differential activity between the species herein assessed and their urban dispersal observed are worthy of note, adding data for supporting vector surveillance at a local scale.

Ecological determinants of leishmaniasis vector, Lutzomyia spp.: A scoping review

Leishmania spp. are zoonotic parasites transmitted by phlebotomine sand flies, including those of the Lutzomyia genus, which can cause leishmaniases in both humans and dogs. Lutzomyia spp. are established in many countries in South and Central America and some areas of the southern United States, with suspected potential of these vectors to undergo further range expansion due to climate change. A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions for Scoping Reviews (PRISMA-ScR) guidelines to describe the current state of knowledge on the key ecological factors associated with Lutzomyia spp. survival, reproduction and establishment. The following electronic databases were searched for eligible studies published from 1 January 1990, to the date of search, 26 April 2023: CAB Direct (CABI), MEDLINE (via Ovid), Biological Sciences Database and Environmental Sciences Database. Primary research articles that were available in English and focused on ecological factors associated with Lutzomyia spp., such as climatic and habitat factors, geographic range, seasonality and temporality, and host abundance, were eligible for inclusion in the study. Following de-duplication, a total of 167 studies were included in Level 1 screening, 64 studies were included in Level 2 screening and 31 studies met the criteria for data extraction. Study locations included Argentina, Brazil, Colombia, Peru, Venezuela, the United States, Mexico and Canada, with some studies including multiple regions. A total of 31 different Lutzomyia spp. were assessed across these studies, with most (51.6%) of the studies focused on Lutzomyia longipalpis. Eligible studies investigated factors such as seasonality (n = 5), temperature (n = 19), precipitation (n = 13), humidity (n = 2), vegetation presence or requirements (n = 13), ecotypes (n = 7), and/or community type (i.e., urban, suburban, rural) (n = 5). Lutzomyia spp. activity was found to be higher during the rainy season, and peak when temperatures were between 20 and 25°C. Lutzomyia spp. were also found to preferentially reside in tropical or subtropical forests, which are characterised by their lack of a distinct dry season and high precipitation. This scoping review summarised the current state of the literature on the ecological factors associated with the survival, activity and reproduction of Lutzomyia spp. While there appears to be some consensus in the literature regarding some ecological requirements (such as seasonality, temperature and habitat features), overall, there is a lack of published research in this topic. This poses a significant challenge for future studies, which aim to predict the future distribution of Lutzomyia spp. in the context of climate and land use changes. Additional ecological research is urgently needed on Lutzomyia spp. given their relevance to both human and animal health.

Updated estimation of cutaneous leishmaniasis incubation period in French Guiana

BACKGROUND

The cutaneous leishmaniasis (CL) incubation period (IP) is defined as the time between parasite inoculation by sandfly bite and the onset of the first CL lesion. IP distribution is difficult to assess for CL because the date of exposure to an infectious bite cannot be accurately determined in endemic areas. IP current estimates for CL range from 14 days to several months with a median around 30-60 days, as established by a few previous studies in both New and Old Worlds.

METHODOLOGY

We estimated CL incubation period distribution using time-to-event models adapted to interval-censored data based on declared date of travels from symptomatic military personnel living in non-endemic areas that were exposed during their short stays in French Guiana (FG) between January 2001 and December 2021.

PRINCIPAL FINDINGS

A total of 180 patients were included, of which 176 were men (97.8%), with a median age of 26 years. When recorded, the parasite species was always Leishmania guyanensis (31/180, 17.2%). The main periods of CL diagnosis spread from November to January (84/180, 46.7%) and over March-April (54/180, 30.0%). The median IP was estimated at 26.2 days (95% Credible Level, 23.8-28.7 days) using a Bayesian accelerated failure-time regression model. Estimated IP did not exceed 62.1 days (95% CI, 56-69.8 days) in 95% of cases (95th percentile). Age, gender, lesion number, lesion evolution and infection date did not significantly modify the IP. However, disseminated CL was significantly associated with a 2.8-fold shortening of IP.

CONCLUSIONS

This work suggests that the CL IP distribution in French Guiana is shorter and more restricted than anticipated. As the incidence of CL in FG usually peaks in January and March, these findings suggest that patients are contaminated at the start of the rainy season.

Blood Feeding Sources of Nyssomyia antunesi (Diptera: Psychodidae): A Suspected Vector of Leishmania (Kinetoplastida: Trypanosomatidae) in the Brazilian Amazon

Present work aimed to identify blood feeding sources and attempt to detect Leishmania DNA in Nyssomyia antunesi, suspected vector of Leishmania sp., from a park in the urban center of Belém, the capital of Pará State, in the Brazilian Amazon. Entire bodies and gut contents of Ny. antunesi engorged females, previously captured in the urban park with Centers for Disease Control (CDC) light traps and aspiration on tree bases, were subjected to Leishmania and vertebrate DNA detection through amplification of the Leishmania mini-exon and vertebrate cytochrome b (cyt b) gene regions, respectively. The quality of DNA extraction from entire bodies was ensured through amplification of the dipteran cyt b region. The vertebrate cyt b amplicons were sequenced and compared with those available on GenBank. A maximum likelihood phylogenetic tree was constructed to assess the clustering patterns of these sequences. Leishmania DNA was not detected. The sequences of 13 vertebrate cyt b amplicons were considered informative, exhibiting similarity and clustering with the following six vertebrate species: Dasyprocta leporina (1), Cuniculus paca (1), Tamandua tetradactyla (4), Choloepus didactylus (4), Pteroglossus aracari aracari (2), Homo sapiens (1). The samples of D. leporina and C. paca were obtained from the CDC canopy, whereas the others were by aspiration from tree bases. The present results revealed the eclectic and opportunist blood-feeding behavior of Ny. antunesi, with birds and mammals, these last ones acting as potential reservoirs for Leishmania species, distributed throughout the vertical forest strata.

Entomological survey of phlebotominae sand flies (diptera: psychodidae) and vector species in the tegumentary leishmaniasis endemic area in eastern brazilian Amazon, Amapá state

Abstract: American tegumentary leishmaniasis is an endemic that has increased considerably in recent decades in the Amazon region, sand flies are the vectors of the transmission of the protozoan that causes leishmaniasis, so the objective of this study was to carry out a survey of the diversity of species and the presence of Leishmania DNA in vectors circulating in three endemic counties for tegumentary leishmaniasis in the eastern Brazilian Amazon (Amapá state, Brazil). Using CDC light traps, a total of 10,773 specimens were collected between February 2019 and February 2020, representing 64 species in 15 genera. The vector specie Nyssomyia umbratilis Ward and Frahia, 1977 was the predominant species (13.20% of the total), being collected in all three counties, followed by Trichopygomyia trichopyga Floch & Abonnenc, 1945 (11.41%), Trichophoromyia ubiquitalis Mangabeira,1942 (9.47%) and Nyssomyia anduzei Rozeboom, 1942 (7.61%). For the identification of Leishmania DNA, 775 pools of unengorged females were used, of which 5 tested positive, 2 of Nyssomya umbratilis Ward & Fraiha,1977, 1 of Nyssomyia anduzei and 2 of Psychodopygus davisi Root,1934, demonstrating a natural total infection rate of 0.64%. This study increases the knowledge of vector diversity, as well as identifying Leishmania spp. in circulation in the eastern region of the Amazon.

Outbreak of Cutaneous Leishmaniasis among military personnel in French Guiana, 2020: Clinical, phylogenetic, individual and environmental aspects

Background

Cutaneous Leishmaniasis (CL) is endemic in French Guiana but cases are usually sporadic. An outbreak signal was issued on May 15^th 2020 with 15 suspected cases after a military training course in the rainforest. An outbreak investigation was carried out.

Methodology/Principal findings

Thirty cases were confirmed. Leishmania guyanensis was the most frequent species (90%). The most frequent presentation was ulcerative (90%). Lesions on the face and hands were frequent (40% each). Eight cases (26%) presented a poor outcome after treatment with pentamidine and required a second line with amphotericin B. Three of them required further treatments with meglumine antimoniate or miltefosine. Two spots within the training area were deemed as likely sites of contamination, due to illegal logging. The isolated Leishmania strains did not form a separate cluster. Participation in Week 13 of year 2020 was associated with infection (OR = 4.59 [1.10–19.83]; p = 0.016) while undergoing only the “Fighting” exercise was protective (OR = 0.1 [0–0.74]; p = 0.021). There was no association between infection and other risk factors at the individual level. The attack rate of Regiment B (14/105 = 13.3%) was significantly higher (OR = 4.22 [1.84–9.53], p = 0.0001) compared to Regiment A (16/507 = 3.2%). The attack rate during this training course (30/858 = 3.5%) was significantly higher (OR 2.29 [1.28–4.13]; p = 0.002) than for other missions in French Guiana during the same period (22/1427 = 1.5%).

Conclusions

This outbreak could be explained by a combination of factors: climatic conditions around week 13, at-risk activities including night trainings, absence of impregnation, a lesser experience of rainforest duties in Regiment B and illegal logging attracting sandflies on military training grounds.

Cutaneous Leishmaniasis is caused by parasites of the Leishmania genus and infects humans after a sandfly bite. Outbreaks are rare and hard to investigate in isolated tropical areas. In this study, the authors explored the different possible origins of an outbreak of cutaneous leishmaniasis among soldiers training in the rainforest of French Guiana. The outbreak occurred in March 2020. Concerning the symptoms, several patients presented resistant infections and multiple lines of treatment, raising the issue of resistant Leishmania strains. The different strains isolated during the outbreak were not genetically closed, as far as routine PCR techniques would indicate. The authors looked for individual behaviours exposing soldiers to sandfly bites but none was significantly associated with infection. The authors found two spots in the military training areas where illegal logging probably increased the density of sandflies and put service members at risk. The 13^th week of 2020 was associated to a higher risk of infection due to climatic conditions. This study shows how interactions between humans and the rainforest can increase the risk of parasitic outbreaks.

Potential vectors of Leishmania spp. in an Atlantic Forest conservation unit in northeastern Brazil under anthropic pressure

BACKGROUND

Phlebotomines are a group of insects which include vectors of the Leishmania parasites that cause visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL), diseases primarily affecting populations of low socioeconomic status. VL in Brazil is caused by Leishmania infantum, with transmission mainly attributed to Lutzomyia longipalpis, a species complex of sand fly, and is concentrated mainly in the northeastern part of the country. CL is distributed worldwide and occurs in five regions of Brazil, at a higher incidence in the north and northeast regions, with etiological agents, vectors, reservoirs and epidemiological patterns that differ from VL. The aim of this study was to determine the composition, distribution and ecological relationships of phlebotomine species in an Atlantic Forest conservation unit and nearby residential area in northeastern Brazil.

METHODS

Centers for Disease Control and Shannon traps were used for collections, the former at six points inside the forest and in the peridomestic environment of surrounding residences, three times per month for 36 months, and the latter in a forest area, once a month for 3 months. The phlebotomines identified were compared with climate data using simple linear correlation, Pearson's correlation coefficient and cross-correlation. The estimate of ecological parameters was calculated according to the Shannon-Wiener diversity index, standardized index of species abundance and the dominance index.

RESULTS

A total of 75,499 phlebotomines belonging to 11 species were captured in the CDC traps, the most abundant being Evandromyia walkeri, Psychodopygus wellcomei and Lu. longipalpis. Evandromyia walkeri abundance was most influenced by temperature at collection time and during the months preceding collection and rainfall during the months preceding collection. Psychodopygus wellcomei abundance was most affected by rainfall and relative humidity during the collection month and the month immediately preceding collection time. Lutzomyia longipalpis abundance showed a correlation with temperature and the rainfall during the months preceding collection time. The Shannon trap contained a total of 3914 phlebotomines from these different species. Psychodopygus wellcomei, accounting for 91.93% of the total, was anthropophilic and active mainly at night.

CONCLUSIONS

Most of the species collected in the traps were seasonal and exhibited changes in their composition and population dynamics associated with local adaptions. The presence of vectors Ps. wellcomei and Lu. longipalpis underscore the epidemiological importance of these phlebotomines in the conservation unit and surrounding anthropized areas. Neighboring residential areas should be permanently monitored to prevent VL or CL transmission and outbreaks.

Further insights into the eco-epidemiology of American cutaneous leishmaniasis in the Belem metropolitan region, Pará State, Brazil

INTRODUCTION:

In the Belém Metropolitan Region (BMR), Pará State, Brazil, American cutaneous leishmaniasis (ACL) is endemic; however, very little is known regarding its causative agents. Therefore, we used our standard diagnostic approach combined with an RNA polymerase II largest subunit (RNAPOIILS)-polymerase chain reaction (PCR) followed by analysis of restriction fragment length polymorphism (PCR-RFLP) to identify Leishmania spp. ACL agents in this region.

METHODS:

Thirty-two Leishmania spp. isolates from patients with ACL in the BMR during 1995-2018 were analyzed. Leishmania spp. DNA samples were amplified using the primers RPOR2/RPOF2, and the 615-bp PCR products were subjected to enzymatic digestion using TspRI and HgaI endonucleases.

RESULTS:

ACL etiological agents in the BMR comprised Leishmania (Viannia) lindenbergi (43.7%) followed by Leishmania (Viannia) lainsoni (34.4%), Leishmania (Leishmania) amazonensis (12.5%), and Leishmania (Viannia) braziliensis (9.4%).

CONCLUSIONS:

To our knowledge, the results of the study revealed for the first time that L. (V.) lindenbergi and L. (V.) lainsoni are the main ACL agents in BMR.

Phlebotomines (Diptera: Psychodidae) from a Urban Park of Belém, Pará State, Northern Brazil and Potential Implications in the Transmission of American Cutaneous Leishmaniasis

In urban ecotourism parks, the life cycle of American cutaneous leishmaniasis (ACL) agents can remain established, where phlebotomines may comprise potential risks for visitors. The present study aimed to survey the phlebotomine fauna of a forest park 'Bosque Rodriques Alves-Jardim Botânico da Amazônia' (BRAJBA), in the urban area of Belém, Brazil. The park was monthly surveyed in 2018 using CDC light traps placed in ground and canopy strata. Leishmania spp. isolated from dissected females were characterized by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) analysis. Fluctuations in specimen capture were correlated with rainfall. Nyssomyia antunesi (Coutinho, 1939) was predominant for all surveyed ecotopes and capture methods in both areas. Females of Ny. antunesi resting on tree bases were observed attempting to bite researchers during early morning. One Bichromomyia flaviscutellata (Mangabeira, 1942) and one Trichophoromyia brachipyga (Mangabeira, 1942) were found naturally infected by flagellates. Only the strain from Th. brachipyga was isolated and characterized as Leishmania (Viannia) lainsoni Silveira, Shaw, Braga and Ishikawa, 1987. Monthly fluctuations of the three most abundant species, Ny. antunesi, Trichophoromyia ubiquitalis (Mangabeira, 1942) and Th. brachypiga, had statistically significant negative correlations with rainfall. The present study provided further information to better understand ACL ecology in the Belém urban area, where the urban parks surveyed appeared to offer potential risk of contracting the disease, thus requiring environmental management. These observations highlighted the need for including Ny. antunesi, Bi. flaviscutellata, Th. ubiquitalis, and Th. brachypiga in the priority list for continuous entomological surveillance.

Molecular Evidence of Leishmania infantum and Leishmania guyanensis in Red Howler Monkey (Alouatta seniculus) from French Guiana

Presence of Leishmania spp. was evaluated in the blood of nine red howler monkeys (Alouatta seniculus) from a specific area of French Guiana, located in the northeast of the Amazon. The molecular detection was performed based on PCR targeting the markers 18S rRNA, kDNA and ITS2 genes, as well as rapid immunomigration tests. Two monkeys were positive for Leishmania infantum and one for Leishmania guyanensis. While L. guyanensis cutaneous leishmaniasis is common, visceral leishmaniasis (human and canine) caused by L. infantum has never been described in this area. The howler monkey proved to be a sentinel and a potential reservoir of a serious zoonosis. These results must be carefully considered by public health officials and veterinarians in the future.

Leishmania DNA detection and species characterization within phlebotomines (Diptera: Psychodidae) from a peridomicile-forest gradient in an Amazonian/Guianan bordering area

In the border region between Brazil and French Guiana, American cutaneous leishmaniasis is a worrisome public health issue, and entomological studies are required there to better identify classical and putative emerging transmission patterns. The present study aimed to detect and characterize Leishmania DNA in the phlebotomine population of Oiapoque (Amapá State, Brazil). Phlebotomines were captured in anthropized and wild environments in the outskirts of Oiapoque municipality, using CDC light traps installed in vertical (ground/canopy level) and horizontal (peridomicile/extradomicile/forest-edge/forest) strata. Captured specimens were identified according to their morphology. Females were processed for Leishmania DNA detection and characterization using a multiplex polymerase chain reaction targeting kinetoplast DNA (kDNA) and the phlebotomine cacophony gene. The kDNA positive samples were characterized by cloning and sequencing the Leishmania 234 bp-hsp70 gene. Among the 3957 phlebotomine specimens captured, 26 pooled female samples were positive for Leishmania (Viannia) spp. DNA. Sequencing analysis allowed species-specific identification of L. (V.) braziliensis DNA in Trichophoromyia ininii, Bichromomyia flaviscutellata, Nyssomyia umbratilis, and Evandromyia infraspinosa, and L. (V.) guyanensis DNA in Ny. umbratilis. A pooled sample of Ny. umbratilis was positive for both L. (V.) braziliensis and L. (V.) guyanensis DNA. The present study provided additional information regarding ACL ecology in Oiapoque, highlighting the presence of L. (V.) braziliensis DNA in different phlebotomine species. The epidemiological implications of these findings and the determinant incrimination of L. (V.) braziliensis as proven vectors in that region must be clarified. In this regard, studies on Leishmania spp. infection and suggestive anthropophilic behavior of associated phlebotomines need to be prioritized in entomological surveillance.