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Talebi-Talghian T, Ghogomu N. Uvular Lesion in a 62-Year-Old Man. JAMA Otolaryngol Head Neck Surg 2023; 149:940-941. [PMID: 37589979 DOI: 10.1001/jamaoto.2023.2223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
An otherwise healthy man in his early 60s presented with a sore throat and skin lesions on his neck. What is your diagnosis?
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Aronson NE, Billick K. Intralesional Antimonial Drug Treatment for Leishmania braziliensis Cutaneous Leishmaniasis: The Knowns and the Unknowns. Clin Infect Dis 2023; 77:583-588. [PMID: 37185765 DOI: 10.1093/cid/ciad248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/28/2023] [Accepted: 04/25/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Naomi E Aronson
- Infectious Diseases Division, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kendall Billick
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
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3
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Dueñas E, Nakamoto JA, Cabrera-Sosa L, Huaihua P, Cruz M, Arévalo J, Milón P, Adaui V. Novel CRISPR-based detection of Leishmania species. Front Microbiol 2022; 13:958693. [PMID: 36187950 PMCID: PMC9520526 DOI: 10.3389/fmicb.2022.958693] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/06/2022] [Indexed: 12/26/2022] Open
Abstract
Tegumentary leishmaniasis, a disease caused by protozoan parasites of the genus Leishmania, is a major public health problem in many regions of Latin America. Its diagnosis is difficult given other conditions resembling leishmaniasis lesions and co-occurring in the same endemic areas. A combination of parasitological and molecular methods leads to accurate diagnosis, with the latter being traditionally performed in centralized reference and research laboratories as they require specialized infrastructure and operators. Clustered regularly interspaced short palindromic repeats/CRISPR-associated protein (CRISPR/Cas) systems have recently driven innovative tools for nucleic acid detection that combine high specificity, sensitivity and speed and are readily adaptable for point-of-care testing. Here, we harnessed the CRISPR-Cas12a system for molecular detection of Leishmania spp., emphasizing medically relevant parasite species circulating in Peru and other endemic areas in Latin America, with Leishmania (Viannia) braziliensis being the main etiologic agent of cutaneous and mucosal leishmaniasis. We developed two assays targeting multi-copy targets commonly used in the molecular diagnosis of leishmaniasis: the 18S ribosomal RNA gene (18S rDNA), highly conserved across Leishmania species, and a region of kinetoplast DNA (kDNA) minicircles conserved in the L. (Viannia) subgenus. Our CRISPR-based assays were capable of detecting down to 5 × 10−2 (kDNA) or 5 × 100 (18S rDNA) parasite genome equivalents/reaction with PCR preamplification. The 18S PCR/CRISPR assay achieved pan-Leishmania detection, whereas the kDNA PCR/CRISPR assay was specific for L. (Viannia) detection. No cross-reaction was observed with Trypanosoma cruzi strain Y or human DNA. We evaluated the performance of the assays using 49 clinical samples compared to a kDNA real-time PCR assay as the reference test. The kDNA PCR/CRISPR assay performed equally well as the reference test, with positive and negative percent agreement of 100%. The 18S PCR/CRISPR assay had high positive and negative percent agreement of 82.1% and 100%, respectively. The findings support the potential applicability of the newly developed CRISPR-based molecular tools for first-line diagnosis of Leishmania infections at the genus and L. (Viannia) subgenus levels.
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Affiliation(s)
- Eva Dueñas
- Laboratory of Biomolecules, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Jose A. Nakamoto
- Laboratory of Biomolecules, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Luis Cabrera-Sosa
- Laboratory of Biomolecules, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Huaihua
- Laboratorio de Patho-antígenos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Cruz
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Hospital Nacional Adolfo Guevara Velasco, Cusco, Peru
| | - Jorge Arévalo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratorio de Patho-antígenos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Pohl Milón
- Laboratory of Biomolecules, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Vanessa Adaui
- Laboratory of Biomolecules, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- *Correspondence: Vanessa Adaui,
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De los Santos MB, Ramírez IM, Rodríguez JE, Beerli P, Valdivia HO. Genetic diversity and population structure of Leishmania (Viannia) braziliensis in the Peruvian jungle. PLoS Negl Trop Dis 2022; 16:e0010374. [PMID: 35605021 PMCID: PMC9126394 DOI: 10.1371/journal.pntd.0010374] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background Human cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis is highly prevalent in the Peruvian jungle, where it affects military forces deployed to fight against drug trafficking and civilian people that migrate from the highland to the lowland jungle for economic activities such as mining, agriculture, construction, and chestnut harvest. We explored the genetic diversity and population structure of 124 L. (V.) braziliensis isolates collected from the highland (Junín, Cusco, and Ayacucho) and lowland Peruvian jungle (Loreto, Ucayali, and Madre de Dios). All samples were genotyped using Multilocus Microsatellite Typing (MLMT) of ten highly polymorphic markers. Principal findings High polymorphism and genetic diversity were found in Peruvian isolates of L. (V.) braziliensis. Most markers are not in Hardy-Weinberg equilibrium; this deviation is most likely caused by local inbreeding, as shown by the positive FIS values. Linkage Disequilibrium in subpopulations was not strong, suggesting the reproduction was not strictly clonal. Likewise, for the first time, two genetic clusters of this parasite were determined, distributed in both areas of the Peruvian jungle, which suggested a possible recent colonization event of the highland jungle from the lowland jungle. Conclusions L. (V.) braziliensis exhibits considerable genetic diversity with two different clusters in the Peruvian jungle. Migration analysis suggested a colonization event between geographical areas of distribution. Although no human migration was observed at the time of sampling, earlier displacement of humans, reservoirs, or vectors could have been responsible for the parasite spread in both regions. L. (V.) braziliensis is widespread in the Peruvian jungle region. In this region, the departments of Cusco and Madre de Dios account for a large number of patients that get infected while working in the virgin forest. For the first time, we described ample genetic diversity among Peruvian L. (V.) braziliensis isolates with new alleles that were not previously reported in South America. In addition, two different genetic clusters or subpopulations of L. (V.) braziliensis in the Amazon Rainforest of Peru were described. This finding reveals the important distribution of parasite populations and suggests a possible colonization event between ecoregions of the highland and lowland Peruvian jungle independently of recent human migration.
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Affiliation(s)
| | | | - Jorge E. Rodríguez
- Unidad de Biotecnología Molecular, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Peter Beerli
- Department of Scientific Computing, Florida State University, Tallahassee, Florida, United States of America
| | - Hugo O. Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit 6, Lima, Peru
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5
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Ocampo CB, Guzmán-Rodríguez L, Moreno M, Castro MDM, Valderrama-Ardila C, Alexander N. Integration of phlebotomine ecological niche modelling, and mapping of cutaneous leishmaniasis surveillance data, to identify areas at risk of under-estimation. Acta Trop 2021; 224:106122. [PMID: 34480871 PMCID: PMC9017289 DOI: 10.1016/j.actatropica.2021.106122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/13/2021] [Accepted: 08/25/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Passive surveillance systems are thought to under-estimate the true incidence of American cutaneous leishmaniasis (ACL) by two- to five-fold. Ecological niche models based on remotely sensed data can identify environmental factors which favor phlebotomine vectors. Here we report an integrated approach to identifying areas at risk of cutaneous leishmaniasis by applying spatial analysis methods to niche model results, and local surveillance data, in two locations in Colombia with differing vector ecology. The objective was to identify townships in which later phases of the project could implement community-based surveillance to obtain direct estimates of under-reporting. MATERIALS AND METHODS The study was carried out in one municipality in each of two departments of the Andean region of Colombia: Pueblo Rico in Risaralda, and Rovira in Tolima. Niche mapping by maximum entropy, based on published and unpublished existing locations of Pintomyia (Pifanomyia) longiflocosa and Psychodopygus panamensis, and using variables on land cover, climate and elevation. Field catches were done in each municipality to test predictions of high relative probability of presence. The niche model results were included as a predictor in a conditional autoregressive spatial model, in which the outcome variable was the number of cases by township, as detected by passive surveillance. RESULTS Having rarefied 173 geolocated records, 46 of Pi. longiflocosa and 57 of Ps. panamensis were used for the niche modelling. At the national level, both species had high relative probability of presence on parts of the slopes of the three Andean cordilleras. Pi. longiflocosa also has a high relative probability of presence in the higher parts of the Magdalena valley, as does Ps. panamensis in some areas close to the Caribbean coast. At the local level, field catches confirmed that Pi. longiflocosa was the most abundant species in Rovira, and likewise Ps. panamensis in Pueblo Rico. The spatial regression showed that the incidence of ACL, according to surveillance, was positively, but not statistically significantly, associated with the relative probability of presence from the risk model. CONCLUSIONS These niche maps bring together published and unpublished results on phlebotomine species which are important vectors in Colombia. Maps of the fitted values of incidence were used to guide the selection of townships in which further phases of the study will attempt to quantify the extent of under-estimation of ACL incidence.
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Affiliation(s)
- Clara B Ocampo
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia; Universidad Icesi., Cali, Colombia; Ministerio de Ciencia Tecnología e Innovación (Minciencias), Bogotá, Colombia
| | - Lina Guzmán-Rodríguez
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia
| | - Mabel Moreno
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia
| | - María Del Mar Castro
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia; Universidad Icesi., Cali, Colombia
| | | | - Neal Alexander
- Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM. Cali, Colombia; Universidad Icesi., Cali, Colombia.
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Marzochi MCDA, Marzochi KBF, Fagundes A, Schubach ADO, Miranda LDFC, Pacheco RDS. Anthropogenic Dispersal of Leishmania (Viannia) braziliensis in the Americas: A Plausible Hypothesis. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.723017] [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
There are several gaps in our knowledge on the origin and spread of Leishmania (Viannia) braziliensis, an etiological agent of cutaneous and mucocutaneous or American tegumentary leishmaniasis, to different biomes, hosts, and vectors, with important epidemiological implications, including the possible existence of an anthroponotic component. Historical, biological, and epidemiological evidence suggests that Leishmania (V.) braziliensis and its variants were preexistent in Amazonia with great genetic variability, where they dispersed with less variability to other regions (clonal expansion). During pre-Columbian times the parasite may have been transported by migrating humans and probably also their dogs, from western Amazonia to the high inter-Andean valleys and from there to other regions of South America. The same thing could have happened later, in the same way, when it spread to non-Amazonian regions of Brazil and other countries of South and Central America, between the late 19th and early 20th centuries, during the so-called Rubber Boom and construction of the Madeira-Mamoré Railway in the Brazilian Amazon, by migrant workers who later returned to their places of origin, transporting the agent. The parasite’s dispersal in genetic correlated clusters, involving unexpectedly distinct ecosystems in Brazil (Amazonian, Cerrado, Caatinga and Atlantic Forest biomes), has continued until the present through human displacement. The infection of certain species of domestic, synanthropic and even wild animals, could be secondary to anthropogenic introduction of L. (V.) braziliensis in new environments. We admit the same phenomena happening in the probable transference of Leishmania infantum (visceral leishmaniasis), and of Yersinia pestis (plague) from the Old world to the New world, generating domestic and wild enzotic cycles from these agents. These assumptions associated with human infections, chronicity and parasite persistence with possibility of recovery of Leishmania in peripheral blood, skin and scars of cured or asymptomatic patients, (that may provide an alternative blood meal), along with the sand flies’ adaptation to the peri-domicile and the high susceptibility of domestic dogs, horses, mules and cats to the parasite, can reinforce the evidence of anthropogenic spread of L. (V.) braziliensis.
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Gutierrez MAC, Lopez ROH, Ramos AT, Vélez ID, Gomez RV, Arrivillaga-Henríquez J, Uribe S. DNA barcoding of Lutzomyia longipalpis species complex (Diptera: Psychodidae), suggests the existence of 8 candidate species. Acta Trop 2021; 221:105983. [PMID: 34048789 DOI: 10.1016/j.actatropica.2021.105983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/27/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
The sand fly Lutzomyia (L.) longipalpis has been implicated as the primary vector of Leishmania infantum, the causative agent of visceral leishmaniasis VL. In addition, it has been associated with atypical cutaneous leishmaniasis transmission in the Neotropic and Central America, respectively. The existence of a L. longipalpis complex species has been suggested with important implications for leishmaniasis epidemiology; however, the delimitation of species conforming it remains a topic of controversy. The DNA Barcoding Initiative based on cox1 sequence variation was used to identify the MOTUs in L. longipalpis including previously described L. pseudolongipalpis. The genetic variation was analyzed based on tree and distance methods. Fifty-five haplotypes were obtained from 103 sequences which were assigned to MOTUs, with a clear separation and a high correspondence of individuals to the groups. Maximum likelihood and Bayesian phylogenetic analysis showed eight MOTUs (100% bootstrap) with high genetic divergence (12.6%). Data obtained in the present study suggest that L. longipalpis complex consists of at least 8 lineages that may represent species. It would be desirable perform additional morphological and molecular analysis of L. longipalpis from Colosó (Caribbean ecoregion) considering that specimens from that area were grouped with L. pseudolongipalpis one of the complex species previously described from Venezuela, which has not been registered in Colombia.
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García Oronoz G, Pedraza-Arévalo LC, Henao-Martínez AF, Franco-Paredes C, Suarez JA. Visceral leishmaniasis in the island of Margarita, Venezuela: a neglected parasitic infection in the Caribbean. Ther Adv Infect Dis 2021; 8:20499361211031714. [PMID: 34377462 PMCID: PMC8320547 DOI: 10.1177/20499361211031714] [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: 04/06/2021] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis carries a significant burden of disease in the Americas with up to 7000 cases reported annually. There are several reports of autochthonous visceral leishmaniasis cases in the Caribbean, including the Dominican Republic, Guadalupe, Martinique, and Trinidad and Tobago. However, we lack recent clinical description and epidemiologic data of visceral leishmaniasis in other islands in the Caribbean. Herein, we describe an autochthonous case of visceral leishmaniasis in the Caribbean Island of Margarita in Venezuela. This index case of visceral leishmaniasis highlights the need for further regional surveillance efforts to identify animal reservoirs and to monitor the occurrence of further clinical cases. Additionally, there is an urgent need for implementing vector control strategies.
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Affiliation(s)
- Gerardine García Oronoz
- Pediatric Infectious Diseases Service, Hospital Dr. Jesus Garcia Coello, Judibana, Venezuela
| | | | - Andrés F Henao-Martínez
- Infectious Diseases Division, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO 80045, USA
| | - Carlos Franco-Paredes
- Infectious Diseases Division, University of Colorado Anschutz Medical Campus, Aurora CO, USA
| | - José A Suarez
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panamá City, Panamá
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Torrico MC, Fernández-Arévalo A, Ballart C, Solano M, Rojas E, Ariza E, Tebar S, Lozano D, Abras A, Gascón J, Picado A, Muñoz C, Torrico F, Gállego M. Tegumentary leishmaniasis by Leishmania braziliensis complex in Cochabamba, Bolivia including the presence of L. braziliensis outlier: Tegumentary leishmaniasis in Cochabamba, Bolivia. Transbound Emerg Dis 2021; 69:2242-2255. [PMID: 34232559 DOI: 10.1111/tbed.14228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/27/2021] [Accepted: 07/05/2021] [Indexed: 01/07/2023]
Abstract
Leishmaniasis is caused by protozoans of the Leishmania genus, which includes more than 20 species capable of infecting humans worldwide. In the Americas, the most widespread specie is L. braziliensis, present in 18 countries including Bolivia. The taxonomic position of the L. braziliensis complex has been a subject of controversy, complicated further by the recent identification of a particular subpopulation named L. braziliensis atypical or outlier. The aim of this study was to carry out a systematic analysis of the L. braziliensis complex in Bolivia and to describe the associated clinical characteristics. Forty-one strains were analyzed by sequencing an amplified 1245 bp fragment of the hsp70 gene, which allowed its identification as: 24 (59%) L. braziliensis, 16 (39%) L. braziliensis outlier, and one (2%) L. peruviana. In a dendrogram constructed, L. braziliensis and L. peruviana are grouped in the same cluster, whilst L. braziliensis outlier appears in a separate branch. Sequence alignment allowed the identification of five non-polymorphic nucleotide positions (288, 297, 642, 993, and 1213) that discriminate L. braziliensis and L. peruviana from L. braziliensis outlier. Moreover, nucleotide positions 51 and 561 enable L. peruviana to be discriminated from the other two taxa. A greater diversity was observed in L. braziliensis outlier than in L. braziliensis-L. peruviana. The 41 strains came from 32 patients with tegumentary leishmaniasis, among which 22 patients (69%) presented cutaneous lesions (11 caused by L. braziliensis and 11 by L. braziliensis outlier) and 10 patients (31%) mucocutaneous lesions (eight caused by L. braziliensis, one by L. braziliensis outlier, and one by L. peruviana). Nine patients (28%) simultaneously provided two isolates, each from a separate lesion, and in each case the same genotype was identified in both. Treatment failure was observed in six patients infected with L. braziliensis and one patient with L. peruviana.
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Affiliation(s)
- Mary Cruz Torrico
- Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia.,Fundación CEADES y Medio Ambiente, Cochabamba, Bolivia.,Secció de Parasitología, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
| | - Anna Fernández-Arévalo
- Secció de Parasitología, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain
| | - Cristina Ballart
- Secció de Parasitología, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain
| | - Marco Solano
- Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Ernesto Rojas
- Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Eva Ariza
- Secció de Parasitología, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain
| | - Silvia Tebar
- Secció de Parasitología, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
| | - Daniel Lozano
- Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia.,Fundación CEADES y Medio Ambiente, Cochabamba, Bolivia
| | - Alba Abras
- Secció de Parasitología, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Laboratori d'Ictiologia Genètica, Departament de Biologia, Universitat de Girona, Girona, Spain
| | - Joaquim Gascón
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain
| | - Albert Picado
- Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain.,Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Carmen Muñoz
- Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Faustino Torrico
- Facultad de Medicina, Universidad Mayor de San Simón, Cochabamba, Bolivia.,Fundación CEADES y Medio Ambiente, Cochabamba, Bolivia
| | - Montserrat Gállego
- Secció de Parasitología, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, Spain
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Clinical and immunological characteristics of tegumentary leishmaniasis cases in Bolivia. PLoS Negl Trop Dis 2021; 15:e0009223. [PMID: 33667232 PMCID: PMC7968743 DOI: 10.1371/journal.pntd.0009223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 03/17/2021] [Accepted: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Tegumentary leishmaniasis (TL) is a parasitic disease that can present a cutaneous or mucocutaneous clinical form (CL and MCL, respectively). The disease is caused by different Leishmania species and transmitted by phlebotomine sand flies. Bolivia has one of the highest incidences of the disease in South America and the diagnosis is done by parasitological techniques. Our aim was to describe the clinical and immunological characteristics of CL and MCL patients attending the leishmaniasis reference center in Cochabamba, Bolivia, in order to gain updated clinical and epidemiological information, to evaluate the diagnostic methods used and to identify biomarkers related to clinical disease and its evolution. METHODOLOGY/PRINCIPAL FINDINGS The study was conducted from September 2014 to November 2015 and 135 patients with lesions compatible with CL or MCL were included. Epidemiological and clinical data were collected using a semi-structured questionnaire. Two parasitological diagnostic methods were used: Giemsa-stained smears and culture of lesion aspirates. Blood samples obtained from participants were used to measure the concentrations of different cytokines. 59.2% (80/135) were leishmaniasis confirmed cases (CL: 71.3%; MCL: 28.7%). Sixty percent of the confirmed cases were positive by smears and 90.6% were positive by culture. 53.8% were primo-infections. Eotaxin and monokine induced by IFN-γ presented higher serum concentrations in the MCL clinical presentation compared to CL cases and no-cases. None of the cytokines presented different concentrations between primo-infections and secondary infections due to treatment failure. CONCLUSIONS/SIGNIFICANCE In Bolivia, parasitological diagnosis remains the reference standard in diagnosis of leishmaniasis because of its high specificity, whereas the sensitivity varies over a wide range leading to loss of cases. Until more accurate tools are implemented, all patients should be tested by both smears and culture of lesion aspirates to minimize the risk of false negatives. Our results showed higher concentrations of several cytokines in MCL compared to CL, but no differences were observed between CL and no-cases. In addition, none of the cytokines differed between primary and secondary infections. These results highlight the need of further research to identify biomarkers of susceptibility and disease progression, in addition to looking at the local cellular immune responses in the lesions.
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de Almeida JV, de Souza CF, Fuzari AA, Joya CA, Valdivia HO, Bartholomeu DC, Brazil RP. Diagnosis and identification of Leishmania species in patients with cutaneous leishmaniasis in the state of Roraima, Brazil's Amazon Region. Parasit Vectors 2021; 14:32. [PMID: 33413563 PMCID: PMC7791761 DOI: 10.1186/s13071-020-04539-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/11/2020] [Indexed: 12/18/2022] Open
Abstract
Background Cutaneous leishmaniasis (CL) is an endemic disease in Brazil that is highly prevalent in the northern region of the country. Although there is a continuous and growing number of cases registered in the state of Roraima, there is limited information regarding the species of Leishmania that affect the human population. In this study, we aimed to characterize which Leishmania species cause human disease in those presenting with cutaneous leishmaniasis in endemic areas of the State of Roraima. Methods We conducted a prospective surveillance study between 2016 to 2018 in health centers located in the State of Roraima, Brazil. Participants with clinical suspicion of CL were enrolled and provided lesion samples for parasitological detection by microscopy. A subset of the samples was tested by polymerase chain reaction and sequencing of the internal transcribed spacer 1 (ITS-1 PCR) for molecular species identification. Results A total of 262 participants were enrolled in this study. Of those, 129 (49.27%) were positive by parasitological examination. Most positive subjects (81.58%) were male, and most cases presented a single lesion (80.26%). ITS-1 PCR and sequencing on a subset of 76 samples allowed us to detect nine different species of Leishmania: L. (V.) braziliensis, L (V.) panamensis, L. (V.) guyanensis, L. (V.) naiffi, L. (V.) shawi, L.(V.) utingensis, L. (V.) lindenbergi, L. (L.) amazonensis and L. (L.) mexicana. Conclusions Our study provides the first assessment of circulating species of Leishmania in the State of Roraima, Brazil, and shows the high diversity in this region. This study opens the path for further research on the transmission of leishmaniasis in the northernmost Brazilian State including vector and reservoir surveillance as well as for intensification of investigation and control activities against CL in the region.![]()
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Affiliation(s)
- Joseneide Viana de Almeida
- Programa de Pós-Graduação em Biologia Parasitária, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Cristian Ferreira de Souza
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Andressa Alencastre Fuzari
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Christie A Joya
- Department of Parasitology, US Naval Medical Research Unit 6, Lima, Peru
| | - Hugo O Valdivia
- Department of Parasitology, US Naval Medical Research Unit 6, Lima, Peru
| | | | - Reginaldo Peçanha Brazil
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
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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: 29] [Impact Index Per Article: 7.3] [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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13
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Santamaría E, Cabrera OL, Pardo RH. Efficacy of factory-treated and dip-it-yourself long lasting insecticide-treated bednets against cutaneous leishmaniasis vectors in the sub-Andean region of Colombia: results after two years of use. Mem Inst Oswaldo Cruz 2020; 115:e190431. [PMID: 32935748 PMCID: PMC7491276 DOI: 10.1590/0074-02760190431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 08/17/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Long lasting insecticide-treated nets (LLINs) may be effective for vector control of cutaneous leishmaniasis (CL). Their efficacy, however, has not been sufficiently evaluated. OBJECTIVE To evaluate the large-scale efficacy of LLINs on Lutzomyia longiflocosa entomological parameters up to two years post-intervention in the sub-Andean region of Colombia. METHODS A matched-triplet cluster-randomised study of 21 rural settlements, matched by pre-intervention L. longiflocosa indoor density was used to compare three interventions: dip it yourself (DIY) lambda-cyhalothrin LLIN, deltamethrin LLIN, and untreated nets (control). Sand fly indoor density, feeding success, and parity were recorded using CDC light trap collections at 1, 6, 12, and 24 months post-intervention. FINDINGS Both LLINs reduced significantly (74-76%) the indoor density and the proportion of fully engorged sand flies up to two years post-intervention without differences between them. Residual lethal effects of both LLINs and the use of all nets remained high throughout the two-year evaluation period. CONCLUSIONS Both LLINs demonstrated high efficacy against L. longiflocosa indoors. Therefore, the deployment of these LLINs could have a significant impact on the reduction of CL transmission in the sub-Andean region. The DIY lambda-cyhalothrin kit may be used to convert untreated nets to LLINs increasing coverage.
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Affiliation(s)
- Erika Santamaría
- Instituto Nacional de Salud, Grupo de Entomología, Bogotá, Colombia
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Pinart M, Rueda JR, Romero GA, Pinzón-Flórez CE, Osorio-Arango K, Silveira Maia-Elkhoury AN, Reveiz L, Elias VM, Tweed JA. Interventions for American cutaneous and mucocutaneous leishmaniasis. Cochrane Database Syst Rev 2020; 8:CD004834. [PMID: 32853410 PMCID: PMC8094931 DOI: 10.1002/14651858.cd004834.pub3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND On the American continent, cutaneous and mucocutaneous leishmaniasis (CL and MCL) are diseases associated with infection by several species of Leishmania parasites. Pentavalent antimonials remain the first-choice treatment. There are alternative interventions, but reviewing their effectiveness and safety is important as availability is limited. This is an update of a Cochrane Review first published in 2009. OBJECTIVES To assess the effects of interventions for all immuno-competent people who have American cutaneous and mucocutaneous leishmaniasis (ACML). SEARCH METHODS We updated our database searches of the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, LILACS and CINAHL to August 2019. We searched five trials registers. SELECTION CRITERIA Randomised controlled trials (RCTs) assessing either single or combination treatments for ACML in immuno-competent people, diagnosed by clinical presentation and Leishmania infection confirmed by smear, culture, histology, or polymerase chain reaction on a biopsy specimen. The comparators were either no treatment, placebo only, or another active compound. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Our key outcomes were the percentage of participants 'cured' at least three months after the end of treatment, adverse effects, and recurrence. We used GRADE to assess evidence certainty for each outcome. MAIN RESULTS We included 75 studies (37 were new), totalling 6533 randomised participants with ATL. The studies were mainly conducted in Central and South America at regional hospitals, local healthcare clinics, and research centres. More male participants were included (mean age: roughly 28.9 years (SD: 7.0)). The most common confirmed species were L. braziliensis, L. panamensis, and L. mexicana. The most assessed interventions and comparators were non-antimonial systemics (particularly oral miltefosine) and antimonials (particularly meglumine antimoniate (MA), which was also a common intervention), respectively. Three studies included moderate-to-severe cases of mucosal leishmaniasis but none included cases with diffuse cutaneous or disseminated CL, considered the severe cutaneous form. Lesions were mainly ulcerative and located in the extremities and limbs. The follow-up (FU) period ranged from 28 days to 7 years. All studies had high or unclear risk of bias in at least one domain (especially performance bias). None of the studies reported the degree of functional or aesthetic impairment, scarring, or quality of life. Compared to placebo, at one-year FU, intramuscular (IM) MA given for 20 days to treat L. braziliensis and L. panamensis infections in ACML may increase the likelihood of complete cure (risk ratio (RR) 4.23, 95% confidence interval (CI) 0.84 to 21.38; 2 RCTs, 157 participants; moderate-certainty evidence), but may also make little to no difference, since the 95% CI includes the possibility of both increased and reduced healing (cure rates), and IMMA probably increases severe adverse effects such as myalgias and arthralgias (RR 1.51, 95% CI 1.17 to 1.96; 1 RCT, 134 participants; moderate-certainty evidence). IMMA may make little to no difference to the recurrence risk, but the 95% CI includes the possibility of both increased and reduced risk (RR 1.79, 95% CI 0.17 to 19.26; 1 RCT, 127 participants; low-certainty evidence). Compared to placebo, at six-month FU, oral miltefosine given for 28 days to treat L. mexicana, L. panamensis and L. braziliensis infections in American cutaneous leishmaniasis (ACL) probably improves the likelihood of complete cure (RR 2.25, 95% CI 1.42 to 3.38), and probably increases nausea rates (RR 3.96, 95% CI 1.49 to 10.48) and vomiting (RR 6.92, 95% CI 2.68 to 17.86) (moderate-certainty evidence). Oral miltefosine may make little to no difference to the recurrence risk (RR 2.97, 95% CI 0.37 to 23.89; low-certainty evidence), but the 95% CI includes the possibility of both increased and reduced risk (all based on 1 RCT, 133 participants). Compared to IMMA, at 6 to 12 months FU, oral miltefosine given for 28 days to treat L. braziliensis, L. panamensis, L. guyanensis and L. amazonensis infections in ACML may make little to no difference to the likelihood of complete cure (RR 1.05, 95% CI 0.90 to 1.23; 7 RCTs, 676 participants; low-certainty evidence). Based on moderate-certainty evidence (3 RCTs, 464 participants), miltefosine probably increases nausea rates (RR 2.45, 95% CI 1.72 to 3.49) and vomiting (RR 4.76, 95% CI 1.82 to 12.46) compared to IMMA. Recurrence risk was not reported. For the rest of the key comparisons, recurrence risk was not reported, and risk of adverse events could not be estimated. Compared to IMMA, at 6 to 12 months FU, oral azithromycin given for 20 to 28 days to treat L. braziliensis infections in ACML probably reduces the likelihood of complete cure (RR 0.51, 95% CI 0.34 to 0.76; 2 RCTs, 93 participants; moderate-certainty evidence). Compared to intravenous MA (IVMA) and placebo, at 12 month FU, adding topical imiquimod to IVMA, given for 20 days to treat L. braziliensis, L. guyanensis and L. peruviana infections in ACL probably makes little to no difference to the likelihood of complete cure (RR 1.30, 95% CI 0.95 to 1.80; 1 RCT, 80 participants; moderate-certainty evidence). Compared to MA, at 6 months FU, one session of local thermotherapy to treat L. panamensis and L. braziliensis infections in ACL reduces the likelihood of complete cure (RR 0.80, 95% CI 0.68 to 0.95; 1 RCT, 292 participants; high-certainty evidence). Compared to IMMA and placebo, at 26 weeks FU, adding oral pentoxifylline to IMMA to treat CL (species not stated) probably makes little to no difference to the likelihood of complete cure (RR 0.86, 95% CI 0.63 to 1.18; 1 RCT, 70 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS Evidence certainty was mostly moderate or low, due to methodological shortcomings, which precluded conclusive results. Overall, both IMMA and oral miltefosine probably result in an increase in cure rates, and nausea and vomiting are probably more common with miltefosine than with IMMA. Future trials should investigate interventions for mucosal leishmaniasis and evaluate recurrence rates of cutaneous leishmaniasis and its progression to mucosal disease.
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Affiliation(s)
- Mariona Pinart
- Free time independent Cochrane reviewer, Berlin, Germany
| | - José-Ramón Rueda
- Department of Preventive Medicine and Public Health, University of the Basque Country, Leioa, Spain
| | - Gustavo As Romero
- Center for Tropical Medicine, University of Brasilia, Brasilia, Brazil
| | | | - Karime Osorio-Arango
- Dirección de Redes en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
| | - Ana Nilce Silveira Maia-Elkhoury
- Communicable Diseases and Environmental Determinants of Health (CDE), Neglected, Tropical and Vector Borne Diseases (VT), Pan American Health Organization/ World Health Organization (PAHO/WHO), Rio de Janeiro, Brazil
| | - Ludovic Reveiz
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington DC, USA
| | - Vanessa M Elias
- Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington DC, USA
| | - John A Tweed
- c/o Cochrane Skin Group, The University of Nottingham, Nottingham, UK
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Correa JP, Bacigalupo A, Yefi-Quinteros E, Rojo G, Solari A, Cattan PE, Botto-Mahan C. Trypanosomatid Infections among Vertebrates of Chile: A Systematic Review. Pathogens 2020; 9:E661. [PMID: 32824290 PMCID: PMC7460458 DOI: 10.3390/pathogens9080661] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/08/2020] [Accepted: 08/14/2020] [Indexed: 01/05/2023] Open
Abstract
We present a review on the natural infection by trypanosomatids of nonhuman vertebrates in Chile, aiming to synthesize and update the knowledge on the diversity of trypanosomatids infecting native and alien vertebrate species. To this end, we conducted a systematic review of literature records published from 1900 to April 2020 on four databases, focusing on the 21 genera of trypanosomatids and Chile. The methods and findings of our review have been based on the preferred reporting items for systematic reviews and meta-analysis (prisma) checklist. We found 29,756 records but only 71 presented relevant information for this review. Overall, there are only two reported trypanosomatid genera infecting vertebrate species in Chile, the genera Trypanosoma and Leishmania. The former is mostly represented by Trypanosoma cruzi (90% of the total records) and to a much lesser extent by Trypanosoma avium, Trypanosoma humboldti, Trypanosoma lewisi, and a couple of unidentified trypanosomatids. A total of 25 mammals have been reported as being infected by T. cruzi, including 14 native and 11 alien species from Orders Artiodactyla, Carnivora, Chiroptera, Didelphimorphia, Lagomorpha, Perissodactyla, and Rodentia. Extensive screening studies using new analytical tools are necessary to grasp the whole potential diversity of trypanosomatid species infecting vertebrates in Chile.
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Affiliation(s)
- Juana P. Correa
- Facultad de Medicina Veterinaria, Universidad San Sebastián, Concepción 4080871, Chile;
| | - Antonella Bacigalupo
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK;
- Departamento de Ciencias Biológicas Animales, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820808, Chile; (E.Y.-Q.); (P.E.C.)
| | - Esteban Yefi-Quinteros
- Departamento de Ciencias Biológicas Animales, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820808, Chile; (E.Y.-Q.); (P.E.C.)
| | - Gemma Rojo
- Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8380000, Chile; (G.R.); (A.S.)
- Instituto de Ciencias Agroalimentarias, Animales y Ambientales (ICA3), Universidad de O’Higgins, San Fernando 3070000, Chile
| | - Aldo Solari
- Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 8380000, Chile; (G.R.); (A.S.)
| | - Pedro E. Cattan
- Departamento de Ciencias Biológicas Animales, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820808, Chile; (E.Y.-Q.); (P.E.C.)
| | - Carezza Botto-Mahan
- Departamento de Ciencias Ecológicas, Facultad de Ciencias, Universidad de Chile, Santiago 7800003, Chile
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16
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Machado CAL, Sevá ADP, Dantas-Torres F, Horta MC. Spatial analysis and epidemiological profile of visceral leishmaniasis, northeastern Brazil: A cross-sectional study. Acta Trop 2020; 208:105520. [PMID: 32413361 DOI: 10.1016/j.actatropica.2020.105520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 02/03/2023]
Abstract
Most visceral leishmaniasis (VL) cases reported in Brazil are from the northeast region, where the disease is strongly linked to poverty. In spite of the still existing inequalities, many social improvements were achieved in the past decades in this region, but the possible impact of these improvements on VL remains poorly investigated. We conducted a cross-sectional study coupled with a spatial analysis of VL cases notified in northeastern Brazil from 2007 to 2017. In total, 21,703 cases were reported during this period, with an annual incidence of 3.6 cases per 100,000 inhabitants. Children under 10 years old and males were more affected, and most cases were from urban areas. Living in municipalities situated in the Cerrado, Amazon or, to a lesser extent, in the Caatinga biomes was a risk factor for VL. This study indicates that the epidemiological profile of VL patients remained unchanged in northeastern Brazil, suggesting that social improvements achieved in this region were not enough to mitigate the risk of this disease among the most affected populations.
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Affiliation(s)
| | - Anaiá da Paixão Sevá
- Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Rod. Jorge Amado, Km 16 - Salobrinho, Ilhéus, Bahia, 45662-900 Brazil
| | - Filipe Dantas-Torres
- Instituto Aggeu Magalhães (Fiocruz-PE), Campus da UFPE - Av. Prof. Moraes Rego, s/n - Cidade Universitária, Recife, Pernambuco, 50740-465 Brazil
| | - Maurício Claudio Horta
- Universidade Federal Rural de Pernambuco, Dom Manuel de Medeiros, s/n - Dois Irmãos, Recife Pernambuco, 52171-900, Brazil; Universidade Federal do Vale do São Francisco, Rodovia BR-407, KM 12 Lote 543 S/n Projeto de Irrigação Nilo Coelho, Petrolina, Pernambuco, 56300-000, Brazil.
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Buzanovsky LP, Sanchez-Vazquez MJ, Maia-Elkhoury ANS, Werneck GL. Major environmental and socioeconomic determinants of cutaneous leishmaniasis in Brazil - a systematic literature review. Rev Soc Bras Med Trop 2020; 53:e20190291. [PMID: 32491100 PMCID: PMC7269534 DOI: 10.1590/0037-8682-0291-2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/13/2020] [Indexed: 11/22/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a zoonotic disease with complex transmission
cycle. Some environmental and socioeconomic factors are known to be the major
determinants of the transmission process, which are involved in configuring the
spatiotemporal patterns and thus can be delimiting. However, the relevance of
these socioeconomic and environmental determinants is still not well understood.
In this study, we aimed to identify the major environmental and socioeconomic
determinants of CL in Brazil by articulating a systematic literature review of
studies that are based on this subject. The methodology included a search for
studies according to a structured protocol using the scientific platforms, such
as Scielo and PubMed. The references of each identified article were who
referred to CL determinants were further screened, and so on. We extracted
information from 41 articles and the determinants were grouped accordingly. Two
measures were evaluated as follows: a) the frequency of citations of the
determinants; and b) the proportion of determinants identified as having
"significant association in analytical studies" with respect to the total number
of determinants analyzed in other analytical studies using the same concept. The
analyzed articles covered most of the regions of Brazil and 7 other countries
bordering Brazil. We found 43 concepts of determinants. However, the final
selection resulted in the identification of 14 major determinants. These results
therefore contribute in the identification of major CL determinants and this
information can be used to establish strategies for identifying risk prone areas
for disease surveillance.
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Affiliation(s)
- Lia Puppim Buzanovsky
- Department of Epidemiology, Pan American Health Organization, World Health Organization, Duque de Caxias, RJ, Brazil
| | - Manuel José Sanchez-Vazquez
- Department of Epidemiology, Pan American Health Organization, World Health Organization, Duque de Caxias, RJ, Brazil
| | - Ana Nilce Silveira Maia-Elkhoury
- Communicable Disease and Environmental Determinants of Health (CDE) Neglected, Tropical and Vector Borne Diseases (VT), Pan American Health Organization, World Health Organization, Washington, D.C., USA
| | - Guilherme Loureiro Werneck
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Hashiguchi Y, Hashiguchi K, Zambrano FC, Parraga FD, Martillo VP, Torres EX, Velez LN, Villegas NV, Gomez EA, Kato H. Natural Leishmania (Leishmania) mexicana infection and biting activity of anthropophilic sand fly Lutzomyia ayacuchensis in the Ecuadorian Andes. Acta Trop 2020; 203:105321. [PMID: 31877283 DOI: 10.1016/j.actatropica.2019.105321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/21/2019] [Accepted: 12/21/2019] [Indexed: 11/18/2022]
Abstract
To elucidate the transmission mode of Andean cutaneous leishmaniasis (Andean-CL), natural Leishmania infection and biting activity of sand flies were tested in a selected sylvatic focus of the endemic area of the Ecuadorian Andes. Monthly sand fly collections and dissections were conducted during 12 months from July 2018 to June 2019. The Leishmania positive specimens/slides with innumerable amounts of actively mobile flagellates made us easy to detect positive sand flies. The promastigotes observed located in the anterior and posterior midgut, without the hindgut localization. The parasite isolated was identified as L. (L.) mexicana by cytochrome b gene analysis. No other Leishmania or flagellate species parasitic in sand flies was observed in the area. Only Lu. ayacuchensis was caught throughout. Monthly microscopic examination of Lu. ayacuchensis revealed 0.75-8.33% of natural L. (L.) mexicana infection rates. Higher Leishmania infection months were present at the end of the wet season of the Andes, while higher sand fly numbers occurred during the dry season. Diurnal biting (blood meal seeking) activity of sand flies started around 17:30 before sunset, increased between 18:00 and 19:30, and thereafter decreased drastically probably because of low temperature (15-18 °C) in the area. The results provide information important for the planning of vector control strategy and management of the disease in the Andean-CL endemic area of Ecuador.
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Affiliation(s)
- Yoshihisa Hashiguchi
- Departamento de Parasitologia y Medicina Tropical, Carrera de Medicina, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Department of Parasitology, Kochi Medical School, Kochi University, Kochi, Japan.
| | - Kazue Hashiguchi
- Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Flavio C Zambrano
- Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Ministerio de Salud Publica, Ecuador
| | | | - Viriginia P Martillo
- Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Ministerio de Salud Publica, Ecuador
| | - Edison X Torres
- Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Ministerio de Salud Publica, Ecuador
| | - Lenin N Velez
- Departamento de Parasitologia y Medicina Tropical, Carrera de Medicina, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Ministerio de Salud Publica, Ecuador
| | - Nancy V Villegas
- Departamento de Parasitologia y Medicina Tropical, Carrera de Medicina, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Eduardo A Gomez
- Departamento de Parasitologia y Medicina Tropical, Carrera de Medicina, Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Leishmaniasis Project (SINDE-SIU #415-214), Facultad de Ciencias Medicas, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador; Ministerio de Salud Publica, Ecuador
| | - Hirotomo Kato
- Division of Medical Zoology, Department of Infection and Immunity, School of Medicine, Jichi Medical University, Tochigi, Japan
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Solomon M, Sahar N, Pavlotzky F, Barzilai A, Jaffe CL, Nasereddin A, Schwartz E. Mucosal Leishmaniasis in Travelers with Leishmania braziliensis Complex Returning to Israel. Emerg Infect Dis 2019; 25:642-648. [PMID: 30882319 PMCID: PMC6433024 DOI: 10.3201/eid2504.180239] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mucosal leishmaniasis (ML) is a complication of New World cutaneous leishmaniasis (CL) caused mainly by Leishmania (Viannia) braziliensis. This retrospective study investigated all cases of ML caused by L. (V.) braziliensis in a tertiary medical center in Israel, evaluating the risk factors, clinical presentations, diagnosis, treatment, and outcome of mucosal involvement in ML caused by L. (V.) braziliensis in travelers returning to Israel. During 1993–2015, a total of 145 New World CL cases were seen in travelers returning from Bolivia; among them, 17 (11.7%) developed ML. Nasopharyngeal symptoms developed 0–3 years (median 8 months) after exposure. The only significant risk factor for developing ML was the absence of previous systemic treatment. Among untreated patients, 41% developed ML, compared with only 3% of treated patients (p = 0.005). Systemic treatment for CL seems to be a protective factor against developing ML.
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Martínez DC, Ávila JL, Molano F. Sandflies (Diptera: Psychodidae: Phlebotominae), present in an endemic area of cutaneous leishmaniasis in western Boyacá, Colombia. Colomb Med (Cali) 2019; 50:192-200. [PMID: 32284664 PMCID: PMC7141144 DOI: 10.25100/cm.v50i3.3051] [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] [Indexed: 11/23/2022] Open
Abstract
Introduction: Sandflies are known for having vector species of the tropical disease Leishmaniasis, a disease which is of an endemic nature in Western Boyacá, where the town of Otanche is one of the main source of Cutaneous Leishmaniasis. Objective: To identify the species of sandfly present in an endemic area of cutaneous leishmaniasis in West Boyacá. Methods: The search and collection of sandflies was carried out using CDC gravid traps, over a period of twelve hours (18:00- 06:00). Identification was carried out by revising the genitalia on both male and female samples under a microscope. The distribution took as reference households with a history of people infected with this disease, locating them intra, peri and extra domicile. Results: Were recollected 361 individuals (252 females and 109 male), belonging to 9 genres and 16 species. 60% of all recollected phlebotominae consists of Nyssomyia yuilli and Nyssomyia trapidoi. Other species recollected and relevant, due to vector precedent, are Lutzomyia hartmanni, Psychodopygus panamensis, Lutzomyia gomezi and Psychodopygus carrerai. Conclusion: It was established that, due to its abundance and vector precedent for the country and the area under study, Nyssomyia yuilli and Nyssomyia trapidoi constitute the species of phlebotominae which may be involved in the transmission of cutaneous Leishmaniasis in the region.
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Affiliation(s)
- David Camilo Martínez
- Universidad Pedagógica y Tecnológica de Colombia, Laboratorio de Entomología, Museo de Historia Natural "Luis Gonzalo Andrade", Grupo de Investigación Sistemática Biológica-SisBio. Tunja, Colombia.,Universidad Pedagógica y Tecnológica de Colombia, Facultad de Ciencias Básicas, Estudiante de Maestría en Ciencia Biológicas. Tunja, Colombia
| | - Julián Leonardo Ávila
- Universidad Pedagógica y Tecnológica de Colombia, Facultad de Ciencias Básicas, Estudiante de Maestría en Ciencia Biológicas. Tunja, Colombia.,Gobernación de Boyacá, Secretaria Departamental de Salud, Laboratorio de Entomología, Grupo de investigación del Laboratorio de Salud Pública de Boyacá. Tunja, Colombia
| | - Fredy Molano
- Universidad Pedagógica y Tecnológica de Colombia, Laboratorio de Entomología, Museo de Historia Natural "Luis Gonzalo Andrade", Grupo de Investigación Sistemática Biológica-SisBio. Tunja, Colombia
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21
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Kavian Z, Alavizadeh SH, Golmohamadzadeh S, Badiee A, Khamesipour A, Jaafari MR. Development of topical liposomes containing miltefosine for the treatment of Leishmania major infection in susceptible BALB/c mice. Acta Trop 2019; 196:142-149. [PMID: 31103698 DOI: 10.1016/j.actatropica.2019.05.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/13/2019] [Accepted: 05/15/2019] [Indexed: 01/16/2023]
Abstract
Herein, we investigated the efficacy of liposomes for the topical delivery of miltefosine (ML) to treat cutaneous leishmaniasis (CL). Liposomes containing varying concentrations of ML (0.5, 1, 2 and 4%) were prepared and characterized by their size and entrapment efficiency. The liposome diameters were between 100-150 nm. The penetration of ML from liposomal formulations through and in the skin was assessed using ex-vivo Franz diffusion cells fitted with mouse skin at 37 °C for 24 h. Data indicated that Lip-ML-4% showed the highest percent of retention across mouse skin (82%). in vitro promastigote and amastigote assays showed that ML and Lip-ML inhibit the growth of parasites either in the culture medium or intracellularly. Lip-ML formulations were topically applied twice a day for 4 weeks to the skin of BALB/c mice infected with L. major. Results showed a significantly (p < 0.001) smaller lesion size in Lip-ML-2 and 4% when compared to controls. At week 8 post-infection, the number of parasites was higher in Lip-ML-0.5% compared to Lip-ML-2 and 4%, however, the difference was not significant. At week 12, the splenic parasite burden was significantly (p < 0.001) lower in mice treated with different Lip-ML formulations when compared to controls. The lesion parasite burden was significantly (p < 0.001) lower in mice treated with either Lip-ML-2 and 4% compared to Lip-ML-0.5% at week 12 post-infection. The results suggested that topical Lip-ML-4% showed optimal ex-vivo penetration and in vivo anti-leishmanial activity against CL caused by L. major when compared to ML cream and other liposomes and thus, merits further investigation.
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Affiliation(s)
- Zahra Kavian
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Hoda Alavizadeh
- Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shiva Golmohamadzadeh
- Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Badiee
- Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Reza Jaafari
- Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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22
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Gallego V, Berberian G, Siu H, Verbanaz S, Rodríguez-Morales AJ, Gautret P, Schlagenhauf P, Lloveras S. The 2019 Pan American games: Communicable disease risks and travel medicine advice for visitors to Peru - Recommendations from the Latin American Society for Travel Medicine (SLAMVI). Travel Med Infect Dis 2019; 30:19-24. [PMID: 31238107 DOI: 10.1016/j.tmaid.2019.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/29/2022]
Abstract
The next Pan American Games will be held in Peru in the period July-August 2019. Around 6680 participants from 41 countries are expected to take part in the event. There will be a total of 62 sport disciplines. This event poses specific challenges, given its size and the diversity of attendees. Such gatherings also have potential for the transmission of imported or endemic communicable diseases, including measles in view of the global outbreak situation, but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations taking into consideration the epidemiology and risks of the main communicable diseases at potential destinations in Peru, recommended immunizations and other preventives measures. These recommendations can be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Although Lima is malaria free, travelers visiting Peruvian high-risk areas for malaria should be assessed regarding the need for chemoprophylaxis. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing vector-borne infections. Other important recommendations for travelers should focus on preventing water- and food-borne diseases including travelers' diarrhea. This paper addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during the Pan American Games and also reviews the spectrum of endemic infections in Lima and Peru to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.
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Affiliation(s)
- Viviana Gallego
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Griselda Berberian
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Hugo Siu
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Lima, Peru
| | - Sergio Verbanaz
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Alfonso J Rodríguez-Morales
- Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, Institute for Epidemiology, Biostatistics and Prevention, Hirschengraben 84, 8001, Zürich, Switzerland
| | - Susana Lloveras
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina; Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia
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23
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Marcondes M, Day MJ. Current status and management of canine leishmaniasis in Latin America. Res Vet Sci 2019; 123:261-272. [PMID: 30708238 DOI: 10.1016/j.rvsc.2019.01.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/18/2019] [Accepted: 01/20/2019] [Indexed: 12/14/2022]
Abstract
Latin America encompasses diverse geographical, cultural and socio-economic conditions, which are reflected in the challenges for infectious disease control in the region. One of the most significant regional infectious diseases for humans and domestic dogs is leishmaniasis, occurring as visceral leishmaniasis (VL) caused by Leishmania infantum (syn. L. chagasi) transmitted by sand flies (Lutzomyia longipalpis) and with a canine reservoir, and the more common cutaneous leishmaniasis (CL) involving multiple Leishmania spp. (particularly L. braziliensis), sand fly vectors and reservoir hosts. VL is spreading within Latin America for reasons related to mass migration of human and canine populations, with incursion into novel environments (e.g. related to deforestation) coupled with a background of poverty and poor public health infrastructure. The challenges for control of VL also include: (1) the accurate identification of infected dogs (particularly subclinically infected dogs) with the current reliance on serological rather than molecular diagnostic methods, (2) controversy surrounding the ethics and efficacy of culling of seropositive dogs, (3) the limited efficacy of currently available canine vaccines and their potential to interfere with interpretation of serological testing, (4) the expense associated with distribution of insecticidal dog collars, which may prove to be the most valuable control method, and (5) the cost and therefore accessibility of licensed medical treatment for canine leishmaniasis by the general population. Resolution of these isssues will necessitate a 'One Health' approach to co-ordination of resources between human and veterinary healthcare.
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Affiliation(s)
- Mary Marcondes
- São Paulo State University (Unesp), School of Veterinary Medicine, Araçatuba, 16050-680 Araçatuba, São Paulo, Brazil.
| | - Michael J Day
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
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24
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Viettri M, Herrera L, Aguilar CM, Morocoima A, Reyes J, Lares M, Lozano-Arias D, García-Alzate R, Chacón T, Feliciangeli MD, Ferrer E. Molecular diagnosis of Trypanosoma cruzi/Leishmania spp. coinfection in domestic, peridomestic and wild mammals of Venezuelan co-endemic areas. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2018; 14:123-130. [PMID: 31014717 DOI: 10.1016/j.vprsr.2018.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 06/23/2018] [Accepted: 10/10/2018] [Indexed: 10/28/2022]
Abstract
American trypanosomiasis and leishmaniases are diseases caused by protozoans of the Trypanosomatidae family. In Venezuela, although several endemic foci of both diseases coincide, there are no reports of coinfection in mammals. The molecular diagnosis of the coinfection T. cruzi-Leishmania spp. was done in 527 blood samples collected on filter paper of several species of mammals (Canis familiaris, Equus asinus, Didelphis marsupialis, Equus mulus, Rattus rattus, Equus caballus, Artibeus fraterculus, Felis catus, Sus scrofa, Bos taurus, Capra hircus and Sciurus granatensis) from the states Cojedes, Aragua, Anzoátegui, Guárico, Miranda and Capital District. The T. cruzi infection was determined through PCR amplification of DNA of kinetoplast minicircles (kDNA) and satellite DNA (sDNA). The Leishmania spp. infection was detected by Leishmania nested PCR (Ln-PCR), and ribosomal DNA internal transcribed spacer 1 PCR (ITS1-PCR). The percentage of infection by T. cruzi was 23.5%, by Leishmania spp. 12.9% and coinfection was 5.7%. D. marsupialis was the species with the highest percentage of infection for each parasitosis (T. cruzi 34.3%, Leishmania spp. 20.0%) and coinfection (14.3%). Anzoátegui was the state with the highest percentage of infection for each parasitosis (T. cruzi 64.9%, Leishmania spp. 64.9%) and coinfection (43.2%). Infections were determined in species not reported as natural reservoirs of T. cruzi (E. asinus and E. mulus) and of Leishmania spp. (E. mulus and S. scrofa). Coinfection was a frequent phenomenon in mammals in several co-endemic zones evaluated.
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Affiliation(s)
- Mercedes Viettri
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela; Departamento de Clinico Integral, Facultad de Ciencias de la Salud, Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela
| | - Leidi Herrera
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
| | - Cruz M Aguilar
- Centro de Investigaciones en Enfermedades Tropicales (CIET-UC), Facultad de Ciencias de la Salud, Universidad de Carabobo, San Carlos, Cojedes, Venezuela
| | - Antonio Morocoima
- Centro de Medicina Tropical de Oriente, Universidad de Oriente (UDO) Núcleo Anzoátegui, Barcelona, estado Anzoátegui, Venezuela
| | - Jesús Reyes
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela
| | - María Lares
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela
| | - Daisy Lozano-Arias
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
| | - Roberto García-Alzate
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
| | - Tony Chacón
- Instituto de Zoología y Ecología Tropical (IZET), Facultad de Ciencias, Universidad Central de Venezuela (UCV), Caracas, Venezuela
| | - María D Feliciangeli
- Centro Nacional de Referencia de Flebótomos, BIOMED, Facultad de Ciencias de la Salud, Universidad de Carabobo, Maracay, Venezuela
| | - Elizabeth Ferrer
- Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED), Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela; Departamento de Parasitología, Facultad de Ciencias de la Salud, Universidad de Carabobo Sede Aragua, Maracay, estado Aragua, Venezuela.
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25
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Best I, Privat-Maldonado A, Cruz M, Zimic M, Bras-Gonçalves R, Lemesre JL, Arévalo J. IFN-γ Response Is Associated to Time Exposure Among Asymptomatic Immune Responders That Visited American Tegumentary Leishmaniasis Endemic Areas in Peru. Front Cell Infect Microbiol 2018; 8:289. [PMID: 30186774 PMCID: PMC6111704 DOI: 10.3389/fcimb.2018.00289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 07/30/2018] [Indexed: 11/13/2022] Open
Abstract
Clinical manifestations of American Tegumentary Leishmaniasis (ATL) include cutaneous (CL) and mucous forms (ML); however, there are asymptomatic individuals who despite being infected do not present any clinical manifestations. This study characterized the cell-mediated immunity of travelers who lived in the Andean highlands of Cusco, free of leishmaniasis transmission, which eventually visited leishmaniasis endemic in the Amazonian basin and returned home without any clinical signs of the disease. Their immune response was compared with CL and ML patients who acquired the disease during their stage in the same region. Fifty-four human subjects from the highlands of Cusco (Peru), who have visited an endemic area, were enrolled: 28 of them did not show any symptoms, 12 showed CL and 14 showed ML. Ten healthy subjects from a non-endemic area (HS) were included as controls. T-cell proliferation was evaluated using peripheral blood mononuclear cells (PBMC) stimulated for 5 days with a total soluble leishmanial antigen (TSLA) of L. (V.) braziliensis. Th1/Th2/Th17 cytokines were also quantified in the supernatants by a flow cytometry multiplex assay. T-cell proliferation was expressed as stimulation index (SI) and the cut off was fixed at SI >2.47. Fifteen out of 28 subjects did not show any signs of disease (54%); subjects with an SI above the cut off. They were defined as asymptomatic immune responders (AIR). CL and ML patients presented a higher SI than HS and AIR. Among the latter group, the exposure time to Leishmania was clearly associated with the IFN-γ response. Increased levels of this cytokine were observed in individuals who remained <90 days in an endemic area of leishmaniasis. Our results evidenced two sub-populations among asymptomatic individuals, one AIR who did not develop clinical disease manifestations when they were exposed to Leishmania in endemic areas. Exposure time to Leishmania in the wild was associated with the IFN-γ response.
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Affiliation(s)
- Ivan Best
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Angela Privat-Maldonado
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Cruz
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mirko Zimic
- Laboratorios de Investigación y Desarrollo, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rachel Bras-Gonçalves
- Institut de Recherche pour le Développement (IRD), UMR177-INTERTRYP, Montpellier, France
| | - Jean-Loup Lemesre
- Institut de Recherche pour le Développement (IRD), UMR177-INTERTRYP, Montpellier, France
| | - Jorge Arévalo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.,Laboratorios de Investigación y Desarrollo, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
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26
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Lamm R, Alves C, Perrotta G, Murphy M, Messina C, Sanchez JF, Perez E, Rosales LA, Lescano AG, Smith E, Valdivia H, Fuhrer J, Ballard SB. Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru. Am J Trop Med Hyg 2018; 99:331-337. [PMID: 29869605 DOI: 10.4269/ajtmh.17-0909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis is endemic to South America where diagnosis is most commonly conducted via microscopy. Patients with suspected leishmaniasis were referred for enrollment by the Ministry of Health (MoH) in Lima, Iquitos, Puerto Maldonado, and several rural areas of Peru. A 43-question survey requesting age, gender, occupation, characterization of the lesion(s), history of leishmaniasis, and insect-deterrent behaviors was administered. Polymerase chain reaction (PCR) was conducted on lesion materials at the Naval Medical Research Unit No. 6 in Lima, and the results were compared with those obtained by the MoH using microscopy. Factors associated with negative microscopy and positive PCR results were identified using χ2 test, t-test, and multivariate logistic regression analyses. Negative microscopy with positive PCR occurred in 31% (123/403) of the 403 cases. After adjusting for confounders, binary multivariate logistic regression analyses revealed that negative microscopy with positive PCR was associated with patients who were male (adjusted odds ration [OR] = 1.93 [1.06-3.53], P = 0.032), had previous leishmaniasis (adjusted OR = 2.93 [1.65-5.22], P < 0.0001), had larger lesions (adjusted OR = 1.02 [1.003-1.03], P = 0.016), and/or had a longer duration between lesion appearance and PCR testing (adjusted OR = 1.12 [1.02-1.22], P = 0.017). Future research should focus on further exploration of these underlying variables, discovery of other factors that may be associated with negative microscopy diagnosis, and the development and implementation of improved testing in endemic regions.
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Affiliation(s)
- Ryan Lamm
- Stony Brook University School of Medicine, Stony Brook, New York.,Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.,US Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Grace Perrotta
- Stony Brook University School of Medicine, Stony Brook, New York
| | - Meagan Murphy
- Stony Brook University School of Medicine, Stony Brook, New York
| | | | - Juan F Sanchez
- Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.,US Naval Medical Research Unit No. 6, Lima, Peru
| | - Erika Perez
- US Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Andres G Lescano
- Universidad Peruana Cayetano Heredia, Lima, Peru.,US Naval Medical Research Unit No. 6, Lima, Peru
| | - Edward Smith
- US Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Jack Fuhrer
- Stony Brook University School of Medicine, Stony Brook, New York
| | - Sarah-Blythe Ballard
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,US Naval Medical Research Unit No. 6, Lima, Peru
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27
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Coughlan S, Taylor AS, Feane E, Sanders M, Schonian G, Cotton JA, Downing T. Leishmania naiffi and Leishmania guyanensis reference genomes highlight genome structure and gene evolution in the Viannia subgenus. ROYAL SOCIETY OPEN SCIENCE 2018; 5:172212. [PMID: 29765675 PMCID: PMC5936940 DOI: 10.1098/rsos.172212] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
The unicellular protozoan parasite Leishmania causes the neglected tropical disease leishmaniasis, affecting 12 million people in 98 countries. In South America, where the Viannia subgenus predominates, so far only L. (Viannia) braziliensis and L. (V.) panamensis have been sequenced, assembled and annotated as reference genomes. Addressing this deficit in molecular information can inform species typing, epidemiological monitoring and clinical treatment. Here, L. (V.) naiffi and L. (V.) guyanensis genomic DNA was sequenced to assemble these two genomes as draft references from short sequence reads. The methods used were tested using short sequence reads for L. braziliensis M2904 against its published reference as a comparison. This assembly and annotation pipeline identified 70 additional genes not annotated on the original M2904 reference. Phylogenetic and evolutionary comparisons of L. guyanensis and L. naiffi with 10 other Viannia genomes revealed four traits common to all Viannia: aneuploidy, 22 orthologous groups of genes absent in other Leishmania subgenera, elevated TATE transposon copies and a high NADH-dependent fumarate reductase gene copy number. Within the Viannia, there were limited structural changes in genome architecture specific to individual species: a 45 Kb amplification on chromosome 34 was present in all bar L. lainsoni, L. naiffi had a higher copy number of the virulence factor leishmanolysin, and laboratory isolate L. shawi M8408 had a possible minichromosome derived from the 3' end of chromosome 34. This combination of genome assembly, phylogenetics and comparative analysis across an extended panel of diverse Viannia has uncovered new insights into the origin and evolution of this subgenus and can help improve diagnostics for leishmaniasis surveillance.
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Affiliation(s)
- Simone Coughlan
- School of Mathematics, Applied Mathematics and Statistics, National University of Ireland, Galway, Republic of Ireland
| | - Ali Shirley Taylor
- School of Biotechnology, Dublin City University, Dublin, Republic of Ireland
| | - Eoghan Feane
- School of Biotechnology, Dublin City University, Dublin, Republic of Ireland
| | | | | | | | - Tim Downing
- School of Mathematics, Applied Mathematics and Statistics, National University of Ireland, Galway, Republic of Ireland
- School of Biotechnology, Dublin City University, Dublin, Republic of Ireland
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28
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Hashiguchi Y, Gomez L. EA, Cáceres AG, Velez LN, Villegas NV, Hashiguchi K, Mimori T, Uezato H, Kato H. Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the vector Lutzomyia sand flies and reservoir mammals. Acta Trop 2018; 178:264-275. [PMID: 29224978 DOI: 10.1016/j.actatropica.2017.12.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/28/2017] [Accepted: 12/02/2017] [Indexed: 11/25/2022]
Abstract
The vector Lutzomyia sand flies and reservoir host mammals of the Leishmania parasites, causing the Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador were thoroughly reviewed, performing a survey of literatures including our unpublished data. The Peruvian L. (V.) peruviana, a principal Leishmania species causing Andean-CL in Peru, possessed three Lutzomyia species, Lu. peruensis, Lu. verrucarum and Lu. ayacuchensis as vectors, while the Ecuadorian L. (L.) mexicana parasite possessed only one species Lu. ayacuchensis as the vector. Among these, the Ecuadorian showed a markedly higher rate of natural Leishmania infections. However, the monthly and diurnal biting activities were mostly similar among these vector species was in both countries, and the higher rates of infection (transmission) reported, corresponded to sand fly's higher monthly-activity season (rainy season). The Lu. tejadai sand fly participated as a vector of a hybrid parasite of L. (V.) braziliensis/L. (V.) peruviana in the Peruvian Andes. Dogs were considered to be principal reservoir hosts of the L. (V.) peruviana and L. (L.) mexicana parasites in both countries, followed by other sylvatic mammals such as Phyllotis andium, Didelphis albiventris and Akodon sp. in Peru, and Rattus rattus in Ecuador, but information on the reservoir hosts/mammals was extremely poor in both countries. Thus, the Peruvian disease form demonstrated more complicated transmission dynamics than the Ecuadorian. A brief review was also given to the control of vector and reservoirs in the Andes areas. Such information is crucial for future development of the control strategies of the disease.
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Esteva L, Vargas C, Vargas de León C. The role of asymptomatics and dogs on leishmaniasis propagation. Math Biosci 2017; 293:46-55. [PMID: 28864398 DOI: 10.1016/j.mbs.2017.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 08/18/2017] [Accepted: 08/25/2017] [Indexed: 10/19/2022]
Abstract
Leishmaniasis is a parasite disease transmitted by the bites of sandflies. Cutaneous leishmaniasis is the most common form of the disease and it is endemic in the Americas. Around 70 animal species, including humans, have been found as natural reservoir hosts of leishmania parasites. Among the reservoirs, dogs are the most important ones due to their proximity to the human habitat. Infection by leishmaniasis does not invariably cause illness in the host, and it also can remain asymptomatic for a long period, specially in dogs. In this work we formulate a model to study the transmission of the disease among the vector, humans and dogs. Our main objective is to asses the impact of dogs as a reservoir as well as the impact of asymptomatic humans and dogs on the spread of leishmaniasis. For this end we calculate the Basic Reproduction Number of the disease and we carry out sensitivity analysis of this parameter with respect to the epidemiological and demographic parameters.
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Affiliation(s)
| | - Cristobal Vargas
- Departamento de Control Automático, CINVESTAV-IPN, México, D.F. 07000, Mexico.
| | - Cruz Vargas de León
- Unidad de Medicina Experimental, Hospital General Dr. Eduardo Liceaga, México, D.F. 06726, Mexico.
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Medina-Morales DA, Machado-Duque ME, Machado-Alba JE. Epidemiology of Cutaneous Leishmaniasis in a Colombian Municipality. Am J Trop Med Hyg 2017; 97:1503-1507. [PMID: 28820714 DOI: 10.4269/ajtmh.17-0233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
This study describes the epidemiological and clinical characteristics of leishmaniasis and the pharmacological treatment of this disease in the municipality of Pueblo Rico, Risaralda, between January 2010 and December 2014. An observational study was conducted using information from the clinical records and epidemiological reports of patients diagnosed and confirmed with leishmaniasis of any age and sex, including sociodemographic, clinical, and pharmacological variables of the therapy received. Univariate and bivariate analyses were performed. A total of 539 cases of leishmaniasis were confirmed, with 29.5% occurring in children under 5 years of age. The median age was 10 years, with predominance in males (55.5%). The indigenous Emberá (aboriginal Americans) were the most affected (50.8%), and 93.3% of cases occurred in people living in scattered rural areas. All lesions corresponded to cutaneous leishmaniasis, of which 251 patients had compromise of the upper limbs (46.6%), 221 of the face (41.0%), and 139 of the lower limbs (25.8%). Pentavalent antimony salts (n-methyl glucamine and sodium stibogluconate) were prescribed in 77.6% (N = 418) of the cases; miltefosine was the second most frequently prescribed medication (21.5%, N = 116). The inhabitants of rural areas and the indigenous communities are at a higher risk of acquiring the infection, particularly among infants, which highlights the importance of the biological, social, and demographic factors involved in the disease. There is a need to seek effective public health actions and further research this disease.
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Affiliation(s)
- Diego Alejandro Medina-Morales
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
| | - Manuel E Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
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Cutaneous leishmaniosis in naturally infected dogs in Paraná, Brazil, and the epidemiological implications of Leishmania (Viannia) braziliensis detection in internal organs and intact skin. Vet Parasitol 2017; 243:219-225. [DOI: 10.1016/j.vetpar.2017.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/13/2017] [Accepted: 07/04/2017] [Indexed: 11/17/2022]
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Abstract
Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide, 1.5 to 2 million new cases occur each year, 350 million are at risk of acquiring the disease, and leishmaniasis causes 70,000 deaths per year. Clinical features depend on the species of
Leishmania involved and the immune response of the host. Manifestations range from the localized cutaneous to the visceral form with potentially fatal outcomes. Many drugs are used in its treatment, but the only effective treatment is achieved with current pentavalent antimonials.
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Affiliation(s)
- Edoardo Torres-Guerrero
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
| | | | - Julieta Ruiz-Esmenjaud
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
| | - Roberto Arenas
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
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Hashiguchi Y, Velez LN, Villegas NV, Mimori T, Gomez EA, Kato H. Leishmaniases in Ecuador: Comprehensive review and current status. Acta Trop 2017; 166:299-315. [PMID: 27919688 DOI: 10.1016/j.actatropica.2016.11.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/17/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
Abstract
This article reviews current knowledge about leishmaniases in Ecuador, proceeding from 1920, when the first human case was described, to the present, mainly focusing on the recent research events published. Regarding basic situations, it appears that 23 of Ecuador's 24 provinces have leishmaniasis-case reports. The disease is one of the mandatory notification infectious diseases in the country since 2005. All the 21,305 cases notified to the Ministry of Public Health, during the period from 2001 through 2014, were said to involve different clinical features of cutaneous leishmaniasis (CL) but not visceral (VL). Eight Leishmania species, L. (Viannia) guyanensis, L. (V.) panamensis, L. (V.) braziliensis, L. (Leishmania) mexicana, L. (L.) amazonensis, L. (L.) major-like, L. (V.) naiffiand L. (V.) lainsoni were characterized. The last two species were most recently reported from the Ecuadorian Amazon regions. Of the 73 Ecuadorian Lutzomyia species (43 man-biting species) recorded, only four, Lu. trapidoi, Lu. gomezi, Lu. ayacuchensis, and Lu. tortura were incriminated as vectors of the Leishmania parasites. Current knowledge on the reservoir hosts of Leishmania in Ecuador is extremely poor. Recently, in Ecuador different kinds of molecular techniques were developed for diagnosis and mass screening of the disease, employing various materials derived from patients and sand fly vectors. These are PCR-RFLP, colorimetric FTA-LAMP etc. Brief comments and recommendations were also given, for future research and control of leishmaniases in Ecuador.
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Pardo RH, Santamaría E, Cabrera OL. Entering and exiting behaviour of the phlebotomine sand fly Lutzomyia longiflocosa (Diptera: Psychodidae) in rural houses of the sub-Andean region of Colombia. Mem Inst Oswaldo Cruz 2017; 112:19-30. [PMID: 27925019 PMCID: PMC5224351 DOI: 10.1590/0074-02760160265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/14/2016] [Indexed: 11/22/2022] Open
Abstract
The present study identified the entering and exiting sites for Lutzomyia
longiflocosa in rural houses of the sub-Andean region in Colombia.
Entering sites were identified with sticky traps set up outside the bedrooms, around
the eave openings, and with cage traps enclosing the slits in the doors and windows
inside the bedrooms. Exiting sites were identified by releasing groups of females
indoors. These females were blood fed and marked with fluorescent powders. Females
were recaptured with the trap placement described above but set up on the opposite
sides of the openings. In the entering experiment, a significantly higher number of
females were captured in the sticky traps at the zone nearest the eave openings (n =
142) than those captured in the other zones of the trap (n = 52); similarly, a higher
number of females were captured on the front side of the house (n = 105) than at the
rear side (n = 37). Only two females were collected in the cage trap. In the exiting
experiment, at the ceiling, the highest percentage (86.2%) of females was recaptured
with sticky traps nearest the eave openings and on the front side of the house
(70.0%). Seven females were collected in the cage trap. Lu.
longiflocosa entered and exited houses primarily through the eave
openings in a non-random pattern in relation to the sides of the house.
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Affiliation(s)
- Raúl Hernando Pardo
- Instituto Nacional de Salud, Grupo de Entomología, Bogotá, Colombia.,Universidad de La Salle, Grupo de Entomología y Enfermedades Transmitidas por Vectores, Bogotá, Colombia
| | - Erika Santamaría
- Instituto Nacional de Salud, Grupo de Entomología, Bogotá, Colombia
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Aronson N, Herwaldt BL, Libman M, Pearson R, Lopez-Velez R, Weina P, Carvalho EM, Ephros M, Jeronimo S, Magill A. Diagnosis and Treatment of Leishmaniasis: Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2016; 63:e202-e264. [PMID: 27941151 DOI: 10.1093/cid/ciw670] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/22/2016] [Indexed: 12/25/2022] Open
Abstract
It is important to realize that leishmaniasis guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. The IDSA and ASTMH consider adherence to these guidelines to be voluntary, with the ultimate determinations regarding their application to be made by the physician in the light of each patient's individual circumstances.
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Affiliation(s)
- Naomi Aronson
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Michael Libman
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | | | - Peter Weina
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | | | | | - Selma Jeronimo
- Federal University of Rio Grande do Norte, Natal, Brazil
| | - Alan Magill
- Bill and Melinda Gates Foundation, Seattle, Washington
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Maia-Elkhoury ANS, E. Yadón Z, Idali Saboyá Díaz M, de Fátima de Araújo Lucena F, Gerardo Castellanos L, J. Sanchez-Vazquez M. Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001-2011. PLoS Negl Trop Dis 2016; 10:e0005086. [PMID: 27824881 PMCID: PMC5100938 DOI: 10.1371/journal.pntd.0005086] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/30/2016] [Indexed: 12/30/2022] Open
Abstract
Leishmaniasis is an important health problem in several countries in the Americas and cases notification is limited and underreported. In 2008, the Pan American Health Organization (PAHO/WHO) met with endemic countries to discuss the status and need of improvement of systems region-wide. The objective is to describe the temporal and spatial distribution of cutaneous leishmaniasis (CL) cases reported to PAHO/WHO by the endemic countries between 2001 and 2011 in the Americas. In the Americas, cutaneous leishmaniasis (CL) cases are notified across a wide geographic area, extending from southern United States to northern Argentina. Currently, 70–75% of all estimated cases of CL worldwide occur in ten countries, including four in the Americas (Brazil, Colombia, Nicaragua, and Peru) and six countries from Africa and the Eastern Mediterranean. This study shows the epidemiological situation and geographical distribution of CL cases reported by passive surveillance system of endemic countries of the American Region from 2001 to 2011, collected and consolidated by the Pan American Health Organization (PAHO). Furthermore, it represents a joint effort of the National Programs of leishmaniases. Despite some limitations, the data were analyzed and discussed and this study represents the first step to understand the global epidemiological situation in this Region and it contributes to the improvement of the surveillance of leishmaniases in the Americas.
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Affiliation(s)
| | - Zaida E. Yadón
- Communicable Diseases and Health Analysis, Pan American Health Organization, Washington, District of Columbia, United States of America
| | - Martha Idali Saboyá Díaz
- Communicable Diseases and Health Analysis, Pan American Health Organization, Washington, District of Columbia, United States of America
| | | | - Luis Gerardo Castellanos
- Communicable Diseases and Health Analysis, Pan American Health Organization, Washington, District of Columbia, United States of America
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Berry I, Berrang-Ford L. Leishmaniasis, conflict, and political terror: A spatio-temporal analysis. Soc Sci Med 2016; 167:140-9. [DOI: 10.1016/j.socscimed.2016.04.038] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 03/06/2016] [Accepted: 04/27/2016] [Indexed: 11/26/2022]
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Worldwide risk factors in leishmaniasis. ASIAN PAC J TROP MED 2016; 9:925-932. [PMID: 27794384 DOI: 10.1016/j.apjtm.2016.06.021] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 06/01/2016] [Accepted: 06/10/2016] [Indexed: 11/22/2022] Open
Abstract
Recently, vector-borne parasitic diseases such as leishmaniasis have been emerged or re-emerged in many geographical areas and resulted in global health and economic concerns that involve humans, domestic animals and wild life. The ecology and epidemiology of leishmaniasis are affected by the between host, reservoir and vector (human, animal and sandfly) and the environment. Important drivers for the emergence and spread of leishmaniasis include environmental factors such as alterations in temperature and water storage, irrigation habits, deforestation, climate changes, immunosuppression by HIV or organ transplant, development of drug resistance, increase traveling to endemic regions and dog importation. War, poor socio-economic status and low level household are also major contributors to the spread of this disease. Health education via the public media and training should be implemented by international organizations and governmental agencies in collaboration with research institutions. Fully protection during transmission season, using bednets and insecticides and reservoirs' control should be also mentioned in the planning. Based on the findings of the recent studies and high prevalence of leishmaniasis, it is concluded that serious public health monitoring should be considered.
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da Costa AP, Costa FB, Soares HS, Ramirez DG, de Carvalho Araújo A, da Silva Ferreira JIG, Tonhosolo R, Dias RA, Gennari SM, Marcili A. Environmental Factors and Ecosystems Associated with Canine Visceral Leishmaniasis in Northeastern Brazil. Vector Borne Zoonotic Dis 2015; 15:765-74. [DOI: 10.1089/vbz.2015.1866] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Andréa Pereira da Costa
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Francisco Borges Costa
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Herbert Sousa Soares
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Diego Garcia Ramirez
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | | | - Juliana Isabel Giuli da Silva Ferreira
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Renata Tonhosolo
- Universidade Federal do ABC, São Bernardo do Campo, São Paulo, Brasil
| | - Ricardo Augusto Dias
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Solange Maria Gennari
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Arlei Marcili
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária, Universidade de São Paulo, São Paulo, São Paulo, Brasil
- Universidade Federal do ABC, São Bernardo do Campo, São Paulo, Brasil
- Universidade de Santo Amaro, São Paulo, São Paulo, Brasil
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Spatial Distribution of Sand Fly Vectors and Eco-Epidemiology of Cutaneous Leishmaniasis Transmission in Colombia. PLoS One 2015; 10:e0139391. [PMID: 26431546 PMCID: PMC4592259 DOI: 10.1371/journal.pone.0139391] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/11/2015] [Indexed: 12/22/2022] Open
Abstract
Background Leishmania is transmitted by Phlebotominae insects that maintain the enzootic cycle by circulating between sylvatic and domestic mammals; humans enter the cycles as accidental hosts due to the vector’s search for blood source. In Colombia, leishmaniasis is an endemic disease and 95% of all cases are cutaneous (CL), these cases have been reported in several regions of the country where the intervention of sylvatic areas by the introduction of agriculture seem to have an impact on the rearrangement of new transmission cycles. Our study aimed to update vector species distribution in the country and to analyze the relationship between vectors’ distribution, climate, land use and CL prevalence. Methods A database with geographic information was assembled, and ecological niche modeling was performed to explore the potential distribution of each of the 21 species of medical importance in Colombia, using thirteen bioclimatic variables, three topographic and three principal components derived from NDVI. Binary models for each species were obtained and related to both land use coverage, and a CL prevalence map with available epidemiological data. Finally, maps of species potential distribution were summed to define potential species richness in the country. Results In total, 673 single records were obtained with Lutzomyia gomezi, Lutzomyia longipalpis, Psychodopygus panamensis, Psathyromyia shannoni and Pintomyia evansi the species with the highest number of records. Eighteen species had significant models, considering the area under the curve and the jackknife results: L. gomezi and P. panamensis had the widest potential distribution. All sand fly species except for Nyssomyia antunesi are mainly distributed in regions with rates of prevalence between 0.33 to 101.35 cases per 100,000 inhabitants and 76% of collection data points fall into transformed ecosystems. Discussion Distribution ranges of sand flies with medical importance in Colombia correspond predominantly to disturbed areas, where the original land coverage is missing therefore increasing the domiciliation potential. We highlight the importance of the use of distribution maps as a tool for the development of strategies for prevention and control of diseases.
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Cutaneous leishmaniasis in travellers: a focus on epidemiology and treatment in 2015. Curr Infect Dis Rep 2015; 17:489. [PMID: 26031962 DOI: 10.1007/s11908-015-0489-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Imported cutaneous leishmaniasis (CL) is a growing problem with increasing global travel to endemic areas. Returned travellers seeking care encounter significant barriers to treatment, including diagnostic delays and difficult access to anti-leishmanial drugs. Treatment recommendations in non-endemic settings are a moving target, reflecting recent developments in Leishmania diagnostics and therapeutics. Accumulating experience with molecular-based species identification has enabled species-directed therapy. Clinicians are reevaluating more toxic traditional regimens in light of newly approved therapeutic agents and emerging data on local cutaneous treatments. Referral centers are implementing treatment decision algorithms designed to maximize efficacy while minimizing adverse events. Although management strategies continue to evolve, treatment of CL in non-endemic settings remains controversial. Persistent reliance on expert opinion reflects lack of research focused on travellers and limited randomized controlled trial evidence. We herein review the current epidemiology of cutaneous leishmaniasis in travellers and species-specific evidence for available therapies.
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Llanes A, Restrepo CM, Del Vecchio G, Anguizola FJ, Lleonart R. The genome of Leishmania panamensis: insights into genomics of the L. (Viannia) subgenus. Sci Rep 2015; 5:8550. [PMID: 25707621 PMCID: PMC4338418 DOI: 10.1038/srep08550] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 01/26/2015] [Indexed: 12/21/2022] Open
Abstract
Kinetoplastid parasites of the Leishmania genus cause several forms of leishmaniasis. Leishmania species pathogenic to human are separated into two subgenera, Leishmania (Leishmania) and L. (Viannia). Species from the Viannia subgenus cause predominantly cutaneous leishmaniasis in Central and South America, occasionally leading to more severe clinical presentations. Although the genomes of several species of Leishmania have been sequenced to date, only one belongs to this rather different subgenus. Here we explore the unique features of the Viannia subgenus by sequencing and analyzing the genome of L. (Viannia) panamensis. Against a background of conservation in gene content and synteny, we found key differences at the genomic level that may explain the occurrence of molecular processes involving nucleic acid manipulation and differential modification of surface glycoconjugates. These differences may in part explain some phenotypic characteristics of the Viannia parasites, including their increased adaptive capacity and enhanced metastatic ability.
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Affiliation(s)
- Alejandro Llanes
- 1] Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Ciudad del Saber, Panamá, Panamá [2] Facultad de Ciencias de la Salud Dr. William C. Gorgas, Universidad Latina de Panamá, Panamá, Panamá [3] Department of Biotechnology, Acharya Nagarjuna University, Guntur, India
| | - Carlos Mario Restrepo
- 1] Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Ciudad del Saber, Panamá, Panamá [2] Department of Biotechnology, Acharya Nagarjuna University, Guntur, India
| | - Gina Del Vecchio
- Facultad de Ciencias de la Salud Dr. William C. Gorgas, Universidad Latina de Panamá, Panamá, Panamá
| | - Franklin José Anguizola
- Facultad de Ciencias de la Salud Dr. William C. Gorgas, Universidad Latina de Panamá, Panamá, Panamá
| | - Ricardo Lleonart
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Ciudad del Saber, Panamá, Panamá
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Barry MA, Koshelev MV, Sun GS, Grekin SJ, Stager CE, Diwan AH, Wasko CA, Murray KO, Woc-Colburn L. Cutaneous leishmaniasis in Cuban immigrants to Texas who traveled through the Darién Jungle, Panama. Am J Trop Med Hyg 2014; 91:345-7. [PMID: 24865687 PMCID: PMC4125260 DOI: 10.4269/ajtmh.14-0124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 04/22/2014] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis is rarely seen in the United States. Four Cuban immigrants traveled along the same route at different times from Cuba to Ecuador, then northward, including through the Darién Jungle in Panama. These patients had chronic ulcerative non-healing skin lesions and were given a diagnosis of leishmaniasis.
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Affiliation(s)
- Meagan A Barry
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Misha V Koshelev
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Grace S Sun
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Sarah J Grekin
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Charles E Stager
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - A Hafeez Diwan
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Carina A Wasko
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Kristy O Murray
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Laila Woc-Colburn
- Medical Scientist Training Program, Interdepartmental Program in Translational Biology and Molecular Medicine, Department of Dermatology, Department of Pathology and Immunology, Department of Pediatrics, National School of Tropical Medicine, and Department of Medicine, Baylor College of Medicine, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
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Soares L, Abad-Franch F, Ferraz G. Epidemiology of cutaneous leishmaniasis in central Amazonia: a comparison of sex-biased incidence among rural settlers and field biologists. Trop Med Int Health 2014; 19:988-95. [DOI: 10.1111/tmi.12337] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Letícia Soares
- Biological Dynamics of Forest Fragments Project; Smithsonian Tropical Research Institute & Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Graduate Program in Ecology; Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Department of Biology; University of Missouri St Louis; St Louis, MO USA
| | | | - Gonçalo Ferraz
- Biological Dynamics of Forest Fragments Project; Smithsonian Tropical Research Institute & Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Graduate Program in Ecology; Instituto Nacional de Pesquisas da Amazônia; Manaus AM Brazil
- Departamento de Ecologia; Instituto de Biociências; Universidade Federal do Rio Grande do Sul; Porto Alegre RS Brazil
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Goto H, Lindoso JAL. Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis. Expert Rev Anti Infect Ther 2014; 8:419-33. [DOI: 10.1586/eri.10.19] [Citation(s) in RCA: 287] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Blum J, Lockwood DNJ, Visser L, Harms G, Bailey MS, Caumes E, Clerinx J, van Thiel PPAM, Morizot G, Hatz C, Buffet P. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis. Int Health 2013; 4:153-63. [PMID: 24029394 DOI: 10.1016/j.inhe.2012.06.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML after the initial infection has been the main argument for systemic treatment. However, this statement needs re-evaluation and consideration of all the available data. The putative benefit of preventing ML should outweigh the toxicity of systemic antileishmanial therapy. To assess the need for and risk of systemic treatment the following factors were reviewed: the incidence and prevalence of ML in endemic populations and in travellers; the severity of mucosal lesions; the efficacy of current options to treat ML; the toxicity and, to a lesser extent, the costs of systemic treatment; the risk of developing ML after local treatment; and the strengths and limitations of current estimates of the risk of developing ML in different situations. Local treatment might be considered as a valuable treatment option for travellers suffering from New World CL, provided that there are no risk factors for developing ML such as multiple lesions, big lesions (>4 cm(2)), localisation of the lesion on the head or neck, immunosuppression or acquisition of infection in the high Andean countries, notably Bolivia.
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Affiliation(s)
- Johannes Blum
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
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González-Salazar C, Stephens CR. Constructing ecological networks: a tool to infer risk of transmission and dispersal of leishmaniasis. Zoonoses Public Health 2013; 59 Suppl 2:179-93. [PMID: 22958263 DOI: 10.1111/j.1863-2378.2012.01479.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We extend a recently developed method for constructing ecological networks to infer potential biotic interactions between species and to also include environmental factors, in particular land cover, thus permitting a simultaneous analysis of the interaction between environment and species distribution as well as inter-species interactions. We apply the method to the transmission and dispersal of leishmaniasis in Mexico. We find that the most important potential vectors and reservoirs can be classified into assemblages associated with different types of habitat. This in turn can be used to understand and map potential transmission risk, as well as to construct risk scenarios for the dispersal of disease from one geographical region to another.
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Affiliation(s)
- C González-Salazar
- Instituto de Biología, Universidad Nacional Autónoma de México, México DF, México
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48
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Zvietcovich F, Castañeda B, Valencia B, Llanos-Cuentas A. A 3D assessment tool for accurate volume measurement for monitoring the evolution of cutaneous leishmaniasis wounds. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:2025-8. [PMID: 23366316 DOI: 10.1109/embc.2012.6346355] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Clinical assessment and outcome metrics are serious weaknesses identified on the systematic reviews of cutaneous Leishmaniasis wounds. Methods with high accuracy and low-variability are required to standarize study outcomes in clinical trials. This work presents a precise, complete and noncontact 3D assessment tool for monitoring the evolution of cutaneous Leishmaniasis (CL) wounds based on a 3D laser scanner and computer vision algorithms. A 3D mesh of the wound is obtained by a commercial 3D laser scanner. Then, a semi-automatic segmentation using active contours is performed to separate the ulcer from the healthy skin. Finally, metrics of volume, area, perimeter and depth are obtained from the mesh. Traditional manual 3D and 3D measurements are obtained as a gold standard. Experiments applied to phantoms and real CL wounds suggest that the proposed 3D assessment tool provides higher accuracy (error <2%) and precision rates (error <4%) than conventional manual methods (precision error < 35%). This 3D assessment tool provides high accuracy metrics which deserve more formal prospective study.
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Affiliation(s)
- Fernando Zvietcovich
- Laboratory of Medical Image Research, Pontificia Universidad Católica del Perú, Lima, Perú.
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Reveiz L, Maia-Elkhoury ANS, Nicholls RS, Romero GAS, Yadon ZE. Interventions for American cutaneous and mucocutaneous leishmaniasis: a systematic review update. PLoS One 2013; 8:e61843. [PMID: 23637917 PMCID: PMC3639260 DOI: 10.1371/journal.pone.0061843] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/14/2013] [Indexed: 12/22/2022] Open
Abstract
Introduction Leishmaniasis is an important public health problem in the Americas. A Cochrane review published in 2009 analyzed 38 randomized controlled trials (RCT). We conducted a systematic review to evaluate the effects of therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis. Methods All studies were extracted from PubMed, Embase, Lilacs (2009 to July, 2012 respectively), the Cochrane Central Register of Controlled Trials (6-2012) and references of identified publications. RCTs’ risk of bias was assessed. Results We identified 1865 references of interest; we finally included 10 new RCTs. The risk of bias scored low or unclear for most domains. Miltefosine was not significantly different from meglumine antimoniate in the complete cure rate at 6 months (4 RCT; 584 participants; ITT; RR: 1.12; 95%CI: 0.85 to 1.47; I2 78%). However a significant difference in the rate of complete cure favoring miltefosine at 6 months was found in L. panamensis and L. guyanensis (2 RCTs, 206 participants; ITT; RR: 1.22; 95%CI: 1.02 to 1.46; I2 0%). One RCT found that meglumine antimoniate was superior to pentamidine in the rate of complete cure for L. braziliensis (80 participants, ITT; RR: 2.21; 95%CI: 1.41 to 3.49), while another RCT assessing L. guyanensis did not find any significant difference. Although meta-analysis of three studies found a significant difference in the rate of complete cure at 3 months favoring imiquimod versus placebo (134 participants; ITT; RR: 1.45; 95%CI: 1.12 to 1.88; I2 0%), no significant differences were found at 6 and 12 months. Thermotherapy and nitric oxide were not superior to meglumine antimoniate. Conclusion Therapeutic interventions for American cutaneous and mucocutaneous leishmaniasis are varied and should be decided according to the context. Since mucosal disease is the more neglected form of leishmaniasis a multicentric trial should be urgently considered.
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Affiliation(s)
- Ludovic Reveiz
- Health Systems Based on Primary Health Care, Pan American Health Organization (PAHO), Washington, DC, United States of America
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Bacon KM, Hotez PJ, Kruchten SD, Kamhawi S, Bottazzi ME, Valenzuela JG, Lee BY. The potential economic value of a cutaneous leishmaniasis vaccine in seven endemic countries in the Americas. Vaccine 2012. [PMID: 23176979 DOI: 10.1016/j.vaccine.2012.11.032] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relatively short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrate important economic benefits.
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Affiliation(s)
- Kristina M Bacon
- Public Health Computational and Operational Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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