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Mendieta D, Vásquez V, Jaén L, Pineda V, Saldaña A, Calzada JE, Samudio F. Insights into the Genetic Diversity of Leishmania (Viannia) panamensis in Panama, Inferred via Multilocus Sequence Typing (MLST). Pathogens 2023; 12:pathogens12050747. [PMID: 37242417 DOI: 10.3390/pathogens12050747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/26/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Leishmaniasis is a disease caused by parasites of the genus Leishmania and transmitted by sand fly vectors. Tegumentary leishmaniasis is the most prevalent clinical outcome in Latin America, afflicting people from 18 countries. In Panama, the annual incidence rate of leishmaniasis is as high as 3000 cases, representing a major public health problem. In endemic regions, L. panamensis is responsible for almost eighty percent of human cases that present different clinical outcomes. These differences in disease outcomes could be the result of the local interplay between L. panamensis variants and human hosts with different genetic backgrounds. The genetic diversity of L. panamensis in Panama has only been partially explored, and the variability reported for this species is based on few studies restricted to small populations and/or with poor resolutive markers at low taxonomic levels. Accordingly, in this study, we explored the genetic diversity of sixty-nine L. panamensis isolates from different endemic regions of Panama, using an MLST approach based on four housekeeping genes (Aconitase, ALAT, GPI and HSP70). Two to seven haplotypes per locus were identified, and regional differences in the genetic diversity of L. panamensis were observed. A genotype analysis evidenced the circulation of thirteen L. panamensis genotypes, a fact that might have important implications for the local control of the disease.
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Affiliation(s)
- Daniel Mendieta
- Facultad de Ciencias Naturales Exactas y Tecnología, Universidad de Panamá, Panama City P.O. Box 0824-00073, Panama
| | - Vanessa Vásquez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Avenida Justo Arosemena, Panama City P.O. Box 0816-02593, Panama
| | - Luis Jaén
- Facultad de Ciencias Naturales Exactas y Tecnología, Universidad de Panamá, Panama City P.O. Box 0824-00073, Panama
| | - Vanessa Pineda
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Avenida Justo Arosemena, Panama City P.O. Box 0816-02593, Panama
| | - Azael Saldaña
- Facultad de Ciencias Naturales Exactas y Tecnología, Universidad de Panamá, Panama City P.O. Box 0824-00073, Panama
- Centro de Investigación y Diagnóstico de Enfermedades Parasitarias (CIDEP), Universidad de Panamá, Panama City P.O. Box 0824-00073, Panama
- Sistema Nacional de Investigación, Panama City P.O. Box 0816-02852, Panama
| | - José Eduardo Calzada
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Avenida Justo Arosemena, Panama City P.O. Box 0816-02593, Panama
- Sistema Nacional de Investigación, Panama City P.O. Box 0816-02852, Panama
| | - Franklyn Samudio
- Facultad de Ciencias Naturales Exactas y Tecnología, Universidad de Panamá, Panama City P.O. Box 0824-00073, Panama
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Avenida Justo Arosemena, Panama City P.O. Box 0816-02593, Panama
- Sistema Nacional de Investigación, Panama City P.O. Box 0816-02852, Panama
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Llanes A, Cruz G, Morán M, Vega C, Pineda VJ, Ríos M, Penagos H, Suárez JA, Saldaña A, Lleonart R, Restrepo CM. Genomic diversity and genetic variation of Leishmania panamensis within its endemic range. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 103:105342. [PMID: 35878820 DOI: 10.1016/j.meegid.2022.105342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Species belonging to the Leishmania (Viannia) subgenus are important causative agents of cutaneous and mucocutaneous leishmaniasis in Central and South America. These parasites possess several distinctive biological features that are influenced by their genetics, population structure, and genome instability. To date, several studies have revealed varying degrees of genetic diversity within Leishmania species. Particularly, in species of the L. (Viannia) subgenus, a generalized high intraspecific genetic diversity has been reported, although, conflicting conclusions have been drawn using different molecular techniques. Despite being the most common Leishmania species circulating in Panama and Colombia, few studies have analyzed clinical samples of Leishmania panamensis using whole-genome sequencing, and their restricted number of samples has limited the information they can provide to understand the population structure of L. panamensis. Here, we used next generation sequencing (NGS) to explore the genetic diversity of L. panamensis within its endemic range, analyzing data from 43 isolates of Colombian and Panamanian origin. Our results show the occurrence of three well-defined geographically correlated groups, and suggests the possible occurrence of additional phylogeographic groups. Furthermore, these results support the existence of a mixed mode of reproduction in L. panamensis, with varying frequencies of events of genetic recombination occurring primarily within subpopulations of closely related strains. This study offers important insights into the population genetics and reproduction mode of L. panamensis, paving the way to better understand their population structure and the emergence and maintenance of key eco-epidemiological traits.
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Affiliation(s)
- Alejandro Llanes
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama, Panama
| | - Génesis Cruz
- Escuela de Biología, Facultad de Ciencias Naturales, Exactas y Tecnología, Universidad de Panamá, Panama City, Panama, Panama
| | - Mitchelle Morán
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama, Panama
| | - Carlos Vega
- Escuela de Biología, Facultad de Ciencias Naturales, Exactas y Tecnología, Universidad de Panamá, Panama City, Panama, Panama
| | - Vanessa J Pineda
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama City, Panama, Panama
| | - Margarita Ríos
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama City, Panama, Panama
| | - Homero Penagos
- Hospital Regional Dr. Rafael Hernández, Caja de Seguro Social, David, Chiriquí, Panama; Sistema Nacional de Investigación-Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panama City, Panama, Panama
| | - José A Suárez
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama City, Panama, Panama; Sistema Nacional de Investigación-Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panama City, Panama, Panama
| | - Azael Saldaña
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama City, Panama, Panama; Sistema Nacional de Investigación-Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panama City, Panama, Panama
| | - Ricardo Lleonart
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama, Panama; Sistema Nacional de Investigación-Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panama City, Panama, Panama.
| | - Carlos M Restrepo
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama, Panama; Sistema Nacional de Investigación-Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panama City, Panama, Panama.
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Davila M, Pineda V, Calzada JE, Saldaña A, Samudio F. Evaluation of cytochrome b sequence to identify Leishmania species and variants: the case of Panama. Mem Inst Oswaldo Cruz 2021; 116:e200572. [PMID: 33886871 PMCID: PMC8061342 DOI: 10.1590/0074-02760200572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/22/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The genetic heterogeneity of Leishmania parasites is a major factor responsible for the wide variety of Leishmania-associated manifestations. Consequently, understanding the genetic make-up of Leishmania species using suitable molecular markers is an important component of realising local and regional scale disease risk. The cytochrome b (cytb) is frequently used to type New World Leishmania species. However, its potential to discriminate Leishmania species and variants requires further evaluation. OBJECTIVES To explore the capacity of cytb gene to identify New World Leishmania species and variants and to develop an approach able to type local Leishmania species and variants. METHODS We retrieved 360 partial and complete Leishmania cytb gene sequences publicly available in GenBank database to study all single nucleotide polymorphisms (SNPs) across the cytb gene that differentiate New World Leishmania species. This information was used to develop an approach based upon the polymorphisms found in a DNA segment of 948bp. We also compared the typing results found with this technique with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) profiling obtained using HSP70 gene as target. One hundred Panamanian isolates were used to both typed Leishmania species and assess local genetic variability. FINDINGS We found complete agreement between our cytb approach and the PCR-RFLP profiling method based on HSP70 for Leishmania species identification. Ninety-two isolates were identified as L. panamensis, although other Viannia species were found circulating at a lower frequency. Three L. panamensis haplotypes were identified in Panamanian provinces. We also provide an initial report of L. guyanensis haplotypes circulating in Panama. MAIN CONCLUSIONS Cytb gene sequence encompasses key main SNPs that aid to identify Leishmania species. The cytb approach developed with this information was able to identify and assess genetic variability of local Leishmania species found in this study.
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Affiliation(s)
- Michelle Davila
- Universidad de Panamá, Facultad de Ciencias Naturales, Exactas y Tecnología, Panama, Panama
| | - Vanessa Pineda
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Laboratorio de Investigación en Parasitología, Panama, Panama
| | - José E Calzada
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Laboratorio de Investigación en Parasitología, Panama, Panama
| | - Azael Saldaña
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Laboratorio de Investigación en Parasitología, Panama, Panama.,Universidad de Panamá, Centro de Investigación y Diagnóstico de Enfermedades Parasitarias, Panama, Panama
| | - Franklyn Samudio
- Universidad de Panamá, Facultad de Ciencias Naturales, Exactas y Tecnología, Panama, Panama.,Instituto Conmemorativo Gorgas de Estudios de la Salud, Laboratorio de Investigación en Parasitología, Panama, Panama
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Diversity, Co-Occurrence, and Nestedness Patterns of Sand Fly Species (Diptera: Psychodidae) in Two Rural Areas of Western Panamá. INSECTS 2021; 12:insects12020113. [PMID: 33525399 PMCID: PMC7912352 DOI: 10.3390/insects12020113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 11/30/2022]
Abstract
Simple Summary Sand flies are insects that can transmit the parasites causing leishmaniasis, a major neglected tropical disease. In the Americas, these insects are highly diverse, and unlike what is observed for other vector-borne diseases, many species co-occur in sites where this disease affects human populations. Here, we present results from a two-year-long study where we study how the number of species changes in two rural areas of Western Panamá with different land use cover and through the dry and wet seasons. We found that species number increased during the wet season and in plots with higher natural forest cover and that species number decreased in both areas in plots when the forest cover decreased, with some species changing through the seasons, and some species disappearing when comparing the sand fly faunas of the most forested with less forested plots. However, our results suggest that seasonality, or the change from a dry to rainy season, can be a more important driver of the number of species locally observed in the studied areas. Abstract Cutaneous Leishmaniasis transmission in the New World is observed in areas with rich sand fly species’ faunas. The diversity and composition of sand fly species can change in response to seasonal weather and land use changes. Here, we present results from a two-year-long study where we collected, using Centers for Disease Control (CDC) light traps, sand flies from two rural areas, Las Pavas (LP) and Trinidad de las Minas (T) in western Panamá. Over 710 trap-nights, we collected 16,156 sand flies from 15 genera and 35 species. We identified 34 species in T, and the most abundant species collected was Nyssomyia trapidoi (Fairchild and Hertig, 1952) (n = 2278, 37%), followed by Psychodopygus panamensis (Shannon, 1926) (n = 1112, 18%), and Trichopygomyia triramula (Fairchild and Hertig, 1952) (n = 1063, 17%). In LP, we identified 26 species, and the most abundant species collected were Ty. triramula (n = 4729, 48%), and Ps. panamensis (n = 3444, 35%). We estimated a higher species’ richness in T (Chao2 ± S.E.: 36.58 ± 3.84) than in LP (27.49 ± 2.28). In T, species’ richness was significantly higher in the rainy season, but no seasonal differences were observed in LP. Species’ assemblages were nested in the two areas. Phlebotomine sand fly species’ abundance increased at the two sites during the rainy season. Our data suggest that seasonality is more important than land use as a factor driving sand fly species’ diversity at the studied sites.
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Miranda ADC, González KA, Samudio F, Pineda VJ, Calzada JE, Capitan-Barrios Z, Jiménez A, Castillo J, Mendoza Y, Suárez JA, Ortiz B, Méndez J, Pascale JM, Grögl M, Sosa N, Saldaña A. Molecular Identification of Parasites Causing Cutaneous Leishmaniasis in Panama. Am J Trop Med Hyg 2021; 104:1326-1334. [PMID: 33432903 DOI: 10.4269/ajtmh.20-1336] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/27/2020] [Indexed: 02/03/2023] Open
Abstract
Isolates from 475 cutaneous leishmaniasis (CL) patients from three endemic regions were studied by three typing techniques. The molecular analysis from lesion scrapings based on hsp70 PCR-RFLP showed that 78.1% (371/475) restriction patterns corresponded to Leishmania (Viannia) panamensis, 19% (90/475) to Leishmania (Viannia) guyanensis, and 3.0% (14/475) to Leishmania (Viannia) braziliensis. Promastigotes isolated by culture from lesions of 228 patients (48.0%, 228/475) were identified by multi-locus enzyme electrophoresis. Of them, 95.2% (217/228) were typified as L. (V.) panamensis, 1.3% (3/228) as L. (V.) guyanensis, 2.2% (5/228) as L. (V.) braziliensis, and 1.3% (3/228) as hybrids (L. [V.] braziliensis/L. [V.] panamensis). However, a partial sequencing analysis of the hsp70 gene from 77 selected samples showed 16.9% (13/77) typified as L. (V.) panamensis, 68.8% (53/77) as Leishmania (V.) sp., 1, 3.9% (3/77) as L. (V.) guyanensis, 1.3% (1/77) as L. (V.) braziliensis outlier, 2.6% (2/77) as Leishmania (Viannia) naiffi, 2.6% as (2/77) Leishmania (V.) sp., and 2 and 3.9% (3/77) hybrid isolates of L. (V.) braziliensis/L. (V.) guyanensis. These results confirm L. (V.) panamensis as the predominant species and cause of CL lesions in Panama and that L. (V.) guyanensis, L. (V.) braziliensis, and L. (V.) naiffi are circulating to a lower degree. Furthermore, the determination of parasite isolates belonging to atypical clusters and hybrid isolates suggests the circulation of genetic variants with important implications for the epidemiology and clinical follow-up of CL in Panama. No evidence of the existence of parasites of the Leishmania (Leishmania) mexicana complex in Panamanian territory was found in this study.
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Affiliation(s)
| | - Kadir A González
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Franklyn Samudio
- Facultad de Ciencias Naturales, Exactas y Tecnología, Universidad de Panamá, Panama, Panama.,Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Vanessa J Pineda
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - José E Calzada
- Facultad de Medicina Veterinaria, Universidad de Panamá, Panama, Panama.,Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | | | - Ana Jiménez
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Juan Castillo
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Yaxelis Mendoza
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - José A Suárez
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Betsi Ortiz
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Juan Méndez
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Juan M Pascale
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Max Grögl
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Néstor Sosa
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| | - Azael Saldaña
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama.,Centro de Investigación y Diagnóstico de Enfermedades Parasitarias (CIDEP), Facultad de Medicina, Universidad de Panamá, Panama, Panama
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Charoensakulchai S, Bualert L, Manomat J, Mungthin M, Leelayoova S, Tan-Ariya P, Siripattanapipong S, Naaglor T, Piyaraj P. Risk Factors of Leishmania Infection among HIV-Infected Patients in Trang Province, Southern Thailand: A Study on Three Prevalent Species. Am J Trop Med Hyg 2020; 103:1502-1509. [PMID: 32700674 DOI: 10.4269/ajtmh.20-0332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
There are two main species of Leishmania reported in Thailand, that is, Leishmania siamensis and Leishmania martiniquensis. Moreover, leishmaniasis cases caused by Leishmania donovani complex were also reported. There is still a lack of information concerning risk factors of Leishmania infection in Thailand. This study aimed to identify the risk factors of Leishmania infection caused by these three species among HIV-infected patients. A cross-sectional study was conducted in HIV clinic at Trang Hospital, Thailand. Nested PCR and sequencing were performed to detect Leishmania DNA in blood and saliva samples and identify Leishmania species. A standardized questionnaire was used to interview individuals. A total of 526 patients were recruited in this study. Sixty-three (12.0%) were positive for L. siamensis, 24 (4.6%) were positive for L. martiniquensis, and 23 (4.4%) were positive for L. donovani complex. Risk factors of L. siamensis infection included using intravenous drug (adjusted odds ratio [AOR] 2.01, 95% CI: 1.01-4.02). Risk factors of L. martiniquensis infection included female gender (AOR 4.23, 95% CI: 1.52-11.75), using recreational drug (AOR 3.43, 95% CI: 1.00-11.74), and having comorbidities (AOR 4.94, 95% CI: 2.00-12.21). Risk factors of L. donovani complex infection included having opportunistic infection (AOR 4.22, 95% CI: 1.00-17.79), CD4 count 200-500 cells/mm3 (AOR 3.64, 95% CI: 1.14-6.86), and not using insect repellent (AOR 3.04, 95% CI: 1.08-8.58). This study identified the risk factors of Leishmania infection caused by three Leishmania species in Thailand. The data could be useful for disease prevention and control. Further studies on trends of Leishmania infection and preventive measures are recommended.
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Affiliation(s)
| | | | - Jipada Manomat
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Saovanee Leelayoova
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Peerapan Tan-Ariya
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | | | - Tawee Naaglor
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Phunlerd Piyaraj
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
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Gonzalez K, Calzada JE, Tomokane TY, Pacheco CMS, Flores GVA, Castro Gomes CM, Pereira Corbett CE, Saldaña A, Laurenti MD. In situ study of cellular immune response in human cutaneous lesions caused by Leishmania (Viannia) panamensis in Panama. Parasite Immunol 2020; 43:e12801. [PMID: 33068443 DOI: 10.1111/pim.12801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022]
Abstract
AIMS Leishmaniasis is considered a disease with multiple clinical/immunopathological characteristics, depending on the immunity of the host and the species of the parasite. In Panama, the most prevalent species that causes localized cutaneous leishmaniasis (LCL) is Leishmania (Viannia) panamensis, and its immune response is poorly studied. Therefore, we evaluated by immunohistochemistry, the in situ immune response during this infection. METHODS AND RESULTS Biopsies from Panamanian patients with LCL were collected and processed by histological techniques. Infection by L. (V.) panamensis was demonstrated by isolation in culture and molecular characterization by Hsp70-RFLP. The in situ immune response was assessed by immunohistochemistry. The immune response was characterized by predominance of T cells, mainly CD8 cells that showed positive correlation with IFN-γ and Granzyme B. CD4 cells presented positive correlation with both IFN-γ and IL-13, pointed by mixed cellular immune response. Regulatory response was characterized by FoxP3 cells, which showed positive correlation to IL-10 but not with TGF-β. CONCLUSIONS L. (V.) panamensis infection triggers a mixed cellular immune response, characterized by the presence of pro-inflammatory, anti-inflammatory and regulatory elements in the skin lesion of Panamanian patients. These data contribute to a better understanding of the immunopathogenesis of Leishmania Viannia infection in Panama.
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Affiliation(s)
- Kadir Gonzalez
- Departamento de Parasitología Molecular, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panamá.,Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - José Eduardo Calzada
- Departamento de Parasitología Molecular, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panamá.,Facultad de Medicina Veterinaria, Universidad de Panamá, Panamá, Panamá
| | - Thaise Yumie Tomokane
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Carmen Maria Sandoval Pacheco
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Gabriela Venicia Araujo Flores
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Cláudia Maria Castro Gomes
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Carlos Eduardo Pereira Corbett
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Azael Saldaña
- Departamento de Parasitología Molecular, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panamá.,Centro de Investigación y Diagnóstico de Enfermedades Parasitarias, Facultad de Medicina, Universidad de Panamá, Panamá, Panamá
| | - Marcia Dalastra Laurenti
- Departamento de Patologia, Laboratório de Patologia de Moléstias Infecciosas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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Involvement of the Inflammasome and Th17 Cells in Skin Lesions of Human Cutaneous Leishmaniasis Caused by Leishmania ( Viannia) panamensis. Mediators Inflamm 2020; 2020:9278931. [PMID: 33192178 PMCID: PMC7641710 DOI: 10.1155/2020/9278931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/24/2020] [Accepted: 09/19/2020] [Indexed: 01/07/2023] Open
Abstract
Localized cutaneous leishmaniasis (LCL) caused by Leishmania (Viannia) panamensis is an endemic disease in Panama. This condition causes ulcerated skin lesions characterized by a mixed Th1/Th2 immune response that is responsible for disease pathology. However, the maintenance of the in situ inflammatory process involves other elements, such as Th17 and inflammasome responses. Although these processes are associated with parasite elimination, their role in the increase in disease pathology cannot be discarded. Thus, the role in Leishmania infection is still unclear. In this sense, the present study aimed at characterizing the Th17 and inflammasome responses in the skin lesions of patients with LCL caused by L. (V.) panamensis to help elucidate the pathogenesis of this disease in Panama. Th17 and inflammasome responses were evaluated by immunohistochemistry (IHQ) in 46 skin biopsies from patients with LCL caused by L. (V.) panamensis. The Th17 immune response was assessed using CD3, CD4, RoRγt, IL-17, IL-6, IL-23, and TGF-β1 antibodies, and the inflammasome response was assessed by IL-1β, IL-18, and caspase-1 antibodies. The presence of the Th17 and inflammasome responses was evidenced by a positive reaction for all immunological markers in the skin lesions. An inverse correlation between the density of amastigotes and the density of RoRγt+, IL-17+, IL-1β+, and caspase-1+ cells was observed, but no correlation between Th17 and the inflammasome response with evolutionary disease pathology was reported. These data showed the participation of Th17 cells and the inflammasome in the inflammatory response of the skin lesions of LCL caused by L. (V.) panamensis infection. These results suggest a role in the control of tissue parasitism of IL-17 and the activation of the NLRP3 inflammasome dependent on IL-1β but cannot exclude their role in the development of disease pathology.
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Rigg CA, Calzada JE, Saldaña A, Perea M, Chaves LF, Valderrama A. Leishmania spp. Infection Rate and Feeding Patterns of Sand Flies (Diptera: Psychodidae) from a Hyperendemic Cutaneous Leishmaniasis Community in Panamá. Am J Trop Med Hyg 2020; 100:798-807. [PMID: 30793681 DOI: 10.4269/ajtmh.17-0628] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
American cutaneous leishmaniasis (ACL) is a common and important vector-borne parasitic zoonosis in Panamá. Here, we study Leishmania spp. infection rates and blood-feeding patterns among common sand flies in Trinidad de Las Minas, a rural community with hyperendemic ACL transmission, and where a deltamethrin fogging trial was performed. Sand flies were collected from April 2010 to June 2011 with light traps installed inside and in the peridomicile of 24 houses. We restricted our analysis to the most abundant species at the study site: Lutzomyia trapidoi, Lutzomyia gomezi, Lutzomyia panamensis, Lutzomyia triramula, and Lutzomyia dysponeta. We detected Leishmania spp. infection in sand flies by polymerase chain reaction (PCR) amplification of the internal transcribed spacer region 1 (ITS-1) in pooled females (1-10 females per pool). Host species of engorged sand flies were identified using a cytochrome b PCR. From 455 sand fly pools analyzed, 255 pools were positive for Leishmania spp., with an estimated infection rate (confidence interval) of 0.096 [0.080-0.115] before the deltamethrin fogging which slightly, but not significantly (P > 0.05), increased to 0.116 [0.098-0.136] after the deltamethrin fogging. Blood meal analysis suggested that pigs, goats, and birds were the most common sand fly blood sources, followed by humans and domestic dogs. DNA sequencing from a subsample of ITS-1 positive pools suggests that Leishmania panamensis, Leishmania naiffi, and other Leishmania spp. were the parasite species infecting the most common vectors at the study site. Our data confirm an association between sand fly species, humans, domestic dogs, and pigs and Leishmania spp. parasites in rural Panamá.
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Affiliation(s)
- Chystrie A Rigg
- Programa Centroamericano de Maestría en Entomología, Universidad de Panamá, Ciudad de Panamá, Panamá.,Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Ciudad de Panamá, Panamá
| | - José E Calzada
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Ciudad de Panamá, Panamá
| | - Azael Saldaña
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Ciudad de Panamá, Panamá
| | - Milixa Perea
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Ciudad de Panamá, Panamá
| | - Luis F Chaves
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica.,Instituto Costarricense de Investigación y enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Costa Rica
| | - Anayansi Valderrama
- Programa Centroamericano de Maestría en Entomología, Universidad de Panamá, Ciudad de Panamá, Panamá.,Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Ciudad de Panamá, Panamá
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10
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Sosa N, Pascale JM, Jiménez AI, Norwood JA, Kreishman-Detrick M, Weina PJ, Lawrence K, McCarthy WF, Adams RC, Scott C, Ransom J, Tang D, Grogl M. Topical paromomycin for New World cutaneous leishmaniasis. PLoS Negl Trop Dis 2019; 13:e0007253. [PMID: 31048871 PMCID: PMC6497224 DOI: 10.1371/journal.pntd.0007253] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/21/2019] [Indexed: 11/29/2022] Open
Abstract
Background Paromomycin-based topical treatments were shown to be effective in curing cutaneous leishmaniasis (CL) lesions caused by Leishmania major in Tunisia. Cure rates of an index lesion were approximately 80%. As a follow on, we conducted a similar Phase 3 trial in Panama to demonstrate the efficacy of these treatments against New World species. The primary objective was to determine if a combination topical cream (paromomycin-gentamicin) resulted in statistically superior final clinical cure rates of an index lesion compared to a paromomycin alone topical cream for the treatment of CL, primarily caused by Leishmania panamensis. Methods We conducted a randomized, double blind, Phase 3 trial of topical creams for the treatment of CL caused by Leishmania spp. Three hundred ninety nine patients with one to ten CL lesions were treated by topical application once daily for 20 days. The primary efficacy endpoint was percentage of subjects with clinical cure of an index lesion confirmed to contain Leishmania with no relapse. Results The clinical cure of the index lesion for paromomycin-gentamicin was 79% (95% CI; 72 to 84) and for paromomycin alone was 78% (95% CI; 74 to 87) (p = 0.84). The most common adverse events considered related to study cream application were mild to moderate dermatitis, pain, and pruritus. Conclusions Superiority of paromomycin-gentamicin was not demonstrated. However, the approximately 80% cure rates for both topical creams were similar to those demonstrated in Tunisia and previously reported with parenteral antimonials. Leishmaniasis, a neglected parasitic infection transmitted by the bite of a female sand fly, is endemic in 98 countries or territories with approximately 0.7 to 1.2 million cutaneous leishmaniasis (CL) cases occurring each year. In Panama, most of the CL cases are caused by L. panamensis and, the first line of treatment is pentavalent antimony, given parenterally for 20 days. These systemic regimen is associated with toxicities that can limit the patient from receiving a full course of treatment. Alternative therapies are needed particularly for patients with mild disease, no mucosal involvement, no immunosuppression, and for patients living in areas with scarce infrastructure. Therefore, less toxic, non-parenteral new therapies against CL are urgently needed. We conducted a comparative clinical study that evaluated Paromomycin topical creams (Paromomycin alone versus Paromomycin+Gentamicin) for the treatment of cutaneous leishmaniasis (n = 399) in three sites of country. Our study demonstrated the efficacy of these preparations against New World leishmanial species (mostly L. panamensis) with a cure rate close to 80%. Our trial supports Paromomycin as a viable alternative treatment for CL caused for the New World Leishmania species.
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Affiliation(s)
- Néstor Sosa
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Avenida Justo Arosemena, Panama City, Panama
- * E-mail: (NS); (JP)
| | - Juan Miguel Pascale
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Avenida Justo Arosemena, Panama City, Panama
- * E-mail: (NS); (JP)
| | - Ana I. Jiménez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Avenida Justo Arosemena, Panama City, Panama
| | - Jeanne A. Norwood
- US Army Medical Materiel Development Activity (USAMMDA), Fort Detrick, MD, United States of America
| | | | - Peter J. Weina
- Walter Reed National Military Medical Center, Bethesda, MD, United States of America
| | - Kendra Lawrence
- US Army Medical Materiel Development Activity (USAMMDA), Fort Detrick, MD, United States of America
| | - William F. McCarthy
- US Army Medical Materiel Development Activity (USAMMDA), Fort Detrick, MD, United States of America
| | - Ryan C. Adams
- US Army Medical Materiel Development Activity (USAMMDA), Fort Detrick, MD, United States of America
| | - Charles Scott
- Fast-Track Drugs and Biologics, North Potomac MD, United States of America
| | - Janet Ransom
- Fast-Track Drugs and Biologics, North Potomac MD, United States of America
| | - Douglas Tang
- Fast-Track Drugs and Biologics, North Potomac MD, United States of America
| | - Max Grogl
- US Naval Medical Research Unit No. 6, in Lima, Peru
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11
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Performance of immunohistochemistry as a useful tool for the diagnosis of cutaneous leishmaniasis in Panama, Central America. Parasitol Int 2019; 71:46-52. [PMID: 30885795 DOI: 10.1016/j.parint.2019.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022]
Abstract
Cutaneous leishmaniasis (CL) is one of the most frequent parasitic zoonoses in Panama. Currently, conventional, molecular and histopathological tests are performed to diagnose CL. Immunohistochemistry (IHC) has proven to be a valuable tool to facilitate the diagnosis of leishmaniasis and to study the cellular immune response developed during the infection. Therefore, considering the absence of IHC in the diagnostic routine in Panama, the objective of this study is to demonstrate the usefulness of this test as a complementary diagnostic tool for improving the sensitivity of histopathology (HP) and helping to study the cellular immune response of patients. Samples from patients with suspected CL were analysed by intradermal reaction of Montenegro (IDRM), smears, culture, PCR (Viannia, Hsp-70), HP and IHC. According to the diagnostic criteria, 95.8% of patients were positive for Leishmania sp., that was characterized as Leishmania (V.) panamensis by PCR-HSP70/RFLP. From positive samples, Leishmania was detected by the tested diagnostic methods in the following degrees: 100% by IDRM, 60% by smears, 93.3% by culture, 100% by kDNA PCR, 78.3% by PCR Hsp-70, 50% by HP and 73.9% by IHC. Although IHC had a poor correlation (k = 0.191) with the diagnostic criteria, the sensitivities of both HP (76.1%) and smears (89.1%) were improved by combining them with IHC. IHC considerably improved the detection of the Leishmania parasites in the histopathological sections, supporting the need to implement this diagnostic tool in Panama. In addition, immunohistochemistry allows evaluation of the patient's immune response and thus provides new guidelines for the treatment and control of CL in Panama.
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12
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González K, Diaz R, Ferreira AF, García V, Paz H, Calzada JE, Ruíz M, Laurenti M, Saldaña A. Histopathological characteristics of cutaneous lesions caused by Leishmania Viannia panamensis in Panama. Rev Inst Med Trop Sao Paulo 2018; 60:e8. [PMID: 29451596 PMCID: PMC5813671 DOI: 10.1590/s1678-9946201860008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/17/2017] [Indexed: 02/04/2023] Open
Abstract
Cutaneous leishmaniasis (CL) is an endemic disease in the Republic of Panama, caused by Leishmania (Viannia) parasites, whose most common clinical manifestation is the presence of ulcerated lesions on the skin. These lesions usually present a chronic inflammatory reaction, sometimes granulomatous, with the presence of lymphocytes, plasma cells and macrophages. This study describes the histopathological characteristics found in the skin lesions of patients with CL caused by Leishmania (V.) panamensis in Panama. We analyzed 49 skin biopsy samples from patients with clinical suspicion of CL, by molecular tests (PCR for subgenus Viannia and HSP-70) and by Hematoxylin-Eosin staining. Samples were characterized at the species level by PCR-HSP-70/RFLP. From the 49 samples studied, 46 (94%) were positive by PCR and were characterized as Leishmania (V.) panamensis. Of these, 48% were positive by Hematoxylin-Eosin staining with alterations being observed both, in the epidermis (85%) and in the dermis (100%) of skin biopsies. The inflammatory infiltrate was characterized according to histopathological patterns: lymphohistiocytic (50%), lymphoplasmacytic (61%) and granulomatous (46%) infiltration, being the combination of these patterns frequently found. The predominant histopathological characteristics observed in CL lesions caused by L. (V.) panamensis in Panama were: an intense inflammatory reaction in the dermis with a combination of lymphohistiocytic, lymphoplasmacytic and granulomatous presentation patterns and the presence of ulcers, acanthosis, exocytosis and spongiosis in the epidermis.
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Affiliation(s)
- Kadir González
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama
| | - Rosendo Diaz
- Departamento de Patología, Hospital Santo Tomás, Panama
| | - Aurea F Ferreira
- Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Víctor García
- Departamento de Patología, Hospital Santo Tomás, Panama
| | - Héctor Paz
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama
| | - José E Calzada
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama
| | | | - Márcia Laurenti
- Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Azael Saldaña
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama
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13
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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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14
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Herrera L, Stephens DE, D’Avila A, George KG, Arman H, Zhang Y, Perry G, Lleonart R, Larionov OV, Fernández PL. Insights into the structural patterns of the antileishmanial activity of bi- and tricyclic N-heterocycles. Org Biomol Chem 2016; 14:7053-60. [PMID: 27376396 PMCID: PMC4958403 DOI: 10.1039/c6ob01149g] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The influence of various structural patterns in a series of novel bi- and tricyclic N-heterocycles on the activity against Leishmania major and Leishmania panamensis has been studied and compounds that are active in the low micromolar region have been identified. Both quinolines and tetrahydrooxazinoindoles (TOI) proved to have significant antileishmanial activities, while substituted indoles were inactive. We have also showed that a chloroquine analogue induces Leishmania killing by modulating macrophage activation.
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Affiliation(s)
- Lizzi Herrera
- Centro de Biología Molecular y Celular de Enfermedades, Instituto de Investigaciones científicas y de alta tecnología (INDICASAT-AIP), Edificio 219, Ciudad del Saber, Apartado 0843-01103, Panamá República de Panamá; Fax: +507 507 0020; Tel: +507 517 0739
- Acharya Nagarjuna University, Nagarjuna Nagar, Guntur, Andhra Pradesh, 522510, India
| | - David E. Stephens
- Department of Chemistry, The University of Texas at San Antonio, San Antonio, Texas, United States of America. Fax: +1 210 458 7428; Tel: +1 210 458 6050
| | - Abigail D’Avila
- Centro de Biología Molecular y Celular de Enfermedades, Instituto de Investigaciones científicas y de alta tecnología (INDICASAT-AIP), Edificio 219, Ciudad del Saber, Apartado 0843-01103, Panamá República de Panamá; Fax: +507 507 0020; Tel: +507 517 0739
| | - Kathryn G. George
- Centro de Biología Molecular y Celular de Enfermedades, Instituto de Investigaciones científicas y de alta tecnología (INDICASAT-AIP), Edificio 219, Ciudad del Saber, Apartado 0843-01103, Panamá República de Panamá; Fax: +507 507 0020; Tel: +507 517 0739
| | - Hadi Arman
- Department of Chemistry, The University of Texas at San Antonio, San Antonio, Texas, United States of America. Fax: +1 210 458 7428; Tel: +1 210 458 6050
| | - Yu Zhang
- Department of Chemistry, The University of Texas at San Antonio, San Antonio, Texas, United States of America. Fax: +1 210 458 7428; Tel: +1 210 458 6050
| | - George Perry
- Department of Biology, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Ricardo Lleonart
- Centro de Biología Molecular y Celular de Enfermedades, Instituto de Investigaciones científicas y de alta tecnología (INDICASAT-AIP), Edificio 219, Ciudad del Saber, Apartado 0843-01103, Panamá República de Panamá; Fax: +507 507 0020; Tel: +507 517 0739
| | - Oleg V. Larionov
- Department of Chemistry, The University of Texas at San Antonio, San Antonio, Texas, United States of America. Fax: +1 210 458 7428; Tel: +1 210 458 6050
| | - Patricia L. Fernández
- Centro de Biología Molecular y Celular de Enfermedades, Instituto de Investigaciones científicas y de alta tecnología (INDICASAT-AIP), Edificio 219, Ciudad del Saber, Apartado 0843-01103, Panamá República de Panamá; Fax: +507 507 0020; Tel: +507 517 0739
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15
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Yamada K, Valderrama A, Gottdenker N, Cerezo L, Minakawa N, Saldaña A, Calzada JE, Chaves LF. Macroecological patterns of American Cutaneous Leishmaniasis transmission across the health areas of Panamá (1980-2012). Parasite Epidemiol Control 2016; 1:42-55. [PMID: 29988197 PMCID: PMC5991822 DOI: 10.1016/j.parepi.2016.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 11/29/2022] Open
Abstract
American Cutaneous Leishmaniasis (ACL) is a neglected vector-borne zoonosis that persists despite increasing socio-economic development and urbanization in Panamá. Here, we investigate the association between environmental changes and spatio-temporal ACL transmission in the Republic of Panamá (1980-2012). We employ a macroecological approach, where patterns of variation in ACL incidence at the spatially coarse-grained scale of health areas are studied considering factors linked to the ecology of ACL transmission. We specifically study impacts of climatic variability, measured by the different phases of El Niño Southern Oscillation (ENSO), within diverse ecosystems and sand fly (Diptera: Psychodidae) vector species, as well as heterogeneous local climatic patterns, deforestation, population growth rates, and changes in social marginalization. We found that over the study period, patterns of ACL incidence: (i) were asynchronous with clusters changing from east to west of the Panamá Canal, (ii) trends increased in the west, and decreased or remained nearly constant in the east, independent of human population growth, (iii) generally increased in years following El Niño, and (iv) decreased as forest cover increased. We found no significant association between changes in socio-economic indicators and ACL transmission. Regarding vector abundance and presence, we found that studies had been biased to locations east of the Panamá canal, and that, in general, the abundance of dominant vector species decreased during the cold phase of ENSO. Finally, our results indicate that a macroecological approach is useful to understand heterogeneities related to environmental change impacts on ACL transmission.
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Affiliation(s)
- Koji Yamada
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto 1-12-4, 852-8523 Nagasaki, Japan.,Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-12-4, 852-8523 Nagasaki, Japan
| | - Anayansi Valderrama
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Apartado Postal No. 0816-02593, Ciudad de Panamá, Panama
| | - Nicole Gottdenker
- Department of Veterinary Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Lizbeth Cerezo
- Departamento de Epidemiología, Ministerio de Salud, Ciudad de Panamá, Panama
| | - Noboru Minakawa
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto 1-12-4, 852-8523 Nagasaki, Japan
| | - Azael Saldaña
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Apartado Postal No. 0816-02593, Ciudad de Panamá, Panama
| | - José E Calzada
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Apartado Postal No. 0816-02593, Ciudad de Panamá, Panama
| | - Luis Fernando Chaves
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto 1-12-4, 852-8523 Nagasaki, Japan.,Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Apartado Postal 304-3000, Heredia, Costa Rica
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16
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Genome-wide discovery and development of polymorphic microsatellites from Leishmania panamensis parasites circulating in central Panama. Parasit Vectors 2015; 8:527. [PMID: 26459121 PMCID: PMC4603350 DOI: 10.1186/s13071-015-1153-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/08/2015] [Indexed: 12/01/2022] Open
Abstract
Background The parasite Leishmania panamensis is the main cause of leishmaniasis in Panama. The disease is largely uncontrolled, with a rising incidence and no appropriate control measures. While microsatellites are considered some of the best genetic markers to study population genetics and molecular epidemiology in these and other parasites, none has been developed for L. panamensis. Findings Here we have developed and tested a new panel of microsatellites for this species, based on high-throughput genome-wide screening. The new set of microsatellites is composed of seventeen loci, mainly spanning trinucleotide or longer motifs. We have evaluated the sensitivity and specificity of the panel based on a sample of 27 isolates obtained from cutaneous leishmaniasis patients from central Panama and also several reference species from both L. (Leishmania) and L. (Viannia) subgenera. The genetic equilibrium was assessed both intra- and inter-loci, while the reproductive mode was evaluated using several tests. The new SSR panel shows high polymorphism and sensitivity, as well as good specificity. The preliminary data described here for L. panamensis suggest extensive departure from Hardy-Weinberg proportions, significant linkage disequilibrium and strong deficit of heterozygotes. Several recombination tests involving multilocus linkage disequilibrium and a phylogenetic approach allowed rejection of frequent recombination in our dataset. Conclusions The genome-wide strategy described here proved to be useful to identify and test new polymorphic SSR loci in Leishmania. The new panel of polymorphic microsatellites is a valuable contribution to the existing molecular markers for the study of genetic structure and other aspects of this important species. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1153-2) contains supplementary material, which is available to authorized users.
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17
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Abstract
Leishmania is an infectious protozoan parasite related to African and American trypanosomes. All Leishmania species that are pathogenic to humans can cause dermal disease. When one is confronted with cutaneous leishmaniasis, identification of the causative species is relevant in both clinical and epidemiological studies, case management, and control. This review gives an overview of the currently existing and most used assays for species discrimination, with a critical appraisal of the limitations of each technique. The consensus taxonomy for the genus is outlined, including debatable species designations. Finally, a numerical literature analysis is presented that describes which methods are most used in various countries and regions in the world, and for which purposes.
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Affiliation(s)
- Gert Van der Auwera
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
| | - Jean-Claude Dujardin
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium Antwerp University, Department of Biomedical Sciences, Antwerp, Belgium
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18
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González K, Calzada JE, Saldaña A, Rigg CA, Alvarado G, Rodríguez-Herrera B, Kitron UD, Adler GH, Gottdenker NL, Chaves LF, Baldi M. Survey of wild mammal hosts of cutaneous leishmaniasis parasites in panamá and costa rica. Trop Med Health 2014; 43:75-8. [PMID: 25859156 PMCID: PMC4361339 DOI: 10.2149/tmh.2014-30] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 11/25/2014] [Indexed: 11/11/2022] Open
Abstract
The eco-epidemiology of American cutaneous leishmaniasis (ACL) is driven by animal reservoir species that are a source of infection for sand flies that serve as vectors infecting humans with Leishmania spp parasites. The emergence and re-emergence of this disease across Latin America calls for further studies to identify reservoir species associated with enzootic transmission. Here, we present results from a survey of 52 individuals from 13 wild mammal species at endemic sites in Costa Rica and Panama where ACL mammal hosts have not been previously studied. For Leishmania spp. diagnostics we employed a novel PCR technique using blood samples collected on filter paper. We only found Leishmania spp parasites in one host, the two-toed sloth, Choloepus hoffmanni. Our findings add further support to the role of two-toed sloths as an important ACL reservoir in Central America.
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Affiliation(s)
- Kadir González
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES) , Apartado Postal No. 0816-02593, Ciudad de Panamá, República de Panamá
| | - José E Calzada
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES) , Apartado Postal No. 0816-02593, Ciudad de Panamá, República de Panamá
| | - Azael Saldaña
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES) , Apartado Postal No. 0816-02593, Ciudad de Panamá, República de Panamá
| | - Chystrie A Rigg
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES) , Apartado Postal No. 0816-02593, Ciudad de Panamá, República de Panamá
| | - Gilbert Alvarado
- Escuela de Biología, Universidad de Costa Rica , Apartado Postal 11501-2060, San Pedro, Costa Rica
| | - Bernal Rodríguez-Herrera
- Escuela de Biología, Universidad de Costa Rica , Apartado Postal 11501-2060, San Pedro, Costa Rica
| | - Uriel D Kitron
- Department of Environmental Studies, Emory University , Atlanta, GA, 30322 USA
| | | | - Nicole L Gottdenker
- Department of Pathology, School of Veterinary Medicine, University of Georgia , Athens, GA, 30602 USA
| | - Luis Fernando Chaves
- Institute of Tropical Medicine (NEKKEN), Nagasaki University , 1-12-4 Sakamoto, Nagasaki 852-8523, Japan ; Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional , Apartado Postal 304-3000, Heredia, Costa Rica
| | - Mario Baldi
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional , Apartado Postal 304-3000, Heredia, Costa Rica
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Cutaneous leishmaniasis and sand fly fluctuations are associated with el niño in panamá. PLoS Negl Trop Dis 2014; 8:e3210. [PMID: 25275503 PMCID: PMC4183471 DOI: 10.1371/journal.pntd.0003210] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/23/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cutaneous Leishmaniasis (CL) is a neglected tropical vector-borne disease. Sand fly vectors (SF) and Leishmania spp parasites are sensitive to changes in weather conditions, rendering disease transmission susceptible to changes in local and global scale climatic patterns. Nevertheless, it is unclear how SF abundance is impacted by El Niño Southern Oscillation (ENSO) and how these changes might relate to changes in CL transmission. METHODOLOGY AND FINDINGS We studied association patterns between monthly time series, from January 2000 to December 2010, of: CL cases, rainfall and temperature from Panamá, and an ENSO index. We employed autoregressive models and cross wavelet coherence, to quantify the seasonal and interannual impact of local climate and ENSO on CL dynamics. We employed Poisson Rate Generalized Linear Mixed Models to study SF abundance patterns across ENSO phases, seasons and eco-epidemiological settings, employing records from 640 night-trap sampling collections spanning 2000-2011. We found that ENSO, rainfall and temperature were associated with CL cycles at interannual scales, while seasonal patterns were mainly associated with rainfall and temperature. Sand fly (SF) vector abundance, on average, decreased during the hot and cold ENSO phases, when compared with the normal ENSO phase, yet variability in vector abundance was largest during the cold ENSO phase. Our results showed a three month lagged association between SF vector abundance and CL cases. CONCLUSION Association patterns of CL with ENSO and local climatic factors in Panamá indicate that interannual CL cycles might be driven by ENSO, while the CL seasonality was mainly associated with temperature and rainfall variability. CL cases and SF abundance were associated in a fashion suggesting that sudden extraordinary changes in vector abundance might increase the potential for CL epidemic outbreaks, given that CL epidemics occur during the cold ENSO phase, a time when SF abundance shows its highest fluctuations.
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Samy AM, Doha SA, Kenawy MA. Ecology of cutaneous leishmaniasis in Sinai: linking parasites, vectors and hosts. Mem Inst Oswaldo Cruz 2014; 109:299-306. [PMID: 24821060 PMCID: PMC4131781 DOI: 10.1590/0074-0276130426] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 02/19/2014] [Indexed: 11/22/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a neglected clinical form of public health importance that is quite prevalent in the northern and eastern parts of Egypt. A comprehensive study over seven years (January 2005-December 2011) was conducted to track CL transmission with respect to both sandfly vectors and animal reservoirs. The study identified six sandfly species collected from different districts in North Sinai: Phlebotomus papatasi, Phlebotomus kazeruni, Phlebotomus sergenti, Phlebotomus alexandri, Sergentomyia antennata and Sergentomyia clydei. Leishmania (-)-like flagellates were identified in 15 P. papatasi individuals (0.5% of 3,008 dissected females). Rodent populations were sampled in the same districts where sandflies were collected and eight species were identified: Rattus norvegicus (n = 39), Rattus rattus frugivorous (n = 13), Rattus rattus alexandrinus (n = 4), Gerbillus pyramidum floweri (n = 38), Gerbillus andersoni (n = 28), Mus musculus (n = 5), Meriones sacramenti (n = 22) and Meriones crassus (n = 10). Thirty-two rodents were found to be positive for Leishmania infection (20.12% of 159 examined rodents). Only Leishmania major was isolated and identified in 100% of the parasite samples. The diversity of both the vector and rodent populations was examined using diversity indices and clustering approaches.
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Affiliation(s)
- Abdallah Mohammed Samy
- Department of Entomology, Faculty of Science, Ain Shams University,
Abbassia, Cairo, Egypt
- Biodiversity Institute/Department of Ecology and Evolutionary Biology,
The University of Kansas, Lawrence, KS, USA
| | - Said Abdallah Doha
- Research and Training Center on Vectors of Diseases, Faculty of
Science, Ain Shams University, Abbassia, Cairo, Egypt
| | - Mohamed Amin Kenawy
- Department of Entomology, Faculty of Science, Ain Shams University,
Abbassia, Cairo, Egypt
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21
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Hotez PJ, Woc-Colburn L, Bottazzi ME. Neglected tropical diseases in Central America and Panama: review of their prevalence, populations at risk and impact on regional development. Int J Parasitol 2014; 44:597-603. [PMID: 24846528 DOI: 10.1016/j.ijpara.2014.04.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 04/04/2014] [Accepted: 04/07/2014] [Indexed: 11/30/2022]
Abstract
A review of the literature since 2009 reveals a staggering health and economic burden resulting from neglected tropical diseases in Panama and the six countries of Central America (referred to collectively here as 'Central America'). Particularly at risk are the 10.2million people in the region who live on less than $2 per day, mostly in Guatemala, Honduras, Nicaragua and El Salvador. Indigenous populations are especially vulnerable to neglected tropical diseases. Currently, more than 8million Central American children require mass drug treatments annually (or more frequently) for their intestinal helminth infections, while vector-borne diseases are widespread. Among the vector-borne parasitic infections, almost 40% of the population is at risk for malaria (mostly Plasmodium vivax infection), more than 800,000 people live with Chagas disease, and up to 39,000 people have cutaneous leishmaniasis. In contrast, an important recent success story is the elimination of onchocerciasis from Central America. Dengue is the leading arbovirus infection with 4-5million people affected annually and hantavirus is an important rodent-borne viral neglected tropical disease. The leading bacterial neglected tropical diseases include leptospirosis and trachoma, for which there are no disease burden estimates. Overall there is an extreme dearth of epidemiological data on neglected tropical diseases based on active surveillance as well as estimates of their economic impact. Limited information to date, however, suggests that neglected tropical diseases are a major hindrance to the region's economic development, in both the most impoverished Central American countries listed above, as well as for Panama and Costa Rica where a substantial (but largely hidden) minority of people live in extreme poverty.
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Affiliation(s)
- Peter J Hotez
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States; Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Houston, TX, United States; James A. Baker III Institute for Public Policy, Rice University, Houston, TX, United States.
| | - Laila Woc-Colburn
- Department of Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Maria Elena Bottazzi
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States; Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Houston, TX, United States
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22
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Dutari LC, Loaiza JR. American Cutaneous Leishmaniasis in Panama: a historical review of entomological studies on anthropophilic Lutzomyia sand fly species. Parasit Vectors 2014; 7:218. [PMID: 24886629 PMCID: PMC4026118 DOI: 10.1186/1756-3305-7-218] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 05/01/2014] [Indexed: 11/17/2022] Open
Abstract
We review existing information on the epidemiology of American Cutaneous Leishmaniasis (ACL) in Panama, with emphasis on the bionomics of anthropophilic Lutzomyia sand fly species. Evidence from Panamanian studies suggests that there are six anthropophilic species in the country: Lutzomyia trapidoi, Lu. panamensis, Lu. gomezi, Lu. ylephiletor, Lu. sanguinaria and Lu. pessoana (Henceforth Lu. carrerai thula). In general, these taxa are abundant, widespread and feed opportunistically on their hosts, which make them potential transmitters of pathogens to a broad range of wildlife, domesticated animals and humans. Furthermore, nearly all man-biting species in Panama (with the exception of Lu. gomezi) expand demographically during the rainy season when transmission is likely higher due to elevated Leishmania infection rates in vector populations. Despite this, data on the distribution and prevalence of ACL suggest little influence of vector density on transmission intensity. Apart from Lu. trapidoi, anthropophilic species seem to be most active in the understory, but vertical stratification, as well as their opportunistic feeding behavior, could vary geographically. This in turn seems related to variation in host species composition and relative abundance across sites that have experienced different degrees of human alteration (e.g., deforestation) in leishmaniasis endemic regions of Panama.
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Affiliation(s)
| | - Jose R Loaiza
- Centro de Biodiversidad & Descubrimiento de Drogas, Instituto de Investigaciones Científicas & Servicios de Alta Tecnología, Edificio 219, Clayton, PO 0843-01103, Ciudad del Saber, República de Panamá.
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Valderrama A, Tavares MG, Filho JDA. Phylogeography of the Lutzomyia gomezi (Diptera: Phlebotominae) on the Panama Isthmus. Parasit Vectors 2014; 7:9. [PMID: 24398187 PMCID: PMC3892078 DOI: 10.1186/1756-3305-7-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 01/03/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Lutzomyia gomezi (Nitzulescu, 1931) is one of the main Leishmania (Vianna) panamensis vectors in Panama, and despite its medical significance, there are no population genetic studies regarding this species. In this study, we used the sequences of the mitochondrial gene cytochrome b/start of NADH1 and the nuclear elongation gene α-1 in order to analyze genetic variation and phylogeographic structure of the Lu. gomezi populations. METHODS A total of 86 Lu. gomezi individuals were captured in 38 locations where cutaneous leishmaniasis occurred. DNA was extracted with phenol/chloroform methods and amplification of genes was performed using PCR primers for mitochondrial and nuclear markers. RESULTS We found a total of 37 and 26 haplotypes of mitochondrial and nuclear genes, high haplotype diversity (h) for all three populations were detected with both molecular markers. Nucleotide diversity (π) was estimated to be high for all three populations with the mitochondrial marker, which was opposite to the estimate with the nuclear marker. In the AMOVA Φst recorded moderate (mitochondrial) and small (nuclear) population structure with statistical significance among populations. The analysis of the fixation index (Fst) used to measure the differentiation of populations showed that with the exception of the population located in the region of Bocas del Toro, the other populations presented with minor genetic differentiation. The median-Joining network of the mitochondrial marker reveled three clusters and recorded four haplotypes exclusively of localities sampled from Western Panama, demonstrating strong divergence. We found demographic population expansion with Fu´s Fs neutrality test. In the analysis mismatch distribution was observed as a bimodal curve. CONCLUSION Lu. gomezi is a species with higher genetic pool or variability and mild population structure, due to possible capacity migration and local adaptation to environmental changes or colonization potential. Thus, knowledge of the genetic population and evolutionary history is useful to understand the implications of different population genetic structures for cutaneous leishmaniasis epidemiology.
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Affiliation(s)
- Anayansi Valderrama
- Department of Medical Entomology, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Panama
| | | | - Jose Dilermando Andrade Filho
- Centro de Referência Nacional e Internacional para Flebotomíneos/Coleção de Flebotomíneos, Instituto René Rachou-Fiocruz, Belo Horizonte, MG, Brasil
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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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25
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Restrepo CM, De La Guardia C, Sousa OE, Calzada JE, Fernández PL, Lleonart R. AFLP polymorphisms allow high resolution genetic analysis of American Tegumentary Leishmaniasis agents circulating in Panama and other members of the Leishmania genus. PLoS One 2013; 8:e73177. [PMID: 24039881 PMCID: PMC3767818 DOI: 10.1371/journal.pone.0073177] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 07/18/2013] [Indexed: 11/18/2022] Open
Abstract
American Tegumentary Leishmaniasis is caused by parasites of the genus Leishmania, and causes significant health problems throughout the Americas. In Panama, Leishmania parasites are endemic, causing thousands of new cases every year, mostly of the cutaneous form. In the last years, the burden of the disease has increased, coincident with increasing disturbances in its natural sylvatic environments. The study of genetic variation in parasites is important for a better understanding of the biology, population genetics, and ultimately the evolution and epidemiology of these organisms. Very few attempts have been made to characterize genetic polymorphisms of parasites isolated from Panamanian patients of cutaneous leishmaniasis. Here we present data on the genetic variability of local isolates of Leishmania, as well as specimens from several other species, by means of Amplified Fragment Length Polymorphisms (AFLP), a technique seldom used to study genetic makeup of parasites. We demonstrate that this technique allows detection of very high levels of genetic variability in local isolates of Leishmania panamensis in a highly reproducible manner. The analysis of AFLP fingerprints generated by unique selective primer combinations in L. panamensis suggests a predominant clonal mode of reproduction. Using fluorescently labeled primers, many taxon-specific fragments were identified which may show potential as species diagnostic fragments. The AFLP permitted a high resolution genetic analysis of the Leishmania genus, clearly separating certain groups among L. panamensis specimens and highly related species such as L. panamensis and L. guyanensis. The phylogenetic networks reconstructed from our AFLP data are congruent with established taxonomy for the genus Leishmania, even when using single selective primer combinations. Results of this study demonstrate that AFLP polymorphisms can be informative for genetic characterization in Leishmania parasites, at both intra and inter-specific levels.
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Affiliation(s)
- Carlos M Restrepo
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Ciudad de Panamá, Panamá ; Department of Biotechnology, Acharya Nagarjuna University, Guntur, India
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26
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Strazzulla A, Cocuzza S, Pinzone MR, Postorino MC, Cosentino S, Serra A, Cacopardo B, Nunnari G. Mucosal leishmaniasis: an underestimated presentation of a neglected disease. BIOMED RESEARCH INTERNATIONAL 2013; 2013:805108. [PMID: 23853773 PMCID: PMC3703408 DOI: 10.1155/2013/805108] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 06/06/2013] [Indexed: 11/18/2022]
Abstract
We present a review of current knowledge about mucosal leishmaniasis (ML). Although involvement of mucous membranes is classically admitted in New World leishmaniasis, particularly occurring in infection by Leishmania (L.) braziliensis species complex, ML is also a possible presentation of Old World leishmaniasis, in either L. donovani or L. major species complex infections. Thus, ML has to be considered not only as a Latin American disease but as an Old and New World disease. We describe ML epidemiology, pathogenesis, clinics, diagnosis, and therapy. Considering both its highly disfiguring lesions and its possible lethal outcome, ML should not be underestimated by physicians. Moreover, leishmaniasis is expected to increase its burden in many countries as sandfly vector distribution is widespreading towards non-endemic areas. Finally, the lack of clear understanding of ML pathogenesis and the absence of effective human vaccines strongly claim for more research.
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Affiliation(s)
- Alessio Strazzulla
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Salvatore Cocuzza
- Division of Otorhinolaryngology, Department of Medical-Surgical Specialties, Policlinico-Vittorio Emanuele Hospital, University of Catania, 95125 Catania, Italy
| | - Marilia Rita Pinzone
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Maria Concetta Postorino
- Division of Pathology and Experimental Microbiology, Elie Metchnikoff Department, University of Messina, 98125 Messina, Italy
| | - Stefano Cosentino
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Agostino Serra
- Division of Otorhinolaryngology, Department of Medical-Surgical Specialties, Policlinico-Vittorio Emanuele Hospital, University of Catania, 95125 Catania, Italy
| | - Bruno Cacopardo
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
| | - Giuseppe Nunnari
- Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, Garibaldi Nesima Hospital, University of Catania, 95125 Catania, Italy
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Chaves LF, Calzada JE, Rigg C, Valderrama A, Gottdenker NL, Saldaña A. Leishmaniasis sand fly vector density reduction is less marked in destitute housing after insecticide thermal fogging. Parasit Vectors 2013; 6:164. [PMID: 23742709 PMCID: PMC3693930 DOI: 10.1186/1756-3305-6-164] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Insecticide thermal fogging (ITF) is a tool to control vector borne diseases. Insecticide application success for vector control has been associated with housing materials and architecture. Vector abundance is correlated with weather changes. Nevertheless, housing quality and weather impacts on vector abundance have been unaccounted for in most New World insecticide control trials for leishmaniasis vectors. METHODS We conducted a 15 month insecticide control trial that included two deltamethrin [6 mg a.i.m-2] based ITF interventions in 12 of 24 monitored houses at Trinidad de Las Minas, a hyperendemic cutaneous leishmaniasis transmission village in western Panamá. During the study we followed sand fly (SF) abundance, keeping track of rainfall and quantified housing quality using an index based on architecture and construction materials. RESULTS We found a 50 to 80% reduction in SF density in the fogged houses when compared with control houses, while controlling for seasonal changes in SF abundance associated with rainfall. We found heterogeneities in the reductions, as abundance changed according to SF species: Lutzomyia gomezi, Lu. panamensis, Lu. dysponeta and Lu. triramula reduced in density between 40% and 90% after ITF. In contrast, Lu. trapidoi density increased 5% after ITF. Differences in the impact of ITF were associated with housing quality, the most destitute houses, i.e., those with features that ease insect entrance, had a disproportionally larger SF abundance, in some cases with increased domiciliary SF density following the ITF. CONCLUSION Our results suggest the potential of insecticide application to control SF density and leishmaniasis transmission could depend on housing quality beyond insecticide efficiency.
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Affiliation(s)
- Luis Fernando Chaves
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Jose E Calzada
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, República de Panamá
| | - Chystrie Rigg
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, República de Panamá
| | - Anayansi Valderrama
- Departamento de Entomología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, República de Panamá
| | - Nicole L Gottdenker
- Department of Pathology, School of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Azael Saldaña
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, República de Panamá
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Saldaña A, Chaves LF, Rigg CA, Wald C, Smucker JE, Calzada JE. Clinical cutaneous leishmaniasis rates are associated with household Lutzomyia gomezi, Lu. Panamensis, and Lu. trapidoi abundance in Trinidad de Las Minas, western Panama. Am J Trop Med Hyg 2013; 88:572-4. [PMID: 23339202 DOI: 10.4269/ajtmh.12-0579] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
American cutaneous leishmaniasis (ACL) transmission patterns have been increasingly associated with domestic and peridomestic environments. Here, we present results from an epidemiological survey of 94 people from 24 households in Trinidad de Las Minas, western Panama. We studied the role of sand fly abundance, housing quality, peridomicile landscape matrix, and vegetation structure on shaping household clinical ACL rate patterns at Trinidad de Las Minas. We found that sand fly abundance was significantly associated with household clinical ACL rates, with a 6% rate increase for each additional Lutzomyia gomezi sand fly found inside a domicile.
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Affiliation(s)
- Azael Saldaña
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama City, Panama.
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29
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Calzada JE, Saldaña A, Rigg C, Valderrama A, Romero L, Chaves LF. Changes in phlebotomine sand fly species composition following insecticide thermal fogging in a rural setting of Western panamá. PLoS One 2013; 8:e53289. [PMID: 23536748 PMCID: PMC3541195 DOI: 10.1371/journal.pone.0053289] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 11/29/2012] [Indexed: 11/19/2022] Open
Abstract
American Cutaneous Leishmaniasis, ACL, is a zoonotic disease with a large richness of co-occurring vector species in transmission foci. Here, we describe changes in patterns of phlebotomine sand fly (Diptera: Psychodidae: Phlebotominae) species composition at the village of Trinidad de Las Minas, Capira, Panamá, a hyperendemic focus of ACL transmission, subjected to a vector control intervention with insecticide thermal fogging (ITF). Our study setting consisted of 24 houses, 12 subjected to two rounds of ITF and 12 kept as control. During 15 months (April 2010- June 2011) we monitored sand fly species composition and abundance with modified HP light traps inside (domicile) and outside (peridomicile) the studied houses. From 5628 sand flies collected, we were able to identify 5617 of the samples into 24 species, a number of species close to 25±1.6, the estimate from the Chao2 Index. The most abundant species were Lutzomya trapidoi (20%), Lu. gomezi (20%) and Lu. triramula (20%). Cluster analyses showed that most of the 24 houses had high similarity in relative abundance patterns of the six most common species, with only few peripheral houses not following the main cluster pattern. We also found that species richness was decreased to 22 species in the fogged houses, of which only 19 were found in the domiciliary environment. Changes in species richness were especially notorious at the end of the wet season. Our results suggest that species richness can decrease following ITF in domiciliary environments, primarily affecting the less common species.
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Affiliation(s)
- Jose E. Calzada
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Azael Saldaña
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Chystrie Rigg
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Anayansi Valderrama
- Departamento de Entomología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Luz Romero
- Departamento de Parasitología, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panamá
| | - Luis Fernando Chaves
- Programa de Investigación en Enfermedades Tropicales, Universidad Nacional, Heredia, Costa Rica
- Graduate School of Environmental Sciences, Hokkaido University, Sapporo, Japan
- * E-mail:
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Soong L, Henard CA, Melby PC. Immunopathogenesis of non-healing American cutaneous leishmaniasis and progressive visceral leishmaniasis. Semin Immunopathol 2012; 34:735-51. [PMID: 23053396 PMCID: PMC4111229 DOI: 10.1007/s00281-012-0350-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 09/21/2012] [Indexed: 12/21/2022]
Abstract
The outcomes of Leishmania infection are determined by host immune and nutrition status, parasite species, and co-infection with other pathogens. While subclinical infection and self-healing cutaneous leishmaniasis (CL) are common, uncontrolled parasite replication can lead to non-healing local lesions or visceral leishmaniasis (VL). It is known that infection control requires Th1-differentiation cytokines (IL-12, IL-18, and IL-27) and Th1 cell and macrophage activation. However, there is no generalized consensus for the mechanisms of host susceptibility. The recent studies on regulatory T cells and IL-17-producing cells help explain the effector T cell responses that occur independently of the known Th1/Th2 cell signaling pathways. This review focuses on the immunopathogenesis of non-healing American CL and progressive VL. We summarize recent evidence from human and animal studies that reveals the mechanisms of dysregulated, hyper-responses to Leishmania braziliensis, as well as the presence of disease-promoting or the absence of protective responses to Leishmania amazonensis and Leishmania donovani. We highlight immune-mediated parasite growth and immunopathogenesis, with an emphasis on the putative roles of IL-17 and its related cytokines as well as arginase. A better understanding of the quality and regulation of innate immunity and T cell responses triggered by Leishmania will aid in the rational control of pathology and the infection.
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Affiliation(s)
- Lynn Soong
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA.
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Valderrama A, Tavares MG, Andrade Filho JD. Anthropogenic influence on the distribution, abundance and diversity of sandfly species (Diptera: Phlebotominae: Psychodidae), vectors of cutaneous leishmaniasis in Panama. Mem Inst Oswaldo Cruz 2012; 106:1024-31. [PMID: 22241128 DOI: 10.1590/s0074-02762011000800021] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Accepted: 10/17/2011] [Indexed: 11/21/2022] Open
Abstract
In Panama, species of the genus Lutzomyia are vectors of American cutaneous leishmaniasis (ACL). There is no recent ecological information that may be used to develop tools for the control of this disease. Thus, the goal of this study was to determine the composition, distribution and diversity of Lutzomyia species that serve as vectors of ACL. Sandfly sampling was conducted in forests, fragmented forests and rural environments, in locations with records of ACL. Lutzomyia gomezi, Lutzomyia panamensis and Lutzomyia trapidoi were the most widely distributed and prevalent species. Analysis of each sampling point showed that the species abundance and diversity were greatest at points located in the fragmented forest landscape. However, when the samples were grouped according to the landscape characteristics of the locations, there was a greater diversity of species in the rural environment locations. The Kruskal Wallis analysis of species abundance found that Lu. gomezi and Lu. trapidoi were associated with fragmented environments, while Lu. panamensis, Lutzomyia olmeca bicolor and Lutzomyia ylephiletor were associated with forested environments. Therefore, we suggest that human activity influences the distribution, composition and diversity of the vector species responsible for leishmaniasis in Panama.
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Affiliation(s)
- Anayansi Valderrama
- Departamento de Biologia Geral, Universidade Federal de Viçosa, 36570-000 Viçosa, MG, Brasil.
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Miranda A, Saldaña A, González K, Paz H, Santamaría G, Samudio F, Calzada JE. Evaluation of PCR for cutaneous leishmaniasis diagnosis and species identification using filter paper samples in Panama, Central America. Trans R Soc Trop Med Hyg 2012; 106:544-8. [PMID: 22818741 DOI: 10.1016/j.trstmh.2012.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 05/17/2012] [Accepted: 05/17/2012] [Indexed: 11/16/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a major vectorborne disease in Panama. In this study, the diagnostic performance and usefulness of two DNA extraction procedures from skin scraping samples collected on FTA filter paper for subsequent PCR diagnosis of CL was evaluated. A positive CL laboratory diagnosis was based on a positive parasitological test (Giemsa-stained smears or in vitro culture) and/or positive PCR test performed from skin scrapings collected in TE buffer (PCR-TE). Of 100 patients with skin lesions suggestive of CL, 82 (82%) were confirmed as CL positive. The sensitivity was calculated for each of the PCR approaches from samples collected on filter paper. The highest sensitivity was achieved by PCR-FTA processed by Chelex 100 (PCR-Chelex) (0.94). PCR-FTA extracted using the FTA purification reagent presented a lower sensitivity (0.60). Good concordance between routine PCR-TE and PCR-Chelex was observed (percent agreement=0.88, κ index=0.65). In conclusion, use of FTA filter paper for skin scraping collection combined with PCR is a reliable and convenient method for CL diagnosis in Panama, with comparable performance to the routine PCR method and with improved sensitivity compared with those of conventional parasitological methods.
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Affiliation(s)
- A Miranda
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), P.O. Box 0816-02593, Panamá City, Panamá
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Valderrama A, Tavares MG, Andrade Filho JD. Report of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in a cutaneous-leishmaniasis-endemic area of Panama. Mem Inst Oswaldo Cruz 2011; 106:1049-51. [DOI: 10.1590/s0074-02762011000800025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 09/22/2011] [Indexed: 11/21/2022] Open
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González C, Rebollar-Téllez EA, Ibáñez-Bernal S, Becker-Fauser I, Martínez-Meyer E, Peterson AT, Sánchez-Cordero V. Current knowledge of Leishmania vectors in Mexico: how geographic distributions of species relate to transmission areas. Am J Trop Med Hyg 2011; 85:839-46. [PMID: 22049037 PMCID: PMC3205629 DOI: 10.4269/ajtmh.2011.10-0452] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 02/28/2011] [Indexed: 11/07/2022] Open
Abstract
Leishmaniases are a group of vector-borne diseases with different clinical manifestations caused by parasites transmitted by sand fly vectors. In Mexico, the sand fly Lutzomyia olmeca olmeca is the only vector proven to transmit the parasite Leishmania mexicana to humans, which causes leishmaniasis. Other vector species with potential medical importance have been obtained, but their geographic distributions and relation to transmission areas have never been assessed. We modeled the ecological niches of nine sand fly species and projected niches to estimate potential distributions by using known occurrences, environmental coverages, and the algorithms GARP and Maxent. All vector species were distributed in areas with known recurrent transmission, except for Lu. diabolica, which appeared to be related only to areas of occasional transmission in northern Mexico. The distribution of Lu. o. olmeca does not overlap with all reported cutaneous leishmaniasis cases, suggesting that Lu. cruciata and Lu. shannoni are likely also involved as primary vectors in those areas. Our study provides useful information of potential risk areas of leishmaniasis transmission in Mexico.
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Affiliation(s)
- Camila González
- Departamento de Zoología, Instituto de Biología, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico.
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Cannella AP, Nguyen BM, Piggott CD, Lee RA, Vinetz JM, Mehta SR. A cluster of cutaneous leishmaniasis associated with human smuggling. Am J Trop Med Hyg 2011; 84:847-50. [PMID: 21633017 DOI: 10.4269/ajtmh.2011.10-0693] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is rarely seen in the United States, and the social and geographic context of the infection can be a key to its diagnosis and management. Four Somali and one Ethiopian, in U.S. Border Patrol custody, came to the United States by the same human trafficking route: Djibouti to Dubai to Moscow to Havana to Quito; and then by ground by Columbia/Panama to the United States-Mexico border where they were detained. Although traveling at different times, all five patients simultaneously presented to our institution with chronic ulcerative skin lesions at different sites and stages of evolution. Culture of biopsy specimens grew Leishmania panamensis. Soon thereafter, three individuals from East Africa traveling the identical route presented with L. panamensis CL to physicians in Tacoma, WA. We document here the association of a human trafficking route and new world CL. Clinicians and public health officials should be aware of this emerging infectious disease risk.
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Affiliation(s)
- Anthony P Cannella
- Division of Infectious Diseases and Division of Dermatology, Department of Medicine, University of California-San Diego, La Jolla, CA 92093, USA
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