The perfect storm: Cutaneous leishmaniasis in troops deployed in the Atlantic forest of Argentina

American cutaneous leishmaniasis (ACL) is the most prevalent form of leishmaniasis, associated with an ulcerative and stigmatizing mucocutaneous pathology. This study assessed the incidence of Leishmania (Viannia) braziliensis in members of the Argentine Army who were exposed to sandfly bites in Iguazú National Park (INP), northeastern Argentina, during an outbreak of ACL in 2019, and the presence of Leishmania in rodents, opossums and phlebotomine sandflies collected in the area of exposure. Samples from military personnel, wild animals and phlebotomine sandflies were analysed. A total of 20 (40%) patients among the Army personnel and two Akodon montensis rodents (11%) were positive for the presence of Leishmania sp. genes by PCR, while Nyssomyia whitmani and Migonemyia migonei, competent vectors of Leishmania, were also found at the same site. Sequences of hsp70 DNA fragments obtained from human samples confirmed the identity of L. (V.) braziliensis. The risk to which military personnel carrying out activities in the forest are exposed is highlighted, and this risk extends to any worker and visitor who circulates without protection in the INP, coming into contact with transmission "hot spots" due to the concentration of vectors, reservoirs and/or parasites.

Entomological, parasitological and molecular investigations in a new focus of cutaneous leishmaniasis in Youssoufia region, Morocco

BACKGROUND AND AIMS

Leishmaniasis is a neglected tropical infection caused by Leishmania parasite that affect human and animal. In Morocco, the cutaneous leishmaniasis has spread substantially to the new areas. The surveillance limited to active foci may underestimate the occurrence of cutaneous leishmaniasis (CL). This study aims to investigate the local transmission of CL in rural districts of Youssoufia province, central Morocco, as a potential focus of CL.

METHODS

For this purpose, parasitological, molecular and entomological investigations were carried out in this area. Data collection concerns potential vectors and human cases. Thus, 402 patients were examined for suspected leishmaniasis lesions in three localities of the province of Youssoufia. In these same localities, 983 sand flies were collected by CDC light traps and sticky paper during one-night per month during 6 months. These sand flies were all identified morphologically using the Moroccan identification key.

RESULTS

The results showed that among the 25 skin lesions detected in a population of 402 individuals, 18 were confirmed by kDNA nested PCR as CL positive patients, of which only 25% were positive by direct examination. Leishmania tropica and Leishmania major were identified as causative agents of CL in the study area. Direct parasitological examination showed a low sensitivity (27.78%), especially for L. major, although its specificity was evaluated at 100%. Regarding entomological results, both genera of the Moroccan sand fly were collected in the study area: Genus/Phlebotomus (75.28%) and Sergentomyia (24.72%). Phlebotomus (P) papatasi, the proven vector of L. major, was the most abundant species (33.98%), followed by Paralongicollum sergenti (22.58%), the confirmed vector of L. tropica; while Sergentomyia (S) minuta, P. longicuspis, S. fallax and P. kazeruni were collected with, respectively, 17.60%, 16.99%, 7.12% and 1.73%.

CONCLUSION

This study constitutes the first report of CL in the study areas, as well as the coexistence of L. tropica and L. major in these rural localities. Local transmission of CL is highly probable, as indicated by the prevalence of the two proven vectors of L. major and L. tropica. To control the spread of this disease, our results suggest the use of highly sensitive molecular methods to detect CL cases in potential leishmaniasis foci, which will improve surveillance.

Association Between Wolbachia Infection and Susceptibility to Deltamethrin Insecticide in Phlebotomus papatasi (Diptera: Psychodidae), the Main Vector of Zoonotic Cutaneous Leishmaniasis

Background: Phlebotomus papatasi (Diptera: Psychodidae) is the main vector of zoonotic cutaneous leishmaniasis. Wolbachia is a symbiotic alphaproteobacteria of arthropods that can be involved in susceptibility or resistance. This study aimed to investigate the relationship between Wolbachia and Deltamethrin susceptibility/resistance in Ph. papatasi. Deltamethrin filter papers (0.00002%) were used to test sand fly field collected from southern Iran. After the test, PCR amplification of the Wolbachia surface protein gene (wsp) was used to measure Wolbachia infection rate in the killed, surviving, and control groups. Result: The rates of infection by Wolbachia strain (wPap, super group A) differed between killed (susceptible) and surviving (resistant) Ph. papatasi specimens. The rate of Wolbachia infection in susceptible individuals was more than twice (2.3) (39% vs. 17%) in resistant individuals with the same genetic background. This difference was highly significant (p < 0.001), indicating a positive association between Wolbachia infection and susceptibility to Deltamethrin. In addition, the results showed that Deltamethrin can act as a PCR inhibitor during detection of Wolbachia in Ph. papatasi. Conclusion: Results of this study show that Wolbachia is associated with Deltamethrin susceptibility level in Ph. papatasi. Also, as Deltamethrin has been identified as a PCR inhibitor, great care must be taken in interpreting Wolbachia infection status in infected populations. The results of this study may provide information for a better understanding of the host-symbiont relationship, as well as application of host symbiosis in pest management.

Assessing reservoir host status in leishmaniasis with special reference to the infectiousness of Leishmania (Viannia) braziliensis infections in wild rodents

Molecular methods have been responsible for a notable increase in the detection of Leishmaniinae infections in wild animals. Determining their infectiousness is of paramount importance in evaluating their epidemiological significance. One of the most efficient ways of determining infectiousness for vector borne diseases is xenodiagnosis with the appropriate vector. However, this is logistically very difficult to accomplish in the field, and an ideal solution is to find a molecular surrogate for xenodiagnosis. In this review we discuss different approaches to the problem by focusing on the infectiousness of Leishmania (Viannia) braziliensis in rodents under laboratory and field conditions. Comparisons with similar studies for other Leishmania species emphasizes that there are pivotal differences in the infectiousness and the importance of asymptomatic infections in different hosts. Potentially the most promising surrogate is the real time quantitative PCR (qPCR). However, its success depends on choosing a tissue that relates to the vector's feeding location and the parasite's tissue tropism. This requires detailed knowledge of the infection of each species in its wild hosts. We conclude that for L. (V.) braziliensis infections in wild rodents the tissue of choice for a molecular xenodiagnostic test, based on the qPCR is blood, providing that a significant number of samples must be examined.

Detection of anti-Leishmania spp. antibodies in poultry from central region of Rio Grande do Sul, Brazil

Domestic birds such as Gallus gallus, Meleagris gallopavo, Anser anser and Numida meleagris are widely distributed throughout the world and maintain contact with humans and other animal species considered reservoirs of both Visceral Leishmaniasis (VL) and American Tegumentary Leishmaniasis (ATL), including dogs and cats; wild canids, marsupials; and synanthropic animals such as rodents and chiroptera. Therefore, this study aimed to detect the presence of anti-Leishmania spp. antibodies in birds from a rural area of the municipality of Santa Maria, southern Brazil. From May to December 2022, 262 blood samples were collected from 244 chickens, 8 turkeys, 7 guinea fowl and 3 geese, distributed in 27 rural properties in 6 districts. All the sites visited presented positive birds for the presence of Leishmania spp. Thus, it is inferred that, contact with this protozoan can induce the production of antibodies, suggesting that these animals can be used as sentinels for the circulation of this agent. In addition, the blood of these animals is a preferred food source for insects of the subfamily Phlebotominae, which can be used them as bioindicators of the presence of these phlebotomes.

Molecular identification of Leishmania tropica in mammals occurring in human-inhabited areas of a cutaneous leishmaniasis endemic focus in North-West Pakistan

Cutaneous Leishmaniasis is endemic in the tribal district of Khyber near the Pak-Afghan border and is caused by Leishmania tropica. In Pakistan, cutaneous leishmaniasis caused by L. tropica is considered anthroponotic and is thought to be maintained by a human-sand fly-human transmission cycle. Along with humans, other mammals may also be acting as reservoir hosts of leishmaniasis in the study area. To investigate the role of non-human mammals in the transmission of leishmaniasis, blood samples were collected from 245 animals from the CL endemic district of Khyber, Pakistan. Leishmania parasite in these samples was detected by amplifying the species-specific sequences in minicircle kinetoplast DNA, using PCR. L. tropica DNA was detected in 18 (7.35%) samples, comprising 11 cows (Bos taurus), 6 goats (Capra hircus), and 1 dog (Canus lupus familiaris). Only a single cow and dog had a leishmaniasis-like lesion, and the remaining positive samples were asymptomatic. None of the tested sheep (Ovis aries) and rat (Rattus rattus, Rattus norvegicus) was positive. The present study reports the first instance of molecular detection of L. tropica in domestic animals. Our study indicates that along with humans' cows, goats and dogs may also be playing an important role in the transmission of anthroponotic cutaneous leishmaniasis in district Khyber in particular and Pakistan in general.

Sand fly bionomics, geospatial investigation and risk factors associated with cutaneous leishmaniasis in district Mardan, Pakistan

The present investigation was designed in response to the 2019 outbreak of cutaneous leishmaniasis (CL) in 34 villages of district Mardan, Pakistan. Sand flies were collected to study their bionomics, breeding sites, and seasonal prevalence from July to September 2019. In 2020, we acquired and digitized data on CL patients in the region to assess the possible spread of the disease to new foci. In the study period, a total of 1572 sand flies were collected, comprising 11 species. Phlebotomus sergenti (827, 52.61%) was the most widespread species. The soil pH in all samples was slightly alkaline (7-8.2) and potassium (K) was the richest component (59.4%). In 2020, there were 975 reported cases, which is an increase from 536 cases in 2019. Elevations of 361-588 m, agricultural land near human settlements, and quaternary alluvium formation had maximum CL cases. In univariate analysis, age between 25 and 35, nationality, family size (7-15 individuals), knowledge of leishmaniasis, site of infection, family members suffering from leishmaniasis, knowledge of sand flies, the difference between mosquitoes and sand flies, biting times of sand flies, use of mosquito spray, an Afghan refugee in the region, preachers visiting, and material of house construction have been identified risk of getting CL (p < 0.05). In stepwise multivariate analysis, nationality, vegetation, site of infection, and material of house construction were more prone to CL (p < 0.05). This study highlights the potential risk factors and sand flies associated with the outbreak of CL in Mardan. The high abundance of P. sergenti suggests their possible role as vectors for the transmission of CL in the region. The increase in reported cases in 2020 compared to 2019 suggests a possible spread of the disease to new foci. The study also revealed that certain demographic and environmental factors were significant risk factors for contracting CL in the district.

Canine Leishmania spp. infection in two distinct foci of visceral and cutaneous leishmaniasis in Tunisia

Visceral leishmaniasis (VL) and zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania (L.) infantum and L. major, respectively, are endemic in Tunisia. The aim of the study was to assess canine Leishmania spp. infection prevalence as well as to identify the Leishmania species involved in two well-documented and geographically distinct VL and ZCL foci. One hundred seventy-six dogs were randomly recruited in the VL focus of Sbikha-Zaghouan (n = 100) and the ZCL focus of Echrarda-Nasrallah (n = 76). Physical examination and blood collection were systemically performed. Needle aspiration was done in case of lymph node (LN) enlargement. All sera were tested by ELISA. kDNA RT-PCR was performed on DNA extracts from (i) buffy coats of seropositive dogs and (ii) LN aspirates. Leishmania species identification was done by ITS1 PCR-sequencing. Thirty-three dogs (18.8%) were infected by Leishmania; 30 having anti-Leishmania antibodies and 3 were seronegative dogs with Leishmania DNA in LN aspirates. Prevalence of infection was significantly higher in VL foci than in ZCL foci (27% versus 7.9%, p = 0.002). Leishmania species was identified in 11 dogs and corresponded to L. infantum. Combination of serology and qPCR on LN aspirates seems to be the best option for canine leishmaniasis diagnosis. Infection is more frequent in VL foci and L. infantum is the only identified species.

Evaluation of murine OX40L-murine IgG1(MM1) fusion protein on immunogenicity against L. mexicana infection in BALB/c mice

The majority of OX40L is found on professional antigen-presenting cells (APC), the potency of OX40L to enhance the immunogenicity of potential vaccines against leishmania is not yet fully investigated. There is no report of administration of OX40L on cutaneous leishmaniasis either in therapy or prophylactic immunisation and the present study for the first time reports the effect of OX40L on L. mexicana infection. In this study, B9B8E2 cells were transfected with the murine OX40L and IgG1 plasmids, were used to produce the mOX40-mIgG1 (MM1). The therapeutic effects of MM1(mOX40L-mIgG1) was tested in a challenge experiment using L. mexicana infected BALB/c mice. Mice received two doses of MM1, on day 3 and 7 after the infection. Mice receiving MM1 generated an inflammatory reaction a few days after the injection of the OX40L, which was gradually dampened and finally disappeared 3 weeks later. There was a significant delay in the growth of developing lesions in mice receiving OX40L compared to controls injected with PBS and the size of lesions in the group receiving MM1 was significantly smaller than that of injected with either PBS. 40% of mice given MM1 remained lesion free for two months, when experiments were terminated. The results clearly indicate the high therapeutic effect of mOX40L-mIgG1 fusion protein in L. mexicana infection. The effect of OX40L on the enhancement of immunisation, needs to be further investigated for developing new vaccine strategies.

Large scale systemic control short-circuits pathogen transmission by interrupting the sand rat (Psammomys obesus)-to-sand fly (Phlebotomus papatasi) Leishmania major transmission cycle

Systemic control uses the vertebrate hosts of zoonotic pathogens as "Trojan horses," killing blood-feeding female vectors and short-circuiting host-to-vector pathogen transmission. Previous studies focused only on the effect of systemic control on vector abundance at small spatial scales. None were conducted at a spatial scale relevant for vector control and none on the effect of systemic control on pathogen transmission rates. We tested the application of systemic control, using Fipronil-impregnated rodent baits, in reducing Leishmania major (Kinetoplastida: Trypanosomatidae; Yakimoff & Schokhor, 1914) infection levels within the vector, Phlebotomus papatasi (Diptera: Psychodidae; Scopoli, 1786) population, at the town-scale. We provided Fipronil-impregnated food-baits to all Psammomys obesus (Mammalia:Muridae; Cretzschmar, 1828), the main L. major reservoir, burrows along the southern perimeter of the town of Yeruham, Israel, and compared sand fly abundance and infection levels with a non-treated control area. We found a significant and substantial treatment effect on L. major infection levels in the female sand fly population. Sand fly abundance was not affected. Our results demonstrate, for the first time, the potential of systemic control in reducing pathogen transmission rates at a large, epidemiologically relevant, spatial scale.

High levels of infectiousness of asymptomatic Leishmania (Viannia) braziliensis infections in wild rodents highlights their importance in the epidemiology of American Tegumentary Leishmaniasis in Brazil

BACKGROUND

The epidemiological significance of wildlife infections with aetiological agents causing human infectious diseases is largely determined by their infection status, contact potential with humans (via vectors for vector-borne diseases), and their infectiousness to maintain onward transmission. This study quantified these parameters in wild and synanthropic naturally infected rodent populations in an endemic region of tegumentary leishmaniasis in northeast Brazil.

METHODS

Capture-mark-recapture (CMR) of rodents was conducted over 27 months in domestic/peri domestic environs, household plantations and nearby Atlantic Forest (9,920 single trap nights). Rodent clinical samples (blood and ear tissue) were tested for infection by conventional PCR and quantitative PCR (qPCR) for Leishmania (Viannia) braziliensis, and xenodiagnosis to measure infectiousness to the local sand fly vector.

RESULTS

A total 603 individuals of 8 rodent species were (re)captured on 1,051 occasions. The most abundant species were Nectomys squamipes (245 individuals, 41% of the total catch), Rattus rattus (148, 25%), and Necromys lasiurus (83, 14%). All species were captured in greater relative frequencies in plantations; R. rattus was the only species captured in all three habitats including in and around houses. Four species, comprising 22.6% of individuals captured at least twice, were geolocated in more than one habitat type; 78.6% were infected with L. (V.) braziliensis, facilitating inter-species and inter-habitat transmission. Species specific period prevalence ranged between 0%-62% being significantly higher in N. squamipes (54-62%) and Hollochillus sciureus (43-47%). Xenodiagnosis was performed on 41 occasions exposing 1,879 Nyssomyia whitmani sand flies to five rodent species (37 individuals). Similar mean levels of infectiousness amongst the more common rodent species were observed. Longitudinal xenodiagnosis of the N. squamipes population revealed a persistent level of infectiousness over 13 months follow-up, infecting a median 48% (IQR: 30.1%-64.2%) of exposed blood-fed vectors. The proportion of exposed flies infected was greater in the low compared to in the high seasonal period of vector abundance. L. (V.) braziliensis parasite loads in rodent blood quantified by qPCR were similar across rodent species but did not represent a reliable quantitative marker of infectiousness to sand flies. The standardised risk of rodent infection in plantations was 70.3% relative to 11.3% and 18.4% in peri domestic and forest habitats respectively. R. rattus was the only exception to this trend indicating greatest risk in the peri domestic environment.

CONCLUSIONS

The results support the view that a collective assemblage of wild and synanthropic rodent species is an important wild reservoir of L. (V.) braziliensis in this region, with N. squamipes and R. rattus probably playing a key role in transmission within and between habitat types and rodent species. Rodents, and by implication humans, are at risk of infection in all sampled habitats, but more so in homestead plantations. These conclusions are based on one of the longest CMR study of small rodents in an American Tegumentary Leishmaniasis (ATL) foci.

Survey on the presence of Leishmania sp. in peridomestic rodents from the Emilia-Romagna Region (North-Eastern Italy)

Leishmaniasis is a neglected vector-borne parasitic disease caused in Italy only by the species Leishmania infantum of the Leishmania donovani complex, which is the causative agent of the zoonotic visceral leishmaniasis (VL) and the sporadic cutaneous leishmaniasis (CL) in humans, and of the canine leishmaniasis (CanL). The disease is considered endemic in southern, central, and insular Italian regions and recognizes phlebotomine sand flies as vector and dogs as main reservoir. Among northern Italian region, Emilia-Romagna shows peculiar epidemiological situation and recent studies are questioning the role of dog as main reservoir of L. infantum. Due to their synanthropic relationship with humans, rodents have been tested for Leishmania spp. in several European countries. The aim of this study was to assess the presence of Leishmania spp. in peridomestic rodents in the Emilia-Romagna. The study was carried out on 136 peridomestic rodents collected by professional pest control services: 47 brown rats (Rattus norvegicus), 39 black rats (Rattus rattus) and 50 mice (Mus musculus). Specimens of earlobe skin, spleen, liver and prescapular lymph nodes were tested with a real-time PCR. Fifteen (11%) rodents, tested positive for Leishmania spp. in particular five brown rats (10.6%), five black rats (12.8%) and five mice (10%). Positivity was obtained from different target organs. These findings revealed the presence of Leishmania spp. in peridomestic rodents of Emilia-Romagna Region, also in two species never tested before in Italy, namely R. norvegicus and M. musculus.

Treatment of canine cutaneous leishmaniasis by Leishmania (Viannia) braziliensis in dogs with furazolidone and β-cyclodextrin: case report

Euthanasia of animals is not accepted as a control for cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis and drugs used in humans for the treatment of leishmaniasis are not allowed for animals in Brazil. Miltefosine was authorized for dogs infected by Leishmania infantum with variable results for L. braziliensis. Thus, nine dogs infected with Leishmania (V.) braziliensis were treated by a combination of furazolidone and β-cyclodextrin. The nine dogs were mongrels, weighing between 4-17 kg and 3-10 years old. These dogs had ulcerous lesions in different regions such as scrotal tissue, auricular pavilion and nostrils. Serological, molecular and protozoal culture techniques were used for laboratory diagnosis. The treatment used furazolidone + β-cyclodextrin complex (1: 2) at a concentration of 60 mg/mL given orally at a dose of 15 mg/kg every 12 hours. The re-epithelialization of lesions occurred between 35 and 41 days of treatment. During fourteen months the animals were monitored and there was no reactivation of lesions or growth of the protozoan in a culture medium of the biopsies. This study demonstrated that treatment with FZD and CD is effective in reducing the cutaneous lesions caused by L. braziliensis in dogs.

Investigation of Leishmania (Viannia) braziliensis Infection in Wild Mammals in Brazil

PURPOSE

Leishmaniasis are infectious and zoonotic diseases and present in cutaneous and visceral forms. Cutaneous leishmaniasis is endemic and widely distributed throughout the state of Espírito Santo, Brazil. Several cases of cutaneous leishmaniasis in humans and dogs associated with Leishmania (Viannia) braziliensis have been reported in the state. This study aimed to investigate the occurrence of natural infection by Leishmania(Viannia) braziliensis in wild mammals found dead (by trampling or natural death) in the Sooretama Biological Reserve, Espírito Santo State.

METHODS

From January 2018 to December 2019, 60 animals were collected. Of these, 47 animals from 12 different species were analyzed. The results were demonstrated using descriptive analysis of the observations to calculate the absolute and relative frequencies of the data.

RESULTS

In the PCR, using specific primers for the genus Leishmania (D1, D2, and D3) and the species Leishmania (Viannia) braziliensis (ISVB/ISVC), 4 positive animals (8.5%) were detected: 1 Cuniculus paca (paca) (25%) and 3 Callithrix geoffroyi (white-faced marmoset) (25%). In the histopathological analysis, the parasitic amastigote form was not observed.

CONCLUSIONS

The natural infection, detected by PCR, by Leishmania (Viannia) braziliensis in Cuniculus paca (paca) and Callithrix geoffroyi (white-faced marmoset) constitutes the first report of infection of this rodent and primate species in the literature. Despite the confirmation of Leishmania (Viannia) braziliensis infection in rodents and primates, the role of these species in the transmission of this zoonosis still needs further observational studies to identify their seasonal variation, transmissibility, infection stability, and the effects of a given parasite on the population and/or individual.

Molecular identification of Leishmania RNA virus in cutaneous leishmaniasis patients and rodent reservoirs in Isfahan province, Iran

Leishmania RNA virus (LRV) is a double-strand RNA virus that was first detected in members of the Leishmania viannia in the New World. The present study aimed to investigate the presence of LRV in the Leishmania species isolated from cutaneous leishmaniasis (CL) patients and rodents as reservoirs in Isfahan province an old zoonotic CL focus, center of Iran. Totally, 85 samples were collected from CL patients (n = 80) and rodent reservoirs (n = 5) from different regions of Isfahan province. Species identification was determined using the PCR-RFLP method. Viral dsRNA was extracted and for observation of 5.3 kb dsRNA on an agarose gel. The presence of LRV was surveyed using the Semi-nested PCR method. For phylogenetic analyzes, 6 samples of 13 isolates were sequenced and a phylogenetic tree was drawn by MEGA7 version 7.0.26. Of 80 Leishmania isolates recovered from the patients with CL, 79 and only one were identified as L. major and L. tropica, respectively. Also, the PCR assays detected four L. major and one L. turanica in five assessed Rhombomys opimus as the rodent reservoirs. LRV was detected only in Leishmania species isolated from 13 species of 85 (15.3%) CL including (L. major, n = 12) and (L. tropica, n = 1). Phylogenetic analysis showed that they were belonged to LRV2 and had the highest similarity with Iranian reference LRV2 in GenBank. Our results showed that the LRV2 was present in cutaneous Leishmania species in Isfahan province is the most historical and touristic province of Iran. In the study LRV was not reported from rodent reservoirs, it may be due to the small sample size. Phylogenetic analysis of current sequences demonstrated that these isolates belong to the registered LRV2 of the Old World.

Behavioural responses of Phlebotomus duboscqi to plant-derived volatile organic compounds

Phlebotomine sand flies are vectors of Leishmania parasites that cause leishmaniases. Both sexes of sand flies feed on plants primarily for sugars, although the chemical cues that mediate attraction to host plants remain largely unknown. Previously, using coupled gas chromatography-mass spectrometry, the authors identified several volatile organic compounds (VOCs) common to preferred host plants for selected Afrotropical sand flies from the Fabaceae family. Of the identified volatiles, the significance of the monoterpenes linalool oxide, ocimene and p-cymene and the benzenoid m-cresol, p-cresol in sand fly behaviour is unknown. In olfactometer assays, the authors tested these compounds singly and in blends for their attractiveness to Phlebotomus duboscqi, cutaneous leishmaniasis vector in Kenya. In dose-response assays, single compounds increased the responses of males and females over controls, but their optimum attractive doses varied between the sexes. Two five-component blends, referred to as Blend-f and Blend-m for females and males respectively, were formulated and tested in dose-response assays against 1-octen-3-ol (positive control). The results of the present study showed that males and females were significantly attracted to varying levels of the two blends. In pairwise assays, the authors evaluated the most attractive of these blends to each sex (i.e., Blend Am for male against Blend Bf for female), revealing that males were attracted to both blends at varying levels, whereas females were indifferent. The study's results demonstrate that plant-derived VOCs can be exploited for sand fly management.

Ecology and spatial distribution of sand fly species in low endemic areas for American Tegumentary Leishmaniasis in the municipality of Seropédica, Rio de Janeiro, Brazil

Due to the fundamental role that sand flies (Diptera: Psychodidae) have in Leishmania spp. (Kinetoplastida: Trypanosomatidae) transmission, the objective of this study was to evaluate the ecology and spatial distribution of species circulating in the municipality of Seropédica, Rio de Janeiro, Brazil. A total of 17 371 specimens were collected between August 2016 and July 2017, and five species were identified: Nyssomyia intermedia (Lutz & Neiva, 1912), Migonemyia migonei (França, 1920), Nyssomyia whitmani (Antunes & Coutinho, 1939), Pintomyia pessoai (Coutinho & Barretto, 1940), and Pintomyia fischeri (Pinto, 1926). In relation to the number of sand flies collected, we observed a significant difference between rural and periurban areas and between the neighbourhoods. We observed that N. intermedia has a relatively greater adaptation to the peridomiciliary environment. This is the first report of Pi. pessoai and Pi. fischeri (only females) in Seropédica as well as the first record of the frequency of phlebotomine species focusing on some ecological indices and the spatial distribution of sand flies. The results presented here aimed to provide an insight into the spatial population dynamics of phlebotomine species in low endemic areas of American Tegumentary Leishmaniasis (ATL) in Seropédica, highlighting important areas for entomological surveillance.

Identification of differential protein expression and putative drug target in metacyclic stage of Leishmania major and Leishmania tropica: A quantitative proteomics and computational view

Cutaneous leishmaniasis (CL) is an infectious disease that commonly caused by Leishmania (L.) major and L.tropica. Recently there has been a growing interest in proteomics analysis on Leishmania for drug target discovery. Therefore, we aimed to distinguish proteins which might be characteristic for each of the species from those shared by both to the detection of drug targets, which may become helpful for designing new drugs for CL. To identify differences in protein profiles of L. major and L. tropica, we conducted a Sequential window acquisition of all theoretical fragment ion spectra mass spectrometry (SWATH-MS) analysis. Totally 67 differentially expressed proteins (DEPs) (fold change> 2 and p < 0.05) were identified between species. Of these, 42 and 25 proteins were up-regulated in L. major and L. tropica, respectively. Several enriched GO terms were identified via biological process of up-regulated proteins. Furthermore, the small molecule metabolic process and translation were detected as significant biological processes for up-regulated proteins in L. major, while translation was identified for L. tropica. Also, KEGG analysis has revealed glycolysis/gluconeogenesis and translation as the top pathways in the proteins up-regulated in L. major and L. tropica, respectively. Finally glycosomal malate dehydrogenase was identified as putative drug target using network and homology analyses. The DEPs between the species are essential in host-pathogen interactions and parasite survival in the macrophage. Furthermore, L. major and L. tropica possibly uses different pathogenicity mechanisms that leads to anthroponotic or zoonotic CL. Our results may help in the drug discovery and chemotherapeutic interventions.

An epidemiological study of cutaneous leishmaniosis in human and dogs

Cutaneous leishmaniosis (CL) is a vector-borne parasitic disease with widespread on the communities throughout the Mediterranean regions and the Middle East, including Iraq. The study aimed for detection and diagnosis of CL in humans and dogs. This is an epidemiological study included six districts in Misan province, during the period from December 2019 to November 2020. All samples were taken from patients and owned-dogs. A total of 436 patients suspected with CL enrolled. A total of 237 owned-dogs were examined. The mean age of patients was (18.15Å}16.92) years. The rate of CL infection was high in Al-Amarah district. About 409 (93.807%) patients were diagnosed as a new case of CL, with no significant difference (P>0.05). The duration from bites by sandflies to the time of being diagnosed with CL ranged from 1 to 18 weeks. Patients owned-dogs (direct contact) were 167 (38.302%), and those with indirect contact were 123 (28.211%). Dogs manifested with clinical features of CL were 74 (27.715%), while those were asymptomatic (193, 72.284%). The lesions in dogs were severe (47, 63.513%), moderate (22, 29.729%), and mild (5, 6.756%). In conclusion, to the best of our knowledge, this epidemiological study of CL was conducted for the first time in Iraq.

Incidence of human dog-mediated zoonoses and demographic characteristics/vaccination coverage of the domestic dog population in Algeria

Control of zoonotic diseases requires a One Health integrated action from both human and animal health sectors. The aims of the present study were to estimate the incidence of dog-mediated zoonoses in humans and to describe demographic characteristics and vaccination coverage of the domestic dog population in Algeria. The results show that rabies, leishmaniosis and echinococcosis are the major zoonoses in Algeria, with an average of 20.6 (deaths), 8,276 and 455 human cases per year, respectively. A door-to-door survey was conducted among 652 households with at least one dog, of which 334 (51.33%) were located in urban areas and 318 (48.77%) in rural areas. The mean number of dogs per household in rural areas (2.02) is higher than that in urban areas (1.41). Furthermore, a high percentage of semi-confined and free-roaming and a low proportion of vaccinated dogs were recorded in rural areas. Vaccination coverage for rabies, canine distemper virus, Rubarth hepatitis, leptospirosis and parvovirus was lowest in rural dog populations. The analysis of risk factors established that semi-confined or free-roaming dogs, non-pedigree breeds, hunting dogs, herding dogs and the presence of more than three dogs per household are risk factors for dogs not being vaccinated.

First molecular detection and identification of Leishmania species in small wild rodents from Turkey

Leishmaniasis is a parasitic disease infecting animals and humans. Two clinical forms (Visceral and cutaneous leishmaniasis) and four species are reported to be present in Turkey. Several studies have investigated canine and human leishmaniasis in Turkey but no study was performed to screen the infection among wild rodents, so far. The present study aims to investigate the role of small wild rodents as reservoir animals for Leishmania spp. in different regions of Turkey. Formalin-preserved tissue samples (spleen, liver, lung) of 712 rodents from 30 provinces were screened for the presence of Leishmania spp. DNA. Before DNA extraction, tissues were dried, rehydrated, and homogenated. Leishmania screening in rodent tissues and species determination was performed with a combination of real-time kDNA and ITS1 polymerase chain reaction protocols. Eight (1.12%) out of 712 animals were found to be positive for Leishmania spp. DNA and species typing revealed five L. infantum, two L. tropica and one L. major among positives. Leishmania major and L. infantum DNA were detected in Apodemus spp. from Zonguldak province located in the Western Black Sea Region, while L. tropica DNA was found in Meriones sp. and Gerbillus dasyurus from Adana and Hatay provinces located in Eastern Mediterranean Region of Turkey. The present study is first to report natural infection of L. infantum, L. major and L. tropica in small wild rodents in Turkey, suggesting their possible roles as reservoirs. Further studies are needed for planning epidemiological studies and also for developing rodent control measures in risky endemic areas to break the transmission cycle.

Leishmania (Viannia) braziliensis type 2 as probable etiological agent of canine cutaneous leishmaniasis in Brazilian Amazon

Canine cutaneous leishmaniasis (CCL) is a zoonosis of public health interest, and in the Americas, Leishmania (Viannia) braziliensis has been identified as the main etiological agent. The present study sought to investigate Leishmania spp. infection in domestic dogs from a rural area of the Xapuri municipality, Acre state, Brazilian Amazonia. For this purpose, visits were carried out to domiciles where the human cases of American cutaneous leishmaniasis (ACL) occurred, followed by the clinical evaluation of the animals in search of clinical signs suggestive of CCL. Blood samples were collected from 40 dogs, 13 of which had lesions suggestive of CCL, and biopsies of these lesions were performed. The methods used were Neal, Novy, and Nicolle’s (NNN) medium cultures and direct parasitological examination. Further, to detect and characterize Leishmania DNA some molecular techniques were performed such as conventional polymerase chain reaction (PCR) and sequencing targeting SSU rDNA and ITS1, restriction fragment length polymorphism (RFLP) and high resolution melting (HRM) analysis targeting hsp70. The investigation revealed that the results obtained from the parasitological methods were negative. In PCR by ITS1 and network topology sequences, six strains from dogs, isolated from the Peruvian Andes, appeared identical to Leishmania (Viannia) braziliensis type 2 (99–100%). By other molecular methods these samples turned out to be positive to Leishmania (Viannia) sp.. The diagnosis of Leishmania in domestic dogs from Acre state showed a high proportion of infected animals, and the occurrence of L. braziliensis type 2 in Brazil for the first time. This new report suggests that L. braziliensis type 2 is both trans- and cis-Andean. However, more studies are needed regarding the clinical and diagnostic aspects of this species of Leishmania.

A fatal case of canine cutaneous leishmaniosis in a dog

A 10-year-old intact female Chihuahua, 2.5 kg of weight and BCS 2 (range 1–5) was taken in for medical consultation due to the presence of four skin lesion, two in the ventral thoracic region and two in the dorsal region. The dog was receiving medication due to congestive heart failure. A cutaneous form of canine leishmaniosis was diagnosed using molecular tools from a 10-years-old Chihuahua dog living in the Caribbean region. The critical health condition of the geriatric patient may have evolved to a fatal renal failure. This report is the first of a fatal case of leishmaniosis in a dog from the endemic region in Mexico.

Role of environmental, climatic risk factors and livestock animals on the occurrence of cutaneous leishmaniasis in newly emerging focus in Iran

INTRODUCTION

Occurrence of leishmaniasis is affected by various biological and environmental factors. Kohgiluye and Boyerahmad (K-B) province is an emerging focus of cutaneous leishmaniasis (CL) in Southwest Iran.

SUBJECTS AND METHODS

To elucidate some angles of occurrence of CL in this province, climatic and environmental factors and close proximity to livestock were studied by univariate and two multivariate logistic regression models. The dwelling addresses of 275 CL patients were obtained from Health Centers records for a 5 years period. The effect of mean annual temperature, minimum mean annual temperature, maximum mean annual temperature, mean annual rainfall, slope, elevation, land covers and close proximity to cattle and sheep/goat sheds on the occurrence of CL were analysed using geographical information systems (GIS) approach.

RESULTS

CL occurred in all counties with the most cases in Northwest, West and South semi-arid and warm regions. Land cover, slope, elevation and close proximity to cattle sheds, were the most effective factors. Urban, dry farm and thin rangeland were found as the most important land covers. Slope and elevation decreased the probability of disease. Close proximity to cattle sheds notably increased the chance of CL. The importance of other factors such as rainfall, temperature and close proximity to sheep/goat sheds only were shown when their effects were evaluated independently from other factors. So regions with urban, dry farm and thin rangeland covers with lower slope and altitude where in close proximity of cattle sheds seems to be potentially most high risk areas.

CONCLUSION

Distribution of CL cases is influenced by combination of environmental, ecological factors and close proximity to livestock sheds but control programs should be focused on cities and villages in the above-mentioned most high risk regions.

Cutaneous Leishmaniasis in Naturally Infected Dogs is Associated with a T Helper-2-biased Immune Response

Skin lesions are a frequent manifestation of Leishmania infantum infections in Mediterranean countries. This study demonstrates by real-time reverse transcriptase-polymerase chain reaction the local cytokine response in skin biopsies from Leishmania-infected dogs ( n = 10). As controls, we investigated skin biopsies from healthy ( n = 10) and fleabite hypersensitive dogs (n = 10). We established a quantitative PCR to determine the parasite burden in biopsies. The objective was to elucidate whether a correlation exists between parasite number, histologic response, and T helper-1 (TH1)/T helper-2 (TH2) cytokine expression in lesional skin of naturally infected dogs. In Leishmania-infected dogs, interleukin-4 (IL-4), tumor necrosis factor α (TNF-α) and interferon-γ (IFN-γ) messenger RNA production was significantly higher than controls. Furthermore, dogs with a high Leishmania burden had a significantly higher IL-4 expression, whereas no difference was noted with regard to expression of other cytokines. By comparing the pattern of inflammation and cytokine expression, a clear trend became evident in that levels of IL-4, TNF-α, and IFN-γ were elevated in biopsies with a periadnexal nodular pattern and in biopsies where the severity of the periadnexal infiltrate was equal to the perivascular to interstitial infiltrate. Expression of IL-4, IL-13, and TNF-α was slightly increased in biopsies where plasma cells prevailed on lymphocytes, whereas expression of IFN-γ was moderately higher when lymphocytes were predominating. In summary, the present study demonstrates that the local immune response in naturally occurring leishmaniasis includes TH1 as well as TH2 cytokine subsets. Furthermore, respective data suggest that increased expression of the TH2-type cytokine IL-4 is associated with both severe clinical signs and a high parasite burden in the skin lesions.

Parasite load in intact and ulcerative skin of dogs with leishmaniais

The skin is the site of inoculation of Leishmania spp. in susceptible hosts, and consequently dermatopathies, especially ulcerative dermatitis, are the main clinical signs observed. The aim of this study was to assess parasitism of the skin (intact and ulcerated) among dogs that were naturally infected by Leishmania spp., through immunohistochemical analysis. Skin fragments (intact and ulcerated) were collected from 13 dogs with positive parasitological (bone marrow aspiration and exfoliative skin) and serological examinations (ELISA S7 Biogene) for Leishmania spp. These samples were processed using the immunohistochemical technique, involving the streptavidin-peroxidase complex. Ulcerative lesions were mainly observed on the elbows (53.84%; 7/13), nostrils (15.38%; 2/13), ears (23.07%; 3/13) and wings of the ilium (7.69%; 1/13). A severe parasite load was detected in 46.15% and 76.92% of the intact and ulcerated skin samples tested, respectively. The parasite load on ulcerated skin was statistically higher than on intact skin (p = 0.0221). These results indicate that the intact and ulcerated skin may host a high parasite load of amastigote forms of Leishmania spp., which can favor the transmission of the parasite.

Infectiousness of Sylvatic and Synanthropic Small Rodents Implicates a Multi-host Reservoir of Leishmania (Viannia) braziliensis

Background

The possibility that a multi-host wildlife reservoir is responsible for maintaining transmission of Leishmania (Viannia) braziliensis causing human cutaneous and mucocutaneous leishmaniasis is tested by comparative analysis of infection progression and infectiousness to sandflies in rodent host species previously shown to have high natural infection prevalences in both sylvatic or/and peridomestic habitats in close proximity to humans in northeast Brazil.

Methods

The clinical and parasitological outcomes, and infectiousness to sandflies, were observed in 54 colonized animals of three species (18 Necromys lasiurus, 18 Nectomys squamipes and 18 Rattus rattus) experimentally infected with high (5.5×10⁶/ml) or low (2.8×10⁵/ml) dose L. (V.) braziliensis (MBOL/BR/2000/CPqAM95) inoculum. Clinical signs of infection were monitored daily. Whole animal xenodiagnoses were performed 6 months post inoculation using Lutzomyia longipalpis originating from flies caught in Passira, Pernambuco, after this parasite evaluation was performed at necropsy. Heterogeneities in Leishmania parasite loads were measured by quantitative PCR in ear skin, liver and spleen tissues.

Results

All three rodent species proved to establish infection characterized by short-term self-resolving skin lesions, located on ears and tail but not on footpads (one site of inoculation), and variable parasite loads detected in all three tissues with maximum burdens of 8.1×10³ (skin), 2.8×10³ (spleen), and 8.9×10² (liver). All three host species, 18/18 N. lasiurus, 10/18 N. squamipes and 6/18 R. rattus, also proved infectious to sandflies in cross-sectional study. R. rattus supported significantly lower tissue parasite loads compared to those in N. lasiurus and N. squamipes, and N. lasiurus appeared to be more infectious, on average, than either N. squamipes or R. rattus.

Conclusions

A multi-host reservoir of cutaneous leishmaniasis is indicated in this region of Brazil, though with apparent differences in the competence between the rodent species. The results provide preliminary insights into links between sylvatic and peri-domestic transmission cycles associated with overlaps in the rodent species’ ecological niches.

Across the Americas, Leishmania (V.) braziliensis is the predominant Leishmania species causing cutaneous and mucocutaneous leishmaniasis in humans. Transmitted by Phlebotomine sandflies, questions remain about the epidemiological contributions of the numerous zoonotic and more domestic host species. Domestication of the principal vector and human infection patterns suggest that human infection risk is predominantly peridomestic, whereas control strategies will be more complex if there is a link to a wildlife transmission cycle. Almost no studies have been conducted on the transmission potential of natural hosts of L. (V.) braziliensis. This study evaluates the infectiousness of experimentally infected natural rodent host species, that in different ecological habitats are proposed to act as a single or a multi-host reservoir. Clinical and parasitological development, and the ability to transmit Leishmania to sandflies, was observed under experimental conditions using a single strain of L. (V.) braziliensis isolated from the wild rat, Necromys lasiurus. Xenodiagnoses were performed with laboratory bred sand fly females established from a local population of Lutzomyia longipalpis. All three rodent species developed disseminated subclinical parasitological infections, but clinical signs (lesions) were transient and self-resolving. N. squamipes, N. lasiurus and R. rattus were all infectious when asymptomatic, though their competence in transmission potential appears to differ with R. rattus showing signs of lower susceptibility. These results provide further evidence that a multi-host reservoir is responsible for maintaining transmission with a bridge between infectious sylvatic and peridomestic rodent populations.

Natural infection of Algerian hedgehog, Atelerix algirus (Lereboullet 1842) with Leishmania parasites in Tunisia

In Tunisia, Leishmania parasites are responsible of visceral leishmaniasis, caused by Leishmania infantum species while three cutaneous disease forms are documented: chronic cutaneous leishmaniasis due to Leishmania killicki, sporadic cutaneous form (SCL) caused by L. infantum and the predominant zoonotic cutaneous leishmanaisis (ZCL) due to Leishmania major. ZCL reservoirs are rodents of the Psammomys and Meriones genera, while for SCL the dog is supposed to be a reservoir. Ctenodactylus gundii is involved in the transmission of L. killicki. However, other mammals could constitute potential reservoir hosts in Tunisia and other North African countries. In order to explore the role of hedgehogs as potential reservoirs of leishmaniasis, specimens (N=6) were captured during July-November period in 2011-2013 in an SCL endemic area in El Kef region, North-Western Tunisia. Using morphological characteristics, all specimens were described and measured. Biopsies from liver, heart, kidney and spleen of each animal were used to extract genomic DNA, which was further used in PCR assays to assess the presence of Leishmania parasites. Different PCRs targeting kinetoplast minicircles, ITS1, mini-exon genes and a repetitive Leishmania- specific sequence, were applied. To further identify Leishmania species involved, RFLP analysis of amplified fragments was performed with appropriate restriction enzymes. Using morphological characters, animals were identified as North African hedgehogs, also called Algerian hedgehogs, that belong to the Erinaceidae family, genus Atelerix Pomel 1848, and species algirus (Lereboullet, 1842). PCR results showed in total that all specimens were Leishmania infected, with different organs incriminated, mainly liver and spleen. Results were confirmed by direct sequencing of amplified fragments. Species identification showed that all specimens were infected with L. major, three of which were additionally co-infected with L. infantum. The present study demonstrates, for the first time in Tunisia, natural infection of hedgehog animals (Atelerix algirus) by the Leishmania parasites species L. major and L. infantum. L. major is also detected for the first time in wild animals captured in the North Western part of the country; likewise for the co-infection of these animals by the 2 Leishmania species. This mammal could play a potential reservoir role in epidemiology of SCL or ZCL and could contribute to emergence or extension of ZCL in the studied region.

Vector and reservoir control for preventing leishmaniasis

BACKGROUND

Leishmaniasis is caused by the Leishmania parasite, and transmitted by infected phlebotomine sandflies. Of the two distinct clinical syndromes, cutaneous leishmaniasis (CL) affects the skin and mucous membranes, and visceral leishmaniasis (VL) affects internal organs. Approaches to prevent transmission include vector control by reducing human contact with infected sandflies, and reservoir control, by reducing the number of infected animals.

OBJECTIVES

To assess the effects of vector and reservoir control interventions for cutaneous and for visceral leishmaniasis.

SEARCH METHODS

We searched the following databases to 13 January 2015: Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS and WHOLIS, Web of Science, and RePORTER. We also searched trials registers for ongoing trials.

SELECTION CRITERIA

Randomized controlled trials (RCTs) evaluating the effects of vector and reservoir control interventions in leishmaniasis-endemic regions.

DATA COLLECTION AND ANALYSIS

Two review authors independently searched for trials and extracted data from included RCTs. We resolved any disagreements by discussion with a third review author. We assessed the quality of the evidence using the GRADE approach.

MAIN RESULTS

We included 14 RCTs that evaluated a range of interventions across different settings. The study methods were generally poorly described, and consequently all included trials were judged to be at high or unclear risk of selection and reporting bias. Only seven trials reported clinical outcome data which limits our ability to make broad generalizations to different epidemiological settings and cultures. Cutaneous leishmaniasisOne four-arm RCT from Afghanistan compared indoor residual spraying (IRS), insecticide-treated bednets (ITNs), and insecticide-treated bedsheets, with no intervention. Over 15 months follow-up, all three insecticide-based interventions had a lower incidence of CL than the control area (IRS: risk ratio (RR) 0.61, 95% confidence interval (CI) 0.38 to 0.97, 2892 participants, moderate quality evidence; ITNs: RR 0.32, 95% CI 0.18 to 0.56, 2954 participants, low quality evidence; ITS: RR 0.34, 95% CI 0.20 to 0.57, 2784 participants, low quality evidence). No difference was detected between the three interventions (low quality evidence). One additional trial of ITNs from Iran was underpowered to show a difference.Insecticide treated curtains were compared with no intervention in one RCT from Venezuela, where there were no CL episodes in the intervention areas over 12 months follow-up compared to 142 in control areas (RR 0.00, 95% CI 0.00 to 0.49, one trial, 2938 participants, low quality evidence).Personal protection using insecticide treated clothing was evaluated by two RCTs in soldiers, but the trials were underpowered to reliably detect effects on the incidence of CL (RR 0.40, 95% CI 0.13 to 1.20, two trials, 558 participants, low quality evidence). Visceral leishmaniasisIn a single RCT of ITNs versus no intervention from India and Nepal, the incidence of VL was low in both groups and no difference was detected (RR 0.99, 95% CI 0.46 to 2.15, one trial, 19,810 participants, moderate quality evidence).Two trials from Brazil evaluated the effects of culling infected dogs compared to no intervention or IRS. Although they report a reduction in seroconversion over 18 months follow-up, they did not measure or report effects on clinical disease.

AUTHORS' CONCLUSIONS

Using insecticides to reduce phlebotomine sandfly numbers may be effective at reducing the incidence of CL, but there is insufficient evidence from trials to know whether it is better to spray the internal walls of houses or to treat bednets, curtains, bedsheets or clothing.

Epidemiological aspects of vector, parasite, and domestic reservoir in areas of recent transmission and no reported human cases of visceral leishmaniasis in Brazil

About 97% of the human cases of the American visceral leishmaniasis (VL) occur in Brazil. In the last few years, the disease expanded to medium- and large-sized cities, in which surveillance and control actions have been intensified, in an effort to control VL spreading. Our two-year study was conducted in Belo Horizonte, the sixth most populous city in Brazil, which is endemic for VL. We focused in two particular districts of recent transmission of the disease, with no reported human cases and submitted to minor surveillance and control actions. Our aim was to draw an epidemiological profile of the local situation concerning Lutzomyia vector, Leishmania parasites, and the main domestic reservoirs (dogs). Lutzomyia longipalpis comprised 96.5% of the total phlebotomine sand flies captured and displayed an expressive minimal infection rate by Leishmania infantum (16.7%). Positive correlations were found between the population densities of L. longipalpis, rainfall and temperature. L. infantum was also detected in the cortelezzii complex and, for the first time, in Lutzomyia lloydi. Leishmania braziliensis, an etiological agent of the American cutaneous leishmaniasis, was also identified in L. longipalpis. Among the 1408 dogs serologically tested by standard enzyme-linked and fluorescence immune assays (ELISA/IFA) 3.6% were positive for VL. L. infantum DNA and Leishmania parasites were identified in 100% and 72.5% of the seropositive dogs, respectively. The co-positivity of other diagnostic tests for VL-Leishmania-nested PCR, imprint and myeloculture-was compared to the standard serology. Both symptomatic or asymptomatic dogs displayed an equal average number of positive diagnostic tests for VL. The districts studied display favorable conditions for the rapid spreading of human infection, in terms of L. longipalpis population density, and presence of L. infantum in both vector and main reservoir.

Epidemiology of canine leishmaniasis in southern Bahia, Brazil

Leishmaniosis is a zoonosis caused by protozoa of the genus Leishmania. American cutaneous leishmaniosis (ACL) is mainly caused by the species L. amazonensis and L. braziliensis, and American visceral leishmaniosis (AVL) is caused by L. infantum chagasi. In addition to their proven roles as reservoirs of AVL, dogs are also suspected by researchers to be reservoirs of ACL due to reports of this infection in domestic environments and of infected dogs in endemic areas. The aim of this study was to detect Leishmania sp. infection in dogs from Vila Operária, Buerarema, Bahia, using parasitological tests, indirect immunofluorescent assay (IFA) and polymerase chain reaction (PCR). Furthermore, this study also aimed to identify risk factors associated with illness in dogs in this locality by conducting an epidemiological survey. For this purpose, 292 dogs were clinically evaluated for the presence of skin lesions, and the dogs that showed these changes were submitted to scarification injury to enable preparation of slides for microscopic study of amastigotes. Subsequently, the dogs underwent blood sampling for serological (IFA) and molecular (PCR) tests. Additionally, the owners of the dogs answered an epidemiological questionnaire to facilitate the identification of risk factors for exposure of dogs to pathogens of ACL. Of the 292 dogs studied, 13 (4.5%) had lesions suggestive of ACL, but with a negative parasitological examination and 147 (50.3%) were seropositive according to the IFA. Of the 273 dogs studied using PCR test, 10 (3.66%) were positive for L. braziliensis, and all samples were negative for L. infantum chagasi. Wastelands in the peridomicile and the presence of light in the household were risk factors associated with ACL. The results show that Vila Operária has asymptomatic dogs with ACL and that the detection sensitivity of the IFA was higher than that of PCR for the infected dogs.

Improving serodiagnosis of human and canine leishmaniasis with recombinant Leishmania braziliensis cathepsin l-like protein and a synthetic peptide containing its linear B-cell epitope

Background

The early and correct diagnosis of human leishmaniasis is essential for disease treatment. Another important step in the control of visceral leishmaniasis is the identification of infected dogs, which are the main domestic reservoir of L. infantum. Recombinant proteins and synthetic peptides based on Leishmania genes have emerged as valuable targets for serodiagnosis due to their increased sensitivity, specificity and potential for standardization. Cathepsin L-like genes are surface antigens that are secreted by amastigotes and have little similarity to host proteins, factors that enable this protein as a good target for serodiagnosis of the leishmaniasis.

Methodology/Principal Findings

We mapped a linear B-cell epitope within the Cathepsin L-like protein from L. braziliensis. A synthetic peptide containing the epitope and the recombinant protein was evaluated for serodiagnosis of human tegumentary and visceral leishmaniasis, as well as canine visceral leishmaniasis.

Conclusions/Significance

The recombinant protein performed best for human tegumentary and canine visceral leishmaniasis, with 96.30% and 89.33% accuracy, respectively. The synthetic peptide was the best to discriminate human visceral leishmaniasis, with 97.14% specificity, 94.55% sensitivity and 96.00% accuracy. Comparison with T. cruzi-infected humans and dogs suggests that the identified epitope is specific to Leishmania parasites, which minimizes the likelihood of cross-reactions.

Leishmaniasis is one of the major diseases of importance in public health and its precise diagnosis may represent one of the most relevant challenges for the control and possible eradication of the disease. In this context, recombinant proteins and synthetic peptides based on Leishmania genes have emerged as valuable targets for serodiagnosis due to their increased sensitivity, specificity and potential for standardization. Cathepsin L-like (CatL) genes are more abundant in stationary promastigotes and amastigotes, and have less than 40% identity with human proteins and more than 60% identity with other Leishmania species. We mapped a linear B-cell epitope in the CatL protein sequence and compared its performance with the recombinant protein and current serology methodologies for the diagnosis of human tegumentary and visceral leishmaniasis as well as of canine visceral leishmaniasis (CVL). Both the recombinant protein and synthetic peptide showed higher specificity and sensitivity than crude preparations commonly used for other antigens, and thus, they are valuable targets to compose an antigen panel that could significantly improve leishmaniasis diagnosis.

Spatial epidemiology of American cutaneous leishmaniasis in a municipality of west São Paulo State, Brazil

BACKGROUND & OBJECTIVES

In the last decade, in the state of São Paulo, 5898 cases of cutaneous leishmaniasis (CL) were reported. This study was undertaken to analyze the epidemiology of CL in the municipality of Teodoro Sampaio, in São Paulo State, Brazil, based on a geographic approach, as very little is known of the relationship between CL and the spatial transformation process.

METHODS

This is a population-based quantitative, descriptive and cross-sectional case study. Surveys of the official notifications in the healthcare center and official sources from 1998 to 2011 were analysed. The data were described based on statistics and the Kernel method to detect hotspots of transmission.

RESULTS

The age group between 21 and 40 yr was most affected, with 24 cases (57.9%). Of the 41 cases reported between 1998 and 2011, 33 cases were having low education status and 31 cases (75.6%) were males. The spatial and temporal distribution was aggregated in three-year periods which permitted the identification of two microfoci, in periods I (1998-2000) and III (2005-2007).

INTERPRETATION & CONCLUSION

The disease has presented, in recent years, a pattern of sporadic transmission or microfoci, and continues to maintain enzootic cycles of Leishmania in a sylvatic environment, ensuring the perpetuation of the pathogen in nature, and the risk of emergence of new cases of CL in domestic animals and humans.

First report of natural infection in hedgehogs with Leishmania major, a possible reservoir of zoonotic cutaneous leishmaniasis in Algeria

We report here the first known cases of natural infection of hedgehogs with Leishmania major. Cutaneous leishmaniasis is an important public health problem in the area of M'sila, a semi-arid province in Algeria's northern Sahara, where two species of hedgehog live, Atelerix algirus and Paraechinus aethiopicus. The aim of this research was to survey Leishmania infection in these hedgehogs and evaluate whether they were reservoir hosts of Leishmania in an endemic zoonotic focus of leishmaniasis. Serological and molecular methods were used to determine the presence of Leishmania in 24 hedgehogs caught directly by hand and identified at species level as 19 A. algirus and 5 P. aethiopicus. Specific anti-Leishmania antibodies were detected in 29.2% of individuals by Western blot and in 26.3% by ELISA. The real-time PCR performed in spleen, ear and blood samples detected Leishmania spp. DNA in 12.5% of the individuals, one A. algirus and two P. aethiopicus. Three skin and two spleen samples of these animals were found to be parasitized and were identified by molecular test as L. major. Considering our results, it is suggested that hedgehogs have a potential epidemiological role as reservoir hosts of L. major.

Can equids be a reservoir of Leishmania braziliensis in endemic areas?

In this study, we detected Leishmania (Viannia) braziliensis infection in equids living in endemic regions of cutaneous leishmaniasis. To determine the role of these animals in the Leishmania cycle, we used two approaches: serological and molecular methods. Antibodies to the parasite were assayed using the Enzyme Linked Immunosorbent Assay (ELISA). Blood samples were collected and tested by polymerase chain reaction (PCR), and the positive products were sequenced. The results showed that 11.0% (25/227) of the equids were seropositive for Leishmania sp, and 16.3% (37/227) were PCR positive. Antibodies were detected in 20 horses, 3 donkeys, and 2 mules, and the parasite DNA was detected in 30 horses, 5 donkeys, and 2 mules. Sequencing the amplified DNA revealed 100% similarity with sequences for Viannia complex, corroborating the results of PCR for L. braziliensis. Our results show that equids are infected with L. braziliensis, which could be food sources for phlebotomines in the peridomiciliary environment and consequently play a role in the cutaneous leishmaniasis cycle.

Validity and reliability of enzyme immunoassays using Leishmania major or L. infantum antigens for the diagnosis of canine visceral leishmaniasis in Brazil

BACKGROUND

American visceral leishmaniasis is caused by the protozoan Leishmania infantum. Dogs are the main reservoirs in the domestic transmission cycle. The limited accuracy of diagnostic tests for canine leishmaniasis may contribute to the lack of impact of control measures recommended by the Brazilian Ministry of Health. The objective of this study was to estimate the accuracy of two enzyme-linked immunosorbent assays employing L. major or L. infantum antigens and their reliability between three laboratories of different levels of complexity.

METHODS

A validation study of ELISA techniques using L. major or L. infantum antigens was conducted. Direct visualization of the parasite in hematoxylin/eosin-stained histopathological sections, immunohistochemistry, and isolation of the parasite in culture.were used as gold standard. An animal that was positive in at least one of the tests was defined as infected with L. infantum. Serum samples collected from 1,425 dogs were analyzed. Samples were separated in three aliquots and tested in three different laboratories. Sensitivity, specificity and the area under de ROC curve were calculated and the reliability was evaluated between the participant laboratories.

RESULTS

The sensitivity was 91.8% and 89.8% for the L. major and L. infantum assays, respectively. The specificity was 83.75% and 82.7% for the L. major and L. infantum assays, respectively. The area under de ROC curve was 0.920 and 0.898 for L. major and L. infantum, respectively. The mean intraclass correlation coefficients between laboratories ranged from 0.890 to 0.948 when L. major was used as antigen, and from 0.818 to 0.879 when L. infantum was used.

INTERPRETATION

ELISA tests using L. major or L. infantum antigens have similar accuracy and reliability. Our results do not support the substitution of the L. major antigen of the ELISA test currently used for the diagnosis of canine visceral leishmaniasis in Brazil.

A search for the rodent hosts ofLeishmania majorin the Larestan region of southern Iran: demonstration of the parasite inTatera indicaandGerbillussp., by microscopy, culture and PCR

Zoonotic cutaneous leishmaniasis (CL) caused by Leishmania major occurs widely in Iran, where several species of rodent serve as the parasite's 'reservoir' hosts. In an attempt to identify the rodent hosts in the Larestan region, which lies in the Fars province of southern Iran (where the incidence of human CL has been rising), 32 rodents (20 Tatera indica, eight Meriones crassus, four Gerbillus sp.) were caught and checked for leishmanial infection. Using two detection methods (the microscopical examination of stained tissue smears and the culture of tissue samples) and a PCR to identify any leishmanial parasites detected, L. major was identified in six of the rodents caught: two male T. indica from Alamarvdasht, two female T. indica from Lamerd, and two females of the genus Gerbillus (one caught in Lamerd and one in Lar). Although the samples were too small to prove that M. crassus is not a significant host of L. major in Larestan, they were large enough to indicate that T. indica and members of the genus Gerbillus serve as reservoir hosts of L. major in the region. Tatera indica appears to be an important host of L. major across much of Iran but this appears to be the first time that the genus Gerbillus has been found to be involved in the epidemiology of CL in the country.

Natural infection of Leishmania (Viannia) braziliensis in Mus musculus captured in Mato Grosso, Brazil

We report natural infection by Leishmania (Viannia) braziliensis in Mus musculus and Necromys lasiurus using molecular analyses (PCR-RFLP) of femoral bone marrow and skin fragments. The aim of this study was to detect infection by pathogenic species of Leishmania in small mammals in the state of Mato Grosso, Brazil. The animals were captured in Peixoto de Azevedo, a cutaneous leishmaniasis-endemic region located in the north of the state, from October 30 to November 3, 2008. Natural infection by Leishmania in synanthropic rodents may be a threat to humans due to cohabitation of human domiciles in this area.

Molecular detection of Leishmania braziliensis in Rattus norvegicus in an area endemic for cutaneous leishmaniasis in Brazil

Leishmania nested PCR (LnPCR) targeted to the SSUrRNA gene and DNA sequencing were used to analyze 315 tissue samples from 80 Rattus norvegicus specimens trapped in an area endemic for leishmaniasis in Belo Horizonte, Minas Gerais, Brazil. Of the samples analyzed, 17.46% (55/315) of all tissues, 10% (8/80) of skin, 26.92% (21/78) of blood, 30.76% (24/78) of bone marrow and 2.53% (2/79) of spleen were positive for Leishmania. The overall infection prevalence was 36.25% (29/80) The DNA sequencing showed that 65.51% (19/29) of the positive animals were infected by parasites belonging to the Leishmania braziliensis complex. The identification of L. braziliensis DNA in R. norvegicus in an area with a high prevalence of leishmaniasis might imply a zoonotic role of this species. The rodent control programs and health education may represent important measures toward the control of leishmaniasis.

Leishmania species: detection and identification by nested PCR assay from skin samples of rodent reservoirs

Many rodent species act as reservoir hosts of zoonotic cutaneous leishmaniasis in endemic areas. In the present study a simple and reliable assay based on nested PCR was developed for the detection and identification of Leishmania parasites from rodent skin samples. We designed Leishmania-specific primers that successfully amplified ITS regions of Leishmania major, Leishmania gerbilli and Leishmania turanica using nested PCR. Out of 95 field collected Rhombomys opimus, 21 were positive by microscopic examination and 48 by nested PCR. The percentage of gerbils infected with L. major, L. gerbilli and L. turanica was 3.2%, 1.1% and 27.4%, respectively. In 15.8% of the rodents, we found mixed natural infections by L. major and L. turanica, 1.1% by L. major and L. gerbilli, and 2.1% by the three species. We concluded that this method is simple and reliable for detecting and identifying Leishmania species circulating in rodent populations.

Leishmania (Viannia) braziliensis: immunoblotting analysis for the detection of IgG subclasses in the diagnosis of symptomatic and asymptomatic dogs

During a seroepidemiological survey 2004-2006 from areas in Brazil endemic for American cutaneous leishmaniasis (ACL), serum samples from 10 dogs with ulcerated cutaneous lesions (S-ACL) and 52 asymptomatic dogs (AS-ACL) of unknown age and breed living in areas endemic for ACL were monitored for 1 year for ulcerated cutaneous lesions and immunoblotting using peroxidase-conjugated secondary anti-IgG, anti-IgG1 and anti-IgG2 dog antibodies. We reported that antibodies against Leishmania (Viannia) braziliensis in the sera of 22/52 dogs with asymptomatic disease showed intense reactivity to peptides larger than 66 kDa. We believe that dogs harboring subclinical amastigotes show an immunoblotting profile similar to that of symptomatic animals because a dog with self-healing presented antigens greater than 66 kDa. Such patterns can be exploited for diagnostic and epidemiological research for leishmaniasis.

[Investigations on leishmaniases at the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine]

The paper assesses the investigations on leishmaniases at the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine in 1920 to 2009. The analysis includes papers on biology, ecology, taxonomy, and experimental transmission of the agents of leishmaniases via the bites of sand flies, the principle in the control of zoonotic cutaneous leishmaniasis (ZCL) during the agricultural development of extensive territories in the Karshin steppe, on quantitative approaches in the epidemiology of ZCL, a search for Russian effective medicaments to treat patients with this disease and the development of criteria for selecting L. major strains for individual and mass vaccinations against ZCL, the revision of Leishmania circulating in great gerbil populations, and the description of the new species L. turanica, an important parasite for L. major persistence from one transmission season to the next. The first investigations on leishmaniasis were made by Prof. E.I. Martsinovsky, the founder and the first director of the Institute in the early 20th century.

Comparative histopathological study of sporotrichosis and American tegumentary leishmaniasis in dogs from Rio de Janeiro

Pyogranulomatous lesions from 80 dogs with sporotrichosis and 26 dogs with American tegumentary leishmaniasis (ATL) were compared microscopically in order to identify features that would support the diagnostic suspicion and direct the subsequent search for the aetiological agent of either infection. Odds ratios and their respective 95% confidence intervals were calculated in order to evaluate the impact of the microscopical findings on the diagnosis of either disease. Lesions with well-formed granulomata were 14 times more likely to be due to sporotrichosis than ATL. Marked neutrophil infiltration into granulomata was 12.26 times more likely to be associated with sporotrichosis when compared with lesions having mild neutrophilic infiltration. Absence of lymphocytes and macrophages in the peripheral infiltrate was associated with a 9.71 and 4.93 higher chance, respectively, of being sporotrichosis rather than ATL compared with lesions where these cells were present. Lesions with a perivascular, perifollicular and interstitial peripheral inflammatory infiltrate were 5.48 times more likely to be due to sporotrichosis than ATL when compared with lesions with a diffuse peripheral infiltrate. Histopathological analysis may therefore contribute to the diagnosis of sporotrichosis or ATL skin lesions in dogs since this method permits the identification of features that direct the diagnostic suspicion, thus facilitating the search for the aetiological agent in histological sections, permitting the precise request of subsequent tests and thereby reducing costs and time taken to achieve a definitive diagnosis and the initiation of appropriate therapy.

Prevalence of antibodies and cell mediated immune response against Leishmania major in feral nonhuman primates from Kenya

In Kenya, Leishmania major is responsible for human cutaneous leishmaniasis (CL). Natural infection with L. major of a vervet monkey and experimental susceptibility of some nonhuman primates (NHPs) from Kenya has been established. However, there has been no comprehensive study of the prevalence of zoonotic CL in Kenya. And also, no investigation has been done to assess whether NHPs could be potential reservoir hosts of L. major even when the involvement of reservoir animals is obligatory in transmission of this parasite. To achieve this, wild caught Chlorocebus aethiops (Vervet monkeys n=213), Papio cynocephalus anubis (olive baboons n=101) and Cercopithecus mitis (Syke's monkeys n=64) from five geographical locations in Kenya were screened for antibodies against L. major using enzyme linked immunosorbent assay (ELISA) and Western blot (WB) analysis. From the population of C. aethiops (n=213) captured, 57 were used in lymphocyte proliferation assay. ELISA revealed a high prevalence of leishmaniasis sero conversion in olive baboons 78/101 (77.2%), vervet monkeys 129/213 (60.6%) and Sykes' monkeys 43/64 (67.2%). WB detected anti-L. major antibodies in 48.5% (49/101) of the baboons, 48% (102/213) of vervet monkeys and 37.5% (24/64) of Sykes' monkey sera. Specific proliferation of peripheral blood mononuclear cells to L. major antigen was demonstrated in 17 of the 57 (29.8%) vervet monkeys. In conclusion, the results of serological assays provide strong circumstantial evidence that CL is prevalent in five Provinces of Kenya and that Kenyan NHPs could be could be a potential reservoir hosts of L. major.

Efficacy of the liposome trifluralin in the treatment of experimental canine leishmaniosis

Liposomes are used as carriers to deliver drugs and to treat diseases where infection is localised in the mononuclear phagocyte system cells, as is the case of leishmaniosis. Trifluralin is a dinitroaniline with proved anti-Leishmania activity in vitro. The efficacy of liposomal trifluralin (LIP/TFL) was studied in the treatment of experimental canine leishmaniosis through quantification of parasite burden using the limiting dilution assay, follow-up of anti-Leishmania antibodies by indirect fluorescent immunoassay and cytokine expression by Reverse Transcriptase-PCR, in the bone marrow, lymph nodes, skin and peripheral blood mononuclear cells in 5 female beagle dogs. After treatment, dogs showed a general remission of clinical signs related to parasite burden reduction and Th1 cytokine mRNA expression, but there was no significant decrease in antibody levels. Alternative treatment schemes with LIP/TFL are necessary to achieve optimal results.