Abstract
BackgroundCutaneous leishmaniasis (CL) is a major public health problem in Libya. The objective of this study was to investigate, for the first time, epidemiological features of CL outbreaks in Libya including molecular identification of parasites, the geographical distribution of cases and possible scenarios of parasite transmission.Methodology/Principal FindingsWe studied 450 patients that came from 49 areas distributed in 12 districts in north-west Libya. The patients' ages ranged from 9 months to 87 years (median age 25 years); 54% of the cases were males. Skin scrapings spotted on glass slides were collected for molecular identification of causative agent. The ribosomal internal transcribed spacer 1 (ITS1) was amplified and subsequently characterized by restriction fragment length polymorphism (RFLP) analysis. In total, 195 samples were successfully identified of which 148 (75.9%) were Leishmania major, and 47 (24.1%) Leishmania tropica. CL cases infected with L. major were found in all CL areas whereas L. tropica cases came mainly from Al Jabal Al Gharbi (46.4%), Misrata (17.8%) and Tarhuna districts (10.7%). A trend of seasonality was noticed for the infections with L. major which showed a clear peak between November and January, but was less pronounced for infections by L. tropica.ConclusionThe first molecular study on CL in Libya revealed that the disease is caused by L. major and L. tropica and the epidemiological patterns in the different foci were the same as in other Mediterranean foci of CL.
Highlights
Leishmaniasis is still one of the world’s most neglected diseases infecting some 2 million humans each year in more than 98 countries or territories
The first molecular study on Cutaneous leishmaniasis (CL) in Libya revealed that the disease is caused by L. major and L. tropica and the epidemiological patterns in the different foci were the same as in other Mediterranean foci of CL
It occurs in three clinical forms including cutaneous leishmaniasishttp://hinari-gw.who.int/whalecomwww. sciencedirect.com/whalecom0/science/article/pii/S1201971211000877 hit41 (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL)
Summary
Leishmaniasis is still one of the world’s most neglected diseases infecting some 2 million humans each year in more than 98 countries or territories. It occurs in three clinical forms including cutaneous leishmaniasishttp://hinari-gw.who.int/whalecomwww. CL is the most common form of the disease in North African countries where three Leishmania species are considered as causative agents; Leishmania major, L. tropica and less frequently L. infantum [1,2,3,4]. In terms of its infection cycle, two types of CL are commonly found; zoonotic cutaneous leishmaniasis (ZCL) caused by L. major and L. infantum, and anthroponotic cutaneous leishmaniasis (ACL) caused by L. tropica in urban areas [9]. The objective of this study was to investigate, for the first time, epidemiological features of CL outbreaks in Libya including molecular identification of parasites, the geographical distribution of cases and possible scenarios of parasite transmission
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