Abstract
Cutaneous leishmaniasis (CL) due to Leishmania tropica is a neglected tropical disease characterized by a wide geographical distribution in the Mediterranean basin and is endemic in several of its countries. In addition, the vector Phlebotomus sergenti is abundantly present all around the basin. Its transmission cycle is still subject to debate. In some countries, the presence of an animal reservoir has been confirmed. In Morocco, CL due to L. tropica has risen since the 1980s and has spread widely to become the most abundant form of leishmaniasis in the territory. However, the anthroponotic transmission is so far the only recognized mode, despite recordings of L. tropica infection in animal hosts. In this review article, we assess the situation of CL due to L. tropica in the Mediterranean basin with a focus on Morocco and gather knowledge about any potential zoonotic transmission in the country. A concomitant zoonotic transmission could explain the persistence of the disease in areas where human protective measures combined with vector management did not help reduce the disease burden.
Highlights
The development and spread of infectious diseases are influenced by humans, animals, and the environment, and around 61% of human infections are zoonotic
We review how cutaneous leishmaniasis (CL) due to L. tropica is present around the Mediterranean basin, with a particular focus on the Moroccan foci, and try to unveil the existence of a zoonotic transmission in the area
Healed CL due to L. tropica can sometimes be followed by Leishmaniasis recidivans (LR), usually appearing as new lesions around the primary healed ones and characterized by a progressive expansion [2]
Summary
The development and spread of infectious diseases are influenced by humans, animals, and the environment, and around 61% of human infections are zoonotic. Zoonotic diseases are constantly emerging and expanding, and new transmission patterns are being uncovered [1]. Leishmaniasis is a neglected tropical parasitic disease caused by intracellular protozoa of the genus Leishmania and transmitted through the bite of female sand flies. 0.7 to 1 million new CL cases are reported annually to WHO from 86 CL endemic countries [3]. In the Old World, Leishmania major, Leishmania aethiopica, and Leishmania infantum are responsible for zoonotic CL ( L. infantum is mainly the cause of zoonotic VL). Leishmania tropica is mainly considered responsible for anthroponotic CL. Healed CL due to L. tropica can sometimes be followed by Leishmaniasis recidivans (LR), usually appearing as new lesions around the primary healed ones and characterized by a progressive expansion [2]
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