Endemic Focus Of Cutaneous Leishmaniasis Research Articles

Ecological site distribution of sand fly species of Mokolo, an endemic focus of cutaneous leishmaniasis in northern Cameroon

Leishmaniasis is a vector borne disease present in two major clinical forms (cutaneous and visceral) in the northern part of Cameroon. The disease is classified as a neglected tropical disease by the World Health Organization and thus, requires more attention. The aim of this study was to correlate the previously established composition and abundance of sand fly fauna with the putative vector status and the ecological behavior in the Mokolo cutaneous leishmaniasis focus to propose fighting strategies integrating vectors control.Over a 12-month period light traps were used for sand flies’ collection in urban, peri-urban and sylvatic environment found in Mokolo, an endemic focus of leishmanisis in northern Cameroon, microscope and taxonomic keys were used for their identification. Nineteen (19) species were identified belonging to the genera Sergentomyia, and Phlebotomus. The influence of human population density on sand fly's species density and composition was assessed trough the evaluation of ecological distribution of sand flies in Mokolo. It came out that, Se. coronula and Se. thomsoni mandarai are strictly wild species and Ph. duboscqi, a domestic species. The other species are generalists.The number of Se. antennata and Se. adami decreases with the increase of the density of human population while Se. distincta, Se. vorax and Ph. duboscqi increase with the density of human population in the study site. Based on its previous reports in the Leishmania transmission in West Africa, Ph. duboscqi should still be considered as the main suspected vector in Mokolo. Ph. duboscqi, Se. distincta, Se. affinis ssp. vorax and Se. schwetzi are highly represented around human dwellings.

Investigation of Epidemiological Aspects of Cutaneous Leishmaniasis in Jahrom, Fars Province, Between 2015 and 2019

Background: Cutaneous leishmaniasis is one of the diseases caused by the Leishmania parasite, which is considered a health problem in Iran. Jahrom, a county in Fars province located in the south of Iran, is one of the endemic foci of cutaneous leishmaniasis. Objectives: The present study investigated the epidemiology of cutaneous leishmaniasis in Jahrom between 2015 and 2019. Methods: A descriptive-analytical study was performed to evaluate the epidemiology of cutaneous leishmaniasis in patients referred to the Jahrom Health Center between 2015 and 2019. Results: A total of 584 cases were identified, of which (347) 59.4% were males and (237) 40.6% were females. The acute cases were observed in all age groups, and the highest proportion was seen at less than 10 years of age. The numbers of patients with cutaneous leishmaniasis from 2015 to 2019 were 180, 88, 117, 108, and 91, respectively. Cutaneous leishmaniasis was more common in autumn and winter. The proportion was higher in males and urban inhabitants. There was a statistically significant difference between the genders and places of residence (P < 0.05). Also, the highest proportion of lesions was on the hands (48.8%). Conclusions: Based on the findings in Jahrom city, the proportion of the disease was higher in younger age groups, males, urban inhabitants, and autumn. The most common lesions were on the hands, feet, and face.

Ecology and Distribution of Sand Fly Species of Mokolo, an Endemic Focus of Cutaneous Leishmaniasis in Cameroon

Ecology and Distribution of Sand Fly Species of Mokolo, an Endemic Focus of Cutaneous Leishmaniasis in Cameroon

Detection of Leishmania donovani in Wild-Caught Phlebotomine Sand Flies in Endemic Focus of Leishmaniasis in Himachal Pradesh, India.

An endemic focus of cutaneous leishmaniasis (CL) is located in the Sutlej River Valley in Himachal Pradesh (India) in the north-western Himalaya where CL co-exists with visceral leishmaniasis (VL). In areas of the Indian subcontinent such as Rajasthan, cutaneous leishmaniasis is transmitted by Phlebotomus papatasi (Scopoli) and Phlebotomus salehi. In Himachal Pradesh, Phlebotomus longiductus (Parrot) is suspected to be the vector for CL. In the current study, sand flies were collected and tested for Leishmania infection and to confirm the vector species causing CL. Sand flies were collected during April and September of 2017–2019 from CL endemic villages of Rampur (Shimla), Nirmand (Kullu) and Nichar (Kinnaur) districts of Himachal Pradesh. The sand flies were identified as Phlebotomus (adlerius) longiductus (Parrot) and Phlebotomus (larrousisus) major (Annandale). The density of P. longiductus was found highest. The elevation of villages ranged from 947 m to 2,130 m and were far from the presence of subsoil water. Field collected sand flies tested positive (7.69%) for Leishmania donovani by PCR-RFLP. The L. donovani sequences detected from P. longiductus were 97% similar to L. donovani sequences reported from the cases of CL in Himachal Pradesh.The Leishmania positive sand flies were morphologically identified as Phlebotomus adlerious longiductus providing one step further evidence towards the vector status of CL in Himachal Pradesh. The findings of the study are of epidemiological significance for strategic planning of vector control for leishmaniasis in India.

Diversity and Bionomics of Sandflies (Diptera: Psychodidae) of an Endemic Focus of Cutaneous Leishmaniasis in Zagora Province, Southeast of Morocco.

The diversity and seasonality for sandflies were studied in 2019 at a focus of zoonotic cutaneous leishmaniasis in Zagora province, southern Morocco. Standardized sampling with CDC light traps was used. A total of 4504 sandflies (4024 Phlebotomus and 480 Sergentomyia) was collected during the study period. Seven species belonging to genus Phlebotomus and six species of genus Sergentomyia were identified. The most abundant species were Ph. papatasi (33.6%) and Ph. longicuspis (25.7%), highlighting the risk for local disease transmission foci. The seasonal activity of sandflies extended from April to November, showing two peaks, one in June-July and one, less important, in late-September-October. Abundance was highest during the months May, June, and July and lowest in August, September, and October. Results of this study provide important baseline data for planning control interventions.

Cutaneous leishmaniasis as an increasing threat for Iranian travellers attending religious ceremonies.

The Islamic Republic of Iran is one of the most important endemic foci of cutaneous leishmaniasis in the world. Annually, a large number of Iranian Shia pilgrims travel to Iraq from this area in order to participate in one of their most important religious ceremonies. This trip has coincided with the seasonal activity of sand flies in recent years. So, cutaneous leishmaniasis could be a serious threat for pilgrims on these trips. To report cases of cutaneous leishmaniasis among Iranian Shia pilgrims attending a religious ceremony in Iraq during 2017. Sixteen patients were referred to our laboratory in the Department of Parasitology and Mycology at Qazvin University of Medical Sciences. Dermal scrapings and stained slides prepared of skin lesions were used to morphological diagnosis. DNA extraction and PCR amplification were optimized to identification of Leishmania species. All of the patients were infected with cutaneous leishmaniasis in microscopic survey. L. major was detected by molecular approach. The number of lesions observed in patients were 1 (31%), 2 (25%), and ≥ 3 (44%). Since a large number of Shia Muslims participate in the annual religious ceremonies, serious measures must be taken to prevent the disease.

Clinical and epidemiological study of cutaneous leishmaniasis in two tertiary care hospitals of Jammu and Kashmir: An emerging disease in North India

BackgroundAn increasing number of patients with cutaneous leishmaniasis (CL) are reporting to tertiary care centers in Jammu and Kashmir, an area that has previously been non-endemic for this disease. This merits consideration of CL as a major health problem of considerable epidemiological importance. The aims of this study were firstly to describe the clinico-epidemiological profile, therapeutic characteristics, and outcomes of patients with CL and secondly to highlight this union territory as a new focus of endemicity for CL. MethodsA two-center hospital-based prospective cohort study was conducted at two tertiary care hospitals in Jammu and Kashmir over a period of 10 years (July 2009 to June 19). All patients presenting to the outpatient departments with lesions suggestive of CL were enrolled for the purpose of this study. Demographic data were recorded on a proforma questionnaire, along with a detailed history and the results of a meticulous examination. Patients diagnosed with CL based on clinical criteria were subjected to slit skin smear (SSS) and histopathological examination for confirmation of the diagnosis. An intralesional pentavalent antimonial, sodium stibogluconate (SSG), was administered at a dose of 0.5 mL/cm2 (100 mg/mL solution) three times weekly to those patients with smaller lesions, and intravenously or intramuscularly at a dose of 20 mg/kg/day to those with larger lesions. The response to treatment was assessed by total re-epithelialization of the lesion and an absence of infiltration and erythema, with or without scarring. Treatment was given until complete resolution of the lesions or for a maximum duration of 10 weeks when given intralesionally and 3 weeks when given systemically. Clinical follow-up was performed twice weekly for the first 2 months and monthly thereafter. The final response to treatment was assessed at 6 months. ResultsThe study included a total of 1300 patients with a mean age of 26.7 ± 18.5 years. The mean duration of the disease was 28.52 ± 13.5 weeks, ranging from 8 to 64 weeks. Lesions were noted mainly on exposed parts of the body, with the face being the most commonly affected site (89.00%). Nodulo-ulcerative plaques were the predominant lesion type observed (73.92%). The presence of Leishman–Donovan bodies could be demonstrated on SSS and histopathology in 60.69% and 39.54% of patients, respectively. The presence of a recognizable histological pattern conforming to CL and a response to a therapeutic trial of SSG was considered to be confirmatory in the remaining patients. Complete cure was achieved in 84.23% of cases during the study period. Single lesions were more likely to respond to treatment as compared to multiple lesions. The route of administration did not have any significant impact on the final outcome. ConclusionsWith the disease showing an escalating trend in Jammu and Kashmir, the possibility of a new focus of endemicity and its impact on public health need to be contemplated, and appropriate measures should be initiated to contain its spread.

The role of sampling by cotton swab in the molecular diagnosis of cutaneous leishmaniasis.

An appreciated sampling technique is essential for achieving optimum results from diagnostic tests of cutaneous leishmaniasis (CL); conventional sampling methods, such as skin biopsy and dermal scrapping, are painful for the patients and require qualified staff and hospital facilities, while swabbing is patient-friendly more comfortable than invasive traditional techniques and can be carried out under field conditions. The aim of this study is to evaluate a non-invasive sampling method (swab) in the cutaneous leishmaniasis diagnosis, compared to microscopic examination. The recruitment of 205 patients was done during 3years in six regions known as endemic CL foci in the south-east, the centre, the south-west and the north of Morocco. The results showed that molecular detection of the nuclear marker ITS1 on swab materials is to be less sensitive than microscopic examination, and the difference was statistically significant (p-value=.036). Thereafter, 55 patients were randomly selected to compare the results of two molecular techniques (ITS1-PCR and nested KDNA-PCR), performed both on swab and on stained smears used for microscopic examination; ITS1-PCR results from stained smears reached 87% positivity against 65,2% for cotton swab; and it was statistically significant (p-value=.019); on the other hand for the KDNA marker, results from cotton swab reached 93% of positivity against 91% for stained smears; and statistically the difference was not significant (p-value=.5113). One can presume that rubbing over the lesion with cotton swab implies a low parasitic load collection, but the choice of the amplification target greatly influences the results obtained from cotton swab; on top of that swab remains useful in the cases of patients with multiples lesions or the latter are located in sensitive places difficult to reach with an invasive method such as the eyelids, the lips or other mucous areas.

Spatial-Temporal Analysis of Lutzomyia trapidoi and Lutzomyia reburra (Diptera: Phlebotominae), in Rural Tourist Locations, Biosphere Reserve and Leishmaniasis Endemic Area, Ecuador.

This research represents the first attempt to assess the spatial and temporal distribution based on micro-meso scales on two species with different host preference habits (anthropophilic vs zoophilic), in the major Leishmaniasis endemic area in Ecuador, tourist locations, and Biosphere reserve. Phlebotomine species, Lutzomyia trapidoi (Fairchild) and Lutzomyia reburra (Fairchild and Hertig), were analyzed by trap/habitat/month/locality/altitude, through the Poisson generalized regression model. Our data reveal a bimodal pattern for both species related with low precipitations and preference for forest habitat. Altitude, proximity to the forest, and the river were the variables that determine the hypervolume of the spatial distribution of relative abundance, where the overlap of these two species increases the risk of translocation and circulation of the etiological agent of leishmaniasis in sylvatic environments to rural-tourist-biosphere reserve areas and vice versa. The ecological characteristics of these two phlebotomines could explain the permanence of the major active and endemic focus of cutaneous leishmaniasis in the North-Western Ecuador a key aspect in tourism health-security in alternative tourism.

Surveillance for Leishmania asymptomatic infection in endemic foci of cutaneous leishmaniasis in Venezuela: a combination of leishmanin skin test and PCR using blood clots improves detection and enables identification of species.

Little is known about the prevalence of asymptomatic leishmaniasis in Venezuela. The objective of this study was to quantify Leishmania asymptomatic infection in six endemic foci of cutaneous leishmaniasis (CL) in Portuguesa State, Venezuela, where no previous data were available. Study of the prevalence of Leishmania asymptomatic infection was carried out in 841 individuals from six endemic foci of CL in the municipalities Sucre and Ospino, Portuguesa State. We applied the leishmanin skin test (LST) and the internal transcribed spacer 1 (ITS1) PCR to DNA from sera and blood clots of all LST-positive and 20% of LST-negative patients. Of 841 inhabitants tested by LST, 197 returned a positive reaction (23.42%); all of the LST-positives (197) and 121 negatives were screened by nested PCR using serum and blood clots. Among the LST-positive group, 2.54% were PCR-positive with sera, while 44.67% were positive with blood clots. In the LST-negative group, PCR was positive in 2.48% of serum samples and in 38.84% of blood clots. It is recommended that LST and PCR on blood clots are used together to detect exposure and asymptomatic infection and for identification of the Leishmania species.

Modeling the Ecological Niche: A Case Study on Bioclimatic Factors Related to the Distribution of Phlebotomus tobbi Adler & Theodor (Diptera: Psychodidae) in Two Endemic Foci of Adana.

Cutaneous leishmaniasis (CL) is a zoonotic infectious disease caused mainly by Leishmania infantum Nicolle, 1908 (Kinetoplastida: Trypanosomatida) transmitted by dominant species Phlebotomus tobbi Adler & Theodor (Diptera: Psychodidae) in Adana, Turkey. CL has been reported to be detected commonly in low-socioeconomic status population scattered in rural areas. The environmental determinants are relatively poorly understood, especially in Adana despite the fact that Adana is endemic foci of CL. The subject of this study was the current and future probability model of P. tobbi in the study areas, and to determine the underlying factors affecting its distribution. Sticky papers and CDC light traps were used for capturing the sand fly specimens. The current and future presence of P. tobbi was modeled using maximum entropy (MaxEnt) techniques. The predictive model indicated the presence of P. tobbi in the southeast and south part of the selected study area with 0.816 area under the curve (AUC) value. The model also implied that its survival could tend to expand with suitable climatic conditions in future (2070) with 0.798 AUC value. In addition, aspect, digital elevation model, BIO3, BIO 10, BIO12, and BIO14 were determined as the most influential variables for current and projected future. ArcGIS and MaxEnt software were used for the ecological niche model analysis to explore the ecological conditions of the disease. I suggest that produced models contribute to better understanding of epidemiology and controlling of vector-borne diseases.

Bir kutanöz leishmaniasis endemik bölgesi olan Adana’nın Karaisalı ilçesinde kum sineği faunası ve çevresel parametrelerin belirlenmesi

Purpose: This paper presents the results of an entomological survey in an endemic focus of cutaneous leishmaniasis in Karaisali province of Adana in Turkey. Materials and Methods: There were two field works in two consecutive years (2013 and 2014), which 1088 sand fly specimens were captured using 136 light traps which were conducted in 11 villages of Karaisali located in southwest part of Adana. Results: Totally, six Phlebotomus species were described: Phlebotomus tobbi (41.54%), Phlebotomus neglectus/syriacus (9.74%), Phlebotomus papatasi (25.18%), Phlebotomus perfiliewi (3.49%), Sergentomyia dentata (18.38%) and Sergentomyia theodori (1.65%). The female/male rate was found to be 1.98. Phlebotomus tobbi, Phlebotomus papatasi, Phlebotomus neglectus/syriacus, Sergentomyia dentata and Sergentomyia theodori were dominant at 201-400m, 0-200m, 801-1000m, 401-600m and 601-800m respectively. Conclusion: Environmental and climatic factors were compared for the presence of sand flies species especially vectors of cutaneous leishmaniasis by univariate binary regression analysis in PASW. Sand fly density maps were generated based on the elevation they were caught by using ARCMAP 10.2. The data also revealed a relationship between presence of the probable vector sand flies and several environmental factors such as altitude, temperature, trap location and humidity in Karaisali.

Clinico-epidemiological features of cutaneous leishmaniasis in Mazandaran Province, northern Iran

IntroductionIran is considered as one of the most important endemic foci of cutaneous leishmaniasis (CL) worldwide. Recently, sporadic cases of CL have been reported in some parts of Mazandaran Province, northern Iran. This study aims to determine the clinical and epidemiological aspects of CL, for the first time, in this area. MethodsAll CL cases registered during 2009–2016 were entered into this descriptive study. Required data was collected from the portal of surveillance system in excel format and entered into SPSS Version 16 software and described as percent frequency, mean, standard deviation, minimum and maximum. The analysis was performed using Chi square and independent T tests. ResultsDuring 2009–2016, 343 subjects were entered into the study. Among investigated patients, 72.6% were male and 87.8% had history of travelling. Mean age of patients was 30.7 years and 21.6% of whom were reported in November while 18.4% were identified in October. The lesions were found in upper limb (39.7%), lower limb (25.7%) and face (6.4%). Of them, 37.3% had one lesion and 22.4% had two lesions. There were no significant difference in the mean age of men and women (p = 0.648) as well as number of lesions in both genders (p = 0.190). ConclusionOur results showed that the most CL cases in the studied area were aged 15–44 most of which had history of recent travelling to endemic areas. According to this study, Mazandaran is not considered as a CL endemic focus and most identified cases were affected following travel to the known endemic Iranian foci of CL.

Co-detection and isolation of Leishmania and Crithidia among naturally infected Tatera indica (Rodentia: Muridae) in Fars province, southern Iran

Objective: To explore the co-detection of natural infection of Trypanosomatidae parasites such as Leishmania and Crithidia in reservoir hosts of leishmaniasis. Methods: Rodent populations were monitored in two endemic foci of cutaneous leishmaniasis of Fars province, southern Iran from March to October 2016. Rodents were trapped alive in several parts of Shiraz and Kharameh cities. Afterwards, their organs were prepared for detection of Leishmania and Crithidia species by molecular, microscopic, and culture methods. Results: Totally, 115 rodents of five species; Tatera indica (T. indica) (85), Rattus rattus (12), Meriones libycus (9), Mus musculus (7), and Rattus norvegicus (2), were trapped alive and their tissue samples were examined using microscopic, cultivation, and molecular assays. Overall, 59 (51.3%) rodents were positive for Leishmania or Crithidia parasites. The highest rate (61.2%; 52/85) of Leishmania infection was related to the T. indica population. The cultivation, and molecular observations showed that two (2.4%; 2/85) of T. indica (foot-pad, and spleen samples) were positive to Crithidia. Conclusions: This is the first report of Crithidia infection in T. indica in Iran. Consequently, more epidemiological and ecological studies are needed to understand the role of Crithidia and Leishmania in T. indica.

Species Composition of Sand Flies (Diptera: Psychodidae) and Modeling the Spatial Distribution of Main Vectors of Cutaneous Leishmaniasis in Hormozgan Province, Southern Iran.

Cutaneous Leishmaniasis (CL) is one of the main neglected vector-borne diseases in the Middle East, including Iran. This study aimed to map the spatial distribution and species composition of sand flies in Hormozgan Province and to predict the best ecological niches for main CL vectors in this area. A database that included all earlier studies on sand flies in Hormozgan Province was established. Sand flies were also collected from some localities across the province. Prediction maps for main vectors were developed using MaxEnt model. A total of 27 sand fly species were reported from the study area. Phlebotomus papatasi Scopoli, Phlebotomus sergenti s.l. Parrot, Phlebotomus alexandri Sinton, Sergentomyia sintoni Pringle, Sergentomyia clydei Sinton, Sergentomyia tiberiadis Adler, and Sergentomyia baghdadis Adler (Diptera: Psychodidae) had the widest distribution range. The probability of their presence as the main vectors of CL was calculated to be 0.0003-0.9410 and 0.0031-0.8880 for P. papatasi and P. sergenti s.l., respectively. The best ecological niches for P. papatasi were found in the central south, southeast, and a narrow area in southwest, whereas central south to northern area had better niches for P. sergenti s.l. The endemic areas are in Bandar-e Jask, where transmission occurs, whereas in Bastak, the cases were imported from endemic foci of Fars province. In conclusion, proven and suspected vectors of CL and VL were recorded in this study. Due to the existence of endemic foci of CL, and favorite ecological niches for its vectors, there is potential risk of emerging CL in new areas.

Phlebotomus halepensis (Diptera: Psychodidae) Vectorial Capacity in Afyon and Nigde Province, Turkey.

Leishmaniasis is a one of the vector-borne diseases and has two clinical forms in Turkey: cutaneous and visceral. The aim of this study was to determine the sand fly fauna in Afyon and Nigde provinces where endemic foci of cutaneous leishmaniasis (CL) in Turkey. In Afyon, 2,259 sand flies were collected in 73 locations in August 2009 and August 2010, using CDC light traps. In total, eight Phlebotomus species were identified; Phlebotomus halepensis (47.41%), Phlebotomus papatasi (31.42%), Phlebotomus neglectus/syriacus (9.38%), Phlebotomus balcanicus (7.48%), Phlebotomus simici (2.12%), Phlebotomus perfiliewi (1.90%), Phlebotomus sergenti (0.08%), Phlebotomus similis (0.13%), and Sergentomyia dentata (0.04%). A total of 418 sand fly specimens were caught by CDC light traps in 40 stations in Nigde in September 2009 and September 2010. In total, seven Phlebotomus species were identified; P. halepensis (74.16%), P. simici (13.87%), P. papatasi (3.82%), P. neglectus/syriacus (2.87%), P. balcanicus (2.63%), P. sergenti (2.39%), and Phlebotomus tobbi (0.23%). Collected sand flies were examined by microscope, and no promastigotes were found in their midguts. We categorized and pooled female specimens (1,031 females, 73 pools of 2-33 individuals). Leishmania species-specific ITS1 real-time PCR assay was performed for detection and identification of parasites. We detected 6 of the 73 pools with Leishmania tropica (Ross, 1903), (Trypanosomatidae). In conclusion, P. halepensis was found to be dominant species in both areas. We are in opinion that our findings support P. halepensis vectorial role for L. tropica in nature and it could be responsible for the transmission of L. tropica in these endemic areas.

Geographical Information Systems in Determination of Cutaneous Leishmaniasis Spatial Risk Level Based on Distribution of Vector Species in Imamoglu Province, Adana.

The Imamoglu district located in the southeast of Adana province in Turkey is an endemic focus of cutaneous leishmaniasis (CL) owing to dominancy of Phlebotomus tobbi, which is a probable vector of Leishmania infantum. About 11.26% of CL cases reported each year are from Imamoglu, Adana, and between 2008 and 2015, 223 cases of CL were reported. Leishmania infantum, which may be transmitted by P. tobbi, Phlebotomus neglectus/syriacus, and Phlebotomus perfiliewi, is referred as leishmaniasis factor in Adana. Thus, the aim of this study was to map the risk areas for each sand fly species using remote sensing images based on environmental factors and geographical characteristics. Two field works in two consecutive years (2013 and 2014) were conducted and six sand fly species were caught, four of which were identified as probable vector species. Field work results were compared with environmental data obtained from satellite images by univariate and binary logistic regression in PASW. ARCMAP 10.2 software was used for geographical adjustments, creating a database and estimating a risk model by using previous risk value formulas. The results showed that the distribution of three probable leishmaniasis vectors (P. tobbi, P. neglectus/syriacus, and P. perfiliewi) was associated with normalized difference vegetation index (NDVI), digital elevation model (DEM), night-time land surface temperature (LSTNIGHT), and emissivity (EMIS31) values, which were related to the local authorities, who take these findings into account when deciding on high risk areas for CL.

Some ecological aspects of Phlebotomine sand flies (Diptera: Psychodidae) in an endemic area of leishmaniasis in Darab district, Fars province, southern Iran

Background: Phlebotomus species are solely responsible for transmitting leishmaniasis in the old world. The disease is endemic in several parts of Iran. Darab district located in Fars province of southern Iran is one of the most important endemic foci of cutaneous leishmaniasis. Sand flies and Methods: To identify the distribution of sand flies, a total of 5019 sand flies were collected in Darab district from May to September 2012. To determine the monthly activity, 2039 sand flies were biweekly collected from indoors and outdoors of two villages at lowland and highland regions. The relationship between the frequency of sand flies and wind speed (greater than 3 m/s as the influential factor) was studied. To determine the number of sand flies' bites per night, a native volunteer exposed his body every 1 h from sunset to sunrise. Results: In total, 13 species of Phlebotomine (five Phlebotomus spp. and eight Sergentomyia spp.) were identified. Besides, a relatively significant relationship was found between the frequency of sand flies and wind speed more than 3 m/s, especially in June and July 2012. Moreover, evaluation of the night blood-feeding peak during 8:00 P.M.–6:00 A.M. indicated that most bites occurred at 11:00-12:00 P.M. and 9:00-10:00 P.M. with 125 and 110 bites, respectively. Conclusion: Phlebotomus papatasi was the dominant species (49.2%). Additionally, wind speed more than 3 m/s showed a preventive effect on sand flies' activity. Thus, insecticide-treated nets are recommended to be used for all inhabitants, especially children and pregnant women, to prevent sand flies' bites through the night.

Susceptibility status of wild population of Phlebotomus sergenti (Diptera: Psychodidae) to different imagicides in a endemic focus of cutaneous leishmaniasis in northeast of Iran.

Phlebotomine sandflies (Diptera: Psychodidae) transmit several important zoonotic diseases to humans and leishmaniasis is one of them. Two types of leishmaniasis, viz. visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL) are endemic in Iran. The main vector of anthroponotic cutaneous leishmaniasis (ACL) is Phlebotomus sergenti. The aim of the present study was to determine the susceptibility status of wild strain of P. sergenti to different imagicides of DDT, bendiocarb and permethrin at the median lethal time, LT50 level. Sandflies were collected from selected village in North Khorasan Province, northeast of Iran from indoors using CDC light-traps. Susceptibility test was carried out against DDT (4%), bendiocarb (0.1%) and permethrin (0.75%) for all the females according to WHO method, and mortality was calculated. Species identification was carried out using the morphological keys. Data were analysed using probit regression analysis to determine the LT50 and LT90 values. In total, 851 female P. sergenti sandflies were tested. LT50 values to DDT (4%), Bendiocarb (0.1%) and permethrin (0.75%) were 15.4, 19.2 and 6.3 min respectively. The values for LT90 were 51.1, 47.4 and 18.6 min respectively. The mortality rates for 1 h exposure time to DDT, bendiocarb and permethrin were 89.8 ± 1.4; 93.6 ± 1.4; and 95.6 ± 1.7%, respectively. The suscesptibility studies revealed development of resistance against DDT (4%) in the wild strain of P. sergenti population. Monitoring and mapping of insecticide resistance in the region is recommended for vector control.

Cutaneous leishmaniasis in Ouazzane and Sidi Kacem provinces, Morocco (1997-2012).

Cutaneous leishmaniasis (CL) is a major public health problem in Morocco. Three distinct parasites are involved; Leishmania tropica, Leishmania major and Leishmania infantum. The objective of this study is to investigate the epidemiological and the clinical features of endemic foci of CL in Sidi Kacem and Ouazzane provinces in the north of Morocco including molecular identification of parasites. We studied the evolution and the distribution of 1,656 CL cases coming from 39 sectors in these provinces between 1997 and 2012. The causative agents of CL in these areas were identified by using the ITS1-PCR-RFLP method. A tendency of seasonality in incidence was observed, showing a peak in April. Most infected patients were from Ouazzane province. The patients' ages ranged from 6 months to 85 years; 54% of them were females. The highest rate lesions were found in the age group of 9 years or less and most lesions were localized in the face (79.6%). The movement of populations from neighboring endemic areas and establishment of habitation in areas where housing conditions are unfavorable favored the emergence of the disease.