Epidemiological Aspects Of Cutaneous Leishmaniasis Research Articles

Cutaneous leishmaniasis in Burkina Faso: Epidemiological evolution of a vector-borne disease locally called “Ouaga 2000 disease”: a minireview

In Burkina Faso, the first case of cutaneous Leishmaniasis (CL) dates from 1960 and a few cases were reported in the following years. The objective of this review was to collect and analyze available data on CLin Burkina Faso to improve case management and control of disease transmission. A review of the literature was carried out using the PubMed, Google Scholar and Hinari databases. Publications dealing with the epidemiological aspects of CL, the parasite species involved, vectors and potential reservoir hosts, as well as drugs used in the treatment of CLwere searched. From 1960 to 1961, Burkina Faso recorded 13 cases of CL. From 2000 to 2005, an average of more than 1500 CLcases were recorded in Ouagadougou. In 2016 authors reported the results of the investigation of a second epidemic focus in Larama, Bassins region. More recently, in 2021, an investigation was carried out in a focus in the Centre-Nord region, bringing the number of CL focus to three in Burkina Faso. Leishmania major is the main species identified. In the wild area in the Ouagadougou focus, rodents Mastomys, Cricetomys, etc. have been described as the potential reservoir hosts, while in the domestic area, the animal reservoir would be the dog. In the focus of Ouagadougou, Phlebotomus duboscqi has been suspected since the 1960s as the possible vector of CL. The diagnosis is essentially microscopic. The first-line treatment meglumine antimoniate (Glucantime) accounted for only 65.9% of prescriptions. According to studies, the relapse rate after the first treatment with pentavalent antimony is about 37%. Despite the neglected disease status given to CL, there is therefore a need to strengthen the fight against this parasitosis by improving access to diagnosis and treatment, vector control and investigations to discover possible new endemic foci.

Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya: Incidence and Epidemiology

Aims. This study was conducted to evaluate the epidemiological aspects of cutaneous leishmaniasis (CL) in patients who were presented to dermatology clinic of main referral hospital in Al-Harab, Al-Jabal Al-Gharbi, and to assess its distribution in relation to age, sex, season, and residency. Methods. In this case series study, all patients with CL, who were referred or presented to dermatology outpatient clinic of Al-Haraba Hospital in the period from Aug to Dec 2019, were enrolled, and were clinically examined. Slit skin smear and/or skin biopsy for microscopic confirmation were performed whenever the diagnosis was suspicious. The information about age, gender, address of patient, date of presentation, and the number of ulcers were collected and analyzed using SPSS. Results. About 110 patients were found to have CL, majority of them 67(60.9%) were females, while 43(39.1%) were males. The ages of patients were ranged from (1 to 84 years). Conclusion. The current findings reported marked increase of cases of CL in December especially in Al-Haraba district compared to other months. Further studies are required to recognize the vector, parasite species and the animal reservoir, which would enable national and local health authorities, in order to implement an effective control program.

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.

Epidemiological Features of Cutaneous Leishmaniasis in Hilly and Plot Areas of Tribal Districts, Khyber-Pakhtunkhwa Province Pakistan

Cutaneous Leishmaniasis is caused by flagellated parasitic protozoans of the genus Leishmania and is spread by vectors. This is a new threat that is endemic to the tropics and subtropics and has a broad geographic distribution. The current research was carried out in all tribal districts of Khyber Pakhtunkhwa province to 2020. The prevalence of Cutaneous Leishmaniasis was found to be higher in children aged 5 to 10 years old in the current research, due to a weakened immune system. In the province, 23 species of phlebotomine sand-flies belonging to the genera Phlebotomus Sergentomyia and grassomiya were discovered. Cutaneous Leishmaniasis is caused by flagellated parasitic protozoans of the genus Leishmania, which are transmitted via the bite of a mosquito. This is an emergent threat and endemic in areas of tropic and sub-tropics and has the epidemiological aspects of Cutaneous Leishmaniasis during the recent epidemic in tribal districts of Khyber Pakhtunkhwa in 2020. The suspected patients of Leishmaniasis from different areas of tribal districts were examined. We came across 700 cases during 3-month period from may to july2020. A major portion G2 ([41.1%; n = 290) of these patients were in age 6 to–10 years. The infection rate was higher in male (75.3%; n = 525) compared to females (25%;n = 125). Both gender and age showed a significant effect on the occurrence of infection. The current study report CL outbreak in the tribal districts of Khyber Pakhtunkhwa which need immediate response from the healthcare authorities. In addition, extensive awareness campaigns are needed for timely prevention of such outbreak. Keywords: Cutaneous Leishmaniasis, outbreak

Evaluation of the Surveillance and Epidemiological Aspects of Cutaneous Leishmaniasis in Babylon Province, Iraq

Leishmaniasis diseases constitute an important public health problem in both tropical and subtropical areas. The aim of this study is to evaluate the epidemiological situation of cutaneous leishmaniasis (CL) in Babylon province, Iraq. The current work included the recording of 142 new cases of CL infection in Babylon province for the period from November 2019 to February 2020. Male infection was represented by 87 cases (61.27%), while females composed 55 samples (38.73%), with a significant difference (p<0.05) between the two groups. The age group of 5-14 years was found to have the highest recorded CL cases (56; 39.44%), while the age group of less than one year had the lowest cases (1; 0.70%), with the differences being significant at p<0.05. Al-Gazali location was found to include the highest recorded CL cases (29; 20.42%), whereas Kish location had the lowest cases (1; 0.70%). The dry type of CL lesions was represented in 112 cases (78.9%), while the wet type was represented 30 cases (21.1%). The ulcero-crusted form of CL sores was more frequent (105; 73.7%), followed by the papulonodular form (30; 21.1%). According to the location of lesions, the upper limb lesions were more frequent (90; 63.16%), followed by the lower limb lesions (37; 26.32%). About 82 (57.9%) of the recorded CL cases were appearing as new cases, whereas 60 cases (42.1%) were recorded as a relapse after treatment. The study concludes that CL is highly distributed in Babylon province.

Epidemiological features of cutaneous leishmaniasis endemic in hilly areas of district Karak, Khyber-Pakhtunkhwa province of Pakistan.

Cutaneous leishmaniasis is a vector borne infection caused by flagellated parasitic protozoans of the genus Leishmania. This is an emergent threat and endemic in areas of tropic and sub-tropics and has a wider geographical distribution. This study was aimed to find the epidemiological aspects of cutaneous leishmaniasis during the recent epidemic in district Karak in 2018-2019. The suspected patients of leishmaniasis from different areas of district Karak were examined. We came across 803 cases during six-month period from August 2018 to January 2019. A major portion (> 37%; n = 299) of these patients were in age 11-20years. The infection rate was higher in female (55.3%; n = 803) compared to males (44.6%; n = 803). Both gender and age showed a significant effect on the occurrence of infection. It is concluded that cutaneous leishmaniasis has appeared as a major health issue in district Karak. The current study report CL outbreak in Karak district which need immediate response from the healthcare authorities. In addition, extensive awareness campaigns are needed for timely prevention of such outbreaks.

Epidemiology of Cutaneous Leishmaniasis in West Africa: a Systematic Review

Cutaneous leishmaniasis (CL) has been described in West Africa (WA) since the beginning of the 20th century. The incidence of cases has markedly increased during the last decades in several countries of the region. Despite that, data remain scarce and fragmentary. The current incidence and geographic distribution of the disease as well as the involved vectors and reservoirs remain poorly documented. The objective of this review was to collect and analyze available data about CL in WA in order to improve the management of cases and the control of the disease transmission. A systematic literature review was performed using the Pubmed, Google Scholar and Hinari databases. Publications focusing on epidemiological aspects of CL, involved parasite species, sand flies and potential reservoir hosts were searched without any restrictions. Unpublished studies were extracted from Google. Manuscripts without full text or summary available were excluded as well as those whose summaries did not contain any usable data. One hundred and fifteen studies were recorded. Among them, 93 filled selection criteria. CL has been reported in 10 West African countries with outbreaks described in five countries. Burkina Faso, where the average incidence of the disease is around 928 cases per year, and Ghana seem to be the most affected. Cases have been confirmed in the majority of studies by microscopy sometimes associated with culture or histology. The exposure rate to Leishmania infection based on leishmanin skin test was relatively high with an overall average of 30.2%. Leishmania major was the only species identified with a predominance of MON-74 (62%) and MON-26 (30.6%) zymodemes. Phlebotomus duboscqi is retained as the vector whereas Sergentomyia darlingi and Sergentomyia ingrami were found naturally infected. Rodents including Arvicanthis niloticus, Gerbilliscus gambiana and Mastomys spp. are reported as the main reservoir hosts. Additional studies are needed to better characterize CL in WA in order to optimize the management of cases and to organize the control of the disease transmission.

Epidemiological aspects of cutaneous leishmaniasis in Southwest of Iran

Background and Aim: Zoonotic rodents (Rodentia: Muridae: Gerbillinae) and Phlebotominae sand flies are the major reservoir hosts and vectors of Leishmania major causing zoonotic cutaneous leishmaniasis, respectively. This study was carried out to evaluate the epidemiological aspects of cutaneous leishmaniasis (CL) in Tangestan County, Southwest Iran. Materials and Methods: This descriptive cross-sectional study was carried out on human cases, probable reservoirs, and vectors of CL at Tangestan County in 2017. The data of patients were taken on health centers and analyzed. To determination faunistic of sand flies, they were collected using sticky paper traps and identified using identification keys. The rodent samples were captured using Sherman live traps and determined for amastigote infection. Results: A total of 436 cases occurred during 2005-2017 and the incidence rate of disease was 0.2-12/100,000 people. Six species of sand flies including three species of Phlebotomus and three species of Sergentomyia including Phlebotomus papatasi, Phlebotomus sergenti, Phlebotomus alexandri, Sergentomyia tiberiadis, Sergentomyia baghdadis, and Sergentomyia clydei were identified. From 185 trapped rodents, 9 species were identified. We founded, 2 out of 132 Tatera indica (1.53%) were positive with Leishmania spp. using the microscopic method. Conclusion: According to the existence of human leishmaniasis cases as a host, T. indica with high abundance and infected to Leishmania as a reservoir, and existence of P. papatasi with high abundance as a suspected vector of disease; there is a potential for transmission of disease in the area. Design of exact control and prevention strategies is highly recommended.

Cutaneous leishmaniasis: an epidemiological study in southwest of Iran.

The current study was aimed to evaluate the frequency and epidemiological aspects of cutaneous leishmaniasis (CL) in the southwest of Iran, an endemic focus for the leishmaniasis from 2014 to 2017. In the present retrospective cross-sectional study, all suspicious CL persons who were referred to health centers affiliated to Abadan School of Medical Sciences (Abadan and Khorramshahr cities) were tested. In this regard, both clinical and parasitological (staining with Giemsa) verifications were performed to diagnose a case. Furthermore, a structured questionnaire containing some demographic details was applied for each positive patient. In total, 151 and 132 positive CL cases were identified in Abadan and Khorramshahr cities, respectively. More frequency of CL was observed during the Winter season, among male subjects, and in urban inhabitants in both cities. The incidence of CL based on age distribution was higher in the age range of 20-30years than others. Besides, the hands and feet were the most involved organs. Although the frequency of CL has declined in the region, CL is still a public health problem. More appropriate control strategies are required to limit and eliminate the infection in the future.

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.

Some epidemiological aspects of cutaneous leishmaniasis with emphasis on vectors and reservoirs of disease in the borderline of Iran and Iraq.

Cutaneous leishmaniasis (CL) is endemic and a major health problem in 17 provinces out of 31 in Iran. This study aimed to determine vectors and reservoirs of the disease using molecular techniques in the borderline of Iran and Iraq. Sand flies and rodents were sampled using sticky paper traps and metal wire live traps, respectively, in the selected villages. About 10% of archived confirmed human positive slides was randomly checked for Leishmania by PCR-RFLP assay. The female sand flies were dissected in alcohol 96% in a sterile condition, the head and two segments of the abdomen end permanently mounted for identification and the remaining of body used for DNA extraction. The direct parasitological tests were carried out on the stained slides of rodents for Leishmania as well as PCR-RFLP assay used for molecular detection of parasite. A total of 2050 sand flies were identified comprising of Phlebotomus papatasi, Sergentomyia sintoni, Se. clydei, Se. mervynae, Se. theodori, Se. dentate and Se. iranica. The Ph. papatasi was ranked as a prevailing sand fly species. Molecular tests on female sand flies revealed infection of Ph. papatasi to Leishmania major. Direct parasitology and molecular tests confirmed of 20% infection to L. major among the sole rodents species "Tatera indica". Due to wide dispersion of rodents colonies in the area and long favorite climate condition for sand flies, the CL foci will be provided the health risk for the religious tourists.

Epidemiological Aspects of Cutaneous Leishmaniasis during 2009-2016 in Kashan City, Central Iran

Cutaneous leishmaniasis (CL) can be seen in 2 forms, zoonotic and anthroponotic, in Iran. In this study, epidemiological aspects of CL were studied during an 8-year period (2009–2016) in city of Kashan, central Iran. The demographic and epidemiological data, including age, sex, occupation, number and site of the lesions, treatment regimen, past history of CL, and season of all patients were gathered from the health centers. Descriptive statistics were used to describe features of the study data. Total 2,676 people with CL were identified. The highest annual incidence was estimated to be 182 per 100,000 population in 2009 and the least was in 2016 (47 per 100,000 population). The highest frequency affected age groups were observed in 20–29 year-old patients (20.9%). More than 51% of the patients were under 30 years old. The maximum frequency of the disease, 1,134 (43.3%), was seen in autumn. The most common location of lesions was hands (61.4%). Most of the patients (81.6%) were treated by systemic glucantime regimen. In the city of Kashan, the incidence rate of the CL disease is significantly higher than many other regions of Iran. To reduce the risk of disease, control of reservoir hosts and vectors of disease, and education of individual protection are strongly recommended.

Epidemiological aspects of American cutaneous leishmaniasis (ACL) in an endemic area of forest extractivist culture in western Brazilian Amazonia.

ABSTRACTThe study sought to analyze clinical and epidemiological aspects of cutaneous leishmaniasis (CL) in Xapuri, Acre, Brazil. Data from 2008 to 2014 registered in the notification records of the disease of the Information System of the Complaints of Notification (SINAN), and the data of the Information Department of the Unified Health System (DATASUS) available from 2007 to 2013 were used and analyzed in the light of the statistics of the temporal series by the Prais-Winsten method and chi-squared test. A total of 906 cases were registered with 60.2% occurring in men and 39.7% in women. The groups from 0 to 4 years of age (48.0%) and from 5 to 19 years of age (23.3%) were the most affected. Regarding the clinical forms, 77.7% presented CL and 22.3% mucocutaneous leishmaniasis (MCL). Among the 896 cases with information on the diagnostic methods used, Montenegro’s skin test predominated (66.4%), with a positive result of 95.8% for CL and 99.3% for MCL. Treatment with N-methylglucamine antimony was performed in 99.4% of the cases, but discontinuously used in the majority of patients. This study presents information which may be used as a tool for the epidemiological surveillance and control of the disease in Xapuri, a region which depends essentially on forest resources and ecological tourism.

Epidemiological Aspects of Cutaneous Leishmaniasis in Iran

Background: The prevalence of Cutaneous Leishmaniasis (CL) has been reported as 1.8% to 37.9% in different provinces of Iran. However, enough knowledge about epidemiological aspects of CL disease is needed to launch a proper program to plan control and preventive strategies about the disease. Objectives: The present study aimed to determine the epidemiological aspect of CL in Iran during the first 6 months of 2014. Patients and Methods: In this cross-sectional study, all cases of CL reported to centers for disease control and prevention (CDC) by state health departments from March 2014 to September 2014 were included. Descriptive statistics including frequency tables, measures of central value, and measures of dispersion to describe the study variables were used to analyze data. Area maps were created using ArcView GIS v. 3.3. Results: Most of the CL cases were observed in eastern, central, and southern provinces. Two thousand thirty-one cases (55.13%) were male and 2,306 (62.6%) were living in urban areas. The mean age of the patients was 27 ± 18 years old. More than 31% of them were under 14 years of age. Also, 3570 individuals (96.91%) were new cases. more wounds were seen so that 62.75% of the wounds were on the hands, 24.8% in the head and neck, and 2.7% in the body. Conclusions: According to the epidemiological features of CL in Iran, Providing a uniform mechanism for control and prevention of this disease is not possible. Thus, initial actions such as staff training, screening in endemic areas, and treatment of patients with urban leishmaniasis as a reservoir for the disease can be useful, according to the geographical position and carrier.

Some Epidemiological Aspects of Cutaneous Leishmaniasis in a New Focus, Central Iran.

Following the epidemic of cutaneous leishmaniasis in Khatam County, Yazd Province, this study was carried out to determine vector, and animal reservoir host(s) and investigate the human infection during 2005-2006. Four rural districts where the disease had higher prevalence were selected. Sticky paper traps were used to collect sand flies during April to November, biweekly. Meanwhile rodents were captured using Sherman traps from August to November. Households and primary schools were visited and examined for human infection in February 2006. The parasite was detected by RAPD-PCR method. The rate of ulcers and scars among the inhabitants was 4.8% and 9.8%, respectively. Three rodent species were captured during the study: Meriones libycus, Rhombomys opimus, and Tatera indica. Six sand fly species were also collected and identified; among them Phlebotomus papatasi had the highest frequency. Leishmania major was detected as the agent of the disease in the area. It was detected from R. opimus and native people.

An Epidemiological Study of Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya

Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.

Epidemiological aspects of cutaneous leishmaniasis in Ilam province, west of Iran (2000–2007)

ObjectiveTo investigate the epidemiology of cutaneous leishmaniasis in Ilam province between 2000 and 2007. MethodsThe data of this descriptive cross-sectional study included the existing data regarding the prevalence of cutaneous leishmaniasis in different seasons, years and districts which were reported to Ilam Provincial Health center between 2000 and 2007. ResultsThe analysis of the collected data revealed that Ilam province was one of the endemic foci of zoonotic cutaneous leishmaniasis caused by Leishmania major. The study also showed the rate of cutaneous leishmaniasis incidence with the general rate of 1.2 per one thousand populations. It was also evident that the highest rate of incidence of cutaneous leishmaniasis was in fall and winter, which is one of the most important characteristics of zoonotic cutaneous leishmaniasis. Ulcers were present in 5 161 Patients. Of these, 28.9% were female and 71.1% were male. 3 447 cases (66.8%) had ulcers on hand and foot, 1 213 cases (23.5%) on face and 501 cases (9.7%) on trunk. A total of 1 907 patients (36.9%) had only one ulcer. But 3 254 cases (63.1%) had more than one ulcer. The highest incidence was found among patients with two age groups of 20–29 years old (46.8%) and 10–19 years old (17.3%). ConclusionsWith respect to the increased prevalence of cutaneous leishmaniasis in Ilam province, health care observers should pay further attention on preventing the disease spread.

Epidemiological aspects of cutaneous leishmaniasis in the Iguazú falls area of Argentina

Over the last three decades the incidence of American cutaneous leishmaniasis (ACL) has increased sharply in Argentina and throughout the world. In the Iguazú Falls area, on the border between Brazil and Paraguay, the incidence of human ACL has risen since 2004. Most of the 36 cases of human ACL reported until 2005 have involved males over 15 years old (75%) infected during deforestation to establish individual farms. Captures carried out in primary forest, periurban areas, and deforested land sites yielded 18,438 sand flies belonging to 13 species; the most prevalent species were Lutzomyia (Nyssomyia) whitmani (87.4%) and Lutzomyia (Mygonemyia.) migonei (7.6%). Cluster analysis was used to group traps according to species and abundance of sand flies. The group of traps located in recently deforested places, in pig and chicken dwellings of houses where ACL cases had been reported in the past, and at one house with an active ACL case, had the highest abundance of Lu. whitmani and Lu. whitmani + Lu. migonei as well as the highest ratio of Lu. whitmani/Lu. migonei. Leishmania sp. infections, both in Lu. whitmani, in Lu. quinquefer, and in smears from human cases were detected by DNA kinetoplast amplification using a generic PCR protocol. The risk of ACL outbreak in the Iguazú Falls area is still associated with economic and leisure activities in primary-secondary forest, including deforestation, rural settlements, fishing, hunting, and ecotourism. In addition, the risk of periurban transmission seems likely, and this is discussed within the framework of surveillance and prevention strategies.